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Interventional > Midterm > Flashcards

Midterm Flashcards

1
Q

what are the stages of a minimally invasive procedure?

A

Pre-procedure
Intra-procedure
Post-procedure

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2
Q

pre procedure

A
  • explain procedure
  • make them physicslly comfortable
  • play music
  • ask questions
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3
Q

intra-procedure (during)

A
  • check in on them
  • walk them thorugh it
  • take their mind off whats happening
  • take sterile field out of view
  • ask to hold their hand
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4
Q

post-procedure

A
  • answer questions
  • knowing when results will come in
  • walk them out
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5
Q

what in the advantage of minimaly invasive procedures

A

Procedures that reduce the time spent in the hospital have a two-fold benefit in that the patient can remain in their own home and also the cost of care for the service provider is reduced.

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6
Q

what is an indication?

A

A symptom that suggests certain medical intervention is necessary

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7
Q

what is a contraindication?

A

specific situation in which a drug, procedure or surgery should not be used because it may be harmful to the patient

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8
Q

what are indications for an US guided biopsy?

A
  • questioning the condition of an organ or gland
  • new symtoms that cannot be diagnosed with other tests
  • new focal lesion/lesions
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9
Q

what are contraindications for an US guided biopsy?

A
  • target is near a major blood vessel/bowel
  • patient is very nervous/ill and unable to hold still
  • unable to visualize the target of interest
  • high risk of bleeding
  • allergy to drugs used during procedure when needed
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10
Q

what are indications for an US guided access and drainage?

A
  • less invasive procedure to reduce complicatons/increase patient comfort
  • increased pressure from fluid accumulation causing discomfort
  • find out the composition of fluid/genetic diagnosis of fetus
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11
Q

what are contraindications for an US guided access and drainage?

A
  • poor visability of target of interest
  • high risk of bleeding
  • allergy to drugs used during procedure when needed
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12
Q

what are indications for an US guided percutaneous therapy?

A
  • less invasive procedure to reduce complications/increase patient comfort
  • am more direct delivery method of treatment vs systemic delivery of treatment
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13
Q

what are contraindications for an US guided percutaneous therapy?

A
  • poor visability of target of interest
  • high risk of bleeding
  • allergy to frugs used during procedure when needed
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14
Q

what are indications for a sonohysterography?

A

submucosal fibroid/polyp/endometrial mass

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15
Q

what are contraindications for a sonohysterography and contrast?

A
  • cervix is shut tight and does not have access to endometrial canal
  • pregnancy
  • poor visability of target of interst
  • patient is very nervous and wont hold still
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16
Q

what are indications of contrast?

A
  • vascularity of lesion during arterial/portal venous phase
  • identify the boarder of lesion
  • focal delivery of medication
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17
Q

what are the differen types of US guided procedures?

A

Biopsy
Access and Drainage
Percutaneous Therapy
Misc

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18
Q

why do we do a liver or renal biopsy?

A

Any lesion identified within the liver or kidney that is suspicious and cannot be 100% diagnosed by imaging

To obtain liver tissue for systemic analysis

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19
Q

why do we do a superficial abdominal/chest biopsy?

A

Suspicious superficial lesion or focal sectional abnormality of the abdominal or chest wall

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20
Q

why do we do a thyroid biopsy?

A

suspicious nodule

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21
Q

why do we do a lymph node biopsy?

A

enlarged abnormal appearing lymph node

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22
Q

why do we do ovarian/endoetrial biopsy?

A

Suspicious ovarian lesions

Thickened endometrium

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23
Q

why do we do a prostate biopsy?

A

Usually for patients with an abnormal DRE or elevated PSA

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24
Q

what is a percuatneous drainage of fluid?

A

Drainage of fluid using needle through skin

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25
Q

why do we access vascularity?

A
  • PICC line insertion
  • Groin vessel for angiogram procedure
  • clotting of PSA
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26
Q

paracentesis

A

Aspiration / Drainage of ascites fluid

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27
Q

Thoracentesis

A

Aspiration / Drainage of pleural effusion

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28
Q

what is Radiofrequency Ablation Therapy of Liver or Renal Lesion?

A

Therapy for primary or metastatic lesions

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29
Q

what is brachytherapy?

A

radioactive seed implants

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30
Q

what is Breast Needle Wire Localization?

A

Localizes the breast lesion for the surgeon

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31
Q

what is a common name for Acetaminophen?

A

tylenol

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32
Q

what is a common name for Acetylsalicylic Acid?

A

aspirin

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33
Q

what is a common name for Ibuprofen?

A

advil

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34
Q

what is a common name for Lidocaine?

A

Xylocaine and Lignocaine

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35
Q

look at medication activity

A

Saved on Laptop

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36
Q

what do many procedures preformed in the diagnostic imaging departments require?

A

special consent forms to be signed by the patient or parent/guardian

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37
Q

what is a consent?

A

a contract wherein the patient voluntarily gives permission to perform a service

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38
Q

what must the patient be informed before consent?

A

all aspects of the procedure prior to signing a consent. At this time the patient may choose to continue with the exam or refuse all together

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39
Q

what must you make sure before you preform the exam?

A

double check and make sure they have signed it

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40
Q

informed consent

A

A competent patient voluntarily accepts a plan for medical care after physician adequately discloses propsed PLAN, RISK AND BENEFITS

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41
Q

voluntary informed consent

A

the decision to either consent or not to consent to treatment must be made by the person themselves, and must not be influenced by pressure from medical staff, friends or family.

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42
Q

infromed-informed consent

A

the person must be given all of the information, by the person who will perform the procedure, in terms of what the treatment involves, including the benefits and risks, whether there are reasonable alternative treatments and what will happen if treatment does not go ahead

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43
Q

capacity informed consent

A

the person must be capable of giving consent, which means they understand the information given to them, and they can use it to make an informed decision.

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44
Q

how may a patient express their consent?

A

written

oral

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45
Q

written consent

A

Mandatory in every invasive diagnostic/therapeutic procedures. Should be in patient’s own language/ have translator if English is not their first language

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46
Q

oral consent

A

Needed in tests such as putting in stitches or radiological examination (especially involving female patients).

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47
Q

what is simple consent?

A

Obtaining a patient’s permission to perform a procedure, without knowledge of that procedure.

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48
Q

expressed consent

A

occurs when the patient does not stop the procedure from taking place

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49
Q

implied consent

A

occurs in emergency situations when it is not possible to obtain consent.

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50
Q

Inadequate consent – aka- Ignorant consent

A

This occurs when the patient has not been informed adequately to make a responsible decision.

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51
Q

what are cathedars?

A

simply tubes of varying lengths and inside diameters with holes in each end that allow the flow of fluids.

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52
Q

what are cathedars manufactured out of?

A

teflon
polyurethane
polyetylene

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53
Q

all cathedars are ____

A

disposable

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54
Q

who makes the choice of cathedar?

A

physicial preforming the procedure

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55
Q

who is responsible for the ordering and the maintenance of the materials used during procedures including the catheters?

A

the sonographer

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56
Q

what are the advantages of teflon cathedar?

A
  • good memory-retains shape
  • high material strength
  • stiffer than other material
  • larger inner diameter
  • higher potential to kink
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57
Q

what are tha advantages to a polyurethane cathedar?

A
  • high tissue compatibility
  • increased lumen diamters
  • increased flow rate
  • low thrombogencity
  • ease of insertion and placement
  • gas sterilized only
  • low incidence of tissue trauma
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58
Q

what are the advantages to a polyethylene cathedar?

A
  • high tissue compatibility
  • contains no additives soft and flexible
  • better torque than polyerethane
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59
Q

how are cathedar sizes expressed?

A

inches or millimeters by THE FRENCH NUMBER

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60
Q

what is the french guage system defined as?

A

diamter times 3” relationship

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61
Q

what is the french number used to measure?

A

diamter of the cathedar

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62
Q

1 Fr=

A

0.3 mm

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63
Q

(mm) =Fr/______

A

3

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64
Q

Fr= D (mm) x _________

A

3

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65
Q

where do some companies imprint information on the cathedars?

A

on the hub

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66
Q

what is the hub of a cathedar?

A

proximal portion of the catheter that provides an attachment for the syringe

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67
Q

what does the distal end of the cathedar look like?

A

can either be straight or shaped

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68
Q

what does the shape of the cathedar depend on?

A

the type of procedure being done and the anatomic part being imaged

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69
Q

what do small balloons do on a cathedar?

A

mechanically occlude vessels and allow hemodynamic studies to be performed as well as providing hemorrhage control, segmental isolation, etc

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70
Q

how are needles measured?

A

Stubs needle gauge system

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71
Q

what does the guage number describe about the needle?

A

outer diamter of the needle

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72
Q

the smaller the gauge number ________

A

the larger the outer diameter

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73
Q

guage needle size for adults

A

21-23

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74
Q

guage needle size for children

A

25-27

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75
Q

what medication uses a 30 or 31 guage?

A

Byetta for diabettes

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76
Q

what is the universal protocol created to prevent?

A

wrong person
wrong procedure
wrong procedral site

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77
Q

what does verification include?

A
  • patient identification double identifier (name, record #, DOB)
  • history and physical in the medical record
  • sign consent with correct procedure verified
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78
Q

what is the sonographers role in the pre procedure set up?

A

Evaluation of:

  • medical records
  • Lab values
  • Allergies
  • Other imaging studies
  • Informed consent
  • Set up sterile biopsy tray
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79
Q

what might site marking be delegated to?

A
  • medical residents
  • fellows
  • physician assistants
  • advanced practice registered nurses
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80
Q

who is accountable for the procedure?

A

licensed independant practitioner

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81
Q

the procedure marking site is _________

A

unambiguous

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82
Q

what is a time out?

A

deliberate pause in activity involving clear communication (that includes active listening and verbal confirmation of the patient, procedure, site and side) among all members of the surgical/procedural team.

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83
Q

what does the timeout include in verifying?

A
  • correct patient ID
  • correct procedure with consent
  • correct site and side=markking
  • allergies patient may have
  • Availability of correct implants and any special equipment or requirements
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84
Q

what are the 3 steps to the universal protocol?

A
  • pre procedure verification process
  • marking the procedure site
  • a time out (PAUSE)
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85
Q

needle activity

A

finnish

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86
Q

where are microorganisms

A
  • microscopic

- Naturally present on and in the human body and environment

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87
Q

when can non-pathogenic microorganisms become infectious?

A

if a patient is immunocomprimised

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88
Q

are microorganisms harmful?

A

Some microorganisms (pathogens) cause specific diseases or infections, but many are also harmless

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89
Q

what is a microorganism?

A

pathogen-virus, bacteria, fungus that can cause a disease

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90
Q

what are common nosocomial infections?

A
  • surgical site/wound infections
  • pneumonia
  • cathedar induced infection
  • bloodstream infections
  • gastrointestinal infections
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91
Q

pneumonia nosocominal infection

A

Ventilator Associated Pneumonia (VAP)

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92
Q

cathedar induced infection

A

UTI

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93
Q

blood stream infection

A

central line insertion

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94
Q

gastrointestinal infection

A

C-Diff
MRSA
VRE

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95
Q

Clostridium Difficile (“C Diff”):

A

a bacterium that causes mild to severe diarrhea and intestinal conditions like pseudomembranous colitis (inflammation of the colon)

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96
Q

what is the most frequent cause of infectious diarrhea in hospitals and long term care?

A

C-DIff

97
Q

Methicillin-Resistant Staphylococcus Aureus (“MRSA”):

A

a bacterium that is resistant to many antibiotics.

98
Q

what problems can MRSA cause?

A

skin infections to pneumonia to bloodstream infections and sepsis

99
Q

Vancomycin Resistant Enterococcus (“VRE”):

A

Enterococci are bacteria that are naturally present in your intestinal tract. Vancomycin is an antibiotic to which some strains of enterococci can become resistant to.

100
Q

where is VRE commonly caught?

A

in hospitals

101
Q

what are common comunity aquired infections?

A 
common cold
influenza
norovirus
bacterial pneumonia
Hep C
102
Q

medical asepsis

A
  • inhibits growth and spread of pathogenic microorganisms

- clean technique

103
Q

surgical asepsis

A
  • destroys all microorganisms and their spore

- sterile technique

104
Q

what are examples of medical asepsis

A
  • handwashing
  • PPE
  • cleaning equipment
105
Q

whats the best way to ensure medical asepsis?

A

handwashing

106
Q

when do we wash our hands?

A
  • before patient care
  • After touching blood, body fluids, secretions, excretions, and contaminated items
  • Immediately after gloves are removed
  • Between patient contacts.
107
Q

what does surgical asepsis do?

A

absence of all microorganisms, pathogens, and spores from an object

108
Q

what requires surgical asepsis?

A

any medical procedure that involves penetration of the bodt tissues (invasive procedure)

  • major and minor surgeries
  • changing dressing
109
Q

principles of sterile field on lect.3 slide 13

A

finnish

110
Q

does traffic have an impact in contamination?

A

no

111
Q

what helps to not contaminate something?

A

cover trays

112
Q

when do we open a sterile tray?

A

just prior to procedure

113
Q

what is the proper attire to wear?

A
  • scrubs
  • cap
  • mask
  • shoe covers
114
Q

zone 1

A

unrestricted zone

people may enter in street clothes. Area of front desk, locker rooms and waiting room for family members.

115
Q

zone 2

A

semi-restricted zone
persons who are dressed in scrub clothing, cap, mask and shoe covers. Area is limited to authorized workers and patients. Storage area for sterile supplies and instruments. No food or drink allowed.

116
Q

zone 3

A

restricted zone
persons wearing scrub suits, mask, cap, shoe covers and sterile applications. Those directly involved in the operation are dressed in sterile gowns and sterile gloves and are often referred to as “being scrubbed.” Area where sterile supplies are opened and where surgical procedure will be performed.

117
Q

where are most common causes of contamination?

A
  • The use of contaminated instruments
  • Contaminated gloves
  • Wet or damp sterile field
  • Microorganisms blown onto a surgical site
118
Q

what are special precautions we take to prevent spead (air)

A

-Ventilation ducts must have special filters
-Airflow in the OR should be unidirectional
-Air pressure in the OR should be greater than the outside corridors (negative pressure)
-Humidity is to be controlled to prevent static electricity
OR doors should remain closed as much as possible

119
Q

who is on the surgical team?

A 
Surgeon
Surgical assistant
Anesthesiologist
Nurse anesthetist
Circulating nurse
Scrub nurse
Imaging Technologist
120
Q

disinfection

A

To remove as many microorganisms as possible from a surface by physical or chemical means.

121
Q

what has to be disinfected?

A

Articles or surfaces that cannot be sterilized in the OR / special procedure room must be disinfected.

122
Q

what is high level disinfectant?

A

Kills vegetative microorganisms and inactivates viruses, but not necessarily high numbers of bacterial spores

123
Q

when is high level capable of sterilization?

A

long contact time (6-10 hours)

124
Q

what is high level disinfectant used on?

A

on medical devices, but not on surfaces such as laboratory benches or floors.

125
Q

what are excamples of high level disinfectants?

A

Formaldehyde
Cidex
Hydrogen peroxide
Trifectant

126
Q

intermediate level disinfectant

A

Kills vegetative microorganisms including Mycobacterium tuberculosis, all fungi and inactivates most viruses

127
Q

what is intermediate level disinfectant used on?

A

Commonly used to disinfect laboratory benches and as part of detergent germicides used for housekeeping purposes

128
Q

intermiediate level disinfectant examples

A
  • 70% ethyl alcohol
  • Isopropyl alcohol
  • Sani-Cloth
  • Bleach
  • Purex
  • ChloraPrep
  • SoluPrep
129
Q

low level disinfectant

A

Kills most vegetative bacteria, some fungi and inactivates some viruses

130
Q

what does low level disinfectant NOT kill?

A

M. Tuberculosis

131
Q

what are some low level disinfectants?

A

Hospital disinfectants or sanitizers

132
Q

low level disinfectant examples?

A
  • Pine-Sol
  • Lysol
  • Providon Iodine (Betadine)
  • Parvosol
133
Q

what are the two types of sterilization?

A
  • physical (heat or radiation)

- chemical

134
Q

what is the most common meethod of physical sterilization?

A

heat becuase it is reliable, easy, econimcal

135
Q

moist heat

A

heat under steam pressure (Autoclave)

136
Q

dry heat

A

dry heat ovens

137
Q

what are the 3 ways of physical sterilization?

A
  • heat
  • filtration
  • radiation
138
Q

what are the types of chemical sterilization?

A
  • gas

- chemical solutions

139
Q

gas chemical sterilization

A

-Ethylene oxide
(Used for materials that cannot withstand steam sterilization)
-Other oxidants
-Plasma
(Ionized gas: electrically charged and non charged particles)

140
Q

chemical solutions

A
  • Alcohols (Ethanol 70%, isopropanol 70%, propanol 60%)
  • Aldehydes (Formaldehyde)
  • Halogens (Chlorine, Iodine)
141
Q

what must you check for before opening a sterile pack?

A

-expiration date
-condition of pack
(cloth wrapped and commericial packs)

142
Q

when must a sonographer open his own gown and towel pack?

A

before begining the surgical scrub

143
Q

what is the purpose of skin prep?

A

the purpose of a skin prep is to remove as many microorganisms as possible by mechanical and chemical means to reduce the potential of infection

144
Q

what should the area of penetration be cleaned with?

A

antiseptic solution

145
Q

what must be done after the skin has been prepared?

A

place sterile drapes around the area of interest

146
Q

what clothes are used as drapes?

A

-disposable sterile cloth towel mainly but a fenestrated drape may be used

147
Q

what are the most common sonography guided biopsy for soft tissue?

A
  • fine needle aspiration (FNA)

- core biopsy

148
Q

what is a FNA?

A

Thin needle (20-25 gauge) is inserted into an area of abnormal appearing tissue under ultrasound guidance

149
Q

how is a FNA preformed?

A
  • Radiologist uses a needle and insert it into the tissue, using a back and forth motion, the cells are collected within the cannula
  • Radiologist can attach a syringe to create negative pressure and aspirate the cells
  • Samples (cells) collected during FNA can help make diagnosis (e.g., Malignant vs benign cells)
150
Q

Is FNA considered safe?

A

yes, generally a safe procedure, complications are rare

151
Q

when is FNA usually done?

A

on lump found just under the skin

152
Q

what areas might a doctor recommend a FNA?

A
  • nodules or masses
  • enlarged lymph nodes
  • inflammed tissue
153
Q

where are common sites for FNA?

A
  • breast
  • thyroid gland
  • lymph nodes in neck, groin, or axilla
154
Q

how do you contain the samples for a FNA solid lesions?

A
  • cells are pushed out of cannula onto microscopic slides
  • a cytology tech will collect samples
  • syringe and needle will be rinsed out with a fluid and that fluid will also be sent to lab for testing
155
Q

Cytopathology/cytology

A

Diagnoses malignant and premalignant cells and diseases on the microscopic level

156
Q

what is a core biopsy?

A

14-19 gauge needle is inserted into an area of abnormal appearing tissue under ultrasound guidance

157
Q

what is usually obtained with a core biopsy?

A

sample of abnormal soft tissue (tumor or lymph node) or random tissue sample in an organ

158
Q

what is the most common core biopsy needle mechanism?

A

reusable spring loaaded needle biopsy gun

159
Q

what is another method for biopsy needle?

A

disposable spring loaded biopsy needle (supercore/trucut needle)-controlled click

160
Q

when preforming a core biopsy, where are the samples usually kept?

A

in a formaldehyde solution for preserving tissue samples (clear fluid) formalin

161
Q

what is formalin?

A
  • A solution of gas formaldehyde in water
  • Widely used for preserving tissue samples. It links protein molecules together, increasing the rigidity of the sample and making it easier to prepare thin slices for microscopic examination. It also prevents decay.
162
Q

where are core samples sent?

A

Surgical Pathology aka histology

163
Q

what are the 2 biopsy techniques?

A
  • free hand

- needle guided

164
Q

what are the needle angle and positionning considerations based on?

A

depth of the target from the skin surface

165
Q

what is the position when sampling superficial structures?

A

the needle is entered at a shallow
angle relative to the skin surface with the needle hub oriented
away from the transducer

166
Q

what is the postition when sampling deeper structures?

A

When sampling deeper structures, the needle is entered at a steep angle relative to the skin surface, and the needle hub is oriented close to the transducer.

167
Q

what is sonix system?

A

ultrasound screen has the dotted lines where the needle will insert

168
Q

pros and cons slide 27 biopsy 1

A

look in notes

169
Q

look at 2nd biopsy presentation

A

indications/diagnois/etc

170
Q

what are the contraindications for a liver biopsy?

A
  • Uncooperative patient (sedation required)
  • Extrahepatic biliary obstruction (risk of biliary peritonitis, septicaemic shock and death)
  • Bacterial cholangitis
  • Abnormal coagulation indices
  • Ascites
  • Cystic lesions (especially echinococcal -cyst)
  • Amyloidosis
  • Patient body habitus or poor penetration of sound through soft tissue
171
Q

what is the normal INR for liver biopsy?

A

< 1.4-1.5

172
Q

what is the normal PTT for liver biopsy?

A

< 45 - 50 sec

173
Q

what is the normal PLT in liver biopsy?

A

> 50 000 - 70 000

174
Q

what may be used to correct cloting abnormalities?

A

vitamin K or fresh frozen plasma

175
Q

what is done pre biposy of liver?

A
  • Check for requisition and previous medical history, along with recent blood work for INR, PTT, PLT.
  • Determine easiest visibility of lesion
  • Determine access (intercostal, subcostal, subxyphoid)
  • Look for ascites
176
Q

what do you do pre biopsy for random liver?

A

determine a region without larger intrahepatic vessels

177
Q

what do you do pre biopsy for a target liver?

A

look for peripherally located lesions with normal parenchyma

178
Q

what are the pre scan images for a random liver biopsy?

A

area of interest 2D and color images

179
Q

what are the pre scan images for a targeted liver biopsy?

A

chosen lesion with measurments and color images

180
Q

how does the patient lie for a liver biopsy?

A

supine or left lateral decubitus

181
Q

what kind of biopsy is done on the liver?

A 
core biposy
(biopsy gun or disposable biopsy needle mechanism)
182
Q

how many samples does the radiologist contain with a core liver biopsy?

A

anywhere between 2-6 samples depending on quality and indication for procedure

183
Q

what guage of needle is used in a liver biopsy?

A

14-18 guage

184
Q

what will be used to clean the skin after a biopsy?

A

alcohol

185
Q

what will we ask the patient to do after applying a bandaid?

A

lie in their right side to apply pressure and decrease the chance of bleeding if the insertion is on the right side

186
Q

what images do we look for for liver post biopsy?

A
  • check if their is bleeding from needle track
  • hematoma
  • 2D and color/power doppler images
  • damage to area near biopsy site
187
Q

what is post biopsy patient care?

A
  • Usually monitored by a nurse in surgical day care unit or other designated nursing unit
  • Patient can use Tylenol if there is pain after procedure
188
Q

when do most complications appear with a liver biopsy?

A

first 3 hours

189
Q

what type of tissue sample so you want to be obtained?

A

Obtain a tissue sample that is representative of the liver lesion or of the hepatic parenchyma and that is adequate enough to obtain a pathologic diagnosis.

190
Q

where is a core liver biopsy sample sent?

A

placed in formalin bottles and sent to HISTOLOGY

191
Q

What are the complications of a liver biopsy?

A
  • Abdominal or shoulder pain
  • Hematoma
  • Hemobilia
  • Hemo- or pneumothorax
  • Vasovagal reaction
  • Puncture to adjacent organs
  • Peritonitis
  • Mortality
192
Q

lec 4 slide 21

A

renal biopsy indications

193
Q

for a random renal biopsy, what kidney and where do we obtain a sample?

A

lower pole of the left kidney is the selected choice

194
Q

what are the indications for a targeted renal biopsy?

A 
Renal cell carcinoma (RCC)
Oncocytoma
Papillary adenoma
Renal lymphoma
Renal leiomyoma (capsuloma)
angiomyolipoma
195
Q

what are the contraindications for a renal biopsy?

A 
Bleeding diathesis
Severe hypertension 
Seeding of RCC
Hydronephrosis
Infection
Patient unable to lie prone
obesity
196
Q

what are complications of a renal biopsy?

A 
Pain
Puncture to adjacent structures
Hematuria
Bleeding/hematoma
Tract seeding
Infection
mortality
197
Q

renal biopsy complication 40-50% appear

A

< 4 hours

198
Q

renal biopsy complication 67-80% appear

A

<8 hours

199
Q

renal biopsy complication 80-100% appear

A

<12 hours

200
Q

coagulopathathy INR threshold

A

<1.4 - 1.5

201
Q

coagulopathathy PTT threshold

A

<45 - 50 sec

202
Q

coagulopathathy PLT threshold

A

> 50 000 - 70 000

203
Q

blood pressure for a renal biopsy

A

<90 mmHg diastolic

204
Q

when should result of blood work be from? (time)

A

24 hours

205
Q

when do you take blood pressure of a patient?

A

just before procedure

206
Q

what type of biopsy can be preformed for a lymph node biopsy?

A

FNA

Core

207
Q

where are FNA samples sent?

A

cytology

208
Q

where are core samples sent?

A

histology

209
Q

what are the indications for a lymph node biopsy?

A
  • Cause of enlarged node
  • Cause of symptoms, such as an ongoing fever, night sweats or weight loss
  • Staging (plan cancer treatment)
210
Q

what is a normal lymph node biopsy result?

A
  • Normal number of lymph node cells
  • Structure and appearance of lymph node cells within are normal
  • No signs of infection are present
211
Q

what is an abnormal lymph node biopsy result?

A
  • Signs of infection may be present, such as mononucleosis (mono) or tuberculosis (TB)
  • Cancer cells may be present. Cancer may begin in the lymph node, such as Hodgkin or non-Hodgkin lymphoma, or may have spread from other sites, such as metastatic breast cancer
  • HIV
  • Inflammatory diseases, such as sarcoidosis
212
Q

what are contraindications for preforming a lymph node biopsy?

A
  • Uncooperative patient
  • Allergies
  • Blood thinners
213
Q

what are complications for a lymph node biopsy?

A 
Pain
Bruising
Bleeding
Infection
Allergic reaction
Lymphedema
214
Q

Adjuvant

A

Enhances the effectiveness of medical treatment and modifies the effects of other agents. Ex) Adjuvant may be added to a vaccine to boost the immune responce.

215
Q

Aspiration

A

Aspiration means to draw in or out using a sucking motion. A medical procedure that removes something from an area of the body. These substances can be air, body fluids, or bone fragments. An example is removing ascites fluid from the belly area.

216
Q

Cannula

A

It is a flexible tube that is inserted generally into the hand or arm. It can either be used to put substances (fluids, medications, ect.) directly into the blood stream, or used to withdraw blood. Ultrasound could be used to ensure the position of the cannula is correctly within the vessel.

217
Q

Catheter

A

A catheter is a flexible tube inserted through a narrow opening into the body to permit injection or withdrawal of fluids. Ultrasound is useful in the guidance and placement of a catheter.

Example: A Foley catheter is placed in the urinary bladder to drain urine.

218
Q

Coagulopathy

A

Coagulopathy is a condition in which the bloods ability to clot is impaired. This can cause prolonged or excessive bleeding. In regards to ultrasound guided biopsies, bleeding is one of the major complications and feared risks of biopsies.

219
Q

Diffuse

A

Not definitely limited or localized. To pass through or spread widely through a tissue.

220
Q

Empathy

A

The ability to understand and share the feelings of another person.

221
Q

Fenestrated Drape

A

A fenestrated drape is a sterile body sheet with a hole, window or opening that allows access to the incision site for operation.

222
Q

Fresh frozen plasma (ffp)

A

Fresh frozen plasma (ffp) is plasma that has been configured, separated from whole blood and frozen solid at -18 degrees within 6 hours of collection. It contains all the coagulation factors, and can be used prior to invasive procedures to assist in coagulation (management of bleeding risks)

223
Q

Gauge

A

A Gauge is a device or an instrument that is used in various procedures for the measuring of the contents, magnitude or amount of something.

224
Q

Hematoma

A

Localized swelling that is filled with blood caused by a break in the wall of a blood vessel. Can occur spontaneously or by trauma. Blood is usually clotted or partially clotted.

225
Q

Hub

A

The expanded portion of a hollow needle that serves as a handle for manipulation and as a site of attachment for a syringe, infusion tube, or some other appliance.

226
Q

Hypodermic

A

Hypodermic refers to the region directly beneath the skin. It can also be used to refer to a syringe or needle that pierces beneath the skin.

Ex) A hypodermic syringe injects a substance into your veins.

227
Q

International Normalized Ratio (INR)

A

INR is a standardized measure of blood and its ability to clot. The ratio is based on each individual personal prothrombin time to the normal mean of prothrombin time. It is used to help monitor the risk of bleeding in patients receiving anticoagulant therapy.

Normal range for INR is 0.8-1.2 The higher the number, the longer it takes for your blood to clot.

228
Q

Justification

A

Justification is an action used to decide whether something is reasonable, or right. In ultrasound, this could relate to justifying whether or not an exam request is correct

229
Q

Lidocaine with Epinephrine

A

Lidocaine is a local anesthetic. It works by blocking nerve signals in your body.

Lidocaine injection is used to numb an area of your body to help reduce pain or discomfort caused by invasive medical procedures such as surgeries, needle punctures, or insertion of a catheter or breathing tube.

Epinephrine, a vasopressor, is added to the anesthetic to increase its effectiveness and to keep the anesthetic effect from spreading to other areas of the body.

230
Q

mobidity

A

the amount of diseased

231
Q

Mortality

A

the amount dead

232
Q

Partial Thromboplastin Time (PTT)

A

PTT is a blood test that measures the time it takes for blood to clot. It is a useful test, as different factors may affect the body’s ability for blood to clot. Examples of this may include medication (heparin), low levels of clotting factors, absence of clotting factors, inhibitors, and more.

This test is done to find a reason for unusual bleeding/bruising, check the liver function, precautionary measures prior to a surgical procedure, other clotting conditions, etc.

Normal range is 25-35 seconds

233
Q

Percutaneous

A

Percutaneous means by way of the skin, in medical terms, it is generally a medical procedure that involves a medical device entering the blood vessels, usually by way of a needle.

234
Q

Platelets (PLT)

A

Platelets, also called thrombocytes, are fragments of larger cells made in the bone marrow called megakaryocytes.

Platelets help the blood heal wounds and prevent excessive bleeding. They work by circulating within our blood and bind together when they recognize damaged blood vessels and cause a blood clot
A normal platelet count ranges from 150,000 to 450,000 platelets per microliter of blood

235
Q

Vasovagal

A

is a reflex of the involuntary nervous system that causes the heart to slow down (bradycardia) and at the same time affects the nerves of the vessels in the legs permitting them to dilate and as a result the blood pressure drops and the blood is circulating tends to go into the legs rather than to the head and this leads to fainting episode as the brain deprived of oxygen

236
Q

Vitamin K

A

Vitamin K is a group of compounds that play a key role in helping the blood to clot which will prevent excessive bleeding. K1 for example can be obtained from leafy greens and other vegetables and K2 from meats, eggs and cheeses. Since vitamin K is important for the blood to clot, low levels raise the risk of uncontrolled bleeding. Deficiencies can be associated with Crohn’s disease of celiac disease.

237
Q

Warfarin

A

Warfarin is an anticoagulant drug (aka Coumarin, Panwarfin and Sofarin) which is used to prevent blood from clotting. It is commonly used to prevent blood clots and reducing the risk of strokes, heart attacks and pulmonary embolisms. It does so by inhibiting the production of prothrombin by vitamin K. It is usually taken in individuals over the age of 65

238
Q

how much lidocaine is used in a procedure?

A

1% lidocaine

Interventional (2 decks)

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