Mosby Simulated Examination One Flashcards

1
Q

An average range for activated partial thromboplastin time (PTT) is:
A. 10-12 seconds.
B. 17-21 seconds.
C. 25-35 seconds.
D. 43-55 seconds.

A

C. 25 to 35 seconds.

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2
Q

Which of the following is the correct angle of insertion for placing a butterfly needle into a vein for IV administration of a contrast agent?
A. 5 degrees.
B. 15 degrees.
C. 45 degrees.
D. 60 degrees.

A

B. 15 degrees.

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3
Q

A total volume of 125 mL of an IV contrast agent is administered IV via automatic injector in 50 seconds. The flow rate for this injection is:

A

2.5 mL. (125 / 50).

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4
Q

The condition whereby the pt suffers from a low concentration of oxygen in the blood is called:

A

Hypoxemia.

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5
Q

While one is obtaining a thorough history from a pt before IV injection of an iodinated contrast material, which of the following topics should be included? (Pick one or more)
1. Any prior allergic reactions to contrast media.
2. Presence of HIV or hepatitis infection.
3. History of asthma.

A

1 and 3 only.

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6
Q

Which of the following factors may affect a patient’s calculated glomerular filtration rate (GFR)? (Pick 1 or more answers)
1. Age.
2. Sex.
3. Race.

A

1, 2, and 3.

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7
Q

Which of the following is contrast agent administration methods provides the greatest overall plasma iodine concentration?
A. Drip infusion.
B. Bolus technique.
C. Biphasic technique.
D. CT portography.

A

B. Bolus technique.

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8
Q

A pt in shock may exhibit which of the following symptoms? (Pick one or more answers).
1. Tachycardia.
2. Rapid, shallow breathing.
3. Cyanosis.

A

1, 2, and 3.

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9
Q

General signs & symptoms of shock

A
  • Rapid breathing.
  • Tachycardia
  • Hypotension
  • Weak pulse
  • Pallor
  • Cyanosis
  • Cold, clammy skin
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10
Q

The drug SOLU-CORTEF may be classified as which of the following?
A. Anticholinergic.
B. Bronchodilator.
C. Antihistamines.
D. Corticosteroid.

A

D. Corticosteroid.

(SOLU-CORTEF is a brand name for Hydrocortisone.

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11
Q

Which of the following is a nonionic contrast material?
A. Iodamide.
B. Iothalamate.
C. Iohexol.
D. Diatrizoate.

A

C. Iohexol.

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12
Q

List non-ionic contrast material

A

Iopamidol (Isovue), Iohexol (omnipaque), and iopromide (Ultravist).

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13
Q

Which of the following terms is used to describe a pt who is having difficulty breathing?
A. Dyslexia.
B. Dyspnea.
C. Dysphagia.
D. Dysphasia.

A

B. Dyspnea.

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14
Q

Lethargic state of consciousness

A

The pt appears drowsy but can be aroused.

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15
Q

Obtunded state of consciousness

A

Pt is in a more depressed level of consciousness & may not easily be aroused from a state of confusion.

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16
Q

Stupor state of consciousness

A

A state of near unresponsiveness (semicomatose).

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17
Q

Coma state of consciousness

A

The pt is completely unresponsive to stimuli.

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18
Q

Which of the following describes the situation in which an assumption is made that an unconscious or otherwise physically unable pt consents to medical treatment?
A. Informed consent.
B. Witnessed consent.
C. Patient proxy.
D. Implied consent.

A

D. Implied consent.

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19
Q

Complete cardiac diastole corresponds to which portion of the cardiac cycle on a ECG?
A. P wave.
B. QRS complex.
C. Alpha wave.
D. T wave.

A

D. T Wave (when diastole occurs).

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20
Q

During CT arthrography, iodinated contrast media is injected directly into the:

A

Joint space.

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21
Q

Which of the following is considered one of the iso-osmolar contrast media (IOCM)?
A. Iodixanol.
B. Iopamidol.
C. Iohexol.
D. Ioversol.

A

A. Iodixanol (Visipaque).

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22
Q

A common site for the IV administration of IV contrast media is the anterior recess of the elbow, otherwise known as the:

A

Antecubital space.

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23
Q

The potentially serious decline in renal function after the IV administration of contrast media is called:
A. Anaphylaxis.
B. Bronchospasm.
C. Contrast-induced nephrotoxicity (CIN).
D. Urticaria.

A

C. Contrast-induced nephrotoxicity (CIN).

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24
Q

Advantages of a saline flush immediately after the IV administration of iodinated contrast material include: (Pick one or more answers)
1. reduction in required contrast agent dose.
2. Reduction in the incidence of contrast-induced nephrotoxicity (CIN).
3. reduction of streaking artifact from dense contrast agent in the vasculature.

A

1, 2, and 3.

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25
Q

Which of the following medications may be administered to dilate the coronary vasculature prior to a cardiac CT examination?
A. Sublingual nitroglycerine.
B. a B-adrenergic receptor blocking agent (B-blocker).
C. Atropine.
D. Albuterol.

A

A. Sublingual nitroglycerin.

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26
Q

A normal range for diastolic blood pressure in an adult is:
A. 40-60 mm HG.
B. 60-90 mm HG.
C. 80-120 mm HG.
D. 95-140 mm HG.

A

B. 60-90 mm HG.

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27
Q

Normal diastolic blood pressure in an adult?

A

60 to 90 mm HG.

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28
Q

Which of the following is a parenteral route of medication administration?
A. Sublingual.
B. Intramuscular.
C. Transdermal.
D. Oral.

A

B. Intramuscular.

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29
Q

Parental route of medication includes:

A

Intramuscular, Intravenous, Intradermal, & Subcutaneous.

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30
Q

Which of the following types of isolation techniques protects against infection transmitted through fecal matter?
A. Acid-fast bacillus isolation.
B. Contact isolation.
C. Enteric precautions.
D. Drainage-secretion precautions.

A

C. Enteric precautions.

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31
Q

Which of the following is considered one of the ionic radiopaque contrast media (RCM)?
A. Iohexol.
B. Iothalamate meglumine.
C. Iopamidol.
D. Ioversol.

A

B. Iothalamate meglumine.

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32
Q

A patient who appears drowsy but can be aroused is said to be:

A

Lethargic.

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33
Q

Direct contraindications to the administration of iodinated contrast material include: (Pick one or more answers)
1. prior life-threatening reaction to iodinated contrast material.
2. Multiple myeloma.
3. Diabetes.

A

1 only.

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34
Q

The acronym CTDI is used to describe what?

A

The radiation dose to the pt during a CT scan.
CTDI = CT dose index.

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35
Q

Contact shields made of _________ may be used to selectively protect radiosensitive organs that lie within the scanned region during a CT acquisition.

A

Bismuth.

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36
Q

Which of the following technical factors has a direct effect on pt dose?
A. Matrix size.
B. Algorithm.
C. MAS.
D. Window Level.

A

C. MAS.

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37
Q

Which of the following devices is used to measure the pt dose from a CT examination?
A. Geiger counter.
B. Proportional counter.
C. Ionization chamber.
D. Film badge.

A

C. Ionization Chamber.

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38
Q

To meet current industry standards for required dose reduction measures, a CT system must employ which of the following? (Pick one or more answers).
1. Automatic exposure control (AEC).
2. Adult and pediatric protocols.
3. Digital Imaging and Communications in Medicine (DICOM) radiation dose structured reporting (RDSR).

A

1, 2, and 3.

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39
Q

When implanting a scan protocol for a CT of the abdomen without contrast on a pediatric pt (40 lb/18 kg) which technical factor should be primarily adjusted?
A. detector configuration.
B. tube milliamperage (mAs).
C. SFOV.
D. Reconstruction algorithm.

A

B. Tube milliamperage (mAs).

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40
Q

Whole-body risk based upon the radiosensitivity of exposed tissues may be estimated using the unit:
A. Stochastic dose.
B. Kerma.
C. Effective dose.
D. CT dose index (CTDI).

A

C. Effective Dose.

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41
Q

The use of iterative reconstruction techniques for CT data processing results in: (Pick one or more answers)
1. decreased noise on the reconstructed image.
2. decreased radiation dose to the pt.
3. decreased imaging reconstruction time.

A

1 and 2 only.

Iterative reconstruction will increase reconstruction time!

42
Q

Which of the following methods may be employed to reduce the radiation dose to the pediatric pt undergoing CT? (Pick one or more answers)
1. reduce mA.
2. limit phases of acquisitions.
3. increase pitch.

A

1, 2, and 3.

43
Q

A decrease in the focus-to-detector distance of a MDCT system would result in:

A

Increased pt dose.

  • it would reduce the distance b/t source and pt position (inverse square law) and increase pt dose!
44
Q

The radiation dose index calculations that takes into account the variations in absorption across the field of view due to beam hardening is termed:

A

CTDIw

CTDIw is calculated from measurements made with dosimeters positioned at the center & periphery of a phantom & accounts for the variance in dose distribution resulting from the effects of beam hardening.

45
Q

The radiation dose structured report (RDSR) must include which of the following details regarding a CT acquisition? (Pick one or more answers)
1. tube current (mA).
2. display field of view (DFOV).
3. tube voltage (kV).
4. acquisition time (seconds).
5. acquisition length (millimeters).

A

1, 3, 4, and 5.

46
Q

The reduction in intensity of the CT x-ray beam as it passes through pt issue may be generally termed:

A

Attenuation.

47
Q

Which of the following clinical scenarios could result in an unnecessary increase in radiation dose to the pt? (Choose 1 or more answers).
1. Using in-plane bismuth shielding with longitudinal and angular tube current modulation (ATCM).
2. Increasing the tube potential (kVp) without a compensatory decrease in tube current (mA).
3. Increasing technical parameters to produce a noise-free image.

A

1, 2, and 3.

48
Q

The dose length product (DLP) of a given CT acquisition may be calculated according to what formula(s)?

A

MSAD x slice width (cm) x number of slices in scan volume, and
CTDIvolume x scan length (cm)

49
Q

A modern CT system may employ complex collimation along the z-axis to reduce pt radiation exposure due to:
A. Binning.
B. Beam hardening.
C. Overbeaming.
D. Interpolation.

A

C. Overbeaming.

50
Q

Which of the following units is used to express the total pt dose from a helically acquired CT examination?
A. roentgen (R).
B. Curie.
C. R-cm (Roentgens per centimeter).
D. MGy-cm (milligrays per centimeter).

A

D. MGy-cm (milligrays per centimeter).

51
Q

Components of a comprehensive CT stroke management protocol typically include: (Choose 1 or more answers)
1. Precontrast sequence of the brain.
2. CTA of the brain and carotids.
3. CT perfusion (CTP) of the brain.

A

1,2, and 3.

52
Q

Simple cysts of the kidney have average attenuation values in the range of:
A. -40 to 0 HU.
B. 0 to +20 HU.
C. +30 to +50 HU.
D. Above +60 HU.

A

B. 0 to +20 HU.

53
Q

After initiation of rapid bolus administration of an iodinated contrast agent, the arterial phase of hepatic contrast enhancement occurs at approximately:
A. 15-20 seconds.
B. 25-35 seconds.
C. 60-70 seconds.
D. 120-180 seconds.

A

B. 25-35 seconds.

54
Q

The abdominal aorta bifurcates at the level of:

A

L4

55
Q

The accumulation of gas within a degenerating intevertebral disc is called the:
A. Aeration effect.
B. Vacuum phenomenon.
C. Oxygen saturation point.
D. Carbonization sign.

A

B. Vacuum Phenomenon.

56
Q

Which of the following CT studies of the head is typically performed without a contrast agent?
A. CT angiogram for Circle of Willis.
B. Coronal scan to r/o pituitary tumor.
C. CT of brain to r/o subdural hematoma.
D. CT of brain to b/o metastatic disease.

A

C. CT of brain to r/o subdural hematoma.

57
Q

Which of the following phases of renal contrast enhancement best demonstrates transitional cell carcinoma (TCC) of the bladder?
A. Early arterial.
B. Corticomedullary.
C. Nephrographic.
D. Excretory.

A

D. Excretory phase

  • after a delay of 3 to 15 minutes demonstrates the urinary tract while it is opacified with a contrast agent.
58
Q

The still-viable ischemic cerebral tissue that surrounds the infarct core in a pt with an acute stroke is termed the:
A. Thrombolytic zone.
B. Hemorrhage focus.
C. Ischemic penumbra.
D. Stroke volume.

A

C. Ischemic penumbra.

  • penumbra is the ischemic, yet still viable, tissue immediately surrounding the infarct zone. It can be described as the region of ischemic brain parenchyma where cerebral blood volume (CBV) is compromised but still higher than 2.5 ml per 100 g of tissue.
59
Q

A complete CT study of the orbits should include:

A

Thin section (1-3 mm) axial and coronal sections.

60
Q

High-resolution computed tomography (HRCT) is most commonly used for the evaluation of:

A

Lungs.

61
Q

During a general CT examination of the abdomen, an IV agent is indicated and is administered with the aid of an automatic injector. Which of the following ranges of flow rate should be used?
A. 0.2-1.0 ml/sec
B. 1.0-3.0 ml/sec.
C. 4.0-6.0 ml/sec.
D. 7.0-10 ml/sec.

A

B. 1.0-3.0 ml/sec.

62
Q

Diffuse fatty infiltration of the hepatic parenchyma may be referred to as:
A. Chromatosis.
B. Steatosis.
C. Cirrhosis.
D. Lipomatosis.

A

B. Steatosis.

63
Q

CT images of the chest should be acquired with the patient:
A. at full inspiration.
B. Breathing quietly.
C. at full expiration.
D. breathing normally.

A

A. at full inspiration.

64
Q

During CT scanning of the head, the gantry should be angled:

A

15 degrees above the infraorbital-meatal line (IOML).

65
Q

What DFOV range should be used when reconstructing the inner ear?

A

around 9.6 cm.

66
Q

During a CT examination of a female pelvis for a suspected malignancy, ascites may be present in an area posterior to the uterus and ovaries known as:
A. the cul-de-sac.
B. Morison pouch.
C. the space of Retzius.
D. the prevesical compartment.

A

A. the cul-de-sac.

67
Q

Which of the following pathologic processes may be considered an interstitial disease of the lungs?
A. Bronchiectasis.
B. Mediastinal lymphadenopathy.
C. Pulmonary metastasis.
D. Bronchogenic carncinoma.

A

A. Bronchiectasis.

68
Q

An enterovesical fistula is an abnormal communication between the bowel and the:
A. uterus.
B. bladder.
C. vagina.
D. Umbilicus.

A

B. Bladder.

69
Q

Positioning the pt with the knees flexed over a foam cushion during a CT examination of the lumbar spine assists in: (Pick 1 or more)
1. decreasing the kyphotic curvature of the lumbar spine.
2. making the pt more comfortable throughout the examination.
3. decreasing the lordotic curvature of the lumbar spine.

A

2 and 3 only.

70
Q

The imaging plane that is parallel to the foot’s planar surface is called the:

A

Axial Plane.

71
Q

The condition of intermittent cramping pain in the legs due to poor circulation is called:
A. varices.
B. claudication.
C. Stenosis.
D. Thrombosis.

A

B. claudication.

72
Q

The high-resolution computed tomography (HRCT) image of the chest was most likely acquired with a section width of:
A. 1 mm.
B. 5 mm.
C. 7 mm.
D. 10 mm.

A

A. 1 mm.

Section width of HRCT is around 1-2 mm.

73
Q

The pituitary gland is best demonstrated during CT in which of the following imaging planes?
A. axial.
B. coronal.
C. sagittal.
D. transaxial.

A

B. coronal.

74
Q

The most common site of organ injury due to blunt abdominal trauma is the:

A

Spleen.

(The liver is the 2nd).

75
Q

The spinal cord ends at a taper point known as the:

A

Conus medullaris.

75
Q

The adult spinal cord ends at what vertebral level?

A

L1-L2.

76
Q

Which of the following terms is used to describe a fibroid tumor of the uterus?
A. Leiomyoma.
B. Cystic teratoma.
C. Endometriosis.
D. Corpus luteum.

A

A. Leiomyoma.

77
Q

Which of the following anatomic organs is located within the peritoneal cavity?
A. Pancreas.
B. Kidneys.
C. Uterus.
D. Liver.

A

D. Liver.

78
Q

What organs are located within the peritoneal cavity?

A

Stomach, Liver, Gallbladder, Spleen, Ovaries, Transverse colon, & most of the small bowel.

79
Q

Which of the following may be included as part of a routine preparation for a general contrast-enhanced CT examination of the abdomen and pelvis? (Pick 1 or more).
1. instructing the pt to take nothing by mouth (NPO) for 4 hours before the exam.
2. 1200 mL of oral contrast agent administered 90 minutes before the exam.
3. having the pt drink 4 liters of polyethylene glycol (PEG) 24 hours before the exam.

A

1 and 2 only

PEG is used for cleaning prep for colonoscopies only!

80
Q

During a complete CT scan of the PELVIS, sections should be obtained from the:

A

Iliac crests to the pubic symphysis.

81
Q

Because of its inherent iodine concentration, the thyroid gland appears __________ on CT images.

A

Hyperdense

In comparison with the surrounding soft tissues, the thyroid gland is hyperdense on CT b/c it naturally contains iodine. This density increases further with administration of an iodinated contrast agent.

82
Q

Air trapping within the trachea & bronchial tree may be optimally demonstrated with Multiplanar volume reconstructions (MPRVs) of the thorax known as:
A. MIPs.
B. 3-D volume renderings.
C. SSDs.
D. Mini-IPS.

A

D. Mini-IPS.

83
Q

Which of the following is NOT a portion of the small bowel?
A. Duodenum.
B. Jejunum.
C. Ileum.
D. Cecum.

A

D. Cecum.

84
Q

The specialized CT examination of the bladder in which an iodinated contrast agent is directly administered under gravity into the bladder, via Foley catheter is termed:

A

CT Cystography.

85
Q

Which of the following best describes the shape of the x-ray beam utilized in MDCT?
A. Pencil beam.
B. Fan-shaped.
C. Electron beam.
D. Cone-shaped.

A

B. Fan-shaped.

86
Q

Collimation of the CT x-ray beam occurs: (Pick 1 or more)
1. At the x-ray tube, regulating slice thickness
2. Just beyond the pt, focusing off-axis transmitted radiation.
3. Before the detectors, limiting the amount of scatter radiation absorbed.

A

1 and 3 only.

87
Q

CT numbers are usually provided in the form of:
A. HU.
B. EMI numbers.
C. Cormacks.
D. U.

A

A. HU.

88
Q

The mathematical technique allowing the reconstruction of motion-free images from helically acquired CT data is called:

A

Interpolation.

89
Q

The full width at half maximum (FWHM) of a CT scanner is used to describe:
A. Spatial resolution.
B. Contrast resolution.
C. Noise.
D. Calibration accuracy.

A

A. Spatial resolution.

90
Q

A first-generation CT scanner consists of an x-ray tube & two detectors that translate across the pts head while rotating in 1-degree increments for a total of:
A. 45 degrees.
B. 90 degrees.
C. 180 degrees.
D. 360 degrees.

A

C. 180 degrees.

91
Q

Which of the following abbreviations is used to identify a computerized network that stores, receives, communicates, and displays digital medical images?
A. WORM.
B. PACS.
C. DICOM.
D. HIPAA.

A

B. PACS.

92
Q

The CT “window” Controls __________ of the CT image as it appears to the viewer.

A

Contrast & brightness.

93
Q

Voxels with equal dimensions along the x-, y-, and z-axes are referred to as:

A

Isotropic.

94
Q

Which of the following artifacts is NOT affected by the CT technologist?
A. motion.
B. partial volume.
C. edge gradient.
D. ring.

A

D. Ring.

95
Q

When one is vowing a MPR image, each pixel represents:

A

The average attenuation occurring within the voxel.

96
Q

Statistical noise appears as _____ on a CT image.

A

Graininess.

97
Q

An acquisition is made on a 64-slice MDCT system in which each detector element has a z-axis dimension of 0.625 mm. With a selected beam width of 40 mm and the beam pitch set at 1.50, how much will the table move with each rotation of the gantry?

A

60 mm.

1.50 = x / 0.625 x 64
1.50 = x / 40
(40) 1.50 = x / 40 (40)
40 x 1.50 = x
60 = x

98
Q

The component of the CT computer system responsible for the data processing of image reconstruction is the:

A

Array Processor.

99
Q

The loss of anatomic info between contiguous sections due to inconsistent patient breathing is called:
A. Cupping artifact.
B. Misregistration.
C. Overshoot artifact.
D. Out-of-field artifact.

A

B. Misregistration.

100
Q

Before a CT image can be reconstructed by a computer, the transmission signal produced by the detectors must be converted into numerical info by a(n):

A

Analog-to-digital converter (ADC).

101
Q

A CT image is formed in part by projecting back all the attenuation values recorded during data acquisition onto a:
A. Pixel.
B. Voxel.
C. Matrix.
D. Reformat.

A

C. Matrix.