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Final Flashcards

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1
Q

TD

A

total diseased

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2
Q

TND

A

total not diseased

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3
Q

FPV

A

false positive

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4
Q

FNV

A

false negative

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5
Q

TP

A

total positives

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6
Q

TN

A

total negatives

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7
Q

total positives

A

true positives + false positives

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8
Q

total negatives

A

true negatives + false negatives

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9
Q

sensitivity

A

true (+) test/ Have disease

TPV/TD

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10
Q

how do we catch sensitivity?

A

lesion detection

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11
Q

specificity

A

true (-) test/Don’t have disease

TNV/TND

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12
Q

positive predictive value

A

true positives/all positives

TPV/TP

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13
Q

negative predictive value

A

true negatives/all negatives

TNV/TN

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14
Q

accuracy

A

true positives + true negatives/total tests

(TPV+TNV) / TOT

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15
Q

looking at benefits and risks, what do medical practices use?

A

benefits over the risks

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16
Q

what affects intensity?

A

power and area

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17
Q

what are factors of bioeffects?

A
  • intensity

- exposure time

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18
Q

longer exposure times=

A

increases the risk of damage

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19
Q

for bioeffect safety, what must be kept inversely proportional?

A

intesity and exposure time

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20
Q

AIUM statement

A

“No independently confirmed adverse effects caused by exposure from present diagnostic ultrasound instruments have been reported in human patients in the absence of contrast agents.”

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21
Q

intensity changes dependant on what?

A

location in the beam

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22
Q

where is the intensity the stongest?

A

center and focus

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23
Q

where is the intensity the weakest?

A

periphery

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24
Q

what are variations of intensity?

A

spatial factors

temporal factors

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25
Q

what are the spatial factors?

A

spatial peak

spatial average

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26
Q

spatial peak

A

intensity at the center

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27
Q

spatial average

A

average of intensities across the beam

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28
Q

temportal intesity changes based on what?

A

moments in time

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29
Q

temporal factors

A

temporal peak
temporal average
pulse average

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30
Q

temporal peak

A

intensity at peak times

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31
Q

temporal average

A
  • average intesity across entire pulse period

- includes dead zone

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32
Q

pulse average

A
  • average intensity across entire pulse duration

- does NOT include dead zone

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33
Q

which spatial factor is higher?

A

spatial peak

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34
Q

list temporal factors from higest to lowest

A
  • temporal peak
  • pusle average
  • temporal average
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35
Q

what is the highest out of all factors?

A

spatial peak

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36
Q

what are spatial and temporal factors used in?

A

research to assess the level of intensity that can cause bioeffects

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37
Q

organizations have set standards that ultrasound providers are to adhere to, what are they?

A

FDA

AIUM

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38
Q

acoustic output statements

A

maxiumum prescribes intensities

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39
Q

acoustic output statements AIUM

A

“No adverse effects have been observed for an unfocused beam having a SPTA below 100mW/cm2, and focused beam SPTA below 1 W/cm2”

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40
Q

acoustic output statements FDA

A

ISPTA = 720 mW/cm2 (upper limit)

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41
Q

what are the differrent intesities?

A

2D ultrasound-weakest
M-mode
colour doppler
PW spectral-strongest

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42
Q

what arre the types of bioeffects?

A 
thermal
mechanical (NON-thermal)
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43
Q

what does ultrasound produce?

A

heat

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44
Q

why would ultrasound heat up tissue?

A

attenuation

  • absorption
  • reflection and scattering
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45
Q

what does frequency not contribute to?

A

more intensity coming out of the probe

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46
Q

higher frequency sound ________ more

A

attenuates

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47
Q

more of the sound energy will be absorbed within the tissue=

A

more heat

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48
Q

acoustic output intensity

A
  • pulser will decide intensity of outgoing signal

- can be adjusted using power dial on machine

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49
Q

thermal index

A

measure of how much the particular sound is heating up the tissue

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50
Q

what is thermal index most commonly associated with?

A

SPTA

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51
Q

What are the different TI standards depending on the type of tissue being assessed?

A

TIS-soft tissue
TIC-cranium
TIB-bone

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52
Q

AIUM standard soft tissue=

A

TIS<2

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53
Q

AIUM standard bone=

A

TIB<1.5

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54
Q

where is there a higher attenuation?

A

in bone

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55
Q

what adjustments must a sonographer make to maintain ALARA?

A
  • acoutic power

- exposure time

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56
Q

what kind of damage can US do to cells?

A

sister chromatid exchange

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57
Q

what kind of damage can US do to plants?

A
  • chromosomal changes
  • growth rate reduction
  • cell death
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58
Q

what kind of damage can US do to animals?

A
  • fetal weight reduction
  • postpartum mortality
  • fetal tissue lesions
  • hind limb paralysis
  • wound repair enhancement
  • tumour regression
59
Q

what type of wave is sound?

A

a pressure wave

-particles are being pushed againsti other particles

60
Q

mechanical effects

A
  • radiation forces

- caviation

61
Q

_________ will deform and disrupt objects

A

shear stresses

62
Q

what can cause flow in a liquid?

A

shear stresses

63
Q

how many types of caviation are there?

A

2 types

64
Q

what is cavitation?

A

production and modification/behaviour of bubbles in a liquid

65
Q

stable cavitation

A

oscillating bubbles (bigger and smaller)

  • produce waves
  • shear forces on nearby cells and organelles
66
Q

transient cavitation

A

oscillating bubbles (bigger and smaller)

  • “POP”!
  • shock waves
  • local high temperature changes
  • light emission
67
Q

what is particilarly dangerous in ‘gas bodies’?

A

mechanical effects

68
Q

what are the characterstics of mechanical effects?

A
  • already contain bubbles

- these micro-explosions hemorrhage lung/intestinal tissue

69
Q

AIUM statement -mechanical effects

A

“No independently confirmed adverse effects caused by exposure from present diagnostic ultrasound instruments have been reported in human patients in the absence of contrast agents.”

70
Q

how do contrast studies work?

A

we introduce microbubbles into the patient and ultrasound them

71
Q

when does the risk for mechanical bioeffects become higher?

A

use of contrast study

72
Q

when is contratt only done?

A

when benefits outweight the risk

73
Q

AIUM-mechanical index

A

<1.9 (0.4-1.9)

74
Q

mechanical effects formula

A

MI=Pr / (f)1/2

75
Q

what is proportional to MI?

A

peak rarefactional pressure

76
Q

what is inversely proportional to MI?

A

frequency

77
Q

lower frequencies have higher_______

A

MI

78
Q

tissue type factor

A

gas containing tissues will have a higher risk of cavitation

79
Q

what kind of damage does MI have on humans with contrast?

A

premature ventricular contractions

80
Q

when was X-ray fisrt seen?

A

1895

81
Q

what is X-ray?

A

radiation which travels through the air in waves/particles. Some of this radiation can pass through objects, particularly soft-tissues

82
Q

radiopaque

A

some objects are more dense (bones/calcium deposits/metal) and absorb the radiation not allowing it to pass through

83
Q

radiopaque objects will show up differently than _________ soft tissues, which will allow the radiation through

A

radiolucent

84
Q

X-ray black

A

fluid/air

85
Q

X-ray Dark Grey

A

bowel

86
Q

X-ray White

A

bone

87
Q

X-ray very white

A

metal

88
Q

X-ray radiopaque

A

blocks the x-rays

89
Q

X-ray radiolucent

A

let the x-rays through

90
Q

what can be correlated from X-ray with ultrasound?

A
  • stones
  • constipation (bowel obstruction)
  • MSK
  • surgical structures
91
Q

what is the X-ray potential for harm?

A
  • accumulation of radiation can result in cell damage that could lead to cancerous conditions
  • high levels of radiation exposure can cause radiation burns
92
Q

how is X-rays used in radiation therapy?

A

x-rays are used to kill malignant cancer cells

93
Q

what are the factors for developing cancer with X-ray?

A
  • exposure time
  • age
  • Gender (women are more likely)
94
Q

what is fluoroscopy?

A

X-ray “movie” a constant beam of X-ray passing through the patient

95
Q

what can you assess with fluoroscopy?

A
  • skeletal
  • digestive
  • urinary
  • respiratory
  • reproductive systems
96
Q

how does Computed Tomography (CT) work?

A

uses special x-ray equipment to obtain cross-sectional pictures of the body

97
Q

what does CT display?

A

detailed images of organs, bones, other tissues

98
Q

what are the uses of CT?

A
  • lesion detection and measurment
  • location of lesions and tumors
  • can guide biopsy or radiation therapy or surgery
  • size determination can be used to see of treament is responding
  • contrast agents can be used as well, similar to US to highlight vasculature/lesions
  • can be administered orally, intravenously or enema
99
Q

which radiation exposure is higher risk? CT or X-ray?

A

CT

100
Q

what is the benefit vs risk for CT vs X-ray

A

eternal struggle

101
Q

what is the risk of CT?

A

very rare causes can cause allergic reactions

102
Q

what are the symtoms to CT allergic reaction?

A
  • mild itching
  • Hives
  • shortness of breath
  • swelling of throat, face or area of contact
103
Q

what is a newer form of CT?

A

spiral (or helical) CT scan

104
Q

what is spiral CT?

A

X-ray machine rotates continuously around the body, following a spiral path to male cross sectional pictures of the body

105
Q

what is better about spiral CT?

A
  • better resolution than CT-better lesion detection

- faster than CT

106
Q

what is Endoscopy -Colonoscopy/ Esophagogastroduodenoscopy(EGD)?

A

non-surgical evaluation of digestive tract

107
Q

what does Endoscopy -Colonoscopy/ Esophagogastroduodenoscopy(EGD) involve?

A

introduction of a small camera into the digestive tract and examination of the walls

108
Q

what can endoscopy detect?

A

abnormalities and inflammations of the walls

109
Q

what is virtual endoscopy?

A

virtual endoscopy is a new technique that uses spiral CT/MRI

110
Q

what are endoscopic views constructed from?

A

3D visualizations taken from the CT/MRI

111
Q

CT colonography or virtual colonoscopy, is under study as a screening technique for __________

A

colon cancer

112
Q

what is mammography?

A

form of X-ray used to assess breast tissue for cancer

113
Q

what can mammography catch?

A

cancer in early stages, often before its palpable

114
Q

does mammography contain radiation?

A

minimal and considered to be very safe

115
Q

screening mammogram

A
  • patient has no symtoms

- recommmended annually after age 40

116
Q

diagnostic mammogram

A
  • patient has a new lump, breast pain or changes to breast tissue
  • this test is commonly done in conjunction with a breast ultrasound
117
Q

with age, bone mineral density ______

A

decreases (commonly associated with osteoporosis)

118
Q

what is a bone (mineral) density exam?

A

measures the amount of calcium within your bones

119
Q

where are the most common areas of reduced BMD?

A

spine
hip
forearm

120
Q

higher BMD=

A

less risk for breaking/fracturing a bone

121
Q

is bone density the same as a bone scan?

A

no

-this is a nuclear medicine exam that involves injection

122
Q

what is MRI?

A

creates a very strong magnetic field that aligns the atoms in the body, which are then exposed to RF waves

123
Q

how does a MRI work?

A

This causes the protons of the atoms to produce a weak signal – “magnetic resonance” – that is picked up by the receiver in the MRI and processed in the computer

124
Q

what are the pros of MRI?

A
  • Completely painless

- Very high resolution imaging (often the gold standard)

125
Q

what are the cons of MRI?

A
  • Metal implants, pacemakers cannot go near the magnet
  • Very, very expensive
  • Claustrophobia
126
Q

what is better seen on CT over MRI?

A

brain bleeding (hemorrhage)

127
Q

when is MRI the gold standard?

A
  • tendon
  • ligaments
  • spinal cord
  • brain infarcts
128
Q

what is angiogrpahy?

A

Use of contrast agents within the vasculature to assess patent/occluded vessels

129
Q

what can angiography be used with?

A

X-ray (fluoroscopy)
CT
MRI

130
Q

ECG (electrocardiogram) aka EKG

A

assessing the electrical activity of the heart

131
Q

stress EKG

A

ECG monitoring during a stress activity

132
Q

holtor monitoring

A

involves 24-48 hour ECG

133
Q

radiotracer

A

Small amounts of radioactive material are placed within the body

134
Q

how is radiotracer inserted into the body?

A

Radiotracer is either injested or inhaled, and is expected to accumulate in a particular organ (usually within an hour)

135
Q

what happens once the radiotracer is in the organ?

A

they give off gamma rays which are picked up by special cameras

136
Q

nuclear medicine is ______ tests

A

functional

137
Q

hot spots

A

accumulation of radiotracer

138
Q

cold spots

A

lack thereof

139
Q

positron emission tomography is a form of what?

A

nuclear medicine

140
Q

what does Positron emission tomography assess?

A

metabolic activity

141
Q

what studies are PET scanning useful in?

A

heart
lungs
brain

142
Q

Combined PET/CT

A

Combination of the two; mapping functionality with the anatomical image (like Duplex Sonography)

143
Q

where is Combined PET/CT usually seen?

A

in psychological studies, showing brain activity in particular regions of the brain

144
Q

combined PET/CT and cancer

A

Often cancerous tissue is more active than normal tissue (or may be more blood hungry), so often shows stronger on PET/CT

Physics 2 (4 decks)

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