Radiology/ Laser Safety (Mordecai) Exam 1 Flashcards by Kaitlyn McDow

Who discovered X-ray therapy in 1895?

A) Thomas Edison
B) Marie Curie
C) Wilhelm Roentgen
D) Alexander Graham Bell

C) Wilhelm Roentgen

While experimenting with currents in a glass tube noticed that a fluorescent screen in the lab began to glow.
Placed objects between the screen and the tube –> called “x” ray = something unknown

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Matching

Match the Type of Radiation with its definition

1 - C) Electromagnetic Radiation
2 - A) Mechanical Radiation
3 - B) Nuclear (Neutron) Radiation
4 - D) Cosmic (Beta) Radiation

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What characteristic best describes non-ionizing radiation?

A) It creates ions by knocking electrons off atoms
B) It is unstable and can lead to nuclear decay
C) It is stable and does not break molecular bonds
D) It disrupts cellular DNA directly by breaking molecular bonds

C) It is stable and cannot knock electrons off atoms or break molecular bonds

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Which of the following is an example of non-ionizing radiation that could be harmful due to heat energy?
Select 2

A) X-rays
B) Gamma rays
C) Radio waves
D) Alpha particles
E) Microwaves
F) Toasters

C) Radio waves
E) Microwaves

The Brave Little Toaster (1987)

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What happens to atoms when exposed to ionizing radiation?

A) They lose protons, forming new elements
B) They lose energy, becoming ionized
C) Their electrons are knocked off, creating ions
D) Their nuclei become unstable, leading to fission

C) Their electrons are knocked off, creating ions

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What is a significant intracellular consequence of ion electrical charges from ionizing radiation? Select 2

A) Increased DNA cellular repair mechanisms
B) Breaks in DNA chains causing apoptosis
C) Enhanced immune response
D) Additive of non-ionized particles in DNA
E) Mutations in DNA chains causing cancer

B) Breaks in DNA chains causing apoptosis
E) Mutations in DNA chains causing cancer

Mutated sperm or egg cell = birth defects

Shorse…or is it a Horsk?

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Which statement best describes the risk of repeated exposure to ionizing radiation?

A) The risk decreases with each exposure
B) The risk is cumulative with each exposure
C) The risk resets after a 6 months
D) The risk can be subtractive with exposure

B) The risk is cumulative, increasing with more exposure
additive risk - accumulates over time

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What is the main difference between X-rays and visible light rays?

A) X-rays are mechanical energy, while visible light is electromagnetic energy
B) The energy level, which is related to wavelength
C) X-rays can be seen by the human eye, while visible light cannot
D) The energy level, which is related to nuclear radiation

B) The energy level, which is related to wavelength

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Which of the following statements is true about X-rays and visible light rays?

A) Both are forms of electromagnetic energy carried by photons
B) Both have the same wavelength and carried by photons
C) X-rays have longer wavelengths than visible light rays
D) Both are visible to the human eye

A) Both are forms of electromagnetic energy carried by photons

Photons are light particles

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X-rays have __ wavelengths and __ energy.

A) longer, lower
B) shorter, lower
C) same, higher
D) shorter, higher

D) shorter, higher
* * X-rays have shorter wavelengths and higher energy.

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Radio waves have ___ wavelengths and ___ energy.

A) shorter, higher
B) longer, higher energy
C) shorter, lower energy
D) longer, lower energy

D) longer, lower

- Radio waves have longer wavelengths and lower energy.

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True or False

We can see x-ray and radio waves on either side of the visible spectrum

False
We see the shorter wavelength/higher energy X-ray waves only right side
We see the longer wavelength/lower energyradio waves only left side

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What causes light to be emitted from an atom?

A) The movement of protons within the nucleus
B) The collision of atoms with each other
C) The movement of electrons in atoms
D) The expansion of the atomic nucleus

C) The movement of electrons in atoms

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When an atom is heated, moving particles excite the atom, causing the electron to jump to a __________ energy level/orbit.

A) Lower
B) Neutral
C) Higher
D) Unchanged

C) Higher

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What must happen for an electron to fall back to its original orbit?

A) It must absorb more energy
B) It must lose mass
C) It must release energy
D) It must stop moving

C) It must release energy in the form of a photon

STNG

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Why are small atoms less likely to absorb X-ray photons?

A) Their electron orbitals are further apart, with large jumps in energy
B) Their electron orbitals are closer together, with low jumps in energy
C) They have more electron orbitals with lower energy
D) Their electrons move faster at higher orbitals

B) Their electron orbitals are closer together, with low jumps in energy

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On X-ray images, soft tissues tend to appear __________ because they are less likely to absorb X-ray photons.

A) Brighter
B) Lighter
C) Grayish
D) Clear

C) Grayish

Small atoms – closer together

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Why do bones appear lighter and brighter on X-ray images compared to soft tissues?

A) Bones are composed of small atoms that reflect light
B) Bones are composed of large atoms that absorb more X-rays
C) Bones are denser and absorb less X-rays
D) Bones have more atoms that scatter X-rays

B) Bones are composed of large atoms that absorb more X-ray photons

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Which type of atoms are more likely to absorb photons, such as X-rays?

A) Small atoms with closely spaced orbitals
B) Large atoms with closely spaced orbitals
C) Large atoms with greater energy differences between orbitals
D) Small atoms with greater energy differences between orbitals

C) Large atoms with greater energy differences between orbitals

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What makes up an electrode pair of an X-ray machine? (select 2)
A) Cathode
B) Canode
C) Anode
D) Anole

B) Cathode
C) Anode

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What role does the cathode play in the X-ray machine?

A) It is a positively charged plate that attracts electrons
B) It heats a filament, causing electrons to fly off
C) It creates photons that pass through the body
D) It focuses the X-ray beam on the target area

B) It heats a filament, causing electrons to fly off

Negative charged side of the x-ray tube

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What happens to the electrons after they are released from the cathode?

A) They are absorbed by the body
B) They are focused into a beam of light
C) They are attracted to the anode
D) They immediately generate photons

C) They are attracted across the tube to the positively charged anode

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What is the primary material used to make the anode in an X-ray machine?

A) Thorium
B) Tantallium
C) Tungsten
D) Thallium

C) Tungsten

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What is the primary function of the window in the thick shield that surrounds the X-ray machine?

A) Allows a narrow beam of photons to escape
B) To protect the patient from photons
C) To cool the machine during operation
D) Fires photons whenever tissue gets too close

A) Allows a narrow beam of photons to escape

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What role does the camera on the opposite side of the X-ray machine play? A) It generates the X-rays B) It records the pattern of X-ray photons C) It focuses the beam onto the desired area D) It adjusts the intensity of the X-ray beam

B) It records the pattern of X-ray photons ## Footnote Slide 11

The image created by an X-ray is the result of a __________ reaction on film. A) Electrical B) Radiation C) Mechanical D) Chemical

D) Chemical ## Footnote Slide 11

__________ light can darken or lighten the X-ray image. A) Infrared B) Ultraviolet C) Ambient D) Reflected

C) Ambient ## Footnote Slide 11

Changes in the intensity of the X-ray beam can result in ____ or ____ exposure, altering the appearance of the image. A) Over / under B) Left / right C) Deep / shallow D) Strong / weak

A) Over / under ## Footnote Slide 11

Which of the following is NOT a common use of radiography (standard X-rays)? A) Bone fractures B) Placement of feeding tubes C) Diagnosis of aneurysms D) Detection of foreign objects

C) Diagnosis of aneurysms | also used for Mammography ## Footnote Slide 12

Computed Tomography (CT) scans combine X-rays with __________ to create accurate 3D images. A) Ultrasound B) Magnetic resonance C) Computer processing D) Radiation therapy

C) Computer processing *Helps to diagnose the anatomical pathology – where the tumor is and exact measurements* ## Footnote Slide 12

Fluoroscopy involves the use of constant X-rays to create __________ images, often with or without contrast. A) Still B) Blurred C) Real-time D) 3D

C) Real-time ## Footnote Slide 12

Which imaging technique involves high levels of xray exposure and is often used for procedures such as aneurysm coiling and cardiac stent placement? A) Radiography B) Mammography C) Computed Tomography (CT) D) Fluoroscopy

D) Fluoroscopy | *need to wear lead at all times ## Footnote Slide 12

# True or False X-rays cannot be used therapeutically

False They can be used for radiation therapy * At higher doses, radiation can damage the cancer cell's DNA ## Footnote Slide 13

What is the most common side effect of radiation therapy? A) Hair loss B) Diarrhea C) Urinary changes D) Fatigue

D) Fatigue ## Footnote Slide 14

Which area of the body is associated with skin changes, edema, and tenderness as side effects of X-ray treatment? A) Head/neck B) Pelvis C) Breast D) Abdomen

C) Breast ## Footnote Slide 14

Which of the following side effects is commonly associated with X-ray treatment of the rectum? A) Hair loss B) Infertility C) Nausea/Vomiting D) Taste changes

B) Infertility *Fatigue, diarrhea, Sexual Problems and urinary changes* ## Footnote Slide 14

Which of the following are common side effects of X-ray treatment for the abdomen? (Select 3) A) Diarrhea B) Skin changes C) Blurry vision D) Urinary changes E) Headache

A) Diarrhea B) Skin changes D) Urinary changes *N/V,Fatigue* ## Footnote Slide 14

Which is **NOT** a side effect for X-ray treatment of the head/neck? A) Mouth changes B) Dysphagia C) Taste changes D) SOB E) Hair loss

D) SOB ## Footnote Slide 14

# True or False Hypothyroidism is a side effect of Head/Neck radiation therapy

True ## Footnote Slide 14

Which of the following side effects are commonly associated with X-ray treatment for the brain? (Select 3) A) Headache B) Blurry vision C) Edema D) Nausea/Vomiting E) Cough

A) Headache B) Blurry vision D) Nausea/Vomiting *Fatigue, Hair Loss, skin changes* ## Footnote Slide 14

Which of the following are common side effects of X-ray treatment for the chest? A) Cough, dysphagia, headache B) Cough, shortness of breath, dysphagia C) Dysphagia, hair loss, urinary changes D) Fatigue, skin changes, dysphagia

B) Cough, shortness of breath, dysphagia *Fatigue, Hairloss* ## Footnote slide 14

What unit is used to measure radiation doses, nearly equivalent to the Rad? A) Sievert B) Millisievert C) Rem D) Curie

C) Rem *Radiation dose times a weighting factor* ## Footnote Slide 15

Radiation doses are often measured in __________, which is 1/1000 of a Rem. A) Millirad B) Millicurie C) Millisievert D) Millirem

D) Millirem (mrem) ## Footnote Slide 15

How much radiation exposure is considered the annual allowable dose for the lens of the **eye**? A) <500 mrem B) <5,000 mrem C) <15,000 mrem D) <50,000 mrem

C) <15,000 mrem ## Footnote Slide 15

What is the maximum annual allowable dose of radiation for *pregnant* individuals? A) <15,000 mrem B) <50,000 mrem C) <500 mrem D) <5,000 mrem

C) <500 mrem *prefer to occur after 2nd trimester! Less likely to affect replicating cells within the fetus/organogenesis* ## Footnote Slide 15

The annual allowable radiation dose for **extremities** is less than __________ mrem. A) 500 B) 5,000 C) 15,000 D) 50,000

D) 50,000 ## Footnote Slide 15

The annual allowable radiation dose for the **whole body** is less than __________ mrem. A) 500 B) 5,000 C) 15,000 D) 50,000

B) 5,000 ## Footnote Slide 15

Which of the following is a direct source of radiation? Select 2 A) Gamma rays from radioactive materials B) Primary X-ray beams C) Cosmic rays from space D) Beta particles from nuclear reactors E) Leakage from equipment F) Theta particles from space

B) Primary X-ray beams E) Leakage from equipment ## Footnote Slide 16

What is the typical amount of radiation exposure (in mrem) from a Coronary Angiogram? A) 5-10 mrem B) 1,500 mrem C) 5,000 mrem D) 5,700 mrem

B) 1,500 mrem ## Footnote Slide 16

A Chest X-ray (CXR) typically results in a radiation dose of __________ mrem. A) 5-10 B) 10-15 C) 10-20 D) 15-20

A) 5-10 ## Footnote Slide 16

The amount of radiation exposure from an angioplasty procedure is typically __________ mrem. A) 5-10 B) 1,500 C) 5,000 D) 5,700

D) 5,700 ## Footnote Slide 16

The amount of radiation from a CT scan is approximately __________ mrem. A) 5-10 B) 1,500 C) 5,000 D) 5,700

C) 5,000 ## Footnote Slide 16

Which procedure results in the highest radiation dose? A) Chest X-ray (CXR) B) Coronary Angiogram C) Angioplasty D) Computed Tomography (CT)

C) Angioplasty ## Footnote Slide 16

Which of the following describes what a **indirect, scattered** source of radiation? A) Direct X-ray beams targeting the patient B) X-rays reflected off surfaces C) Natural radiation from the atmosphere D) Radiation emitted directly from radioactive materials

B) X-rays reflected off surfaces *like tables, patients, and other objects* ## Footnote Slide 17

What happens when the **collimation** or the *width* of the beam is **narrowed** during an X-ray procedure? A) The scatter stays the same B) No scatter occurs C) More scatter occurs D) Less scatter occurs

D) Less scatter occurs **Wider the collimation, the more radiation scatter)** ## Footnote Slide 17

When object thickness increases (obese), __________ scatter will occur. A) More B) Less C) Same D) No

A) More | clarified by Dr. Mordecai ## Footnote Slide 17

How does *increasing* the air gap (the distance from the patient) affect the amount of scattered radiation? A) It decreases scatter B) It increases scatter C) It has no effect on scatter D) It focuses the scatter

B) It increases scatter ## Footnote Slide 17

Fetal radiation doses below __________ mrem are unlikely to cause effects, especially after 20 weeks of pregnancy. A) 1,000 B) 5,000 C) 10,000 D) 50,000

C) 10,000 ## Footnote Slide 18

Which of the following are key methods to reduce radiation exposure according to the ALARA principle? (Select 3) A) Time B) Distance C) Temperature D) Shielding E) Frequency

A) Time - Reduce the time spent near the beam entry B) Distance - further away the less exposure D) Shielding -Lead aprons, portable shields, thyroid, lead glasses ## Footnote slide 19

Doubling the distance from a direct radiation source reduces the exposure rate to __________ of the original level. A) Half B) One-third C) One-fourth D) One-fifth

C) One-fourth Basically it will go down to 1/4 of what the original level was. So 1/4th of 20mrem is 5mrem. ## Footnote Slide 19

What distance from the patient is recommended to reduce scatter radiation? A) 3 feet B) 6 feet C) 9 feet D) 12 feet

B) 6 feet *attempt to be > 6ft from patient* ## Footnote Sldie 19

When wearing two dosimeter badges, one should be worn on the collar outside the apron, and the other should be worn on the __________ inside the apron. A) Chest B) Back C) Waist D) Shoulder

C) Waist ## Footnote Slide 20

# The DONTS Do not share dosimeters with others or leave them in the car because __________ radiation can interfere with their accuracy. A) Solar B) Gamma C) X-ray D) Cosmic

D) Cosmic ## Footnote Slide 20

The principles of MRI are based on interactions between: A) Electromagnetic waves and electrons B) Static magnetic fields and atom nuclei C) Sound waves and bones D) Radioactive isotopes and tissues

B) Static magnetic fields and (individual) atom nuclei ## Footnote Slide 24

In MRI, a magnetic field is used to orient the nuclei of ____ molecules to the north-south poles. A) Oxygen B) Carbon C) Hydrogen D) Nitrogen

C) Hydrogen ## Footnote Slide 24

How does MRI create an image? A) By using X-rays to penetrate tissues B) By reflecting sound waves off tissues C) By using radio wave pulses D) By ionizing molecules to produce a visual representation

C) By using radio wave pulses *to change the orientation of specific atoms, which radiates energy to create an image* ## Footnote Slide 24

In MRI, contrast is generated by: A) The absorption of X-rays by tissues B) The reflection of sound waves from tissues C) The time till tissue relaxation when radiofrequency turned off D) The emission of gamma rays from tissues

C) The time till tissue relaxation when radiofrequency turned off * When the radio frequency is turned off, protons realign with the magnetic field releasing electromagnetic energy. ## Footnote Slide 25

Which of the following factors affect the contrast generated in an MRI? (Select 2) A) The temperature of the room B) Various densities of hydrogen nuclei in tissues C) Different chemical and physical properties of tissues D) The speed of sound in tissues

B) Various densities of hydrogen nuclei in tissues C) Different chemical and physical properties of tissues ## Footnote Slide 25

Which of the following are the two contrast views used in MRI? A) T3 and T4 B) Alpha and Beta C) T1 and T2 D) Gamma and Delta

C) T1 and T2 ## Footnote Slide 25

What happens during T1 contrast imaging in MRI? A) The magnetic vector relaxes B) The magnetic vector aligns C) The magnetic vector accelerates D) The magnetic vector remains stationary

A) The magnetic vector relaxes * Radio frequency is **off** and not trying to move the orientation of the atom * Provides a good *grey-white* matter contrast * **Good for viewing anatomy** ## Footnote Slide 25

How do fat and water appear on a T1-weighted MRI image? A) Fat appears dark; water appears bright B) Fat appears bright; water appears dark C) Both fat and water appear bright D) Both fat and water appear dark

B) Fat appears bright; water appears dark *provides good grey-white matter contrast…anatomy* ## Footnote Slide 25

What happens during T2 contrast imaging in MRI? A) The axial spin relaxes B) The magnetic vector aligns C) The axial spin accelerates D) The magnetic vector remains stationary

A) The axial spin relaxes * Radio frequency turned **on** * Great for identifying tissue **edema** * **Good for viewing pathology** ## Footnote Slide 25

On a T2-weighted image, fat appears ________. Water will appear ________on a T2-weighted MRI image. A) Fat appears dark; water appears bright B) Fat appears bright; water appears dark C) Both fat and water appear bright D) Both fat and water appear dark

A) Fat appears dark; water appears bright *identifies tissue edema easily…pathology* ## Footnote Slide 25

What is the most common contrast material used for MRI? A) Iodine B) Barium C) Gadolinium D) Technetium

C) Gadolinium ## Footnote Slide 26

How does gadolinium enhance the quality of MRI images? A) By reflecting sound waves B) By absorbing X-rays C) By altering the magnetic properties of nearby water molecules D) By increasing tissue temperature

C) By altering the magnetic properties of nearby water molecules ## Footnote Slide 26

Which of the following are potential side effects of gadolinium when used as a contrast agent in MRI? (Select all that apply-3) A) Itching B) Rash C) Abnormal skin sensation D) Fever E) Dizziness

A) Itching B) Rash C) Abnormal skin sensation *Rare severe reactions* ## Footnote Slide 26

With normal kidney function (GFR), gadolinium clears from the body within: A) 6 hours B) 12 hours C) 24 hours D) 48 hours

C) 24 hours ## Footnote Slide 26

# True or False The magnetic field always on.

True ## Footnote Slide 27

Ferromagnetic objects in a magnetic field experience which of the following forces? (Select 2) A) Attractive force pulling them toward the center of the magnet B) Torque attempting to line them up with the magnetic field C) Repulsive force pushing them away from the magnetic field D) Neutral force with no effect

A) Attractive force pulling them toward the center of the magnet B) Torque attempting to line them up with the magnetic field ## Footnote Slide 27

Which of the following item(s) is/are MRI-compatible? A) Oxygen/nitrous oxide tanks B) Anesthesia machine C) Monitors D) Infusion pumps E) Plastic surgical tools F) Stretchers G) Crash carts

E) Plastic surgical tools ## Footnote Slide 27

Which of the following are risks associated with MRI? (Select 4) A) Projectile risk B) Electromagnetic interference C) Radiofrequency energy D) Increased radiation exposure E) Acoustic noise up to 125 dB

A) **Projectile risk** B) **Electromagnetic interference** causing artifacts such as in ECG interpretatio C) **Radiofrequency energy** causing tissue/device heating E) **Acoustic noise** up to 125 dB, requiring hearing protection for CRNA and patient ## Footnote Slide 28

Anesthesia is often used during MRI because it requires multiple image sequences, each taking up to ____ minutes, and any movement can cause image ____. A) 1-2 minutes B) 5-7 minutes C) 10 minutes D) 15-20 minutes E) clarity F) distortion G) blank effect H) increase scan speed

C) 10 minutes F) distortion ## Footnote Slide 29

Which anesthesia techniques can be used for MRI procedures? A) Sedation only B) General anesthesia only C) Both sedation and general anesthesia D) Regional anesthesia only

C) Both sedation and general anesthesia *po or IV; Sevoflurane MRI safe vaporizer; TIVA* ## Footnote Slide 29

Which of the following are key anesthesia care considerations during MRI? (Select 5) A) EKG, pulse oximetry, BP, and capnography every 15 minutes when providing anesthetics B) Airway management (cannula, mask, ETT, or LMA) C) Suction availability D) Use of ventilator only, no spontaneous ventilation allowed E) Minimizing movement F) MRI-compatible infusion pumps or long IV tubing G) Induction in the MRI room only, never in a separate room

A) EKG, pulse oximetry, BP, and capnography every 15 minutes when providing anesthetics B) Airway management (cannula, mask, ETT, or LMA) C) Suction availability E) Minimizing movement (e.g., use of Versed) F) MRI-compatible infusion pumps or long IV tubing * *Complications, have airway access* * *Laryngoscope handles, blades are not MRI compatible, induction done in separate room* ## Footnote Slide 30

What is a key concern with patient positioning during head and neck MRI scans? A) Risk of limb injury B) Airway inaccessibility C) Overheating D) Nerve compression

B) Airway inaccessibility ## Footnote Slide 31

What potential injury should be monitored for during abdominal MRI scans when the patient's arms are positioned over their head? A) Spinal cord injury B) Brachial plexus injury C) Rib fracture D) Hip dislocation

B) Brachial plexus injury ## Footnote Slide 31

Which of the following implanted devices could be affected by an MRI scan? (Select 3) A) Pacemakers B) AICDs (Automatic Implantable Cardioverter Defibrillators) C) Implanted insulin pumps D) Dental fillings

A) Pacemakers B) AICDs C) Implanted insulin pumps ## Footnote Slide 32

What symptoms might occur if a person moves too quickly toward an MRI field (e.g., running into the MRI room)? A) Increased heart rate and sweating B) Dizziness, headache, light flashes, and nausea C) Shortness of breath and chest pain D) Muscle cramps and joint pain

B) Dizziness, headache, light flashes, and nausea *Move calmly in the MRI room.* ## Footnote Slide 32

Which of the following **are** MRI-compatible? (Select all that apply) A) Heart valves B) Endovascular and biliary stents (after eight weeks) C) Coronary stents (immediately) D) Vascular ports and IVC filters E) Orthopedic implants

ALL OF THE ABOVE * Heart valves safe * Endovascular and biliary stents are usually embedded **after eight weeks** * Coronary stents OK **immediately** * Vascular ports and IVC filters are safe * Any Orthopedic implants...titanium, safe; screws are made of lead and **securely in bone.** ## Footnote Slide 32

What does the acronym LASER stand for? A) Light Amplification by Spontaneous Emission of Radiation B) Light Amplification by Simulated Emission of Radiation C) Light Amplification by Stimulated Emission of Radiation D) Light Absorption by Stimulated Emission of Radiation

C) Light Amplification by Stimulated Emission of Radiation ## Footnote Slide 35

Which of the following best describes the differences between ordinary light and laser light? A) Ordinary light has a focused narrow beam, while laser light spreads out in many directions. B) Ordinary light contains many wavelengths that spread out in many directions, while laser light has a specific wavelength with a focused narrow beam and high intensity. C) Ordinary light has a specific wavelength, while laser light contains many wavelengths. D) Both ordinary light and laser light contain many wavelengths and have a focused narrow beam.

B) Ordinary light contains many wavelengths that spread out in many directions, while laser light has a specific wavelength with a focused narrow beam and high intensity. ## Footnote Slide 35

In which of the following medical fields are lasers commonly used? (Select all that apply) A) Cosmetic surgeries B) Refractive eye surgery C) Dental procedures D) General surgery E) ENT procedures

ALL OF THE ABOVE - Cosmetic surgeries - Refractive eye surgery to reshape cornea (LASIX) - Dental procedures - General surgery (Condyloma resection, TURP/TURB) - ENT procedures (Sinuses, Tracheal tumor resection, )Vocal cord polyp resection ## Footnote Slide 36

The unexcited state electrons orbit the nucleus at the ____ energy. A) Highest B) Lowest C) Intermediate D) Random

B) Lowest ## Footnote Slide 37

In the unexcited state, electrons occupy orbits __________. A) Closest to the nucleus B) Farthest from the nucleus C) At a random distance from the nucleus D) Outside the atom

A) Closest to the nucleus ## Footnote Slide 37

Which of the following steps are involved in the production of radiation? (Select 3) A) Absorption of energy from an energy source B) Electrons becoming excited and moving to higher orbits C) Electrons returning to their ground state and emitting photons of energy D) Electrons staying in their excited state permanently

A) Absorption of energy from an energy source B) Electrons becoming excited and moving to higher orbits C) Electrons returning to their ground state and emitting photons of energy ## Footnote Slide 37

Which property of laser radiation refers to all photons having the same wavelength? A) Coherence B) Collimation C) Monochromatic D) Dispersion

C) Monochromatic ## Footnote Slide 38

What does coherence in laser radiation mean? A) All photons are moving randomly. B) The travel of photons is synchronized in time and space. C) The photons have varying wavelengths. D) The beam of photons is dispersed in different directions.

B) The travel of photons is synchronized in time and space. *Don’t move randomly* ## Footnote Slide 38

What does collimation in laser radiation refer to? A) The spreading out of photons in many directions. B) The laser beam photons being nearly parallel. C) The synchronization of photon travel in time and space. D) The variation in photon wavelengths.

B) The laser beam photons being nearly parallel. *Allows beam to be focused on small area* ## Footnote Slide 38

Which of the following are advantages of laser surgery? (Select 4) A) Excellent precision B) Poor hemostasis C) Rapid healing D) Increased scar formation E) Less postoperative edema and pain F) Lower infection rates

A) Excellent precision - Good hemostasis C) Rapid healing - Less scar formation E) Less postoperative edema and pain F) Lower infection rates ## Footnote Slide 39

What gives a type of laser its name? A) Wavelength B) Lasing Medium C) Beam Intensity D) Frequency

B) Lasing Medium

Which of the following are examples of lasing mediums? (Select 3) A) Argon B) Carbon Dioxide C) Helium D) Nd:YAG

A) Argon B) Carbon Dioxide D) Nd:YAG ## Footnote Slide 40

Which of the following statements are true about the Argon laser? (Select 2) A) It has modest tissue penetration of 0.05-2mm B) It is used in dermatology C) It has deep tissue penetration of more than 5mm D) It is not used in medical procedures

A) It has modest tissue penetration of 0.05-2mm B) It is used in dermatology ## Footnote Slide 40

Which of the following are characteristics of the Carbon Dioxide laser? (Select -3) A) Minimal scatter B) Causes significant surrounding tissue damage C) Surrounding tissue damage is negligible D) Commonly used for procedures on vocal cords and in the oropharynx

A) Minimal scatter C) Surrounding tissue damage is negligible (Absorbed by water with minimal heat dispersion) D) Commonly used for procedures on vocal cords and in the oropharynx ## Footnote Slide 40

Which of the following are characteristics of the Nd:YAG laser? (Select 3) A) Most powerful laser B) Superficial tissue penetration C) Deeper tissue penetration D) Used for tumor debulking

A) Most powerful laser C) Deeper tissue penetration (2-6mm) D) Used for tumor debulking ## Footnote Slide 40

Which two laser hazards are of the greatest concern to CRNAs? (select 2) A) Perforation of a vessel or structure B) Airway fire C) Embolism D) Atmospheric contamination E) Inappropriate energy transfer

B) Airway fire D) Atmospheric contamination *Important to wear Particulate laser mask that will protect you from breathing anything* ## Footnote Slide 41

Which of the following are hazards associated with laser use? (Select 3) A) Atmospheric decontamination B) Perforation of a vessel or structure C) Embolism D) Inappropriate energy transfer E) Increased recovery time

B) Perforation of a vessel or structure C) Embolism D) Inappropriate energy transfer ## Footnote Slide 41

What is laser plume primarily composed of? A) Large dust particles B) Fine particulates produced by vaporization of tissue C) Excessive laser light D) Water vapor

B) Fine particulates produced by vaporization of tissue ## Footnote Slide 42

Which of the following are potential risks associated with exposure to laser plume? (select 3) A. Development of asthma B. Headache and nausea after inhalation C. Interstitial pneumonia, bronchiolitis, emphysema D. Immediate skin burns E. Potential carcinogenic effects F. Increase in blood pressure

B. Headache and nausea after inhalation C. Interstitial pneumonia, bronchiolitis, emphysema E. Potential carcinogenic effects ## Footnote Slide 42

Which of the following precautions should be taken during laser procedures? Select all that apply. A. Ensure that the provider is wearing laser glasses. B. Tape the patient's eyes and provide laser glasses. C. Ensure that all windows in the room are covered. D. Wear masks specifically designed to filter laser plume that may contain vaporized viruses. E. Utilize appropriate suction to remove laser plume from the surgical site. F. Have water or saline irrigation available on the back table. G. Don't tent drapes to avoid pockets of oxygen for the patient.

ALL OF THE ABOVE ## Footnote Slide 43

Which of the following components are part of the fire triad? Select all that apply-3. A. Ignition source B. Fuel C. Oxidizer D. Water E. Carbon dioxide

A. Ignition source B. Fuel C. Oxidizer ## Footnote Slide 44

Which of the following are major **sources** of fires in the operating room? (Select 2) A. Electrosurgical units (ESU) and cautery devices B. Laser C. Anesthesia machines D. Surgical drapes E. Ventilators

A. Electrosurgical units (ESU) (Electrosurgical units aka "Bovie") and cautery devices B. Laser

Which of the following scenarios can lead to an endotracheal fire? (Select 3) A. Surgeon is lasering the airway through the endotracheal tube (ETT) and burns through the PVC tube. B. Surgeon is completing a tonsillectomy in a pediatric patient with an uncuffed tube. C. Surgeon is using a bovie to cut through the trachea for a tracheotomy. D. Surgeon is performing a laparoscopic cholecystectomy using only non-heat-generating tools. E. Surgeon is suturing skin during a routine outpatient procedure.

A. Surgeon is lasering the airway through the endotracheal tube (ETT) and burns through the PVC tube. B. Surgeon is completing a tonsillectomy in a pediatric patient with an uncuffed tube. C. Surgeon is using a bovie to cut through the trachea for a tracheotomy. ## Footnote Slide 45

Which of the following practices promote airway fire safety during laser procedures? (Select 4) A. Use laser-resistant endotracheal tubes (ETTs). B. Use high-inspired oxygen concentrations (100% O₂). C. Apply wet pledgets around the ETT and tape the strings to the face. D. Fill the ETT cuff with methylene blue to show signs of rupture. E. Use a bovie to cut into the trachea during a tracheotomy. F. Remove the ETT during the laser procedure and reinsert as needed.

A. Use laser-resistant endotracheal tubes (ETTs). * *Low-inspired (21% if possible) O2* C. Apply wet pledgets around the ETT and tape the strings to the face. D. Fill the ETT cuff with methylene blue to show signs of rupture. * *Use scissors to cut into trachea instead of bouvie* F. Remove the ETT during the laser procedure and reinsert as needed. ## Footnote Slide 46

Which of the following are key components of an anesthesia plan for airway surgery? (Select 3) A. Preoperative evaluation of the airway B. Mutual planning with the surgeon C. Use of total intravenous anesthesia (TIVA) D. Routine use of inhalation agents for maintaining anesthesia.

**A. Preoperative evaluation of airway** (stridor, flow volume loops, CT, fiberoptic eval) **B. Mutual planning with surgeon** (Intermittent apneic oxygenation, jet ventilation) **C. Total IV anesthesia** (Propofol, remifentanil, Xylocaine spray) ## Footnote Slide 47

Which of the following are components of an anesthesia plan to prevent airway fire during laser procedures? Select -4 A. Fill the endotracheal tube (ETT) cuff with methylene blue. B. Use dry gauze for protection around the airway and face. C. Use short, repeated pulses of laser instead of long continuous mode. D. Maintain oxygen concentration below 30% and avoid nitrous oxide. E. Communicate and monitor video cameras for signs of an airway fire.

A. Fill the endotracheal tube (ETT) cuff with methylene blue. * *Wet saline gauze protection of airway/face* C. Use short, repeated pulses of laser instead of long continuous mode. D. Maintain oxygen concentration below 30% and avoid nitrous oxide. E. Communicate and monitor video cameras for signs of an airway fire. ## Footnote Slide 48