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1ST YEAR SYSTEMS: Cardiovascular > Imaging of circulatory disturbances > Flashcards

Imaging of circulatory disturbances Flashcards

1
Q

Types of anatomical vascular imaging? (5)

A 
Plain films - simple x-ray
contrast angiography
ultrasound
CT 
MRI
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2
Q

Types of functional vascular imaging? (3)

A

Radionuclide Imaging
MRI functional imaging
Ultrasound

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3
Q

problems with vascular imaging?

A

Soft tissue contrast - contrast between different soft tissues can only be enhanced by the injection of contrast media
Functional significance of lesions (ie how does it affect bodily function)
Is treatment effective

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4
Q

Structures in order of density in radiographic imaging? (most dense to least dense)

A 
Metal 
Bone
Muscle
Fat
Air
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5
Q

What does radiographic contrast allow you to discriminate between?

A

different vascular structures between their densities

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6
Q

which important structures can’t be seen very well?

A

Blood vessels

Lumen of hollow viscera

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7
Q

What are the ideal properties of a man-made contrast agent in radiology?

A

Inert

Unequal distribution in and out of selected body compartments –so you can tell where the vessel starts and stops

Painless
Easy to use
cheap

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8
Q

Iodinated Contrast

A 
Differential X Ray attenuation
Inert
Stable in selected body compartments
Painless
Easy to use
Cheap
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9
Q

Problems with Iodinated Contrast (6)

A 
Major Reactions (allergic)
Renal Dysfunction – molecules are quite large 
Disturbance of Thyroid Metabolism
Disturbance of Clotting
Seizures
Pulmonary oedema
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10
Q

Parenteral Iodinated Contrast ie IV, IM, SC - common effects (6)

A 
Metallic Taste
Feeling of warmth
Arterial injections
Micturition - urination
Discomfort
Rarely nausea
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11
Q

Metformin and complications with iodinated contrast

A

used to treat type 2 diabetes

serious reaction as your kidneys may not be able to properly remove metformin from your blood.

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12
Q

If a patient has had a previous contrast reaction then what is the next reaction like?

A

more severe

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13
Q

asthma/atopy and iodinated contrast

A

asthma - more likely to develop bronchospasm

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14
Q

define atopy

A

genetic tendency to develop allergic diseases such as allergic rhinitis, asthma and atopic dermatitis eczema

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15
Q

What is a catheter angiography

A

Vessel punctured and catheterised

Sterile procedure

Contrast injected using pump injector

Rapid series of images acquired - arteries, veins, and the heart chambers

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16
Q

what is digital subtraction imaging?

A

take initial image and then take another and then take one away from the other – only shows vessels

e.g angiography

17
Q

Uncontrolled arterial injury

A

blood spills out into tissues - non-contained

18
Q

Types of interventional Radiology (6)

A

Minimal invasive treatment of lots of things

Angiography / Angioplasty

Embolisation

Catheter thrombolysis

Drainage of abscesses

Nephrostomy

Vertebroplasty

19
Q

when to use angioplasty?

A

Short stenoses or occlusions

Sessile / concentric plaques

Iliac > sfa > popliteal > crural - bigger the vessel the better the result. More proximal the problem, the more likely you are to get a solution

A balloon to stretch open a narrowed or blocked artery. Most modern angioplasty procedures also involve inserting a short wire-mesh tube, called a stent, into the artery during the procedure.

20
Q

Carbon dioxide as a contrast agent

A

CO2 is quite safe - it gets absorbed really quickly by vessels

Useful in patients with poor renal function or sensitivity to iodinated contrast agents

21
Q

What is a negative contrast agent

A

gases of low density (air, oxygen, carbon dioxide) which appear radiolucent.

22
Q

Problems with Angioplasty

A

Occlusion

Dissection – tear in lining – get second channel of blood flow

Embolisation

Rupture

Infection

23
Q

pros/cons of ultrasound of vascular disturbances

A

No radiation dose

Quick, portable

non invasive

resolution vs penetration

may be more physiological

operator dependant

variable imaging quality

24
Q

true or false:- ultrasound can show direction of blood flow

A

true

25
Q

what is lung scintigraphy?

A

lung scan
image using gamma camera

patient has to breath in an aerosol that will localise in the alveoli - tracer

V/Q lung scan, is a type of medical imaging using scintigraphy and medical isotopes - examines airflow (ventilation) and blood flow (perfusion) in the lungs.

mainly used to exclude pulmonary embolism (PE)

26
Q

applications of radionuclide imaging (3)

A

Perfusion of transplant kidneys

Blood loss into gastrointestinal tract

Cerebrovascular perfusion - dementia

27
Q

CT angiogram

A 
Gives information about other structures
Sensitive
IV injection only
Radiation Dose
High Contrast Dose
Expensive
28
Q

MR angiography pros and cons

A

Sensitive
Specific
No radiation
No nephrotoxic contrast

Very expensive
Needs state of the art machinery
High contrast cost

29
Q

out of CTA and MRA which is better for females of child baring age

A

MRA - prevent exposure to radiation

30
Q

consent and radiology

A

newly qualified doctors should not routinely obtain consent from patients

the doctor performing the interventional procedure should be the one to obtain consent from the patient

only when a newly qualified doctor has detailed knowledge from active involvement and experience in interventional studies should they gain informed consent from patients

31
Q

reaction that contrast media may induce can range from…

A

mild rash to severe, acute anaphylaxis

32
Q

gold standard imaging option for DVT

A

contrast venography

However, this procedure is invasive, not always technically possible, and it carries a small risk of an allergic reaction or venous thrombosis.

33
Q

what imaging is appropriate for abdominal pain due to suspected abdominal aortic aneurysm leak

A

CT

1ST YEAR SYSTEMS: Cardiovascular (39 decks)

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