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Sam's Abdomen II > Test Review for Intraventional Procedures and MSK > Flashcards

Test Review for Intraventional Procedures and MSK Flashcards

1
Q

What are some contraindications for biopsies?

A 
Uncorrectable bleeding disorder
Unsafe needle path
Uncooperative patient, moving
cannot control bleeding
Masses are isoechoic to surrounding organ parenchyma – look for indirect signs
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2
Q

What is the position of the patient undergoing a thoracentesis?

A

Patient is in a sitting position, with legs over the edge of the cart
Arms are placed forward on a bedside table

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3
Q

The national patient safety standards mandate that a “Time Out” be performed before beginning any procedure. What is in a “Time Out”?

A

When everyone involved with the procedure is present, a Time Out is done to verify patients name, DOB, all equipment and supplies are present, patient agrees with procedure

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4
Q

What size needle gauge is used in fine needle aspirations FNAs?

A

25 gauge needles are used, usually 5 passes to obtain enough cells

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5
Q

What is the role of the cytopathology team?

A

Cytology technologist is normally present to make slides for the Pathologist to diagnose and looks under the microscope to make sure there are sufficient samples

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6
Q

What is the primary advantage of an ultrasound guide procedure?

A

Real time visualization of the tip of the needle at all times

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7
Q

What are ALL the advantages of an ultrasound guided procedure?

A

Real time visualization of the tip of the needle at all times
Fast
Patient position can be easily changed
Staff is by the patient throughout entire exam to offer comfort
No radiation

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8
Q

What is a common indication for a biopsy?

A

to confirm a malignancy in a mass

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9
Q

What lab test is used to evaluate the effects of heparin, aspirin and antihistamine on blood clotting process?

A

PTT (partial thromboplastin time)

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10
Q

What are some post biopsy complications?

A 
minor:
post-procedural pain 
discomfort 
vasovagal reactions 
hematomas 
serious:
bleeding 
hemorrhage 
pneumothorax
pancreatitis 
biliary leakage 
peritonitis 
infection 
death
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11
Q

A higher percentage of positive cells are observed in what thyroid mass? What portion of it?

A

calcifications in goiters or adenomas

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12
Q

What is the best way to recognize the tip of the needle with ultrasound?

A

its an echogenic dot on the image

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13
Q

In a renal transplant procedure which part of the kidney is typically biopsied?

A

the upper pole

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14
Q

What are the limitations of ultrasound guided procedures?

A

not all masses can be visualized with ultrasound

the needle tip may be difficult to see

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15
Q

The international normalized ratio (INR) was developed because of the variable results of what lab test?

A

PT (prothrombin time)

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16
Q

Which one of the following types of biopsies uses an automatic spring loaded device?

A

core biopsies

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17
Q

What wait time after discontinuing the use of aspirin or blood thinner? How long should the patient be off blood thinner before having a procedure?

A

4 to 6 hours for heparin
3 to 4 days for coumadin
5 to 7 days for aspirin

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18
Q

An image should be documented with the patient’s name and what else before the exam is begun?

A

“time out”
date and time
needle tip documentation

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19
Q

What is the most common organ biopsied?

A

liver

20
Q

What would be a reason to perform a renal parenchymal biopsy?

A

patients with:
proteinuria
nephrotic syndrome
renal failure

21
Q

What part of the kidney is being biopsied when the a renal parenchymal biopsy is being performed?

A

lower pole of the left kidney

22
Q

What is the specific complication to a renal biopsy?

A

perinephric hematoma and hematuria

23
Q

Biopsies of the spleen carry an increased risk for what?

A

bleeding or hemorrhage

24
Q

What patient position is commonly used in a prostate biopsy?

A

LLD

Left Lateral Decubitus

25
Q

What lab test could indicate a liver lesion?

A

elevated AFP (alpha-fetoprotein)

26
Q

A bursa provides what function?

A

a fluid filled cavity that helps reduce the friction between moving parts of a joint

27
Q

If you see a baker’s cyst, what would that be an example of?

A

a communicating bursa

28
Q

Infringement of the median nerve of the wrist results in what disorder?

A

carpal tunnel syndrome

29
Q

The tendon responsible for dorsal and plantar flexion of the foot is what tendon?

A

Achilles Tendon

30
Q

What type of tendinitis causes pain over the lateral wrist?

A

de Quervain’s tendinitis

31
Q

A complete tear of the muscle with straight forward appearance of a retracted hyperechoic muscle surrounded by a hematoma?

A

Clapper in the bell sign

32
Q

Support and strength of a joint result in part from which one of these structures?

A

ligament

33
Q

When compared with muscle, a normal nerve is what type of sonographic appearance?

A

a nerve has a hyperechoic appearance compared with muscle

34
Q

Artifact in musculoskeletal ultrasound include what?

A

aniosotrphy
reverberation
time of flight artifact
refractile shadowing

35
Q

Why is the achilles tendon at an increased risk for injury?

A

limited blood supply

36
Q

Indications for wrist sonography include what?

A

masses
loss or decrease of digital mobility
pain and swelling
trauma
foreign body location
numbness of the middle and index fingers
weakness or clumsiness of the hand
tingling with nerve percussion (Tinel’s sign)
pain with wrist flexion when sustained for a minute or longer (Phalen’s sign)

37
Q

Acute rotator cuff tear may be caused by what?

A

biceps tendon ruptures
falls
shoulder dislocations

38
Q

What is the proximal portion of the muscle?

A

origin

39
Q

Tendinitis is often see more in the shoulder, wrist and what other joint?

A

heel and elbow

40
Q

What is the easiest tendon to image with sonography in the adult shoulder?

A

biceps tendon

41
Q

The most common site of an Achilles tendon tear?

A

above the insertion of the tendon into the calcaneus

42
Q

What is the largest tendon in the body?

A

Achilles tendon

43
Q

Patient’s with carpal tunnel syndrome they’re experiencing a pain with a certain sign. What is this sign called?

A

Tinel’s sign or Phalen’s sign

44
Q

What is the normal sonographic appearance of muscle?

A

homogeneous with multiple fine parallel echoes

45
Q

What is the hypoechoic halo around a tendon?

A

synovial sheath
measures only a couple millimeters
inflammation of the sheath helps diagnosing problems with the tendon

Sam's Abdomen II (2 decks)

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