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AP 2 Book
Lecture 1 exam study - Contrast Media
| Question | Answer |
|---|---|
| Tissue density is determined by the number of protons (positive charges)within the nuclei of the tissue's atoms, other wise known as the? | Atomic Number |
| The reduction of radiation as it passes through matter | Attenuation |
| More X-rays are absorbed (attenuated) by structures with _____ atomic numbers. | high |
| The Atomic Number of the organs is approximately what? (digestive, urinary, biliary, cardiovascular systems) | 7.4 |
| The degree of differential absorption resulting in differing absorption characteristics of the tissues in the body | Subject Contrast |
| Differences in density between two adjacent areas on a radiographic image | Radiographic Contrast |
| Organs within the Digestive, Biliary, and Urinary Systems and the blood vessels of the Cardiovascular System are said to have _____ subject contrast, they absorb _____ ______ amount of radiation and appear ______ as surrounding tissue. | The same; similar |
| Contrast media that are administered to a patient to enhance the contrast of a particular structure are what? | Pharmaceutical Agents |
| The use of contrast media does what to to a structure, which in turn does what to the absorption of X-rays? | Alters the density of the structure; Alters the absorption |
| The use of contrast media produces a visible change in the ______ _____ visualized on an image. | Radiographic Contrast |
| What are the two classifications of Contrast Media: | Negative Contrast Media and Positive Contrast Media |
| Negative Contrast Media has a ____ Atomic Number, resulting in _____ radiation reaching the image receptor. | Low; more |
| What color will negative contrast media appear on a radiographic image? | Black |
| What is the most common negative contrast media used? | Room Air |
| Positive Contrast Media has a ____ Atomic Number, resulting in ____ radiation reaching the image receptor. | high; less |
| What color will positive contrast media appear on a radiographic image? | White |
| is Positive Contrast Media Radiopaque or Radiolucent? | Radiopaque |
| Is Negative Contrast Media Radiopaque or Radiolucent? | Radiolucent |
| What are the two types of positive contrast media used in radiology to enhance visibility of structures on a radiographic image? | Barium Sulfate and Water-Soluble Iodinated Contrast Media |
| Atomic Number of Barium? | 56 |
| When combined with oxygen and sulfate, barium forms the inert compound barium Sulfate, abbreviated as what? | BaS04 |
| Barium Sulfate use: 1. 2. 3. | 1. Administered either orally or rectally and only in the Gastrointestinal System 2. It is insoluble in water 3. When mixed with water it forms a colloidal suspension |
| Barium Sulfate as a colloidal suspension: 1. 2. | 1. Barium sulfate particles will settle over time in water 2. The suspension must be dense enough to coat the mucosal lining and outline visceral walls, yet able to flow smoothly through digestive system |
| How is Barium available? | Prepackaged paste, liquid, powder, and tablet form |
| Thickness of Barium Sulfate depends upon what? | How much water is added |
| Thick barium sulfate contains what part barium and what part water? | 3-4 parts BaS04 to 1 part water |
| Thin barium sulfate contains what part barium and what part water? | 1 part BaS04 to 1 part water |
| Thick Barium Sulfate typically comes in what form? | Paste |
| Barium Sulfate is used for ACBE to adhere to the ______ ______ prior to putting in air | mucosal lining |
| Thin Barium Sulfate comes in what form and is used for what examinations? | Powder; UGI, SBFT, BE (examinations of the stomach |
| Barium Sulfate Tablets are useful for what? | Visualizing foreign objects or strictures (narrowing) in the Esophagus during fluoroscopy |
| Where do Barium Sulfate tablets dissolve when mixed with water? | In either the Esophagus or Stomach |
| ______ kV must be used for barium examinations in order to penetrate the Barium Sulfate | High (typically 100-110) |
| Barium Sulfate has very ____ toxicity | low |
| Because one of the functions of the Large Intestine is to absorb water, barium sulfate can cause what? | A bowel impaction |
| Why should care be take to avoid patient vomiting after ingestion of barium sulfate? | aspiration into lungs (potential for pneumonia or mediastinitis) |
| Is it common to have an allergic reaction to barium sulfate? | No, its very rare |
| Contraindications of Barium Sulfate: 1. 2. 3. 4. | 1. Suspected GI or bowel perforation 2. Pre-surgery 3. Post-surgery |
| The element ______ is used in water soluble contrast media because it forms stable compounds | iodine |
| Atomic number of Iodine | 53 |
| Iodinated contrast media are used to visualize: 1. 2. 3. 4. 5. 6. | 1. Urinary System 2. Spinal Canal 3. Female Reproductive System 4. Biliary System 5. Joints of the Musculoskeletal System 6. When BaS04 is contraindicated |
| Water-Soluble Iodinated Contrast Media are used because they: 1. 2. 3. | 1. Mix readily with blood and body fluids 2. Are absorbed and excreted by the kidneys through the circulatory system 3. Come in a variety of concentrations depending upon the % of iodine in solution |
| Five specific characteristics of Water-Soluble Iodinated Contrast Media: | 1. Iodine Content 2. Osmolality 3. Concentration 4. Viscosity 5. Toxicity |
| Iodine Content refers to what? | The contrast media's ability to absorb x-ray photons |
| The higher the concentration of iodine, the _____ x-rays will be absorbed, the _____ radiopaque the structure will appear on an image | more; more |
| Iodine Content is stated in units of what? | Milligrams/milliliter (MG/MI) |
| Hypaque 90%/462 means there are: 1. 2. | 1. 90 grams of salts in 100 ml of solute 2. 462 mg of Iodine in each milliliter of solution (stated as a % - 46.2%, divide milligrams per milliliters by 10) |
| The number of particles in a solution | Osmolality |
| What is the Osmolality of human blood? | 300 milliosmoles/kilogram |
| Measures the body's electrolyte-water balance | Plasma Osmolality |
| The osmolality of a contrast media is directly related to what? | The occurrence of adverse reactions |
| The higher the osmolality, the ______ the chance for an adverse contrast media reaction | greater |
| refers to the total % of salts in solution | Concentration |
| What measures the resistance of the fluid to flow of a solution? | Viscosity |
| Viscosity is determined by? | The number of _____ in solution and the ______ between these particles |
| Why is contrast media frequently warmed to body temperature? | To reduce viscosity making it easier to inject |
| The toxicity of an Iodinated Contrast Media is related to its: 1. 2. 3. 4. | 1. Chemical configuration 2. Osmolality 3. Iodine concentration 4. Rate of Injection |
| Theory that states that the shifts in osmolality between the contrast media (1000-2400 osmol/kg) and blood plasma (300 osmol/kg) may cause vasodilation, changes in blood volume and pulmonary artery pressures and alterations in cardiac output | Osmolality Theory |
| Theory that states that the CNS is sensitive to ionic changes that interfere with normal electrical activity in the body, introduction of ICM disassociates the solution and forms ionic bonds, changing the composition of the blood (seizures, cardiac dys) | Ionization Theory |
| Theory that states that the Molecular interaction of contrast with blood creates a histamine release, suppression of enzymes and binds contrast agent to serum protein, results in increase in thrombin and coagulation time (produces anaphylactic reaction) | Molecular Toxicity Theory |
| Adverse reactions to Water-Soluble Iodinated Contrast Media are usually ACUTE and the vast majority will occur within when? | The fist 5 minutes after injection |
| Contrast Media reaction that causes Nausea, vomiting, metallic taste in mouth, hot flashes | Mild reaction |
| Contrast Media reaction that causes Urticaria, wheezing, hypotension, tachycardia, facial adema | Moderate reaction |
| Urticaria | Hives |
| Contrast Media reaction that causes Anaphylactic Shock, Respiratory Distress, Respiratory/Cardiac Arrest | Severe reaction |
| Two forms of Water-Soluble Iodinated Contrast agents come in two forms: | Ionic and Non-ionic |
| True or False? Ionic and Non-ionic forms of Water-Soluble Iodinated Contrast Agents both contain Iodine as the radiopaque element? | True |
| Formed from complex molecules containing a carboxyl group in the form of benzoic acid | Ionic organic iodides |
| Ionic iodinated contrast media contain a positively charged side chain element called? | A Cation |
| A salt, usually consisting of sodium, meglumine, or a combination of both | Cation |
| The cation is combined with a negatively charged component called the what? | Anion |
| Side chains that attach to the parent benzoic acid ring, along with three iodine atoms | Cation and anion |
| Once WSICM is injected the cation _______ from the parent compound or anion, creating what? | dissociates; two separate ions |
| ________ is directly related to the occurrence of adverse contrast media reactions (toxicity) | Osmolality |
| Common trade names of Ionic contrast media include: 1. 2. 3. 4. | 1. Hypaque 2. Conray 3. Renografin 4. Optiray |
| Non-ionic Organic Iodides contain Iodine, but contain no what? | Positively charged cations |
| Common trade names of non-ionic contrast media include: 1. 2. 3. 4. | 1. Omnipaque 2. Isovue 3. Amipaque 4. Ultravist |
| When molecules do not form ionic bonds when mixed with blood plasma (non-ionic contrast media), they are considered? | Isotonic |
| Common trade names of Oral/rectal WSICM 1 2 | Gastrografin or Oral Hypaque |
| Route of administration of WSICM when contrast medium is introduced directly into the anatomy of interest by means of a catheter or needle? | Direct Route |
| Examination where a urinary catheter conveys contrast medium to the bladder | Cystogram |
| Examination where an intrathecal injection of iodinated contrast medium goes into the spinal canal (thecal sac) | Myelogram |
| Examination an injection of iodinated contrast medium goes into the joint space | Arthrogram |
| Examination where an injection of iodinated contrast medium goes into the uterus | HSG |
| Examination where an injection of iodinated contrast medium goes into the salivary ducts | Sialogram |
| Examination in which a direct injection of contrast medium goes into the Hepatic Ducts of the Liver | Transhepatic Cholangiogram |
| Examination in which a direct injection of contrast medium goes into the Common Bile Duct during surgery to remove gallbladder | Operative Cholangiogram |
| Examination in which an injection of contrast medium goes through an Endoscope into the Common Bile Duct | ERCP |
| Examination in which an a direct injection of contrast medium goes into the Common Bile Duct post-Cholecystectomy | T-Tube Cholangiogram |
| Prior to an injection of Iodinated Contrast Medium, a thorough patient history is conducted to include: 1 2 3 4 | 1. Allergies to food/medications 2. History of asthma 3. History of any previous iodinated contrast reactions 4. History of Cardiac or Renal Impairment |
| What labs are evaluated prior to the use of injectable Water-Soluble Iodinated contrast media procedures? | Most current Creatinine (Cr < 1.5), GFR (<30), and/or BUN (all within 30 days) |
| Contraindications to the use of Water-Soluble Iodinated Contrast Media include: 1. 2. 3. 4. 5. | 1. Allergy or sensitivity to Iodine 2. Anuria 3. High Creatinine Level or Renal Disease 4. Congestive Heart Failure 5. Severe Dehydration |
| A chemical waste molecule that is generated from muscle metabolism, produced from Creatine | Creatinine |
| Laboratory test that estimates how much blood passes through the Glomeruli of the kidneys each minute along with other factors | Glomerular filtration rate (GFR) |
| Normal GFR range | 90-120 |
| Drug given to manage non-insulin dependent diabetes mellitus | Metformin Hydrochloride |
| The American College of Radiology recommends that Metformin be withheld how long after the contrast procedure and resumed only if what? | 48 hours; the kidney function is within normal limits |
Created by:
teresachristensen
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