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CSA > quality assurance radiology e lec > Flashcards

quality assurance radiology e lec Flashcards

1
Q

what is quality assurance

A

the planned and systematic exclusion of procedures to ensure high quality images of high diagnostic yield at min radiation dosage

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2
Q

why is important with quality assurance

A

getting it right the first time
procedures in place to get a high quality image
overall review with feedback from previous records

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3
Q

why do we do QA

A 
reduces the necessity of retakes 
minimises radiation to patient
minimise costs
minimises inconvenience 
saves time
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4
Q

what is the no 4 core of knowledge

A

a person physically directing medical exposure is expected to have an acquired the principles of QA and quality control applied to both equip and technique

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5
Q

what is the purpose of QA

A

adequate diagnostic information
radiation doses need to be as low as possible
relevant statutory requirements

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6
Q

who should do it

A 
named person responsoble for implementation 
the whole dental team 
radiation protection supervisor 
operator 
dental nurse
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7
Q

how should we do it

A

comprehensive programme
inexpensive
shouldn’t require infrequent verification and modification
formal records to be kept and frequency of checks to be defined

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8
Q

the aim of QA programme

A

written down common sense

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9
Q

what are the essential procedures

A 
image quality 
patient dose and x ray equipment 
darkroom films and processing
training 
audits
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10
Q

how is quality rated

A

prospective evaluation:

retrospective evaluation

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11
Q

what is prospective evaluation

A

ratings are assigned and recorded as viewed. analysis of results at intervals not greater than 6 months

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12
Q

retrospective evaluation

A

representative sample drawn at regular intervals and rated and recorded
analysis not greater than 6 month

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13
Q

rating of image quality

A

excellent
acceptable
unacceptable errors

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14
Q

what does it mean if an imagine quality is excellent

A

no errors of prep

exposure, positioning, processing or handling

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15
Q

what does an image quality mean if its acceptable

A

some errors but which do not detect from the diagnostic utility of the radiograph

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16
Q

what does an image quality mean if its unacceptable errors

A

render the radiograph diagnostically unacceptable

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17
Q

what is the issue with image quality

A

it is subjective eg one persons acceptable is another persons unacceptable

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18
Q

quality ratings should be kept with

A

any actions taken

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19
Q

what do we do if there is an unacceptable radiograph

A

record the date, nature of fault, known or suspected cause, number of repeat radiographs

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20
Q

what do we need to look at in regards to patient dose and x ray equipment

A

need to monitor patient dose
low as practicable- x ray must comply with standards
if the representative dose is higher than the diagnostic reference levels( DRL) and review needs to be carried out
routine surveillance

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21
Q

what is the equipment consist of

A

X ray set
image receptor
intensifying screens and cassettes
viewing boxes

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22
Q

the x ray set: electrical safety

A

must comply with the latest regulations including safe use of work equipment, and guidance on the provision and use of work equipment regulations 1998

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23
Q

who checks equipment

A

appropriately qualified person

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24
Q

what do we also need to write when we check equipment

A

records of maintenance checks

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25
Q

what tests to dental x ray equipment go under

A

routine tests
acceptance tests
critical examination

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26
Q

what is the critical examination test

A

legal responsibility of the installer but the legal person is advised to obtain it
also the installer must consult with the radiation protection adviser (RPA)

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27
Q

what does the installer need to consult the RPA about

A

in regards to nature, extent, and results of examination

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28
Q

what is the essential content of the critical examination

A 
clear and unambiguous description  of equipment and location 
acceptability of location 
evaluation of warning signals 
evaluation of exposure control 
sufficient radiation protection 
evaluation of safety systems
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29
Q

what statement needs to be given to the user

A

provided with adequate info about proper use, testing and maintenance

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30
Q

who is responsible of carrying out the the acceptance test

A

legal person

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31
Q

who needs to be consulted in the acceptance test

A

the RPA

32
Q

what should the routine test values be compared against

A

baseline values

33
Q

what in regards to dosage needs to be tested

A

if the equipment is operating within agreed parameters

and assessment of typical patient dose for comparison with DRL

34
Q

how is the routine etch different

A

different emphasis

35
Q

what does the routine test confirm

A

no significant change to equipment and location

36
Q

what can we compare our previous results with

A

with our actual results of the routine test

37
Q

which body analyses the results form the x ray

A

THE NRBP( national radiological protection board)

38
Q

what does the image look like if you have poor contact

A

slightly blurry

39
Q

what is included in the inventory of x ray equipment

A 
name of manufacturer 
model number 
serial number 
year of manufacture 
year of installation
40
Q

how are the errors categorised

A
  1. patient prep
  2. patient positioning
    3 exposure
    4 processing
    5 film handling
41
Q

what do we need to be aware of when taking x rays

A 
patients jewellery- lip piercings
necklace, earrings
and glasses 
braces 
hair grips 
dentures
42
Q

what patient errors can occur

A

cone cutting- can be an error with the patient, x ray tube or film holder

43
Q

how should a bitewing be taken

A

should be the occlusal plane almost horizontal parallel with the long axis of the film
no more overlap of enamel than half the thickness of enamel

44
Q

what is the percentage of errors if no film holders are used

A

28%

45
Q

what is the percentage of errors if film holders are used

A

4%

46
Q

what is the issue with panoramic positioning

A

very susceptible to patient positioning errors esp anteriors

47
Q

what does it usually mean if we see black on an x ray

A

over exposure to radiation or light

48
Q

what could be shown on the panoramic radiograph

A

a very obvious white shadowing in the central region due to slumping

49
Q

what are the classes of malocclusion

A 
class 1- normal incisal relationship- just slightly overlapping the lower incisor 
class 2- upper incisor have an increased overbite either anteroposteriorly or sup inferiorly  
class 3- the upper incisors are behind the lower incisors
50
Q

what can the panoramic radiograph look like if the patient is moving their tongue

A

obvious black shadowing on the mandible and a white undulating shadow line

51
Q

what is recommended when taking a panoramic

A

it is recommended to have the patient put their tongue on the roof of their mouth

52
Q

what can we use for adequate panoramic positioning

A

bite block
chin rest
use light bean diaphragms-vertical and horizontal lights to help with positioning

53
Q

where do light beam diaphragms help position

A

mid face
canine region
frankfort plane

54
Q

what is the frankfort plane

A

a line from the tragus of the ear through the palpable bony infraorbital rim area and is parallel to the floor

55
Q

what can go wrong with exposure factors

A

underexposure
overexposure
double exposure]

56
Q

what exposure factors are under our control

A

depends on machine and technique
kV
time
mA

57
Q

what factor can we control in a panoramic

A

time

58
Q

what should you be given when you have an intra oral set installed

A

should be given typical exposure values eg from lower molar PA
and you should extrapolate

59
Q

what can you work out from the typical exposure values given

A

extrapolate

list of typical exposure values for different techniques, different sizes of patient and different areas of the mouth

60
Q

what should viewing conditions be like

A

use proper viewing box- with analogue film
get rid of extraneous light
magnifying glass
x viewer- which blacks out extraneous light with a magnifying glass

61
Q

how many % of dental practices used 50% greater exposure than was required due to faulty processing

A

30%

62
Q

why can pale films develop

A

due to exhausted developer
over diluted developer
time too short
temperature too low

63
Q

why can dark films develop

A

too long in the developer
concentration in the developer too much
temperature too high
developer contaminated by fixer

64
Q

why do we get low contrast

A 
overdevelopment
underdevelopment
fixer contamination
inadequate fixation
fixer exhaustion
65
Q

who lays down the standards of QA films and processing

A

suppliers

66
Q

what standards are laid down by suppliers in regards to QA films and processing

A 
film speed
expiry date
storage conditions
processing conditions
frequency of changing solutions
cleaning instructions for automatic processors
67
Q

what are some QA procedures put in place

A

records to control film stock
records to control and validate chemical changes
cleaning procedures for automatic processes

68
Q

how do you monitor chemicals

A

expose test object( standard distance and time)
developed in new chemical
used as reference
at regular intervals expose new film under same conditions
compare with reference

69
Q

what can you use as a test object

A

pre prepared strips
step wedge
teeth

70
Q

what do we need to be careful of when taking a panoramic but in regards to gloves

A

the talc from our gloves can transfer on the film when we are adjusting it and leave finger print marks on the radiograph

71
Q

what are crimp marks

A

semi lunar dark marks which are due to bending of the films

72
Q

how are you meant to store sheet film

A

upright as if something presses on the film it can result in static electricity showing up on the film

73
Q

what do we need to do for QA for darkrooms processing

A

routine tests for light tightness
safelights
checks at least every year
keep a log

74
Q

how do you test for light tightness

A

the coin test
put a coin on a exposed film- sensitisies the emulsion and left out with the safelight
and the film processed and see if you can see the outline of the coin- if you see the outline it is not safe

75
Q

what should intensifying screen be cleaned with

A

a lint free cloth and a proprietary cleaner

76
Q

what should be kept in the radiation protection files

A 
QA of working procedures
local rules 
legal persons procedures 
procedural and operational elements
procedures not directly linked to x ray equipment
77
Q

what should the procedure log have

A

the existence of local rules
record each time modified
intervals not exceeding 12 months

CSA (51 decks)

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