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PCM III Exam 1 > Lecture 3: Diagnostic Imaging Overview > Flashcards

Lecture 3: Diagnostic Imaging Overview Flashcards

1
Q

Which imaging modality uses high frequency sound waves to generate an image?

A

Ultrasound

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2
Q

What are the pros and cons of using ultrasound?

A
  • Pros = no radiation, cheaper, and non-invasive
  • Cons = bowel gas and lung tissue hinder US image; dependence of skills of techni
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3
Q

What is a FAST exam for diagnostic imaging and it’s primary views or windows?

A
  • Focused Assessment w/ Sonography in Trauma
  • Subxiphoid
  • RUQ
  • LUQ
  • Suprapubic
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4
Q

A FAST exam diagnostic study is used to assess for what?

A

Free fluid in body

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5
Q

What are the 5 radiographic densities and how do each appear?

A
  1. Metal - BRIGHT WHITE
  2. Air - BLACK
  3. Soft tissue - LIGHT GRAY
  4. Fat - DARK GRAY
  5. Mineral - OFF WHITE
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6
Q

What are the 2 GI contrasts that can be used with X-ray?

A
  1. Barium
  2. Gastrograffin
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7
Q

After giving contrast to patient for XR, how long should you wait for best visualization?

A

45 mins s/p ingestion

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8
Q

Move to what type of XR has decreased costs?

A

Digital XR

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9
Q

What are the cons of using XR for imaging?

A
  • 2D pic
  • Radiation exposure
  • Poor detail of soft tissue
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10
Q

Which imaging modality is used for mammograms and line/tube placement?

A

XR

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11
Q

How does fluoroscopy imaging work?

Allows for what type of imaging?

A

Uses continually emitted x-rays and allows for real-time visualization

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12
Q

How do the images and radiation exposure differ btw fluoroscopy and XR?

A
  • Images are intensified = decreased radiation exposure
  • Images are attenuated differently than XR
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13
Q

What are 6 uses for Fluoroscopy?

A
  1. Esophagram
  2. Upper GI study
  3. Small bowel follow-thru
  4. Barium enema
  5. Cardiac
  6. Vascular
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14
Q

What are 3 cons associated with using CT imaging?

A
  • Potential contrast rxn
  • Exposure to radiation
  • Diagnosis limitations
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15
Q

What type of contrast is used with CT scans?

A

IV iodinated

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16
Q

What are the best uses of contrast with CT?

A
  • Vessels
  • Visualize tissue changes
  • Urinary tract
  • Fallopian tubes
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17
Q

Any suspicion of what 3 complications should make you think about using contrast with a CT?

A
  • Bleed
  • Renal stone
  • Retroperitoneal hematoma
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18
Q

Neuro contrast with CT is good for visualizing what?

A
  • Veno/angiogram
  • Abscess
  • Malignancy
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19
Q

One of the strengths of using MRI is that it provides greater detail of what structures?

A

Soft tissues

20
Q

MRI uses a magnetic field to manipulate what?

A

Polarity of H+ ions

21
Q

In regards to T1 vs. T2 weighted MRI images which has a higher signal intensity of water and is therefore more suitable for visualizing pathology?

22
Q

In regards to T1 vs. T2 weighted MRI images which gives better views of normal anatom (anatomical details, fat containing structures, subacute hemorrhages)?

23
Q

When using MRI what are 4 patient situations you must be aware of and take precaution to?

A
  • Cardiovascular devices = pacemakers, stents, mechanical valves, IVC filters
  • Unstable pts
  • Claustrophobic and agitated pts
  • Large body habitus
24
Q

What is the preferred type of contrast used with MRI?

A

Gadolinium

25
Using gadolinium with T1-weighted MRI improves the visibility of what?
- Inflammation - Tumors - Blood vessels and some organs - Blood supply
26
Nephrogenic systemic fibrosis is a possible adverse effect associated with what contrast agent?
Gadolinium
27
Although generally well tolerated, what are some of the risks associated with the use of gadolinium as a contrast agent? Especially in which pt populations?
- Contrast induced nephropathy - Nephrogenic systemic fibrosis - **Advanced renal failure** or **dialysis pt** (GFR \<30 mL)
28
When is the onset of nephrogenic systemic fibrosis following gandolinium exposure? Signs/Sx's?
- **Onset:** 2 days - 18 weeks s/p exposure! - **Sx**: thickening and hardening of skin. Spares head. Mimics **scleroderma!** - Stiffen extremities involved, **flexion contractures**
29
What are the pros associated with using MRI?
- Safe - **NO radiation** - Extremely precise w/ incredible soft tissue detail
30
What are 4 cons associated with using MRI?
- Not widely available - Costly - Body habitus - Pts must have extreme patience **(30-90 mins)**
31
What are 3 systems that MRI is used for?
- Neuro - MSK - Repro
32
Which type of imaging modality uses the injection of contrast media **directly** into artery or vein via needle or catheter?
Angiography
33
What 3 systems is angiography utilized in?
- Neuro - Pulmonary - Cardiovascular
34
What are 3 deterministic effects (acute) associated with ionizing radiation exposure?
- Burns - Sterility - Radiation sickness
35
What are 2 stochastic effects (chronic) associated with ionizing radiation exposure?
- Cancer - Hereditary
36
Which patient populations are at **greatest** risk from ionizing radiation exposure?
- Children - Young adults - Women of repro. age (always get **urine** β-hCG)
37
The cells most sensitive to radiation damage have what 3 characteristics?
- Rapidly dividing - Undifferentiated - Have a long mitotic figure
38
What 4 imaging modalities use ionizing radiation?
1. Radiograph (XR) 2. CT 3. Fluoroscopy 4. Nuclear medicine
39
Contrast is used with medical imaging to increase the differences in?
**Density** between anatomic structures
40
Special consideration for using contrast and radiation imaging techiques should be taken in renal patients with what serum Cr?
Cr ≥ 1.5
41
Which days during pregnancy are considered **critical** and should be considered when selecting an imaging modality with contrast or radiation?
Days 16-45!
42
Special consideration while using contrast and radiation imaging modalities need to be taken in pts on what medication? Need to beware of what?
**Metformin** --\> beware of lactic acidosis
43
What are the signs/sx's of **hypersensitivity** rxns to contrast agents?
Hives, anaphylaxis, urticaria, pruritus, and angioedema
44
What are the signs/sx's of **chemotoxic** rxns to contrast agents?
Self limited: **N/V** and **flushing**
45
What are the signs/sx's of **vasovagal rxns** to contrast agents?
- **Increased** vasovagal **tone** - ↑ vagal tone -\> **↓ SA and AV** node conduction = **bradycardia** w/ **vasodilation**

PCM III Exam 1 (12 decks)

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