Vascular Intervention Flashcards
The tibial pulse is felt where?
Just posterior to the lateral malleolus
At the top of the foot
Behind the knee
Just posterior to the medial malleolus
Just posterior to the MEDIAL malleolus
What is used to enlarge an entry site and provide smoother, safer access for multiple exchanges and difficult catheter manipulations?
Glide wires
Sheaths
Dilators
Peel aways
Sheaths
Who or what allows a last image to be displayed after the exposure has stopped?
Digital fluoroscopy
The interventional radiologist
Use of rapid filming
The selected film medium
Digital fluoroscopy
What process allows the VI suite personnel to recall a stored image and manipulate it?
DICOM process
PACS process
Post procedural subtraction
Temporal subtraction
Post procedural subtraction
In an older VI suite that uses CRT monitors, what are the two available scan modes?
1) progressive
2) repeating
3) interlaced
4) dynamic
1, 2
1, 4
2, 3
1, 3
1) Progressive
3) Interlaced
What process converts the video image from the TV chain into a digital format?
ADC
VDC
VDP
TVD
ADC
True or false…
DSA takes the image received by the intensifier in analog format, converts it to digital information, then is processed by the computer for storage and display.
True
DSA uses _____ to average together several frames to reduce electronic and quantum noise.
Temporal subtraction
A high contrast medium
Television/digital image chain
Frame integration
Frame integration
True or false…
DSA allows window and level adjustments to manipulate pre-procedural images.
False. You can only manipulate POST-procedural images.
DSA signal to noise (SNR) should be:
30-60 frames per second
1024 x 768
1000:1
640 x 480
1000:1
What feature uses a pre-contrast mark and a contrast filled image to produce a subtracted image?
Image reversal
Temporal subtraction
Temporal filtering
Post procedural subtraction
Temporal subtraction
What process adds a small amount of the mask back into the subtracted image but not enough to affect the image?
Land marking
Edge enhancement
Image re-masking
Window adjustment
Land marking
Images to be archived and stored may be sent to:
1) Digital disks 2) recorders 3) PACS 4) printed to hard copy media
1, 2
1, 2, 3
2, 4
All of the above
All of the above
Of the 3 most common injection formats, which is the one used mainly in the US?
1) fixed flow rate injector 2) air compression injector 3) pressure dependent injector
1
2
3
None of the above
3) pressure dependent injector
True or false….
The primary function of the pressure injector safety is to prevent damage to the injector and the selected catheter.
False. The pressure injector safety feature is to prevent damage to the injector, the selected catheter, AND THE PATIENT’S SAFETY AS WELL.
What forms of patient identification must be made and verified before any procedure is performed on a patient?
1) MRN 2) DOB 3) name 4) written doctors orders that match request
1, 2
1, 3
1, 2, 3
All of the above
All of the above
True or false…
Educating the patient about their proposed procedure will have little or no effect on the outcome of the exam.
False. Educating the patient pre-procedure makes the patient MORE COMPLIANT AND COMFORTABLE WITH WHAT THEY MAY EXPECT.
It is the job of the _____ to check that all emergency equipment is present and functioning in their procedure room.
Engineer
Nurse
Radiologist
VI radiographer
VI radiographer
True or false…
When a patient is to be sedated for a procedure, the nurse along with monitoring the patient, can and should act as a circulator as well.
False. The nurse’s SOLE DUTY when a patient is sedated is to monitor the payment only, and nothing else.
What forms of patient identification must be made and verified before any procedure is performed on a patient?
{MRN, DOB, name, and written doctor’s order correlates with request}
MRN and DOB
MRN and name
MRN, DOB, and name
All of the above
All of the above
What form of consent is essential prior to performing any exam or procedure on a patient?
oral
written
blanket
informed
informed
True or false…
An H&P must be available and include all the body systems listed prior to performing any invasive procedure.
True
Normal values for BUN and creatinine would fall in which range, respectively?
13, 0.8
13, 2.6
26, 0.8
26, 2.6
13, 0.8
A patient’s drug absorption rate may be affected by?
1) age 2) food in the stomach 3) body weight
1, 2
2, 3
1, 3
All of the above
All of the above
Your patient’s discomfort during the injection of contrast media is mostly contributed to the contrasts?
Toxicity
Osmolality
Viscosity
Volume
Osmolality
Severe allergic reaction to a contrast agent may result in shock, which is characterized by?
1) rapid breathing 2) high pulse rate 3) possible loss of consciousness
1, 2
1, 3
2, 3
All of the above
2) high pulse rate 3) possible loss of consciousness
A patient’s vasovagal reaction is characterized by?
1) sweating 2) increased blood pressure 3) nausea
1, 2
1, 3
2, 3
All of the above
1) sweating 3) nausea
To enhance demonstration of the portal venous system, which of the following drugs may be injected prior to angiography?
Pitressin
Epinephrine
Tolazoline
Heparin
Tolazoline
Which of the following types of emboli would specifically be associated with trauma in a long bone?
Fat
Air/gas
Pulmonary
Tumor
Fat
What possible results may lidocaine mixed with contrast media exhibit?
1) may make the exam less painful
2) make decreased irritability and prevent PVCs
3) is permissible for arterial examination of upper extremities
1, 2
1, 3
2, 3
All of the above
1) may make the exam less painful
2) make decreased irritability and prevent PVCs
The dorsal pedal pulses somewhere?
At the dorsum of the foot
Just posterior to the medial malleolus
At the top of the foot around the 1st and 2nd metatarsals
At the anterior portion of the below
At the top of the foot around the 1st and 2nd metatarsals
_____ is the degree of stickiness or thickness of the contrast agent.
Toxicity
Osmolality
Viscosity
Volume
Viscosity
The ability of a contrast to be solvent with blood to thwart embolization is?
Toxicity
Osmolality
Viscosity
Miscibility
Miscibility
Vascular stenting is used in conjunction with angioplasty to?
Hold down the intimal flaps
Prevent restenosis
Hold the vessel open
At as a sheath
Hold down intimal flaps
True or false…
Angioplasty is always performed prior to stenting to expand the vessel.
False. PTA is almost always done POST stent placement, but optional pre stent placement.
True or false…
Caval filters may only be placed in the IVC.
False. Caval filters are placed in both the inferior and superior vena cava. When there is a clot present either in both iliac arteries or extending up to the renal veins, the filter is usually placed via a jugular approach in a supra renal location so as not to include the renal veins.
The most common problem associated with catheterization is?
Anaphylactic reaction to the contrast media
Nephrotoxicity
Cholesterol embolization
Bleeding at the puncture site
Bleeding at the puncture site
When the catheter is being threaded over the guide wire, it is the radiographer’s responsibility to?
1) Keep the wire held taught (clotheslining)
2) Keep enough slack to be able to advance the wire, if needed
3) Be sure the end of the guide wire remains within the sterile field
1, 2
1, 3
1, 2, 3
2, 3
1, 2, 3
Using a catheter with only a single end hole and no side holes may result in?
1) A stronger stream of contrast
2) Less catheter recoil
3) Transient narrowing of the vessel just beyond the catheter tip
1, 2
1, 2, 3
2, 3
1, 3
1) A stronger stream of contrast
3) Transient narrowing of the vessel just beyond the catheter tip
Which of the following blood pressure measurements would contraindicate angiography?
90/60
110/80
120/90
150/100
150/100
Which of the following may be used to relax the walls of arteries during angiography?
Benadryl
Nitroglycerin
Demerol
Pitressin
Nitroglycerin
Because contrast media is _____. The BUN and creatinine should be within normal range before exam is begun.
Viscous
Nephrotoxic
Electrolytic
Dynamic
Nephrotoxic
Patients who present with a decreased red blood cell count, hemoglobin, and hematocrit level may be diagnosed with?
Anemia
Leukemia
Erythema
Erythemia
Anemia
Dilation of an artery is termed?
Clot
Thrombus
Aneurysm
Embolus
Aneurysm
A potentially life-threatening condition where blood fills the intima of an artery is?
Coarctation of the artery
Dissection of the artery
Saccular aneurysm of the artery
Fusiform aneurysm of the artery
Dissection of the artery
Which of the following medications could be used to optimize visualization during a splenic arteriogram?
Vasopressin
Pituitrin
Dopamine
Priscoline
Priscoline
Which of the following medications would be used to reverse an overdose of morphine or sublimaze?
Nifedipine
Narcan
Pitressin
Priscoline
Narcan
Normal oral temperature is?
35°C
36°C
37°C
38°C
37°C
Which of the following are symptoms of a diabetic patient who is taken insulin but has not eaten?
1) Clammy, cool skin
2) Nervousness and irritability
3) Fruity smelling breath
1, 2
1, 3
2, 3
1, 2, 3
1) Clammy, cool skin
2) Nervousness and irritability
Which of the following statements regarding the cation portion of the contrast medium molecule is true?
1) it is the positive portion
2) it provides to the solubility
3) Provides the radiopaque portion
1, 2
1, 3
2, 3
1, 2, 3
1) it is the positive portion
2) it provides to the solubility
The antecubital vein is often _____.
1) Easily found
2) The access site used for short term IV solutions
3) The access site for contrast media injections
1, 2
1, 3
2, 3
1, 2, 3
1) Easily found
3) The access site for contrast media injections
True or false…
Fentanyl (sublimaze) is weaker than morphine and longer acting.
False. Fentanyl (sublimaze) is 100 times STRONGER than morphine and SHORTER acting.
Demerol (meperidine) is used in the angiography suite usually to help with shaking that can be caused when given what medication?
Activase
TPA
Priscoline
Urikinase
Urikinase
Amiodarone and other similar types of medications that control premature atrial or ventricular contractions, supraventricular tachycardia, atrial flutter or fibrillation are what class of medication?
Antiarrhythmics
Analgesics
Anti-emetic
Emergency medications
Antiarrhythmics
What class of drugs does aspirin, Pletal, Plavix, and ReoPro fall under?
Anxiolytics
Anti-emetic
Anticoagulants
Antiplatelets
Antiplatelets
Of the following medications, which one offers a relaxing and amnesia effect on the patient?
Valium
Ativan
Versed
Narcan
Versed
To reverse overmedication of Versed, Valium, or Ativan, which is the proper counter agent?
Flumazenil (Romazicon)
Narcan (naloxone)
Atropine sulfate
Epinephrine
Flumazenil (Romazicon)
True or false…
Epinephrine should not be given to relieve bronchospasm, laryngospasm, or anaphylaxis. The correct drug in this situation should be Benadryl.
False. Epinephrine SHOULD BE given to relieve bronchospasm, laryngospasm, or anaphylaxis. Benadryl is an antihistamine and is given for allergic reactions.
To open a clotted vessel, catheter, or other device which has been clotted for a relatively short duration, thrombolytic drugs may be given. Which of the following is not an example of a thrombolytic drug?
Urikinase
Glassorvase
Streptokinase
Tenecteplase
Glassorvase
Glucagon is an effective relaxant of smooth muscle structures, and is used primarily in which procedure?
Nephrostomy tube placement
Chest tube placement
Percutaneous gastrostomy tube placement
Biliary tube placement
Percutaneous gastrostomy tube placement
True or false…
The injection of medications falls under the scope of the radiologist, radiographer, and the nurse.
False. Injection of medications falls into the scope of the radiologist, and the nurse. Radiographers’ scope of medication administration include contrast media ONLY.
The angular portion of the needle tip is the?
Bevel
Cannula
Gauge
Hub
Bevel
During an interventional procedure your patient begins to show symptoms of dyspnea, chest pain, tachycardia, hypotension, agitation, disorientation, and cyanosis. What did the patient possibly acquire?
Anaphylaxis
Cardiac arrhythmias
Hemothorax
Air embolism
Air embolism
_____ is a serious allergic reaction, whose signs and symptoms may be urticaria, faintness or consciousness, swelling, asthmatic symptoms, death. You should administer _____ via IV is soon as possible.
Air embolism, epinephrine
Anaphylaxis, adrenaline
Tachycardia, Demerol
Anaphylaxis, epinephrine
Anaphylaxis, adrenaline
Vasovagal response is characterized by what symptoms?
1) Fainting or black out
2) warm and sweaty
3) nausea and pale skin coloration
1, 2
2, 3
1, 3
1, 2, 3
1, 2, 3
The method by which needle entry is made into an artery is known as the _____ technique.
Feldbaum
Seldinger
Dilinger
Single wall needle
Seldinger
Which of the following are criteria for performing a vascular interventional bedside procedure?
Body habitus exceeds the state guidelines for your interventional labs equipment
Peripheral access for emergency medication included ministration is poor or nonexistent, and the patient’s condition is not conducive to transport to the original lab
Chest tube insertion or emergency bedside dialysis is needed on an emergency basis
All of the above
All of the above
True or false…
Informed consent and pre-procedure labs within normal limits are not required for interventional procedures.
False.
The left and right hepatic duct join to become the?
Common bile duct
Hepatic artery
Common hepatic duct
Portal duct
Common hepatic duct
Which of the following does the celiac artery not supply?
stomach
intestines
liver
spleen and pancreas
Intestines
_____ is a term describing a group of symptoms (pain, vomiting, cramping after eating, diarrhea, weight loss) caused by chronic poor blood flow.
Intestinal angina
Bowel obstruction
PMS
Colitis
Intestinal angina
What supplies blood to the small intestines, cecum, ascending aorta, hepatic flexure, and the right half of the transverse colon?
SAM
SMA
GDA
IMA
SMA
What supplies blood to the left half of the transverse colon, splenic flexure, descending colon, and rectosigmoid area?
HGA
SMA
IDA
IMA
IMA
The _____ is formed by the union of the superior mesenteric vein and the splenic vein.
Hepatic vein
Inferior mesenteric vein
Portal vein
Diaphragmatic vein
Portal vein
True or false…
The splenic artery branches from the right side of the celiac access and supplies the spleen and pancreas.
False. The splenic artery branches from the LEFT side of the celiac access and supplies the spleen and pancreas.
The walls of arteries have three layers, which of the following are listed in the correct order from outside to the inside layers:
Adventitia, intima, media
Adventitia, media, intima
Intima, media, adventitia
Media, intima, adventitia
Adventitia, media, intima
Both the contrast filled vessel and item being introduced into the vessel are displayed together when _____ is utilized.
Roadmapping
Pixel shifting
Land marking
Mask image utilization
Roadmapping
True or false…
The aortic arch is best visualized with a 45° right anterior oblique (RAO) position.
False. The aortic arch is best for last with a 45° LEFT anterior oblique LAO position.
Various methods of revascularization are available. Which method is the most frequently used?
Laser
Atherectomy
Percutaneous transluminal angioplasty (PTA)
Stenting
Percutaneous transluminal angioplasty (PTA)
PTA can be applied to almost any vessel, but is most commonly performed on all the following arteries except?
Iliac
Femoral
Cerebral
Renal
Cerebral
Anterior cerebral artery
2
Internal carotid artery
1
Middle cerebral artery
3
Pericallosal artery
4
Anterior parietal artery
5
Posterior parietal artery
6
Ophthalmic artery
7
Anterior internal frontal artery
8
Middle internal frontal artery
9
Vertebral artery
1
Basilar artery
2
Posterior cerebral artery
3
Posterior inferior cerebellar artery
4
Anterior inferior cerebellar artery
5
Superior cerebellar artery
6
Parieto-occipital artery
7
Calcarine artery
8
Celiac trunk
1
Common hepatic artery
3
Left gastric artery
2
Right gastric artery
5
Gastroduodenal artery
4
Cystic artery
9
Right hepatic artery
8
Left hepatic artery
7
Middle hepatic artery
10
Portal vein
1
Cystic duct
7
Common bile duct
2
Abdominal aorta
1
Internal iliac artery
2
Common iliac artery
3
External iliac artery
4
Common femoral artery
5
Profunda femoris artery
6
Superficial femoral artery
7
Popliteal artery
8
Anterior tibial artery
9
Posterior tibial artery
10
Dorsalis pedis
11