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NIS > NIS numbers > Flashcards

NIS numbers Flashcards

1
Q

magnetic field strength above which a patient with an implanted cardiac pacemaker should NOT be allowed

A

5 Gauss (0.5 mT)…………………… (1 Gauss = .0001 Tesla, or 1 Tesla = 10,000 Gauss)

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2
Q

reversal of midazolam

A

Flumazenil 0.2 mg IV

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3
Q

hearing protection must be provided for MRI exams in which sound pressure exceeds:

A

99 decibels

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4
Q

what radiation level can ring dosimeters detect

A

30 mrem of gamma and 40 mrem of beta

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5
Q

how many hospital deaths per year were attributable to medical errors

A

44,000-98,000 deaths

(2000 IOM To Err is Human)

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6
Q

societal cost of medical erros

A

$17-29 billion dollars

(2000 IOM To Err is Human)

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7
Q

how many Americans experience a diagnostic error or know someone how did?

A

1 out of 6 ppl

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8
Q

What % of postmortem exams were associated with diagnostic erros

A

10%

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9
Q

ASA class I

A

A normal healthy patient

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10
Q

ASA Class II

A

A patient with mild systemic disease

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11
Q

ASA Class III

A

A patient with severe systemic disease

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12
Q

ASA Class IV

A

A patient with severe systemic disease that is a constant threat to life

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13
Q

ASA Class V

A

A moribund patient who is not expected to survive without the operation

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14
Q

ASA Class VI

A

A declared brain-dead patient whose organs are being removed for donor purposes

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15
Q

ages where kids experience a gradual transition to self determination

A

12-18 years

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16
Q

Age cut off for medical decision making

A

< 12 yo cannot make their own decisions.

Between 12-18 is a gray area and you have to determine 3 things:

  1. legal determination of maturity
  2. evidence the child is sufficiently mature to make own decisions
  3. conditions exempting parental consent
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17
Q

time peroid for hand washing with soap and water

A

15 seconds

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18
Q

time period for washing hands with hand sanitizer

A

20 seconds

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19
Q

All MR sites should have a handheld magnet ( >________Gauss)

A

All MR sites should have a handheld magnet ( >1000 Gauss)

……” or handheld ferromagnetic detection device, which allows for testing of external objects and some superficial internal implants”

pg 21

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20
Q

insulating pads for the MRI scanner are necessary to keep skin at least _______ from the skin surface

A

1 -2 cm

insulating pads for the MRI scanner are necessary to keep skin at least 1-2 cm from the skin surface

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21
Q

volume of liquid Helium in MR scanners

A

typically 1500 to 2000 L

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22
Q

temperature of liquid helium in MRI scanners

A

-269 C, 4 K

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23
Q

When the magnet is quenched, what is the increase in volume from He liquid to gas

A

760 fold increase in volume

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24
Q

incidence of severe life threatening allergic like reactions

A

estimated to be 0.01% to 0.04%

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25
Q

incidence of allergic like CT contrast rxn

A

< 1%

most of which were mild

26
Q

risk of another allergic like rxn to the same class of contrast media if you have had a rxn before

A

5 x increased risk

27
Q

increased risk of adverse contrast rxn in a patient with allergies or asthma

A

2-3 x increased risk

28
Q

time period in which thyroid cancer pts should not receive CT IV contrast before I-131 treatment

A

No IV contrast 4-6 weeks before I-131 treatement

contrast will saturate the thyroid and could render treatment ineffective

29
Q

even if pre-medicated, if a breakthrough contrast rxn occurs what % are similar severity to the initial contrast rxn

A

80%

“Even with appropriate use of an accepted premedication regimen, breakthrough reactions occur in a small number of high-risk patients. When they do occur, they are of similar severity to the initial reaction about 80% of the time, less severe about 10% of the time, and more severe about 10% of the time.”

pg 25

30
Q

PC-AKI is defined as kdiney injury within what time perioid of contrast administration

A

24-48 hours

31
Q

CIN is most likely to develop in pts with GFR < _____ mL/min/1.73 m2

A

GFR < 30

…or AKI

32
Q

Administration of large or multiple doses of contrast media within __________ may also be a risk factor for AKI

A

24-48 hours

pg 26

33
Q

AKI should be diagnosed whenever:

A

1) an absolute serum creatinine increase of at least 0.3 mg/ dL; or
2) a percentage increase in serum creatinine of at least 50% (1.5-fold above baseline); or
3) a reduction in urine output to 0.5 mL/kg/h for at least 6 hours.

34
Q

usual clinical course of PC-AKI (time periods)

A
  • a rise in serum creatinine beginning within 24 hours of contrast media administration,
  • peaking at about 4 days
  • and then usually returning to baseline by 7 to 10 days.
35
Q

If a potentially at-risk patient’s condition is stable, a creatinine value within _____________ of contrast administration is generally considered sufficient.

A

30 days

pg 27

36
Q

The American College of Radiology Committee on Drugs and Contrast Media currently recommends that no precautions are necessary in diabetic patients taking metformin, unless the eGFR is < _____________ mL/min/1.73 m2 (in which case the patient should not be taking metformin anyway)

A

<30

37
Q

a diabetic patient is on metformin and their GFR is < 30, so you hold their metformin. How long do you hold it for?

A

withheld for 48 hours after contrast media administration and only reinstituted if the renal function is reassessed and found to be acceptable.

38
Q

how much maternally administered contrast media enters breast milk?

A

1%

39
Q

Of contrast media that makes it into breast milk, what % is absorbed through an infant’s Gi tract?

A

1%

40
Q

The reported overall rate of extravasation with power injection for CT ranges from _____________%

A

The reported overall rate of extravasation with power injection for CT ranges from 0.1% to 1.2%.

41
Q

if indwelling lines have been in for _______ is there an increased risk for extravasation when power injecting with CT IV contrast?

A

24 hours

Patients are believed to be at increased risk for extravasation when:

  • more peripheral access sites are used (such as the hand, wrist, foot, and ankle) rather than the antecubital fossa,
  • when utilized indwelling lines have been in place for more than 24 hours (in which case some degree of phlebitis may be present),
  • and when there are multiple punctures into the same vein.
42
Q

What % of extravasation injuries resolve without adverse sequelae?

A

98%

In the remaining 2% of injuries, some patient morbidity develops because contrast media can damage adjacent tissue, likely due to a combination of direct toxic effects and its hyperosmolality.

Adverse effects are usually self-limited, most commonly consisting of prolonged pain or swelling.

43
Q

Severe extravasation injuries (compartment syndrome) occur in _________% of patients with extravasations.

A

<1%

44
Q

% gad excreted into breast milk

A

0.04%

45
Q

% gad contrast absorbed by baby’s gut after drinking breast milk from mom who just got gad

A

1%

46
Q

who gets NSF

A

CKD

with GFR < 30 mL/min/1.73 m2

specifially:

  1. Stage 4: GFR 15-29 mL/min/1.73 m2
  2. Stage 5: GFR < 15 mL/min/1.73 m2
47
Q

pt with eGFR < 30 mL/min/1.73 m2. What three high risk GBCM are absolutely contraindicated

A
  1. gadodiamide [Omniscan®],
  2. gadoversetamide [OptiMark®],
  3. gadopentetate dimeglumine [Magnevist®]
48
Q

mild reaction to contrast media time frame

A

usually resolve in 20-30 min and do NOT require medical treatment

49
Q

for hypotensive patient, what position do you put them in?

A

Elevate legs at least 60 degrees (Trendelenburg position)

50
Q

% of radiologists named in medical malpractice lawsuits each year

A

7%

51
Q

indemnity payment (a sum of money paid as compensation) average in malpractice cases

A

$480,000

52
Q

how much time does the average radiology spend in their career with an unresolved open malpractice claim?

A

19 months

53
Q

level 1 results must be communicated within what timeframe?

(tension pneumothorax, ruptured aortic aneurysm, acute intracerebral hemorrhage, and pneumoperitoneum)

A

60 minutes

54
Q

level 2 results must be communicated within what timeframe?

A

12 hours

55
Q

reading room ambient lighting

A

25-50 lux

56
Q

maximum gray value luminance for diagnostic monitors

A

350 dd/m2

57
Q

maximum gray value luminance for mammo monitors

A

420 cd/m2

58
Q

lossless compression of file size

A

3:1

59
Q

lossy compression ratio

A

10:1

60
Q

compression ratios of lossy and lossless

A

Lossy is 10:1

lossless is 3:1

61
Q

how much downtime is allowed per year

A

50 minutes of downtime per year

62
Q

high availability systems are expected to perform at:

A

“four nines”… or 99.99% of uptime

NIS (16 decks)

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