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PCM II Final > Imaging and Clinical Applications > Flashcards

Imaging and Clinical Applications Flashcards

1
Q

4 things that should be done for all patients’ studies

A
  1. Verify patient identity (patient name matches on study)
  2. Verify date/time of study is correct
  3. Verify study type i.e. x-ray/CT/MRI is correct
  4. Get older study or record for comparison

Steps 1-3 = ALWAYS DO, Step 4 = Optional but ideal

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2
Q

What are the 4 types of radiological studies?

A
  • Plain x-rays
  • CT scans
  • MRI
  • Ultrasound
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3
Q

What is an orthogonal x-ray?

A

X-ray taken at 90 degrees

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4
Q

Commonly ordered X-ray views for:

Chest (3)

A
  • PA or AP
  • Lateral
  • Portable
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5
Q

Commonly ordered X-ray views for:

UE (3)

A
  • AP (frontal)
  • Lateral
  • Oblique (let’s you see things between AP & lateral)
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6
Q

Commonly ordered X-ray views for:

LE (3)

A
  • AP (frontal)
  • Lateral
  • Oblique (let’s you see things between AP & lateral)
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7
Q

Commonly ordered X-ray views for:

Abdomen (4)

A
  • Supine
  • Upright
  • Decubitus
  • AAS
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8
Q

Commonly ordered X-ray views for:

Pelvis (3)

A
  • AP (inlet/outlet)
  • Lateral
  • Frog-leg
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9
Q

Commonly ordered X-ray views for:

Facial B./Skull (4)

A
  • Frontal
  • Lateral
  • Upright Water’s
  • Nasal Views
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10
Q

Commonly ordered X-ray views for:

Cervical spine (5)

A
  • AP
  • Lateral
  • Oblique
  • Flexion/Extension
  • Open-mouth
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11
Q

Commonly ordered X-ray views for:

Thoracic spine (3)

A
  • AP
  • Lateral
  • Oblique
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12
Q

Commonly ordered X-ray views for:

Lumbar spine (3)

A
  • AP
  • Lateral
  • Oblique
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13
Q

Commonly ordered X-ray views for:

Sacral spine (1)

A
  • AP (inlet/outlet) same as pelvis
    • Caveat: low sensitivity
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14
Q

Ideal imaging modality for sacral spine

A

CT

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15
Q

Ideal imaging modality for neurologic injuries

A

MRI

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16
Q

Order the following from least dense to most dense:

  • Soft-tissue
  • Bone
  • Air
  • Metal
  • Fat
A
  1. Air
  2. Fat
  3. Soft-tissue
  4. Bone
  5. Metal
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17
Q

Match structure to expected appearance on plain films:

Air, fat, soft-tissue, bone, metal

  • Very bright (very white)
  • Dark (black, radioluscent)
  • Bright (white)
  • Less dark, but still dark
  • Medium (gray)
A
  1. Air = dark
  2. Fat = less dark, but still dark
  3. Soft-tissue = medium (gray)
  4. Bone = bright
  5. Metal = very bright
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18
Q

Distinguish between a PA and AP view

  • where is beam traveling from?
  • where is film that beam is traveling to and hitting?
A
  • PA view
    • beam traveling from back (P) and hitting film in front (A)
  • AP view
    • beam traveling from front (A) and hitting film back (P)
19
Q

PA or AP view, which is preferred in majority of chest cases?

Why?

Under what circumstances is the other usually ordered?

A
  • PA view
  • AP view can give enlarged view of heart & vessels leading to false cardiomegaly dx
  • AP view usually ordered when unable to position patient erect as needed for PA
20
Q

Fractures are easily identified on plain films by looking for ______ (outer portion of B.) disruptions

A

Cortical disruptions

21
Q

Fluid is ______ dense than air and therefore appears _____

A

more dense than air and therefore appears medium gray to bright white

22
Q

Calcifiied structures that appear dense and bright on abdominal x-rays?

A

kidney stones

23
Q

4 patterns of plain film misdiagnosis?

  1. Nml ____ & _____
  2. _____ recognition failure
  3. Associated _____
  4. Suboptimal _____ & number of ______
A
  1. Nml anatomy & variants
  2. Pattern recognition failure
  3. Associated pathology
  4. Suboptimal positioning & number of projections (only visible on certain view, all other views nml)
24
Q
  • Presence of what structure visualized on an x-ray can indicate the patient is a child?
  • What does it look like?
A
  • Growth plate
  • Smooth, radioluscent line
25
Q

2 imaging modalities that present with ionizing radiation risk

A
  • X-rays
  • CT scans
26
Q

Order the following from least hounsfield unit (HU, aka x-ray beam) absorbed to most HU absorbed on CT.

  • H2O
  • body fluid, i.e. ascites
  • blood
  • fat
  • air
  • bone/metal
A
  1. air (least dense, -800 HU)
  2. fat (-70 HU)
  3. H2O (0 HU)
  4. body fluid, i.e. ascites (0-20 HU)
  5. blood (40-60 HU)
  6. bone/metal (800+ HU)
27
Q

On CT dense structures appear? less dense structures appear?

A
  • Dense structures appear white
  • Less dense structures appear darker
28
Q

Different _____ in CT enables evaluation of different organs within single image.

A

windowing

29
Q

Almost all CT scans are acquired in what plane?

A

axial plane

30
Q

how are 3D or coronal, sagittal, and oblique plane images acquired in CT scans?

A

through reformatting and stacking of axial scan images

31
Q

3 things useful for clinicians to know when evaluating CT images?

A
  • slice thickness
  • location of 1st and last slices
  • type of contrast used
32
Q

How is CT angiography similar to conventional angiography?

How is it different?

A

Similar: obtain same info, radiation exposure, IV contrast use

Different: less invasive

33
Q

How is CT angiography different from basic CT?

A
  • need faster scanner
  • need larger needle size to get faster IV contrast injection rate
34
Q

How does water appear on T2 MRI images?

A

Remember WWII:

Water appears White on T2 (II) images

35
Q

How does water appear on T1 MRI images?

A

Black (opposite of T2)

36
Q

How do tumors and inflammatory masses appear on T2 images?

A

white

37
Q

Advantages of MRI:

  • Greater ____ of soft tissue
  • Acquired _____
  • Get vascular study _____
  • No _____
A
  • Greater differentiation of soft tissue
  • Acquired in any plane
  • Get vascular study without IV contrast
  • No radiation exposure
38
Q

Disadvantages of MRI:

  • Longer ______
  • Very sensitive ______
A
  • longer aquisition time
  • very sensitive motion artifact
39
Q

Advantages of U/S:

  • No ____
  • Acquired _____
  • Less ____
  • Performed at _____
  • Provide ____ imaging
A
  • No radiation exposure
  • Acquired in any plane
  • Less expensive
  • Performed at bedside
  • Provide real-time imaging
40
Q

Disadvantages of U/S:

  • Less _____ images
  • Takes _____ than CT
  • ______ depending on operator skills
  • ______ are 2 structures not visualized well in U/S
A
  • Less sharp & clear images
  • Takes more time than CT
  • Highly variable quality and accuracy depending on operator skills
  • Bones and lungs are 2 structures not visualized well
41
Q

What is the concern w/ CT imaging in pregnant women?

A

Ionizing radiation exposure to fetus

42
Q

What is the concern w/ MRI in pregnant women?

A

Field strength (1.5T vs 3T) can potentially heat fetal/amniotic fluid

43
Q

What are 3 contrast agents that should be avoided when imaging pregnant women?

A
  • iodinated contrast
  • oral contrast
  • gadolinium
44
Q
A

PCM II Final (10 decks)

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