M1: Hazards Associated w/ Medical Imaging Flashcards
Hazards in Med Imaging: ________ reactions to iodinated contrast media.
Anaphylactoid
Hazards in Med Imaging: Exposure to _________.
Ionizing radiation
Hazards in Med Imaging: MRI ______ issues.
Safety
Hazards in Med Imaging: Contrast-Induced ________.
Nephropathy
Hazards in Med Imaging: caused by Gd-containing contrast media.
Nephrogenic Systemic Sclerosis (NSF)
Result of damage to cells, including cell death and genetic damage. Bone marrow, lymph glands and gonad.
Radiation effects
Two types of effects may result from radiation damage
Stochastic & Deterministic
Dose dependent. Cell death, radiation burns, cataracts and decreased fertility.
Deterministic
May occur without threshold level. Probability proportional to dose. Increased cancer risk.
Stochastic
Radiation dose from medical imaging techniques. Calculating the overall risk. Concept of susceptibilities of the various tissues and organs & Type of radiation received. Number of frontal CXR. Amount of BG radiation that is received as a normal process. Joules per Kg. Sievert.
Effective dose
ALARA Principle
As Low As Reasonably Achievable
ALARA Principle: Each radiation is justified on a __________ basis.
Case by Case
ALARA Principle: The minimum number of ________ is taken and minimum __________ screening time used.
Radiographs. Fluoroscopic.
ALARA Principle: ________ is only used when patient is unable to come to the radiology department.
Mobile Equipment
ALARA Principle: ___ or ___ should be used where possible.
Ultz or MRI
ALARA Principle: are more sensitive to radiation.
Children
ALARA Principle: In Pediatric radiology, use of ________ and adjustment of _________ parameters.
Gonad shields. CT scanning.
Exposure to Radiation in Reproductive Age & Pregnancy: Radiation exposure of _______ and _______ should be minimized.
Abdomen & Pelvis
Exposure to Radiation in Reproductive Age & Pregnancy: All females of reproductive age asked if they could be _______ prior to radiation exposure.
Pregnant
Exposure to Radiation in Reproductive Age & Pregnancy: __________ posted in the medical imaging department asking patients to notify the radiographer of possible pregnancy.
Multilingual signs
Exposure to Radiation in Pregnancy: most sensitive during the stage of
Organogenesis
Exposure to Radiation in Pregnancy: Post ________ or ideally until baby is born where possible.
24 weeks
Exposure to Radiation in Pregnancy: Radiographic exposure to _____, ______ and _______ may still be done any time during the pregnancy.
Chest, Skull & Limbs
Exposure to Radiation in Pregnancy: Delay Breastfeeding for
2 days
Anaphylactoid Contrast Media Reactions: Mild form
Urticaria & Pruritus “UP”
Exposure to Radiation in Pregnancy: Moderate form
More sever Urticaria, Bronchospasm & Hypotension “MBH”
Exposure to Radiation in Pregnancy: Severe form
Unconsciousness, Cardiac arrest, Convulsion, More severe bronchospasm, Pulmonary edema, Pulmonary collapse & Laryngeal edema “UCC MPPL”
Percentage of mild reactions with non ionic low osmolar contrast media.
3%
Percentage of intermediate reactions with non ionic low osmolar contrast media.
0.04%
Percentage of severe reactions with non ionic low osmolar contrast media.
0.004%
Risk Assessment Questionnaire in Anaphylactoid Contrast Media Reaction: History of ______ & _______. And _______ reaction to iodonated contrast media.
Asthma & Atopy. Previous.
Reduction of renal function. >25% increase in serum creatinine within 3 days of contrast medium injection. 15% may require dialysis. Self-limiting with resolution in __________.
Contrast-Induced Nephropathy (CIN). 1-2 weeks.m
Risk Factors of CIN
Multiple myeloma, Pre existing renal impairment, Age >60, Recent organ transplant, DHN & Sepsis “M PARDS”
CIN Risk Reduction: Risk factors should be identified by
Risk Assessment Questionnaire
CIN Risk Reduction: Use of other imaging modalities in high risk patients. Examples are
Ultz & Noncontrast enhanced CT
CIN Risk Reduction: Use of __________ as possible.
Minimum contrast
CIN Risk Reduction: Adequate _______ before and after contrast medium injection.
Hydration
CIN Risk Reduction: Various pretreatments have been described like
Oral acetylcysteine
MRI Safety Issues: Interaction of the magnetic fields with ________ materials and __________.
Metallic. Electronic devices.
MRI should not be performed on the ff
Electrically active implants, Cochlear implants and Neurostimulators “ECN”
Rare disease. Gd-based contrast media complications in patients with renal failure.
Nephrogenic Systemic Sclerosis
Initial Symptoms (3 months prior to injection) of NSS
Pain, Erythema (legs), Pruritis, Thickening of skin & SubQ tissues and Fibrosis of internal organs (heart, liver & kidneys) “PEP TF”
Should be measured first in patients with NSS
GFR
Risk Factors of NSS
Diabetes, HPN, Renal dse & Recent Organ transplant “DHRR”
