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

Infection and Inflammation Flashcards

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?

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?

A

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

25
Q

99mTc-HMPAO vs. 111In-Oxine
which has lower body bkg?

A

111In-Oxine

26
Q

99mTc-HMPAO vs. 111In-Oxine
which is the agent of choice for chronic infections?

A

111In-Oxine

27
Q

where does 99mTc-HMPAO localize?

A

regular bone marrow and at the site of inflammation

28
Q

where does 111In-Oxine localize?

A

at the red marrow

29
Q

which leukocyte is most likely to be labelled due to its high abundance?

A

neutrophils

30
Q

what is the acceptable %tag for labelled WBCs?

A

40-60%

31
Q

what collimator is used when imaging with 111In-Oxine?

A

medium energy collimators

32
Q

when do you routinely image when using 111In-Oxine?

A

at 24hrs

33
Q

with 99mTc-HMPAO, what do we initially see for normal biodistribution?

A

lungs, liver and spleen

34
Q

with 99mTc-HMPAO, what do we see at 1-2 hrs for normal biodistribution?

A

lungs, liver, spleen, bladder, kidneys, bone marrow, + sometimes gallbladder

35
Q

with 99mTc-HMPAO, what do we see at 3-4 hrs for normal biodistribution?

A

lung activity is decreasing
but bowel activity can be seen

36
Q

when do we see bowel activity in all patients using 99mTc-HMPAO?

A

at 24hrs

37
Q

digital subtraction

A

subtracting the SC image from the In-WBC image that were acquired simultaneously

38
Q

what scan needs to be done first when the indication is osteomyelitis?

A

3-phase

39
Q

if the SC scans show uptake in the same area has the WBC scans, what does it mean?

A

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
Q

what can cause a false positive for infection/inflammation studies?

A
  • GI bleeds
  • post sx wounds show uptake for 2-3 weeks, unless intense or beyond time
41
Q

what is the half life of 67Ga?

A

78 hrs

42
Q

what are the 4 energies of 67Ga?

A

93, 185, 296, 388 keV

43
Q

what does 67Ga-Citrate bind to?

A

transferrin in blood

44
Q

how is 67Ga-Citrate excreted? when?

A

kidney and bowel in first 24 hrs
just bowel after that

45
Q

at sites of infection, what does 67Ga-Citrate bind to?

A

lactoferrin

46
Q

what releases lactoferrin?

A

dying leukocytes and bacterial siderophores

47
Q

when using 67Ga-Citrate for imaging for abscess, when do we image?

A

6-24 hrs

48
Q

when using 67Ga-Citrate for imaging for tumors, when do we image?

A

48-72hrs

49
Q

when imaging with 67Ga, what does the lambda sign represent?

A

it is a common indicator for sarcoidosis if there is also prominent salivary gland uptake

50
Q

67Ga Citrate, 111In WBC, 99mTc WBC
which is better for chronic infections and FUO with no recent hx of sx?

A

67Ga

51
Q

67Ga Citrate, 111In WBC, 99mTc WBC
which is better for lung imaging and nonbacterial infections?

A

67Ga

52
Q

67Ga Citrate, 111In WBC, 99mTc WBC
which is better for vertebral osteomyelitis?

A

67Ga

53
Q

67Ga Citrate, 111In WBC, 99mTc WBC
which is better for abdominal imaging?

A

111In

54
Q

67Ga Citrate, 111In WBC, 99mTc WBC
which is better for acute infections?

A

99mTc then 111In then 67Ga

55
Q

67Ga Citrate, 111In WBC, 99mTc WBC
which is better for IBD?

A

99mTc

56
Q

67Ga Citrate, 111In WBC, 99mTc WBC
which is better for extremities?

A

99mTc

NMED 291 - Clinical Procedures 2 (11 decks)

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