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22 spring: Radiology > Test 2: lecture 8 > Flashcards

Test 2: lecture 8 Flashcards

1
Q

types of contrast studies

A
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2
Q

___ are a type of positive contrast

A

barium and iodine

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3
Q

___ are a type of negative contrast

A

room air

CO2

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4
Q

___ is a type of double contrast

A

barium and gas

iodine and gas

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5
Q

pneumocystogram

A

place urinary catheter

remove urine, place air

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6
Q

where can you use negative contrast?

A

put air in area to make wall thickness apparent and outline hollow organs

bladder: pneumocystogram

colon: pneumocolon

stomach: pneumogastrogram

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7
Q

advantages, disadvantages and risks of negative contrast

A

add air to area

Advantages:
¨ Always available, cheap

Disadvantages:
¨ Limited info

Risks:
¨ Over distention and rupture
¨ Air embolism (= obstruction of a blood vessel caused by the entrance of air into the bloodstream). (CO 2 better soluble à risk ↓↓)

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8
Q

positive contrast is used for

A

(add high atomic number substance→ radiopaque → white)

Outlining of internal surface of hollow organs, vessels
and ducts

Organ location and size

Wall thickness

Filling defects

Viscus rupture

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9
Q

intraluminal filling defect

A

positive contrast

calculus, blood clot, FB, gas bubble

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10
Q

intramural filling defect

A

positive contrast

arising from the wall (mass-neoplasia, abscess granuloma, polyp) even if occupies the entire lumen!

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11
Q

extraluminal filling defect

A

seen in positive contrast study

a lesion outside the images organ, compressing/displacing it

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12
Q

what kind of positive contrast can only be used in the GI tract

A

barium

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13
Q

What positive contrast can be used for transit and emptying times of the GI tract

A

barium

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14
Q

advantages of barium

A

positive contrast

Relatively cheap
¨ Relatively tasty
¨ Good mucosal coating (imaging, curative?)
¨ Non-toxic, No side effects (intraluminal)
¨ If aspirated- usually benign (from bronchi-expectorated. From alveoli- phagocytosed and transported to tracheobronchial ln)

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15
Q

disadvantages of barium

A

Can only be used in the GI tract (+ airways).
¨ Leakage into mediastinum or peritoneum →inflammation, fibrosis and granuloma formation. Surgical emergency. → DO NOT USE IF GI RUPTURE IS SUSPECTED!
¨ Should not be used pre- or post endoscopy ( pre- blocks vision, post- risk of leakage↑)

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16
Q

if GI perforation is suspected or pre endoscopy what positive contrast should be used

A

iodinated medium

17
Q

esophagram

A

give barium or iodine to look at esophagus

18
Q

when to use barium enema

A

tell the difference between small and large bowel loops

masses, strictures, ect

19
Q

ionic iodinated contrast

A

Dissociate into anions and cations → hyperosmolar.

Side effects (mainly due to hyperosmolarity)

Cost ↓

20
Q

non-ionic iodinated contrast

A

Do not dissociate into anions and cations → hypoosmolar.

Side effects much less severe and less common.

Cost ↑

21
Q

in the GI tract what happens to ionic iodinated contrast

A

ionic → hyperosmolar, this means fluids will be drawn in → dilutes the contrast and decreases image quality

22
Q

where can you not use ionic iodinated contrast media

A

intrathecal injection (myelogram) → spinal cord

23
Q

where can you use iodinated contrast

A

you can use it almost anywhere

24
Q

intravenous urogram

A

inject iodine into the veins, this will travel to the kidneys to be excreted

makes kidneys easier to see

25
Q

for viscus rupture what kind of contrast is recommended

A

Positive Iodinated Contrast Medium

Positive: largest contrast with normal body opacities (negative- same as gas in lungs or GI).

Iodinated: can’t use barium in peritoneal cavity or mediastinum → inflammation.

Preferably non-ionic: ionic medium pulls more fluid (hyperosmolar).

26
Q

when to use double contrast

A

gas and barium

gas and iodine

used most commonly in the bladder

27
Q

what is the advantage of double contrast

A

can see very small detects because the gas provides a dark background

28
Q

Examples of intra-luminal filling defects are…

Abscess, sludge

Blood clots, polyps

Granulomas, air

Bladder calculi, gas bubbles

Neoplasia, foreign body

A

Bladder calculi, gas bubbles

29
Q

In a colonogram, when the colon does not fill up well with contrast medium due to an enlarged prostate, this is an example of an…

Intra-mural filling defect

Intra-luminal filling defect

Extra-ordinary filling defect

Not enough information provided to determine nature of filling defect

Extra-luminal filling defect

A

Extra-luminal filling defect

30
Q

For which of the following studies barium should NOT be used?

Bronchogram

Colonogram

Retrograde vaginogram

Esophagram

Gastrogram

A

Retrograde vaginogram

31
Q

A pyelogram is a sensitive study to rule out…

Vascular anomaly

Urethral obstruction

Urinary bladder calculi

Ureteral obstruction

Urinary bladder tear

A

Ureteral obstruction

32
Q

An appropriate choice of contrast media for a double contrast cystogram would be…

Ionic and non-ionic iodine

Barium and iodine

Iodine and saline

Iodine and CO2

Barium and room air

A

Iodine and CO2

33
Q

In a colonogram, when the colon does not fill up well with contrast medium due to an enlarged prostate, this is an example of an…

Not enough information provided to determine nature of filling defect

Extra-ordinary filling defect

Intra-luminal filling defect

Intra-mural filling defect

Extra-luminal filling defect

A

Extra-luminal filling defect

34
Q

For which of the following studies barium should NOT be used?

Esophagram

Gastrogram

Bronchogram

Colonogram

Retrograde vaginogram

A

Retrograde vaginogram

35
Q

Which of the following may be a reason to choose iodine over barium?

Minimizing side effects in a hypovolemic patient

Expecting endoscopy may be required after the contrast study

Financial concerns

Wanting to optimize mucosal coating

Suspecting urinary bladder ulcerations

A

Expecting endoscopy may be required after the contrast study

36
Q

Using an ionic iodinated contrast medium may…

Be recommended for a patient with heart disease

Be the first choice for an esophagram in most patients

Be a safer choice for an unstable patient

Be used for a myelogram

Result in poorer image quality in the GI tract

A

Result in poorer image quality in the GI tract

37
Q

A pyelogram is a sensitive study to rule out…

Ureteral obstruction

Urinary bladder tear

Urethral obstruction

Urinary bladder calculi

Vascular anomaly

A

Ureteral obstruction

38
Q

A cat is vomiting and possibly ingested a small ball last night. You would recommend to perform a ___ using ___

A

upper GI contrast study

barium (could use iodinated agent if the ball is still in the stomach and endoscopy for removal is considered after the contrast study..)

39
Q

A dog presents with regurgitations. On plain radiographs, there is evidence of pneumomediastinum (=free air in mediastinum). To rule out esophageal perforation, you would perform a ___ using ___

A

positive contrast esophagram

non-ionic iodinated

22 spring: Radiology (11 decks)

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