Ultrasound-Guided Interventional Techniques/Non Cardiac Chest

Question 1

A major advantage of ultrasound guidance is the continuous real-time visualization of the biopsy needle allows:

Answer 1

Adjustments the needle as needed during the procedure

Question 2

_______ may obscure a mass

Answer 2

Bowel gas

Question 3

The most common indication for a biopsy:

Answer 3

To confirm malignancy

Question 4

An important lab test to review prior to procedure:

Answer 4

PTT(Partial Thromboplastin Time): bleeding time

Question 5

Needle gauge corresponds to the:

Answer 5

Size/diameter

Question 6

Needle size: Higher number=

Answer 6

Smaller diameter

Question 7

A core biopsy uses an automated, spring loaded device called a:

Answer 7

Biopsy gun

Question 8

Used to guide needle placement to drain/obtain samples from as cites or pleural effusions

Answer 8

Paracentesis/thoracentesis

Question 9

Drainage of fluid/abscess collections is usually performed with/without a needle guide?

Answer 9

With

Question 10

Paracentesis/thoracentesis is usually performed with/without a needle guide?

Answer 10

Without

Question 11

Technique that doesn’t use a needle guide

Answer 11

Free hand technique

Question 12

Free hand technique is usually used for draining:

Answer 12

• ascites
• pleural fluid
• superficial lesions

Question 13

Benefit of using needle guide:

Answer 13

-faster placement of needle

Question 14

Looks at slides to determine if material/sample is diagnostic

Answer 14

Cytopathologist

Question 15

Benefits of having a cytopathologist:

Answer 15

• more successful procedures
• decrease # of passes
• reduced procedure time

Question 16

Minor biopsy complications:

Answer 16

• postprocedural pain/discomfort
• vasovagal reactions(pale, nausea, fainting)
• hematoma

Question 17

Rare, serious biopsy complications:

Answer 17

• bleeding/hemorrhage
• pneumothorax
• pancreatitis
• biliary leakage
• infection
• death

Question 18

Technology that allows side-by-side comparison and superimposition of 2 image sets:

Answer 18

Fusion technology

Question 19

Tip of the needle should appear:

Answer 19

Echogenic

Question 20

Tricks to see the needle:

Answer 20

• move needle up/down
• bob or juggle stylet
• use harmonics or compound imaging

Question 21

Fluid accumulation around the lung

Answer 21

Pleural effusion

Question 22

_____ should be evaluated for signs of pleural effusion

Answer 22

Lower chest

Question 23

Pleural effusion: Complex fluid is a sign of—

Answer 23

Malignancy, infection, or blood

Question 24

Pleural effusion is classified as _____ or ______

Answer 24

1. Transudative

2. Exudative

Question 25

*pressure infiltration* caused by increased hydrostatic pressure, typically from heart, liver, or renal failure

Answer 25

Transudative pleural effusion

Question 26

*inflammation* caused by pneumonia, cancer, or pulmonary embolism(PE)

Answer 26

Exudative pleural effusion

Question 27

Treatment of pleural effusion that determines the origin/cause of the fluid, or used for therapeutic reasons/pain relief

Answer 27

Thoracentesis

Question 28

Patient position for thoracentesis:

Answer 28

Upright

Question 29

For a thoracentesis, the fluid is accessed:

Answer 29

Posteriorly and between the ribs

Question 30

Thoracentesis: not to exceed ___ per day

Answer 30

1.5 liters

Question 31

Complication of thoracentesis: collapsed lung

Answer 31

Pneumothorax

Question 32

Pneumothorax occurs when:

Answer 32

Air leaks into the space between lung and chest wall

Question 33

Sonographically, a pneumothorax will show absence of _____

Answer 33

Lung sliding/gliding

Question 34

Treatment for pneumothorax:

Answer 34

Chest tube

Question 35

Fluid around the heart

Answer 35

Pericardial effusion

Question 36

Replacement of normal air-filled alveoli with fluid, inflammation, pus, blood, neoplastic cells

Answer 36

Lung consolidation

Question 37

Pneumothorax is diagnosed by:

Answer 37

Chest x-ray(CXR)