CT/MRI S2 TEST 1
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| administration of contrast media into a vessel | intravenous/intravascular
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| administration of contrast orally or rectally into the GI system | gastrointestinal
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| injection of contrast into the intrathecal space surrounding the spinal cord | intrathecal
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| injection of contrast media into a joint space | intraarticular
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| *there has to be _ HU difference between tissues to be seen on a CT image | 10
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| ct intravascular contrast increases _-_ HU | 40-75
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| clearance in patients with normal renal function | 2 hours
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| the number of particles in solution per kilogram of water | osmolality
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| osmolality of blood | 290
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| what is osmolality measured in | mOsm/kg
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| osmolality of conray | 1400
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| osmolality of optiray | 502
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| anything 1300 and above is considered | HOCM (extremely worried about reaction in teh patient and dehydration)
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| osmolality of visipaque | 290
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| isomolar means | osmolality has the same as blood plasma
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| what controls homeostasis in the body | hypothalamus
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| the thickness or friction of a fluid as is flows | viscosity
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| what can change the viscosity of a fluid | heating/warming it up (it can be injected easier)
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| which has higher viscosity LOCM or HOCM | LOCM
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| whether an agent will separate in particles or not when dissolved in a solution | ionicity
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| composed of molecules that will disassociate into ions when in a solution | ionic contrast
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| type of contrast that will not dissociate | nonionic
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| what are some indications for contrast | gliomas, glioblastomas, astrocytomas, ependymomas, mengiomas, neuromas, trauma, infection....
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| harm caused by chemical effects, dose, and speed of injection; true allergic reaction; will become more severe with another exposure | chemotoxic
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| resemble allergic reactions but produce no antibodies; not "true" allergic response; they are "allergic like" reactions | idiosyncratic
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| idiosyncratic reactions most often occur when | within an hour after administration
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| leakage of fluid from a vein into the surrounding tissues | contrast extravasation
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| what do you do if contrast extravasation happens | NOTIFY THE RADIOLOGIST
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| what size needle should be used to prevent extravasation | 18-20 G
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| where should you avoid when injecting contrast | hand, wrist, foot, ankle
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| patients with asthma have a _ x the risk of contrast reactions compared to those without asthma | 5-8
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| people with hay fever have _ x increased risk of contrast reactions compared to those without hay fever or allergies to drugs or food | 2
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| cessation of urine production | anuria
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| what does it mean to have known hypersensitivity | once a person has had a previous reaction even a very limited exposure can trigger a severe reaction
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| if individuals are allergic to seafood are they always allergic to iodine | NO
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| what is CIN | contrast induced nephropathy
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| who is at a higher risk for CIN | pts with diabetes, acute kidney injury, stage IV or V kidney function
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| t/f you do not need to screen for pregnancy when giving contrast | false; technically contrast will not affect the mother negatively, but they would still be getting radiation so you must screen
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| what affect does contrast have on patients with hyperthyroidism | can intensify thyroid toxosis
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| what are some ways to reduce contrast reactions | premedication, perform uncontrasted study, find alternative study, use low osmolar contrast media
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| positive contrast agents appear _ on an image | bright
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| negative contrast agents appear _ | dark
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| contraindications to giving barium sulfate | colon obstructions, colon perforation, tracheosophageal fistula, pyloric stenosis, hypersensivity to barium, aspiration
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| adverse reactions to barium | diarrhea, impaction, abdominal cramping, barium granuloma, barium appendicitis, perforation
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| oral iodinated contrast should be used when | question of bowel perforation
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| _ is a negative or neutral contrast agent | water
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| what is the ct wait time for intrathecal administration ** | 1-4 hours
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| if the patient has had to wait after having intrathecal contrast what should you do | roll the patient, and elevate the patients head 30 degrees
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| what are the most common places we used intraarticular contrast | hip, shoulder, wrist
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| for intraarticular contrast it is injected to better visualize what | soft tissues of the joint
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| most facilities require a serum creatine to be done every _ months if needed | 3
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| routine scanning uses what phase | venous phase
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| HU units 10-30 is what phase | venous (nonequillibrium)
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| HU units 30 or more is what phase | arterial (blus)
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| HU units of less than 10 is what phase | equillibrium (delayed)
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| what should you give a patient that has a known allergy of contrast | benadryl, prednisone, medrol
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| what medication are we concerned about with diabetic pts | metformin
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| which contrast can cause diarrhea, abdominal pain, and flatulence | oral iodinated contrast
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| how long should a generally take for contrast to leave the body | 24 hours
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| T1 weighted contrast includes | gadolinium & hepatocyte-directed contrast agents
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| T2 weighted contrast includes | reticuloendothelial agents & iron oxide agents
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| what is the appearance of gadolinium on T1 ? T2? | T1 bright; T2 dark
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| describe gadolinium | a heavy metal, is not organ specific, clears from the body rapidly
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| what is the half-life of gadolinium | 1.25-1.6 hours
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| what is the standard dose for gadolinium | .1 cc/lb or 1 cc/10 lb
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| what is the max gadolinium a pt can get | 20 cc
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| what are the contraindications / precautions when administering gadolinium | sickle cell disease, renal failure, allergies, asthma, pregnant/lactating women, previous reactions to gado or iodinated contrast
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| what are the adverse reactions to gadolinium | headaches, dizziness, urticaria, injection site warmth/coldness, increase in bilirubin and blood iron, death
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| how long does gado elevated bilirubin and how long after having it should you wait to get the labs | 4-6 & wait 24-48 hours
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| what are the pros about using hepatocyte-directed contrast agents | they are organ specific, can detect smaller liver lesions, and detect metastases
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| what is gado retention | when it remains in the body for longer then the normal time
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| the number one used t1 contrast agent | gadolinium
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| t2 weighted contrast; reticuloenthdothelial agents apear | super paramagnetic agent
kupffer cells (in liver)
normal tissues appear dark
abnormal tissues appear bright
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| can you inject retculentnothelial in a pressure injector | no; must be hand injected over a thrity minute time period
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| t2 iron oxide contrast agent | super-paramegnetic agent
general name = feridx
liver agent
known to cause groin and back pain
if pt cannot have iron DO NOT GIVE
20 min injection
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| feridex is taken up by | macrophages
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| why do you typically not do colon studies in MRI | peristalsis
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| clay minerals - kaopectate/kaolin does what | decreases t1 times or majorly decreases t2 times
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| iron (geritol) does what | decreases t1 times and t2 times
very safe
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