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Laboratory Medicine > radiology > Flashcards

radiology Flashcards

1
Q

Radiopaque

A

not allowing the passage of xrays (more white)

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2
Q

Radiolucent

A

allow the passage of xrays (more black)

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3
Q

Describe what xrays are

A

form of ionizaing radiation/electromagnetic wave energy, generated by an electrical source. relatively low energy

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4
Q

How are xrays describe in relation to radiography?

A

x-rays are waveform pockets of energy called photons. the amt of energy in a diagnostic xray photon is measured in electron volts (KeV)

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5
Q

How do short wavelengths and energy relate to xrays?

A

xrays are energy of extremely short wavelength. the shorter the wavelength, the greater the energy and the greater the ability to penetrate various materials

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6
Q

How do xrays produce images?

A

xrays leave the xray tube thru a small opening that regulates the size of the beam. the beam is directed at the part of the body to be imaged. The film or screen is placed behind the patient

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7
Q

Attenuation

A

the greater the density of the tissues, the greater the absorption of the xrays

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8
Q

describe plain films

A

the most common diagnostic xray format, film or digital. no contrast mat’l is used to enhance structures.

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9
Q

What are some examples of plain films?

A

CXR, KUB, skeletal films, dental films

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10
Q

Rank the densities of material in the body from most dense to least dense.

A

metal > bone > muscle > blood > liver > lung > fat > air

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11
Q

What factors affect image quality?

A

motion, thickness of body part, scatter, magnification, distortion

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12
Q

How do determine scatter for best image quality?

A

want beams to be narrow and specific for area, unless you want larger area, then you have to scatter more

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13
Q

How does magnification affect image quality on xray?

A

as an object moves toward the source of the xray beam, its shadow becomes larger. CXR taken from back casts larger shadow on heart and lungs making them seem larger than they really are

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14
Q

How does distortion affect image quality of xrays?

A

if not lined up with the film a whole different view opens

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15
Q

AP chest xray

A

has the machine in the front and the xray film in the back. this makes the heart look larger

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16
Q

PA chest xray

A

has the machine in the back and the xray film in the front. this makes the heart look smaller or normal

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17
Q

Describe fluroscopy

A

moving/real time xrays, images can be recorded and played back or captured as a still picture

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18
Q

What are some examples of fluroscopy?

A

barium swallow, angiography, draining abscesses, intraoperative feedback

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19
Q

What are CTs used for?

A

evaluation of soft tissue and bone as compared to plain xrays

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20
Q

What are CT scans?

A

uses xrays to create 3D pictures of cross-sections of the body

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21
Q

What are the different CT techniques?

A

bone windows, lung windows, venous phase aquisition, IV contrast, oral contrast

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22
Q

What part of the body can a CT image?

A

Any part

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23
Q

What kind of angiographies can CTs perform?

A

pulmonary, cardiac, abdominal, peripheral vessels

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24
Q

Describe the IV contrast used with CT scans?

A

iodinated, cleared thru the kidneys so unable to use in renal failure

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25
Describe the oral contrast used with CT scans?
barium, H2O soluble iodinated contrast. not cleared thru kidneys. may get constipation.
26
What is a CI of using oral barium contrast?
someone who might have GI perforation. could lead to peritonitis
27
Describe what an MRI is?
uses a magnetic field and pulses of radio wave energy to make pictures of organs and structures inside the body. a large magnet aligns our protons thru the delivery of radiofrequency pulse waves
28
What are MRIs useful for?
imaging soft tissues (brain, spinal cord, muscles, tendons, ligaments, ect)
29
Describe the contrast used for MRI studies?
contrast is gadolinium based. can worsen renal failure. SE and allergic rxn are rare
30
What is a CI to having a MRI?
patients with metal in their body
31
Describe how ultrasound works
ultrasound transducer converts electrical energy to a brief pulse of high-frequency sound energy that is transmitted into patient tissues. the transducer then becomes a receiver that detects sound echoes reflected from the tissues
32
Describe the use of ultrasounds
can image most body parts, noninvasive, contrast can be used in special circumstances, technology limited by fat and air
33
Hyperechoic
increased amplitude of ultrasound waves returned. typical of bone and dense tumor tissue "white spots"
34
hypoechoic
decreased amplitude of ultrasound waves returned. typical of air or fluid or tissue that is less dense then what surrounds it "dark spots"
35
describe doppler ultrasound
uses reflected sound waves to evaluate blood as it flows through a blood vessel. flow is measured using velocities
36
What is doppler ultrasound used for?
helpful for determining clots, helpful for evaluation of possible stenosis of the artery and plaque build up,
37
What is nuclear medicine used for?
primarily shows physiologic fxn of system, more organ specific
38
How does nuclear medicine work?
uses a radiotracer (isotope) that's injected into a vein, ingested or inhaled to image organ. the isotope emits gamma rays and this energy is imaged
39
How is the dosage of isotope for nuclear medicine determined?
based on size of the patient. an obese patient needs bigger isotope dose. this means that they have more radiation exposure
40
What are the different types of nuclear medicine studies?
bone scan, PET, myocardial perfusion scan, MUGA scan, cardiac viability scan, parathyroid scan, thyroid scan, hepatobiliary scan, VQ scan, lymphoscintingrapphy
41
What is a bone scan used for?
evaluates bone related pathology: bone pain, stress fractures, bone lesions, infection
42
What is PET scan used for?
evaluation of cancer metastatsis
43
What is a myocardial perfusion scan used for?
evaluation of cardiac ischemia and cardiac fxn
44
What is a MUGA scan used for?
cardiac fxn
45
What is a cardiac viability scan used for?
evaluates for hibernating myocardium to determine if revascularization would be beneficial
46
What is a parathyroid scan used for?
evaluation of adnomas
47
What is a thyroid scan used for?
evaluation of nodules and hyperthyroidism
48
What is a hepatobiliary scan used for?
evaluation of gall bladder disease
49
What is a VQ scan used for?
evaluation for pulmonary embolus
50
What is a lymphoscintigraphy used for?
evaluation of the lymph system for disease
51
What is a red cell study used for?
evaluation for occult bleeding when unable to determine source of bleeding by endoscopy
52
describe PET
produces 3d image of fxnal processes of in the body. commonly used to evaluate for cancer metastasis, $$$
53
How does a PET scan work?
radioactive isotope injected and detected by gamma ray technology. tumors show up as more metabolically active than the surrounding tissue
54
how is angiography used?
imaging blood vessels, uses fluoroscopy but can be obtained w/MRI and CT technologies. requires IV contrast
55
What are some risks of angiography?
thrombosis, dissection, bleeding, complications from sedation, complications from IV contrast, careful in renal failure
56
What is IV contrast?
used to light up the vasculature, the kidneys, bladder in plain xrays, fluoroscopy, and CT scan. spreads thru the blood stream, excreted by glomerular filtration in kidneys
57
What are CI to IV contrast?
shellfish or iodine allergy
58
What are adverse effects to IV contrast?
allergic rxn, n/v, hives, feeling of warmth with injection, pain at site of injection
59
What are some life threatening rxns to contrast?
bronchospasm, laryngeal edema, LOC, seizures, cardiac arrest, complete cardiac collapse, cardiotoxicity, hypotension, dysrhythmias, precipitation of CHF
60
What is contrast induced nephropathy?
acute renal failure occurring w/in 48 hrs of contrast administration. fairly common and preventable. defined as > 25% increase in serum creatinine
61
How do you prevent contrast induced nephropathy?
check creatinine and BUN within one week of any contrast procedure. pt should be well hydrated
62
What is metformin used for?
oral anti-hyperglycemic used for treatment of type II DM
63
What could happen when a pt using metformin has IV contrast?
may precipitate fatal lactic acidosis in the presence of renal impairment
64
What are FDA recommendations for metformin and IV contrast?
withhold metformin in patient receiving iodinated contrasts. keep discontinued for 48 hrs after delivery of contrast. then check creatinine and BUN, if it's normal resume metformin
65
What premedication can be used to reduce risk of allergic rxn to IV contrast?
prednisone and diphenydramine (benadryl)
66
What are the different types of GI contrast?
barium sulfate, water soluble oral contrast, air, CO2
67
Describe barium contrast adverse effects?
leakage of barium out GI perforation into peritoneum. acts as foreign body rxn and worsens peritonitis. severe constipation, obstipation
68
Describe water soluble iodinated contrast use
used when bowel obstruction is suspected. dilute solns are used for bowel opacification for CT scans
69
What are the risks of water soluble iodinated contrast?
if aspirated can cause pneumonitis, can cause diarrhea. risk for elderly and neonates
70
Rank radiation exposure in studies from highest to lowest
Upper GI > chest CT > xray abdomen > bone scan > mammogram > CXR >>>ultrasound/MRI (0)

Laboratory Medicine (2 decks)

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