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IV Procedures & CM

Study Questions

The iodine in the CM increases the _____ of the xray photons. attenuation
The increase in brightness on CT image associated with tissues perfused by IV contrast agents is: enhancement
_____ IV CM divide into charged particles (ions) when in a solution, like the patient's blood stream. Ionic
_____ IV CM do not divide into charged particles when in solution. Non-ionic
When a ____ CM is injected, the entire molecule remains intact as it passes through the body and is excreted in the same form by kidneys. non-ionic
Non-ionic CM belongs to the _____ osmolar category of IV CM. low
What is the concentration of particles in a non-ionic, low osmolar IV CM? around 500 to 850 mOsm/kg
What is the concentration in an ionic, high osmolar IV CM? around 1300 to 1600 mOsm/kg
IV CM are said to be ____ or ____ compared to blood plasma. hyperosmolar or hypertonic
_____ solutions will cause a net movement of water from within the tissues into the vascular space. Hypertonic
How can the severity of the osmotic effect, and the associated reaction, be reduced? by administering non-ionic, low osmolar CM
_____ acts by constricting smooth muscle and venules, dilating arterioles, producing localized edema, accelerating heart rate, lowering BP, and increasing gastric and mucous secretions. Histamine
What category of reaction mechanism can be caused by anything other than the properties of the CM, the amount injected, or the injection rate? idiosyncratic reaction mechanism
What injection rate would you use for a CTA? 4 to 5 cc/sec
Which vein drains the dorsal part of the hand, and runs between the pectoralis major and deltoid muscles, through clavipectoral fascia and finally joins axillary vein? cephalic vein
Which vein is the vessel of choice for injecting IV CM? basilic vein
What causes the basilic vein to remain more stationary than the cephalic vein when starting an IV in the cubital fossa? There is an anastomosis between the basilic and cephalic veins at elbow which helps basilic vein to remain quite stationary within subcutaneous tissue
How much should the needle tip be withdrawn before advancing the catheter up the vein? 2 to 3 mm
What side of the heart receives blood returning to the heart through the superior and inferior vena cava? the right side of the heart
What defines the bolus phase of enhancement? There is a significant density difference between the abdominal aorta and inferior vena cava
During which of the contrast enhancement are CTA images of optimal quality? during the bolus phase of contrast enhancement
What characterizes the non-equilibrium phase of enhancement? there is a 10 to 30 HU density difference between the abdominal aorta and inferior vena cava
During what phase of CM enhancement does the bolus start to disburse into capillaries, and then into veins? non-equilibrium phase
During which phase of enhancement do we generally obtain the best differentiation of structures in soft tissues as a result of CM injection? non-equilibrium phase
What characterizes the equilibrium phase of contrast enhancement? there is a density difference of less than 10 HU between the abdominal aorta and inferior vena cava
During which phase of enhancement is the agent's concentration in the veins similar to the concentration of arteries? equilibrium phase
The liver receives about ___% of its blood from the portal vein and about ___% from the hepatic vein. 80%; 20%
When does the hepatic arterial phase of liver enhancement occur? 20 to 40 seconds after start of injection
When does the portal venous phase of liver enhancement occur? 60 to 90 seconds after start of injection
If scanning is performed in the liver later than portal venous phase, in equilibrium phase, many hepatic tumors become ___ with liver tissue and may not be visible on images. isodense
What can be administered in order to inhibit gastric peristalsis? glucagon
Barium sulfate solutions used in CT are much more dilute than those used in radiography, typically containing a ____ to ____% barium sulfate suspension. 1% to 3%
What are the concentrations of iodinated oral agents? from 6 to 9 mg of iodine per mL
Why are oral iodinated CM tolerated so much better than IV iodinated CM? because oral agents use a much lower concentration of iodine
How much of iodinated oral contrast is absorbed by the body? around 0.1% to 0.5%
What is a typical dose of IV contrast for a head scan? 100 mL
About how long would you wait before scanning the head after injection of IV CM for studies involving metastatic disease, AIDS, or multiple sclerosis? About 45 minutes
Why are IV CM used in studies of the neck? for differentiation of blood vessels from lymph nodes and outline the epidural venous plexus
Blood vessels and vascular tumors appear ___ (more/less) dense than lymph nodes when IV CM is used. more
What is the typical dosage of IV CM, rate, and delay time for studies of the neck? 100 to 125 mL; 2 to 2.5 mL/s; 35 sec
When scanning the brachial plexus, it is advantageous to do what? inject in the arm which is contralateral to side of primary interest in order to avoid streak artifacts
What is the typical dose of IV CM, rate, and delay time for CT chest? 100 mL; 3 mL/sec; 20 to 25 sec
When scanning an abdomen, it is important to complete scanning before the organ of interest has reached the ____ phase of enhancement. equilibrium
Tumors of the liver typically receive their blood supply from which vessel? hepatic artery
What is the typical dose of IV CM, rate, and delay time for CT pelvis? 100 mL; 2 to 3 mL/sec; few minutes to allow for ureter and bladder enhancement
What would be a typical pediatric dose of IV CM for conventional, serial scan? 2 mL/kg of body weight
What would be a typical pediatric dose of IV CM for a helical scan? 1.5 mL/kg of body weight
What can be increased to scan the vessel more quickly in a CTA exam? pitch
Created by: sspatel