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NMED 291 - Clinical Procedures 2 > Infection and Inflammation > Flashcards

Infection and Inflammation Flashcards

(56 cards)

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1
Q

inflammation is (non/specific) response to injury.

A

nonspecific

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2
Q

infection is a response due to?

A

microorganisms present

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3
Q

infection without inflammation can occur in what kind of patients?

A

those that are severely immunocompromised

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4
Q

what is the relationship between infection and inflammation?

A

inflammation doesn’t always mean infection, but infections typically cause inflammation

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5
Q

when the body is responding to infections, what does the body start to release?

A

histamine, bradykinin, serotonin

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6
Q

what do chemical mediators do to the body?

A

increase blood flow and capillary permability

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7
Q

diapedesis

A

movement of cells into tissues through the endothelial cells of the capillaries

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8
Q

cellular phase of infection

A

chemotaxis causing local macrophages and neutrophils to go to the site

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9
Q

chronic phase of infection

A

arrival of lymphocytes (B, T and NK cells)

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10
Q

what inhibits the infection process?

A

alcohol, NSAID, corticosteroid meds

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11
Q

types of granulocytes

A

1.neutrophils
2. eosinophils
3. basophils

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12
Q

types of agranulocytes

A

lymphocytes and monocytes

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13
Q

ratio of RBCs to WBCs

A

1000:1

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14
Q

what is the WBC imaging exam of choice for vertebral osteomyelitis/diskitis?

A

Gallium WBCs

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15
Q

what is the WBC imaging exam of choice for pulmonary infections and sarcoidosis of the lungs?

A

gallium WBCs

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16
Q

what is the difference between 111In-Oxine and 99mTc-HMPAO in terms of them labelling WBCs?

A

Oxine allows for the In to enter the cells, then in the cell, oxine diffuses out leaving In to bind intracellularly

99mTc-HMPAO enters the cells then changes into a secondary complex which prevents it from diffusing out of the cells

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17
Q

when labelling WBCs, cells should be re-injected into patients within ____ of removal.

A

3 hours

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18
Q

99mTc-HMPAO vs. 111In-Oxine
which has superior imaging characteristics?

A

99mTc-HMPAO

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19
Q

99mTc-HMPAO vs. 111In-Oxine
Which is produced by a cyclotron?

A

111In-Oxine

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20
Q

99mTc-HMPAO vs. 111In-Oxine
Which is preferred for peds?

A

99mTc-HMPAO

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21
Q

99mTc-HMPAO vs. 111In-Oxine
Which is earlier imaging time?

A

99mTc-HMPAO

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22
Q

99mTc-HMPAO vs. 111In-Oxine
Which is better for extremities? Why?

A

99mTc-HMPAO
due to higher photon flux

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23
Q

99mTc-HMPAO vs. 111In-Oxine
Which is better for abdominal/pelvic imaging? Why?

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A

111In-Oxine
due to absence of bowel activity

24
Q

99mTc-HMPAO vs. 111In-Oxine
which is the agent of choice for osteomyelitis in a diabetic foot and prosthetic joints? why?

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A

111In-Oxine
due to its ability to perform dual isotope imaging

25
99mTc-HMPAO vs. 111In-Oxine which has lower body bkg?
111In-Oxine
26
99mTc-HMPAO vs. 111In-Oxine which is the agent of choice for chronic infections?
111In-Oxine
27
where does 99mTc-HMPAO localize?
regular bone marrow and at the site of inflammation
28
where does 111In-Oxine localize?
at the red marrow
29
which leukocyte is most likely to be labelled due to its high abundance?
neutrophils
30
what is the acceptable %tag for labelled WBCs?
40-60%
31
what collimator is used when imaging with 111In-Oxine?
medium energy collimators
32
when do you routinely image when using 111In-Oxine?
at 24hrs
33
with 99mTc-HMPAO, what do we initially see for normal biodistribution?
lungs, liver and spleen
34
with 99mTc-HMPAO, what do we see at 1-2 hrs for normal biodistribution?
lungs, liver, spleen, bladder, kidneys, bone marrow, + sometimes gallbladder
35
with 99mTc-HMPAO, what do we see at 3-4 hrs for normal biodistribution?
lung activity is decreasing but bowel activity can be seen
36
when do we see bowel activity in all patients using 99mTc-HMPAO?
at 24hrs
37
digital subtraction
subtracting the SC image from the In-WBC image that were acquired simultaneously
38
what scan needs to be done first when the indication is osteomyelitis?
3-phase
39
if the SC scans show uptake in the same area has the WBC scans, what does it mean?
it means that it is negative for infection as the SC is used to show BM. if that area has uptake with SC, means it is the site of BM.
40
what can cause a false positive for infection/inflammation studies?
- GI bleeds - post sx wounds show uptake for 2-3 weeks, unless intense or beyond time
41
what is the half life of 67Ga?
78 hrs
42
what are the 4 energies of 67Ga?
93, 185, 296, 388 keV
43
what does 67Ga-Citrate bind to?
transferrin in blood
44
how is 67Ga-Citrate excreted? when?
kidney and bowel in first 24 hrs just bowel after that
45
at sites of infection, what does 67Ga-Citrate bind to?
lactoferrin
46
what releases lactoferrin?
dying leukocytes and bacterial siderophores
47
when using 67Ga-Citrate for imaging for abscess, when do we image?
6-24 hrs
48
when using 67Ga-Citrate for imaging for tumors, when do we image?
48-72hrs
49
when imaging with 67Ga, what does the lambda sign represent?
it is a common indicator for sarcoidosis if there is also prominent salivary gland uptake
50
67Ga Citrate, 111In WBC, 99mTc WBC which is better for chronic infections and FUO with no recent hx of sx?
67Ga
51
67Ga Citrate, 111In WBC, 99mTc WBC which is better for lung imaging and nonbacterial infections?
67Ga
52
67Ga Citrate, 111In WBC, 99mTc WBC which is better for vertebral osteomyelitis?
67Ga
53
67Ga Citrate, 111In WBC, 99mTc WBC which is better for abdominal imaging?
111In
54
67Ga Citrate, 111In WBC, 99mTc WBC which is better for acute infections?
99mTc then 111In then 67Ga
55
67Ga Citrate, 111In WBC, 99mTc WBC which is better for IBD?
99mTc
56
67Ga Citrate, 111In WBC, 99mTc WBC which is better for extremities?
99mTc

NMED 291 - Clinical Procedures 2 (11 decks)

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