Rite ad 6 Flashcards by William Kerns

After an emergent quench has begun, how long does it take for the magnetic field to be reduced to a safe level?

Approximately 7 minutes
Approximately 1 hour
Approximately 15 minute
Approximately 30-60 seconds

Approximately 30-60 seconds

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What are the reasons that we would quench an MRI unit? Select all that apply.

An uncontrollable fire occurs in the MRI room
Code blue occurs in the MRI room
A large ferrous object is pinning a patient
It is the end of your shift

An uncontrollable fire occurs in the MRI room

A large ferrous object is pinning a patient

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Which of the following are considerations for a quench vent pathway?

Restrict access to quench vent area
Use signage to indicate quench vent outside
Have the quench vent inspected on a consistent basis
All of the choices

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Which of the following are risks associated with the cryogen substance found in a superconducting unit if it enters the MRI room? Select all that apply.

Magnetohydrodynamic effect
Asphyxia
Disorientation
Hypothermia

Asphyxia
Disorientation
Hypothermia

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A quench is performed and a malfunction of the quench vent cause cryogen to leak in the room. The patient is in danger from which of the following?

All of the choices
Sedation
Heating
Damage to eardrum

Damage to eardrum

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A fire breaks out in the MR room, cannot be controlled, and poses a serious threat. Which of the following would be safest to do first?

Leave the area
Wait for firefighters
None of the choices
Quench the magnet

Quench the magnet

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A nurse accidentally brings an MR unsafe cart into the room and it gets stuck to the MR unit pinning a patient against the scanner. The cart is large and the nurse cannot get around it. What do you do?

Try to move the cart
Call a code blue
Call for a group of people to move the cart
Quench the magnet

Quench the magnet

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A quench is performed and a malfunction of the quench vent causes cryogen to leak in the room. Pressure builds up and the door cannot be opened. What could you do to get to the patient?

Tell the patient to try to open the door
Call for help to get the door open
Wait till the pressure dissipates
Break the window to the zone IV

Break the window to the zone IV

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A quench is performed and a malfunction of the quench vent causes cryogen to leak in the room. The patient is in danger from which of the following?

All of the choices
Hypothermia
Asphyxiation
Frostbite

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What eGFR level indicates severe kidney failure?

31-45 mL/min/1.73m2
60-89 mL/min/1.73m2
46-60 mL/min/1.73m2
0-15 mL/min/1.73m2

0-15 mL/min/1.73m2

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Which of the following are considered anaphylactoid reactions? Select all that apply.

Headache
Hives
Abdomen pain
Difficulty breathing

Hives

Difficulty breathing

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For all inpatients receiving group I contrast, ACR recommends an eGFR should be obtained within

An eGFR obtained within the last 7 days is sufficient and no additional eGFR is required
2 days prior to the planned administration of a group I or group III GBCA
eGFR, is not necessary in inpatients as the potential benefit of a GBCA-enhanced MRI exam are felt to outweigh the risk of NSF

2 days prior to the planned administration of a group I or group III GBCA

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Which of the following patient histories may increase the chance for a gadolinium contrast reaction? Select all that apply.

Currently recovering from a cold
History of seasonal allergies
History of heart disease
History of a reaction to iodinated contrast

History of seasonal allergies

History of a reaction to iodinated contrast

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How long does it take to excrete gadolinium contrast from a patient with normal kidney function?

4 hours
24 hours
48 hours
9 hours

24 hours

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A conservative approach to breast-feeding after a mother receives gadolinium contrast is:

To continue breast-feeding immediately after receiving an intravenous injection of gadolinium contrast
To wait 12-24 hours to breastfeed after intravenous injection of gadolinium contrast
To pump and dump breastmilk for 168 hours after intravenous injection of gadolinium contrast
To mix formula with breastmilk for 24 hours after intravenous injection of gadolinium contrast

To wait 12-24 hours to breastfeed after intravenous injection of gadolinium contrast

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What eGFR level indicates mild kidney function loss?

30-45 mL/min/1.73m2
45-60 mL/min/1.73m2
0 mL/min/1.73m2
60-89 mL/min/1.73m2

60-89 mL/min/1.73m2

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Which of the following is used to determine renal function?

eGFR
Blood platelet
D-dimer
Both GFR and D-dimer

eGFR

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Which of the following can be given to a patient to relieve the symptoms of a severe allergic reaction? Select all that apply.

Advil
Diphenhydramine
Epinephrine
Propofol
Corticosteroid

Diphenhydramine
Epinephrine

Corticosteroid

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Which of the following are physiologic factors that occur from an anaphylactic reaction? Select all that apply.

Elevated creatinine levels
Headache
Vasodilation
Bronchiole smooth muscle contraction

Vasodilation
Bronchiole smooth muscle contraction

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Which of the following is a short-term effect of gadolinium contrast?

GAP
NSF
Gadolinium retention
Nausea

Nausea

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Approximately how much gadolinium is absorbed by an infant from a mother who has breastfed them and has received a dose of gadolinium contrast?

> 1%
0.0004%
0.4%
20%

0.0004%

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Group I agents are associated with the greatest number of:

unconfounded cases of NSF, so the use of eGFR is not required
confounded cases of NSF, so the use of eGFR is not required
confounded cases of NSF, so the use of eGFR is required
unconfounded cases of NSF, so the use of eGFR is required

unconfounded cases of NSF, so the use of eGFR is required

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Gadolinium contrast media is excreted into breastmilk in an unstable non-water-soluble form.

False
True

False

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T1 shortening pre-contrast from a history of multiple doses of gadolinium contrast is commonly seen in which of the following? Select all that apply.

Heart
Achilles tendon
Globus pallidus
Dentate nucleus

Globus pallidus
Dentate nucleus

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A patient is set to have an MRI knee scan with and without contrast and has labs drawn. The results show that the patient has an eGFR of 25. It is highly suggested that what occurs according to the manufacturer’s BlackBox warning? The patient should not undergo an MRI. A full dose of gadolinium can be given unless the patient has a history of allergies to contrast media. A half dose of gadolinium contrast should be given. Gadolinium contrast is not given.

Gadolinium contrast is not given.

In evaluating a patient for a potential contrast reaction, what assessments should be made if clinically feasible: (select all that apply) What is the patient’s pulse? Can the patient speak? What is the patient’s blood pressure? What is the quality of the patient’s breathing?

What is the patient’s pulse? Can the patient speak? What is the patient’s blood pressure? What is the quality of the patient’s breathing?

Earplugs can reduce noise when used properly by how much? 40-50 decibels 10-30 decibels 70-90 decibels 0-10 decibels

10-30 decibels

What is the A-weighting limit for noise produced in MRI per the IEC 60601-2-33 document? 99 dBA 69 dBA 40 dBA 120 dBA

99 dBA

Using a headset and earplugs will reduce noise by how much? By the reduction of headset + the reduction of earplug divided by two The reduction of overall headset capacity By the reduction of earplugs (10-30dB) and a portion of the overall headset reduction 50dB

By the reduction of earplugs (10-30dB) and a portion of the overall headset reduction

Eddy currents are produced from which of the following? Gradient magnetic field Walking through the static magnetic field Moving MR table All of the choices

Gradient magnetic field Walking through the static magnetic field Moving MR table

What unit is used to determine how well hearing protection works? dt NRR PHR HRR

NRR

The _________ gradients are used to express what gradient coils are activated in a pulse sequence diagram to fill our k space. Logical Physical

Logical

Theoretically, which of the following has the greatest chance for the time-varying gradient field to cause arrhythmogenesis in the patient? Select all that apply. Scanning the head with abandoned leads in their chest Using a slew rate of 200 T/m/s Scanning at a 1 T MR unit Scanning an MR cardiac study

Scanning the head with abandoned leads in their chest Using a slew rate of 200 T/m/s

Which of the following will reduce noise the most? NRR 33 dB NRR 0 dB NRR 10 dB NRR 25 dB

NRR 33 dB

Which of the following will produce the lowest chance for peripheral nerve stimulation? EPI Conventional spin echo Gradient echo Fast spin echo

Conventional spin echo

The NRR is a unit of measurement used to measure what? The function of hearing protection Potential of heating Peripheral nerve stimulation Translational force

The function of hearing protection

A patient is having an MR pelvis scan and has a brain stimulator. They are advanced feet first. What risks are associated with this implant when considering the time-varying gradient magnetic field? The only risk is associated with the static field None Electrical current induction Heating of stimulator

Electrical current induction

Which of the following pulse sequences will produce the greatest chance for peripheral nerve stimulation? Conventional spin echo Fast spin echo Gradient echo Inverse recovery

Gradient echo

How can noise be reduced in MRI for a patient during an exam? Earplugs Headphones Sponge Earplugs and headset

Earplugs and headset

Which of the following is true of 3 T MRI? Select all that apply. It has a greater chance for peripheral nerve stimulation than at 1.5 T It will produce more stimulation at isocenter than higher field strengths It will have a larger maximum spatial gradient than a 1.0 T unit It will have a higher whole-body SAR limit in normal mode than the normal mode at a 1.5 T

It has a greater chance for peripheral nerve stimulation than at 1.5 T It will have a larger maximum spatial gradient than a 1.0 T unit

Which of the following will produce the greatest chance for peripheral nerve stimulation? Conventional spin echo Gradient echo DWI Fast spin echo

DWI

The noise heard in MRI is caused by which of the following? Increased heating in a circuit Two competing magnetic fields (gradient field and magnetic field) Larmor force The antenna effect

Two competing magnetic fields (gradient field and magnetic field)

The gradient coils are located around the patient in the gantry and as the coils are activated there is little effect of the time-varying gradient magnetic field at___________, but extreme effects of the time-varying gradient magnetic field at the periphery of our patient, isocenter isocenter, the periphery of our patient

isocenter, the periphery of our patient

Which of the following will reduce patient heating? Select all that apply. Using saturation bands Increase flip angle Increase duration of RF exposure (soft RF pulse) Increase TR Decrease the bandwidth

Increase duration of RF exposure (soft RF pulse) Increase TR Decrease the bandwidth

Which of the following can reduce the risk of patient burns caused by the antenna effect from external equipment? Avoid scanning a patient with a transmit-receiver coil. All of the choices Use only spin echo sequences. Place a barrier between tissue/skin and electrical devices touching our patient

Place a barrier between tissue/skin and electrical devices touching our patient

Which of the following will increase patient heating? Increasing the TR Decreasing the TE Decreasing the flip angle Increasing the echo train length

Increasing the echo train length

Which of the following pulse sequences will produce the most patient heating? Inverse recovery sequence Gradient echo Conventional spin echo Single shot fast spin echo

Single shot fast spin echo

A patient has a medication patch on them with a foil backing. This patient is at risk of what? Magnohydrodynamic effect Missile effect Peripheral nerve stimulation Burning

Burning

Which of the following will influence the SAR? Select all that apply. Type of RF coil Body shape and size The tissue permittivity The tissue conductivity

Type of RF coil Body shape and size The tissue permittivity The tissue conductivity

Which of the following pulse sequences will produce the most heating? Conventional spin echo DWI Conventional gradient Fast spin echo

Fast spin echo

Which of the following are risks associated with a linearly placed pacing wire within a patient? Resonant heating Radiant heating Loop induction Near field burning

Resonant heating

A patient has a removed vagus stimulator with the leads left in and is having an MR knee scan performed with a transmit-receive coil. In terms of patient burning, is the risk low? Yes, only if that patient is less than 200lb Yes, only with a heat sink No Yes

Yes

Which of the following techniques can be used to reduce the heating in a fast spin echo? Increase the echo spacing Reduce the TR Increase the flip angle Tell them to hold their breath

Increase the echo spacing

Which of the following will create RF energy localized to only a specific body part? None of the choices Receive only coil Body RF coil Transmit-receive coil

Transmit-receive coil

A patient has a carotid stent and is having an MR knee scan performed. In terms of patient heating, can this patient be scanned with relatively low risk? Yes, only with a heat sink No Yes Yes, only if that patient is less than 200lb

Yes

If you expose a patient to RF energy, which of the following items could burn a patient? Select all that apply. Insulated wire with the ends touching the patient Sternal wires BB Cardiac stent Femur rod

Insulated wire with the ends touching the patient

What is the relationship between SAR and field strength? Inverse Linear Squared Logarithmic

Squared

Which of the following can be used to reduce a proximity burn? Use ECG gating Use a barrier between the patient and the gantry Unwind loops in wires from the static magnetic field Increase TR

Use a barrier between the patient and the gantry

A patient is undergoing an MR brain and has pacing wires. What would lower the risk of this exam? Select all that apply. It is never safe Increase the flip angle Ice pack on the patient’s chest Using a transmit-receive brain coil Decrease TR

Using a transmit-receive brain coil

An obese patient is laying in the MR gantry and has bare skin touching the sides of the bore. What is she at risk of? Magnetophosphenes Missile effect Peripheral nerve stimulation Proximity burning

Proximity burning

Which of the following will reduce the risk of patient with a pacing wire from getting burned? Select the best answer given that the patient is having an MR pelvis performed. Advance patient into scanner head first Place an ice pack on the patient’s chest Don’t expose wires to the gradient field Position patient with pacing wires as far from RF exposure field

Position patient with pacing wires as far from RF exposure field

A patient is warming up during their exam. What can be done to reduce the heating? Select all that apply. Decrease phase encoding Use parallel imaging Increase slices Increase the TR Increase the ETL

Decrease phase encoding Use parallel imaging Increase the TR

Why does a fast spin echo produce more heat than a conventional spin echo sequence? It doesn’t use a 180-degree RF pulse It does not It contains more 180-degree refocusing pulses It has more gradient activations

It contains more 180-degree refocusing pulses

Why is magnetic shielding used on an MR unit? To reduce heating To reduce the e-fields To maintain field homogeneity To limit the fringe field

To limit the fringe field

When performing an MR pelvis scan, which of the following would cause the most artifact in our exam? Titanium hip replacement Dacron iliac graft IUD Ureter stent

Titanium hip replacement

______ magnetic shielding uses coils of wire in the opposite direction than found with the coil of wire used to produce the static magnetic field. Active Passive

Active

The spatial magnetic gradient has the most influence on which of the following? Translational force Peripheral nerve stimulation Heating Noise

Translational force

Testing has shown that larger deflection angles in implants have been seen when objects are exposed to a _____-bore MR system when compared to a _____-bore MR system. This means that _____-bore MR unit have a steeper magnetic spatial gradient. short, long, short short, long, long long, short, long long, short, short

short, long, short

Translational force is typically strongest where? At every 10cm from isocenter Along the table Isocenter By the control panel on the MR unit

By the control panel on the MR unit

The differences in magnetic field strength as you approach the MRI unit are termed what? Gauss line Gradient coils RF energy Spatial magnetic gradient

Spatial magnetic gradient

Which of the following will produce the largest artifact in MRI? Super paramagnetic objects Diamagnetic objects Paramagnetic objects Ferromagnetic objects

Ferromagnetic objects

When performing an abdominal MRI, which of the following would pose the largest artifact issue? Femur rodding with titanium Sternal wires with stainless steel Descending aortic aneurysm repair with stainless steel mesh Lumbar 4-5 fusion with stainless steel

Descending aortic aneurysm repair with stainless steel mesh

A patient coming in for an MRI of the lumbar spine for pain, what would you say the level of risk is? Use a saturation band over the implant Cannot scan a lumbar spine Low High

Low

It is common to find superconductive MRI units manufactured with vertical magnetic fields. False True

False

Rotational force is strongest where? It is uniform everywhere On the table At the control panel on the MR unit Isocenter

Isocenter

How do you determine the total attractive force of a ferrous object at a given magnetic field strength? By the speed of the gradient coils and the static magnetic field. Using the SAR. By the static field strength and the spatial magnetic gradients. By the static magnetic field strength.

By the static field strength and the spatial magnetic gradients.

A BB is located near a vessel. Would you consider this a high risk to the patient? Depends on if it is stainless steel or not Maybe Yes No

Yes

What formula is mathematically used to describe the spatial magnetic gradient? dB/dx dB/dt Gauss W/kg

dB/dx

A patient has a non-ferrous MR conditional pain pump and as you advance them in very quickly, they start to complain that the pain pump is moving. What would you do? Tell them that the pain pump is safe and that nothing will happen to them. Since the pain pump is non-ferrous, it is not possible for it to move. Cancel the patient’s exam. Advance the patient into the gantry slowly.

Advance the patient into the gantry slowly.

Typically, where is the area surrounding the MR unit with the highest spatial magnetic gradient field? Isocenter Area peripheral to the opening of the bore At the 5 gauss line MR table prior to being advanced into the gantry

Area peripheral to the opening of the bore

When scanning an MR pelvis on this patient for pain, what would you say the risk to the patient is? Only with a heat sink Not for a knee Moderate High

Moderate

How do we calculate the maximum spatial gradient/force product? dB/dx * B dB/dt * W/kg B W/kg

dB/dx * B

If a standard of care is not delivered to a patient and DID NOT result in injury, it is called what? Tort Negligence Malpractice Felony

Negligence

Which of the following can be used to test if an object is ferrous? Select all that apply. Radiograph Ferromagnetic detection system Metal detector Tester magnet

Ferromagnetic detection system Tester magnet

What are the patient FDA limits for the time-varying gradient coils? 35 T/s To the comfort of the patient To the point a patient has a seizure 10 T/s

To the comfort of the patient

An MRI technologist has heart disease and requires a pacemaker. What does this mean for this technologist? They are unable to work in the MR environment. They can go into the MR environment as long as they can meet their pacemakers conditions None of the choices They must limit their time in zone IV.

They can go into the MR environment as long as they can meet their pacemakers conditions

If a standard of care is not delivered to a patient and this resulted in an injury to that patient, it is called what? Infraction Malpractice Tort Negligence

Malpractice

MRI magnets can explode because ______. Helium converts to gas in the Dewar Helium is flammable Magnetic can not explode Helium is reactive with air

Helium converts to gas in the Dewar Helium is reactive with air

What is a deposition in a court case? The opening words in a court case. The final verdict in a case. The reason why a defendant is on trial. A testimony of what happened.

A testimony of what happened.

A technologist is on their cellphone while a patient is being scanned. The patient is trying to get a hold of the technologist, but the technologist doesn’t notice. This is an example of what? Tort Felony Malpractice Negligence

Negligence

What is defined in the captain of the ship doctrine? It defines the fact that there is a person who is responsible for the care of another. None of the choices It does not apply in medicine. It states that the technologist is responsible for the care of a patient.

It defines the fact that there is a person who is responsible for the care of another.

Which of the following are true of level 1 MR personnel according to the ACR Manual on MRI Safety? Select all that apply. Have enough MR safety training to take care of themselves in the MRI environment Can perform an MRI scan Can enter zone III unaccompanied Can be responsible for non-MR personnel in zone IV

Have enough MR safety training to take care of themselves in the MRI environment Can enter zone III unaccompanied

Which of the following is an ASTM MR label used in MRI? Select all that apply. MR compatible MR safe MR conditional MR unsafe

MR safe MR conditional MR unsafe

What is the ICNIRP occupational workers dose for magnetic flux limit to the extremities? 2 Tesla 8 Tesla 400 milliTesla 14 Tesla

8 Tesla

An MR technologist is distracted by another patient and brings a non-MR compatible O2 tank into the room which severely injures a patient. This is an example of what? Malpractice Negligence Tort Infraction

Malpractice

What is the ICNIRP occupational workers dose for magnetic flux limit for the head and torso? 2 Tesla 14 Tesla 400 milliTesla 8 Tesla

2 Tesla

Which are true of individuals WORKING in zone 3 according to the ACR Manual on MRI Safety? Select all that apply. Competencies must be done annually MR screening sheet should be filled out Must complete one live or prerecorded competency in MR safety Maybe level 1 or 2 MR personnel.

Competencies must be done annually MR screening sheet should be filled out Must complete one live or prerecorded competency in MR safety Maybe level 1 or 2 MR personnel.

What organization is responsible for defining the limits of the MRI environment on occupational works? ACR FDA JCAHO ICNIRP

ICNIRP

Which of the following are true of MR level 1 personnel according to the ACR Manual on MRI Safety? Select all that apply. Can enter zone III unaccompanied Need annual basic MR safety training Can be responsible for non-MR personnel in zone IV Can perform an MRI scan

Can enter zone III unaccompanied Need annual basic MR safety training

Which of the following are true when scanning unresponsive patients according to the ACR Manual on MRI Safety 2020? Select all that apply. Patients are suggested to be monitored during procedure. Areas of suspected implantation should be radiographed. Must be examined by a level 2 personnel. Areas of scars of unknown origin, and the chest and spine region must be radiographed.

Patients are suggested to be monitored during procedure. Areas of suspected implantation should be radiographed. Must be examined by a level 2 personnel. Areas of scars of unknown origin, and the chest and spine region must be radiographed.