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Chapter 14 > Workbook > Flashcards

Workbook Flashcards

1
Q

The kidneys and ureters are located in the

A

Retroperitoneal

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2
Q

The ? glands are located directly superior to the kidneys.

A

suprerenal (adrenal)

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3
Q

Which structures create a 20 degree angle between the upper pole and lower pole of the kidney?

A

psoas major muscles

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4
Q

What is the specific name for the mass of fat that surrounds each kidney?

A

perirenal fat or adipose capsule

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5
Q

What degree of rotation from supine is required to place the kidneys parallel to the IR?

A

30 degrees

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6
Q

Which two landmarks can be palpated to locate the kidneys?

A

xiphoid process and iliac crest

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7
Q

Which term describes an abnormal drop of the kidneys when the patient is placed erect?

A

nephroptosis

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8
Q

List the three functions of the urinary system.

A

Remove nitrogenous
Regulate water levels
Regulate acid base balance

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9
Q

A buildup of nitrogenous waste in the blood is called.

A

Uremia

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10
Q

The longitudinal fissure found along the central medial border of the kidney is called the

A

Hilum

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11
Q

The peripheral or outer portion of the kidney is called the

A

Cortex

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12
Q

The term that describes the total functioning portion of the kidney is

A

Renal parenchyma

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13
Q

The microscopic functional and structural unit of the kidney is the

A

Nephron

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14
Q

The efferent arterioles carry blood on the glomeruli.

A

False

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15
Q

What is another (older) name for the glomerular capsule?

A

Bowman capsule

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16
Q

The glomerular capsule and proximal and distal convoluted tubules are located in the medulla of the kidney.

A

False

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17
Q

Which structure of the medulla is made up of a collection of tubules that drain into the minor calyx?

A

Renal pyramids

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18
Q

Which two processes move urine through the ureters to the bladder?

A

Peristalsis

Gravity

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19
Q

Which one of the following structures is located most anterior as compared with the others?

A

Urinary bladder

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20
Q

What is the name of the junction found between the distal ureters and urinary bladder?

A

Ureterovesical junction

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21
Q

What is the name of the inner, posterior region of the bladder formed by the two ureters entering and the urethra exiting?

A

Trigone

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22
Q

What is the name of the small gland found just inferior to the male bladder?

A

Prostate gland

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23
Q

The total capacity for the average adult bladder is:

A

350 to 500ML

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24
Q

Which one of the following structures is considered to be most posterior?

A

Kidneys

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25
Q

Intravenous contrast media may be administered by either:

A

Bolus injection

Drip infusion

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26
Q

The patient (or legal guardian) must sign an informed consent form before a venipuncture procedure is performed on a pediatric patient.

A

True

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27
Q

For most IVUs, veins in the ? are recommended for venipuncture.

A

Antecubital fossa

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28
Q

The most common size of needle used for bolus injections on adults is:

A

18 to 22 gauge

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29
Q

The two most common types of needles used for bolus injection of contrast media are

A

Butterfly

Over the needle catheter

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30
Q

In the correct order, list the six steps followed during a venipuncture procedure as listed and described in the textbook

A

1) wash hands and put on gloves
2) select site, apply tourniquet, and cleanse the site
3) initiate puncture
4) confirm entry and secure needle
5) prepare and proceed with injection
6) Remove needle or catheter

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31
Q

The bevel of the needle needs to be facing downward during the actual puncture into a vein.

A

False

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32
Q

If extravasation occurs during the puncture, the technologist should slightly retract the needle and then push it forward again

A

False

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33
Q

If unsuccessful during the initial puncture, a new needle should be used during the second attempt.

A

True

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34
Q

The radiologist is responsible for documenting all aspects of the venipuncture procedure in the patient’s chart.

A

False

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35
Q

Uses a parent compound of venzoic acid

A

Ionic

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36
Q

Will not significantly increase the osmolality of the blood plasma

A

Nonionic

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37
Q

Incorporates sodium or meglumine to increase solubility of the contrast media.

A

ionic

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38
Q

Creates a hypertonic condition in the blood plasma

A

ionic

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39
Q

Is more expensive

A

nonionic

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40
Q

Produces less severe reactions

A

nonionic

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41
Q

Is a near isotonic solution

A

nonionic

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42
Q

Poses a greater risk for disrupting homeostasis

A

ionic

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43
Q

Uses a parent compound of an amide or glucose group

A

nonionic

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44
Q

May increase the severity of side effects

A

ionic

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45
Q

Which one of the following compounds is a common anion found in ionic contrast media?

A

Diatrizoate or iothalamate

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46
Q

Any disruption in the physiologic functions o the body that may lead to a contrast media reaction is the basis for the:

A

Chemotoxic theory

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47
Q

An expected outcome to the introduction of contrast media is described as a

A

Side Effect

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48
Q

The normal creatinine level for an adult should range between

A

0.6 to 1.5 mg/dl

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49
Q

Normal BUN levels for an adult should range between

A

8 to 25 mg/100ML

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50
Q

Metformin hydrochloride is a drug that is taken for the management of

A

Diabetes/Mellitus

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51
Q

The American College of Radiology recommends that metformin be withhelf for ? hours after a contrast medium procedure and resumed only if kidney function is again determined to be within normal limits.

A

48

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52
Q

The leakage of contrast media from a vessel into the surrounding soft tissues is called

A

Extravascation (infiltration)

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53
Q

List the two general categories of contrast media reactions:

A

Local

Systemic

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54
Q

Which type of reaction is a true allergic response to iodinated contrast media?

A

anaphylactic reactor

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55
Q

Which type of reaction is caused by the stimulation of the vagus nerve by introduction of a contrast medium, which causes heart rate and blood pressure to fall?

A

Vasovagal reaction

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56
Q

Vasovagal reactions are not considered to be life threatening

A

False

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57
Q

Brachycardia (<50 beats/minute)

A

Severe (reaction to contrast)

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58
Q

Tachycardis (>100 beats/minute)

A

Moderate (reaction to contrast)

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59
Q

Angioedema

A

Moderate (reaction to contrast)

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60
Q

Lightheadedness

A

Mild (reaction to contrast)

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61
Q

Hypotension (systolic blood pressure <80 mm Hg)

A

Severe (reaction to contrast)

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62
Q

Temporary renal failure

A

Severe (reaction to contrast)

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63
Q

Laryngeal swelling

A

Severe (reaction to contrast)

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64
Q

Cardiac Arrest

A

Severe (reaction to contrast)

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65
Q

Mild hives

A

Mild (reaction to contrast)

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66
Q

Mild level contrast media reactions do not usually require medication or medical assistance.

A

True

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67
Q

Urticaria is the formal term for excessive vomiting.

A

False (hives)

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68
Q

A temporary failure of the renal system is an example of a(n) ? reaction.

A

Severe

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69
Q

Convulsions

A

Severe systemic (reaction)

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70
Q

Metallic taste

A

Side effect (reaction)

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71
Q

Angioedema

A

Moderate systemic (reaction)

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72
Q

Bradycardia

A

Severe systemic (reaction)

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73
Q

itching

A

Mild systemic (reaction)

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74
Q

Vomiting

A

Mild systemic (reaction)

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75
Q

Temporary hot flash

A

Side effect (reaction)

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76
Q

Respiratory arrest

A

Severe systemic (reaction)

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77
Q

Pulmonary edema

A

Local (reaction)

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78
Q

Extravasation

A

Severe systemic (reaction)

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79
Q

Severe urticaria

A

Moderate systemic (reaction)

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80
Q

What should the technologist do first when a patient is experiencing either a moderate or a severe level contrast media reaction?

A

call for medical assistance

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81
Q

What is the primary purpose of the premedication procedure before an iodinated contrast media procedure?

A

to reduce the severity of contrast media reactions

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82
Q

Which of the following drugs is often given to the patient as part of the premedication procedure?

A

combination of Benadryl and prednisone.

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83
Q

Which type of patient is a likely candidate for the premedication procedure before a contrast media study?

A

Asthmatic patient

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84
Q

In addition to notifying a nurse or physician when contrast media has extravasated into the soft tissues, what should the technologist first do to increase reabsorption?

A

Elevate the affected extremity or use a cold compress followed by a warm compress

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85
Q

Tissue inflammation from extravasated contrast media peaks 1 to 2 hours after the incident.

A

False

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86
Q

Acute renal failure may occur 48 hours after an iodinated contrast media procedure.

A

True

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87
Q

List 10 contraindications that may prevent a patient from having a contrast media procedure performed.

A

1) hypersensitivity to iodinated contrast media
2) Anuria
3) Multiple myeloma
4) Diabetes Mellitus
5) Sever hepatic or renal disease
6) congestive heart failure
7) pheochromocytoma
8) sickle cell anemia
9) patients taking metforming or similar medication
10) renal failure acute or chronic

88
Q

A trademark name for a diuretic drug is

A

Lasix

89
Q

Why is the term IVP incorrect in describing a radiographic examination of the kidneys, ureters, and bladder after intravenous injection and contrast media?

A

An IVP (intravenous pyelogram) is a study of the renal pelvis.

90
Q

What is the correct term for an (IVU)?

A

Intravenous urogram

91
Q

Which specific aspect of the kidney is visualized during an IVU?

A

The collecting system of the kidney.

92
Q

Which one of the following conditions is a common pathologic indication for an IVU?

A

Hematuria

93
Q

Which one of the following conditions is described as a rare tumor of the kidney?

A

Pheochromocytoma

94
Q

Pneumouria

A

Presence of gas in urine

95
Q

Urinary reflux

A

Backward return flow of urine

96
Q

Uremia

A

Excess urea and creatinine in the blood

97
Q

Anuria

A

Complete cessation of urinary secretion

98
Q

Polyuria

A

Passage of large volume of urine

99
Q

Micturition

A

Act of voiding

100
Q

Retention

A

Inability to void

101
Q

Oliguria

A

Diminished amount of urine being excreted

102
Q

Glucosuria

A

Presence of glucose in urine

103
Q

Urinary incontinence

A

Constant or frequent involuntary passage of urine

104
Q

Renal agenesis

A

Absence of a functioning kidney

105
Q

Acute renal failure

A

Indicated by presence of uremia, oliguria, or anuria

106
Q

Enlargement of the prostate gland

A

Benign prostatic hyperplasia

107
Q

Fusion of the lower poles of kidneys during the development of the fetus

A

Horseshoe kidney

108
Q

inflammation of the capillary loops of the glomeruli of the kidneys

A

Glomerulonephritis

109
Q

Artificial opening between the urinary bladder and aspects of the large intestine.

A

vesicorectal fistula

110
Q

A large stone that grows and completely fills the renal pelvis

A

Staghorn calculus

111
Q

Increased blood pressure to the kidneys due to atherosclerosis

A

Renal hypertension

112
Q

Normal kidney that fails to ascent into the abdomen but remains in the pelvis

A

Ectopic kidney

113
Q

Multiple cysts in one or both kidneys

A

Polycystic kidney disease

114
Q

Rapid excretion of contrast media

A

Renal hypertension

115
Q

Mucosal changes within bladder

A

Cystitis

116
Q

Bilateral, small kidneys with blunted calyces

A

Chronic Bright disease

117
Q

Irregular appearance of renal parenchyma or collecting system

A

Renal cell carcinoma

118
Q

signs of abnormal fluid collections

A

Vesicorectal fistula

119
Q

Abnormal rotation of the kidney

A

Malrotation

120
Q

Elevated or indented floor of bladder

A

BPH

121
Q

signs of obstruction of urinary system

A

Renal Calculi

122
Q

A condition characterized by regions or areas of subcutaneous swelling caused by allergic reaction to food or drugs is termed

A

Angioedema

123
Q

contraction of the muscles within the walls of the bronchi and bronchioles, producing a restriction of air passing through them, is a condition called

A

Bronchospasm

124
Q

Loss of consciousness resulting from reduced cerebral blood flow is termed

A

syncope

125
Q

An eruption of welts (hives) often caused by a hypersensitivity to food or drugs is a condition termed

A

Uriticaria

126
Q

What type of renal calculi is often associated with chronic urinary tract infections?

A

Staghorn calculi

127
Q

The patient should void before an IVU to prevent possible rupture of the bladder if compression is applied.

A

True

128
Q

What is the primary purpose of ureteric compression?

A

to enhance filling of the pelvicaliceal system w/ contrast medium

129
Q

List the six conditions that could contraindicate the use of ureteric compression:

A 
Possible ureteric stones
Abdominal mass
Abdominal aortic aneurysum
recent abdominal surgery
severe abdominal pain
acute abdominal pain
130
Q

What does the timing for an IVU exam start?

A

at start of injection of contrast media

131
Q

List the routine five-step imaging sequence for a routine IVU:

A 
1 minute nephrogram or nephrotomography
5 minute full KUB
10 to 15 minute full KUB
20 minute posterior R and L oblique posterior
postvoid (prone PA or erect AP)
132
Q

What is the primary difference between a standard and hypertensive IVU?

A

A hpertensive IVU requires a shorter span of time between projections.

133
Q

In which department are most retrograde urograms performed?

A

surgery (inpatient or outpatient facility)

134
Q

A retrograde urogram examines the anatomy and function of the pelvicaliceal system.

A

False (nonfunction)

135
Q

The Brodney clamp is used for male and female retrograde cystourethrograms.

A

False

136
Q

Which of the following involves a direct introduction of the contrast media into the structure being studied?

A

Retrograde urogram
Retrograde cystogram
Retrograde urethorogram

137
Q

Which of the following alternative imaging modalities is not routinely being used to diagnose renal calculi?

A

Magnetic resonance imaging

138
Q

urinary studies on pediatric patients should be scheduled early in the morning to minimize the risk for dehydration.

A

True

139
Q

The number of retrograde urography procedures for urethral calculi has been reduced as a result of the increased use of CT.

A

True

140
Q

Exposure factors used during a CT procedure can be adjusted to compensate for a decrease or increase in body size according to ? and ?.

A

height

weight

141
Q

The patient does not require extensive bowel preparation before a CT scan for renal calculi.

A

True

142
Q

Which imaging modality is used to detect subtle tissue changes following a renal transplant?

A

MRI

143
Q

Nuclear medicine is highly effective in demonstrating signs of vesicoureteral reflux.

A

True

144
Q

How will an enlarged prostate gland appear on a postvoid radiograph taken during an IVU?

A

the prostate gland will indent the floor of the bladder.

145
Q

Where should the pneumatic paddle be placed for the ureteric compression phase of an IVU?

A

just medial to the ASIS and lateral to the spine.

146
Q

What can be done to enhance filling of the calyces of the kidney if ureteric compression is contraindicated?

A

place the patient in a 15 degree trendenlenburg position

147
Q

A retrograde pyelogram is primarily a nonfunctional study of the

A

renal pelvis, major and minor calyces of the kidneys

148
Q

What are the four reasons a scout projection is taken before the injection of contrast media for an IVU?

A

Verify patient preparation
determine whether exposure forms are acceptable
verify positioning
detect any abnormal calcifications

149
Q

What specific anatomy is examined during a retrograde ureterogram?

A

Primarily the ureters

150
Q

Which specific position is recommended for a male patient during a voiding cystourethrogram?

A

30 degree RPO

151
Q

What KV range (analog and digital) is recommended for an IVU?

A

70-75 KV analog

70-80 KV digital

152
Q

There is a change in SID recommendations when placing a patient erect versus supine for an IVU AP projection.

A

False

Both the AP erect and supine IVU image have recommended 40” SID

153
Q

Male and female patients should have the gonads shielded for an AP scout projection

A

False

not female; would obstruct essential anatomy

154
Q

Tomograms taken during an IVU with an exposure angle of 10 degree or less are called zonography.

A

True

155
Q

How many tomogranms (zonograms) are usually produced during a routine IVU?

A

Three

156
Q

At what stage of an IVU is the renal parenchyma best seen?

A

within 1 minute after injection

157
Q

Where is the CR centered for a nephrotomogram?

A

midway between xiphoid process and iliac crest

158
Q

Which specific position, taken during an IVU, places the left kidney parallel to the IR?

A

RPO

159
Q

How much obliquity is required for the LPO/RPO projections taken during an IVU?

A

30 degrees

160
Q

Which position best demonstrates possible nephroptosis?

A

erect position

161
Q

What CR angle is used for the AP projection taken during a cystogram?

A

10 to 15 degree caudad

162
Q

A radiograph of an AP scout projection of the abdomen, taken during an IVU, reveals that the symphysis pubis is cut off slightly. The patient is too large to include the entire abdomen on a 14 times 17 inch IR. What should the technologist do in this situation?

A

A second projection of the bladder should be taken, using a smaller IR paced crosswise to include this region the large IR should be centered 1 or 2 inches higher to include the upper abdomen.

163
Q

A nephrogram is ordered a part of an IVU study. When the nephogram image is processed, there is a minimal amount of contrast media within the renal parenchyma and the calyces are beginning to fill with contrast media. What specific problem led to this radiographic outcome?

A

Too long of a delay between the injection of contrast media and the imaging of nephrogram. The nephogram needs to be taken no later than 60 seconds after injection.

164
Q

A 45 degree RPO radiograph taken during an IVU reveals that the left kidney is foreshortened. What modification is needed to improve this image during the repeat exposure?

A

Decrease the obliquity of the RPO to no more than 30 degrees.

165
Q

An AP projection taken during the compression phase of an IVU reveals that the majority of the contrast media has left the collecting system of the kidneys. The technologist placed the pneumatic paddles near the umbilicus and ensured that they were inflated. What can the technologist do to ensure better retention of contrast media in the collecting system during the compression phase of future IVUs?

A

Place the neumatic paddles just medial to the ASIS to allow for compression of the distal ureters against the pelvic brim.

166
Q

An AP axial projection radiograph taken during a cystogram reveals that the floor of the bladder is superimposed over the symphysis pubis. What can the technologist do to correct this problem during the repeat exposure?

A

Increase caudad angulation of the CR to project the synphysis pubis below the bladder. The typical CR angle is 10-15 degrees caudad.

167
Q

A patient comes to the radiology department for an IVU. While taking the clinical history, the technologist learns the patient has renal hypertension. How must the technologists modify the IVU imaging sequence to accommodate this patient’s condition?

A

Decrease the span of time between projections to capture all phases of the urinary system. (take images at 1, 2, and 3 minutes rather than 1, 5, and 15.

168
Q

A the technologist patient comes to the radiology department for an IVU. The AP scout reveals an abnormal density near the lumbar spine that the radiologist suspects is an abdominal aortic aneurysm. What should the technologist do about the ureteric compression phase of the study that is part of the procedure protocol?

A

The technologist should not perform the compression phase of the study. Uretric compression is contraindicated when an abdominal aortic areurism is suspected (the technologist should consult with the radiologhist or physician.

169
Q

A patient comes to the radiology department for an IVU. The patient history indicates that he may have an enlarged prostate gland. What projection will best demonstrate this condition?

A

The erect prevoid AP projection will best demonstrate an enlarged prostate gland.

170
Q

A patient with a history of bladder calculi comes to the radiology department. A retrograde cystogram has been ordered. During the interview, the patient reports that he had a severe reaction to contrast media in the past. What other imaging modality can be performed to best diagnose this condition?

A

Ultrasound, CT or nuclear medicine scan

171
Q

The same patient described in question 9 may also have calculi in the kidney. What is the preferred imaging modality for this situation when iodinated contrast media cannot be used.?

A

Ct is preferred but a nuclear medicine procedure can also be performd

172
Q

A patient comes to the radiology department for an IVU. As the patient’s clinical history is being reviewed. It is discovered that he is diabetic. What additional question(s) should the patient be asked during the interview before the procedure?

A

The patient should be asked whether he is taking metformin or similar medication to control diabetes. If his response is yes, document and inform this radiologist of the patient’s condition and medication history before injection. The referring physician may be asked to check kidney function, before the patient resumes this medication.

173
Q

During an IVU, the patient complains of a metallic taste and has a sudden urge to urinate. What action should the technologist take?

A

There are expected side affects and the technologist should reassure the patient. No medical treatment is required.

174
Q

While viewing the chart of a patient scheduled for an IVU, the technologist discovers that the BUN of the patient is 15mg/100 mL with a creatinine level of 1.3 mg/dL. Can this patient safely undergo an IVU?

A

Although the technologist should inform the radiologist or injecting technologist of the blood chemistry levels both BUN and creatine levels are within the range of normal.

175
Q

The kidneys are ? structures.

A

Retroperitoneal

176
Q

The ureters enter the ? aspect of the bladder.

A

Posterolateral

177
Q

The kidneys lie at ? angle in relation to the coronal plane.

A

30 degree

178
Q

An abnormal drop of more than ? inches, or ? cm, in the position of the kidneys when the patient is erect indicates a condition termed nephroptosis.

A

2 or 5

179
Q

The buildup of nitrogenous waste in the blood creates a condition called

A

Uremia

180
Q

How much urine is normally produced by the kidneys in 24 hours?

A

1.5 L

181
Q

The renal veins connect directly to the

A

Inferior vena cava

182
Q

The 8 to 18 conical masses found within the renal medulla are called the

A

Renal pyramids

183
Q

The major calyces of the kidney unite to form the

A

Renal pelvis

184
Q

The microscope unit of the kidney (of which there are more than 1 million in each kidney) is called the

A

nephron

185
Q

About 50% of the glomerular filtrate processed by the nephron is reabsorbed into the kidney’s venous system.

A

False

186
Q

The loop of Henle and collecting tubules are located primarily in the medulla of the kidney.

A

True

187
Q

The three constricted points along the length of the ureters where a kidney stone is most likely to lodge are:

A

ureteropelvic (UP) Junction
near brim of pelvis
ureterovesical (UV) junction

188
Q

The inner, posterior triangular aspect of the bladder that is attached to the floor of the pelvis is called the

A

Trigone

189
Q

Under what circumstances should a pregnant patient have an IVU performed?

A

When the benefit of the procedure outweights the risk of the radiation exposure.

190
Q

List the two classes of iodinated contrast media used for urinary studies:

A

Ionic and nonionic

191
Q

The normal range of creatinine in an adult is:

A

0.6 to 1.5mg/dL

192
Q

How long must a patient be withheld from taking metformin after an iodinated contrast media procedure?

A

48 hours

193
Q

Hot flashes are classified as a

A

side effect

194
Q

Which one of the following veins is not normally selected for venipuncture during an IVU.

A

axillary

195
Q

At what angle is the needle advanced into the vein during venipuncture?

A

20 to 45 degree

196
Q

How long should the venipuncture site be cleaned with an alcohol wipe before needle insertion?

A

30 seconds

197
Q

How high should the tourniquet be placed above the puncture site?

A

3 to 4 inches

198
Q

Which one of the following conditions is considered high risk for an iodinated contrast media procedure?

A

pheochromocytoma

199
Q

What is the normal range for a patient’s BUN?

A

8 to 25 mg/100ML

200
Q

What is the best course of action for a patient experiencing a mild systemic contrast media reaction?

A

Observe and reassure patient

201
Q

Which of the following is a symptom of a vasovagal reaction?

A

Cardiac arhythmias

202
Q

A true allergic reaction to iodinated contrast agents is classified as a(n)

A

anaphylactic reaction

203
Q

Which of the following drugs may be given to minimize the risk for acute renal failure following a contrast media procedure?

A

Lasix

204
Q

Metformin is a drug given to patients with:

A

diabetes

205
Q

Which one of the following drugs can be given as part of the premedication protool before an iodinated contrast media procedure?

A

prednisone

206
Q

excretion of a diminished amount of urine in relation to the fluid intake is the general definition for:

A

nephroptosis

207
Q

Constant or frequent involuntary passage of urine is termed:

A

urinary incontinence

208
Q

The absence of a functioning kidney is called

A

renal agenesis

209
Q

Complete cessation of urinary secretion by the kidneys is termed

A

anuria

210
Q

Adult forms of polycystic disease are inherent.

A

True

211
Q

Hypernephroma is another term:

A

renal cell carcinoma

212
Q

Laryngeal swelling is classified as a:

A

severe level reaction

213
Q

Which one of the following conditions may produce hydronephrosis?

A

renal obstruction

214
Q

The patient should void before the IVU to prevent dilution of the contrast media in the bladder.

A

True

215
Q

Which one of the following conditions would contraindicate the use of ureteric compression?

A

ureteric calculi

216
Q

Typically, at what timing sequence during an IVU are the oblique projections taken?

A

20 minute following injection

217
Q

Which projections best demonstrates the renal parenchyma? when should it (they) be taken?

A

nephrogram or nephrotomograp by immediately after completion of injection

Chapter 14 (3 decks)

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