Radiology & Laboratory

Question 1

What are some adverse effects of IV contrast?

Answer 1

• NV
• Hives (urticaria)
• Warmth with injection
• Pain at injection site

Question 2

What are some severe/potentially life threatening IV contrast reactions?

Answer 2

• severe bronchospasm
• laryngeal edema
• LOC
• seizures
• cardiac arrest
• cardiotoxicity
• hypotension, dysrhythmias, precipitation of CHF

Question 3

Contrast induced nephropathy: fairly common–w/in 48hours. What is defined as and what lab test rise and when does it return to baseline?

Answer 3

• serum creatinine and BUN levels rise in first 24 hours– peak within 48-72 hours
• return to baseline 10-14 days
• defined as > 25% increase in serum creatinine w/in 5 days

Question 4

How do you prevent contrast induced nephropathy?

Answer 4

• serum creatinine and BUN drawn w/in 1 week of procedure
• pt well hydrated
• encourage drinking several liters of fluid over 12-24 hours before and after IV contrast admin
• identify high risk pts to team
• discuss alternative studies (benefit v risk)

Question 5

Discuss the importance in withholding metformin with patients receiving IV contrast, what it can cause, and what to check.

Answer 5

May precipitate FATAL lactic acidosis in prescence of renal impairment. Pts receiving iodinated contrast agents should WITHOLD metformin day of procedure and 48 hours after. Check serum creatinine and BUN after 48 hours to see if normal–resume metformin.

Question 6

What do you give if pt at risk for allergic reaction?

Answer 6

• Premeditate with 50mg oral prednisone 13, 7, and 1 hour prior to contrast admin.
• Dihenydramine (Venedryl) 50mg orally, IV, or IM at 1 hour prior to contrast.
• Will NOT eliminate risk, but helps to decrease

Question 7

Name types of GI contrast.

Answer 7

Barium sulfate, Gastrografin (water soluble oral contrast), air, CO2

Question 8

Discuss barium, side affects, precautions, and pt instruction.

Answer 8

• leakage of barium out of GI perf into peritoneum acts as foreign body = peritonitis
• severe constipation, bowel obstruction, obstipation
• instruct pts to use laxatives

Question 9

What is Gastrogafin, when is it used and what are complications and CI

Answer 9

*water soluble IODINATED contrast
*used when bowel obstruction is suspected
*complications = pneumonitis if aspirated, significant diarrhea due to osmotic loading
Risks: elderly, neonates

Question 10

What is the order of increasing radiation out of radiology tests?

Answer 10

MRI, Ultrasound, CXR, Mammogram, XRabdomen, Upper GI, Chest CT, Bone scan

Question 11

What is in a CMP?

Answer 11

Na, K, Cl, CO2, GLU, BUN, Creat, Ca, albumin AST, ALT, ALP, T. Billi, Total protein

Question 12

What is in a BMP?

Answer 12

Na, K, Cl, CO2, Glu, BUN, Creat, Ca

Question 13

What is in a LFT?

Answer 13

albumin, AST (SGOT), ALT (SPGT), ALP (alk phos), T. Billi, D. Billi

Question 14

What is in a renal function panel?

Answer 14

Na, K, Cl, CO2, Glu, BUN, Creat, Ca, albumin, inorganic phosphate

Question 15

What is in a lipid panel?

Answer 15

total cholesterol, HDL, LDL, triglycerides