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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
Q

Describe the oral contrast used with CT scans?

A

barium, H2O soluble iodinated contrast. not cleared thru kidneys. may get constipation.

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26
Q

What is a CI of using oral barium contrast?

A

someone who might have GI perforation. could lead to peritonitis

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27
Q

Describe what an MRI is?

A

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

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28
Q

What are MRIs useful for?

A

imaging soft tissues (brain, spinal cord, muscles, tendons, ligaments, ect)

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29
Q

Describe the contrast used for MRI studies?

A

contrast is gadolinium based. can worsen renal failure. SE and allergic rxn are rare

30
Q

What is a CI to having a MRI?

A

patients with metal in their body

31
Q

Describe how ultrasound works

A

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
Q

Describe the use of ultrasounds

A

can image most body parts, noninvasive, contrast can be used in special circumstances, technology limited by fat and air

33
Q

Hyperechoic

A

increased amplitude of ultrasound waves returned. typical of bone and dense tumor tissue “white spots”

34
Q

hypoechoic

A

decreased amplitude of ultrasound waves returned. typical of air or fluid or tissue that is less dense then what surrounds it “dark spots”

35
Q

describe doppler ultrasound

A

uses reflected sound waves to evaluate blood as it flows through a blood vessel. flow is measured using velocities

36
Q

What is doppler ultrasound used for?

A

helpful for determining clots, helpful for evaluation of possible stenosis of the artery and plaque build up,

37
Q

What is nuclear medicine used for?

A

primarily shows physiologic fxn of system, more organ specific

38
Q

How does nuclear medicine work?

A

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
Q

How is the dosage of isotope for nuclear medicine determined?

A

based on size of the patient. an obese patient needs bigger isotope dose. this means that they have more radiation exposure

40
Q

What are the different types of nuclear medicine studies?

A

bone scan, PET, myocardial perfusion scan, MUGA scan, cardiac viability scan, parathyroid scan, thyroid scan, hepatobiliary scan, VQ scan, lymphoscintingrapphy

41
Q

What is a bone scan used for?

A

evaluates bone related pathology: bone pain, stress fractures, bone lesions, infection

42
Q

What is PET scan used for?

A

evaluation of cancer metastatsis

43
Q

What is a myocardial perfusion scan used for?

A

evaluation of cardiac ischemia and cardiac fxn

44
Q

What is a MUGA scan used for?

A

cardiac fxn

45
Q

What is a cardiac viability scan used for?

A

evaluates for hibernating myocardium to determine if revascularization would be beneficial

46
Q

What is a parathyroid scan used for?

A

evaluation of adnomas

47
Q

What is a thyroid scan used for?

A

evaluation of nodules and hyperthyroidism

48
Q

What is a hepatobiliary scan used for?

A

evaluation of gall bladder disease

49
Q

What is a VQ scan used for?

A

evaluation for pulmonary embolus

50
Q

What is a lymphoscintigraphy used for?

A

evaluation of the lymph system for disease

51
Q

What is a red cell study used for?

A

evaluation for occult bleeding when unable to determine source of bleeding by endoscopy

52
Q

describe PET

A

produces 3d image of fxnal processes of in the body. commonly used to evaluate for cancer metastasis, $$$

53
Q

How does a PET scan work?

A

radioactive isotope injected and detected by gamma ray technology. tumors show up as more metabolically active than the surrounding tissue

54
Q

how is angiography used?

A

imaging blood vessels, uses fluoroscopy but can be obtained w/MRI and CT technologies. requires IV contrast

55
Q

What are some risks of angiography?

A

thrombosis, dissection, bleeding, complications from sedation, complications from IV contrast, careful in renal failure

56
Q

What is IV contrast?

A

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
Q

What are CI to IV contrast?

A

shellfish or iodine allergy

58
Q

What are adverse effects to IV contrast?

A

allergic rxn, n/v, hives, feeling of warmth with injection, pain at site of injection

59
Q

What are some life threatening rxns to contrast?

A

bronchospasm, laryngeal edema, LOC, seizures, cardiac arrest, complete cardiac collapse, cardiotoxicity, hypotension, dysrhythmias, precipitation of CHF

60
Q

What is contrast induced nephropathy?

A

acute renal failure occurring w/in 48 hrs of contrast administration. fairly common and preventable. defined as > 25% increase in serum creatinine

61
Q

How do you prevent contrast induced nephropathy?

A

check creatinine and BUN within one week of any contrast procedure. pt should be well hydrated

62
Q

What is metformin used for?

A

oral anti-hyperglycemic used for treatment of type II DM

63
Q

What could happen when a pt using metformin has IV contrast?

A

may precipitate fatal lactic acidosis in the presence of renal impairment

64
Q

What are FDA recommendations for metformin and IV contrast?

A

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
Q

What premedication can be used to reduce risk of allergic rxn to IV contrast?

A

prednisone and diphenydramine (benadryl)

66
Q

What are the different types of GI contrast?

A

barium sulfate, water soluble oral contrast, air, CO2

67
Q

Describe barium contrast adverse effects?

A

leakage of barium out GI perforation into peritoneum. acts as foreign body rxn and worsens peritonitis. severe constipation, obstipation

68
Q

Describe water soluble iodinated contrast use

A

used when bowel obstruction is suspected. dilute solns are used for bowel opacification for CT scans

69
Q

What are the risks of water soluble iodinated contrast?

A

if aspirated can cause pneumonitis, can cause diarrhea. risk for elderly and neonates

70
Q

Rank radiation exposure in studies from highest to lowest

A

Upper GI > chest CT > xray abdomen > bone scan > mammogram > CXR&raquo_space;>ultrasound/MRI (0)

Laboratory Medicine (2 decks)

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