Unit 3 (Contrast)

Home > Flashcards > Print Preview

The flashcards below were created by user nenyabrooke on FreezingBlue Flashcards. What would you like to do?

  1. what was the very first contrast used, and when was it first used, and on what?
    • cinnabar, vaseline, and gypsum
    • one month after xray discovered (1985)
    • on an amputated hand
  2. what was the second noted contrast used (after the amputated hand in 1895), on what, and when?
    • iodine contrast in an inorganic form (sodium iodide), which was toxic
    • used on humans to make urine radiopaque
    • 1923 (30 yrs after first contrast)
  3. what was the third noted contrast used (after the toxic sodium iodide), and when?
    • a safe intravascular water-soluble contrast
    • 1950
  4. four routes of contrast media introduction:
    • area with direct connection to outside of body: GI, genitourinary, respiratory
    • bloodstream: liver (CT), kidney
    • directly in vessels: angiogram
    • cavities w/ no connection to the outside: joint spaces, bile ducts
  5. what is the factor which determines whether a technologist is permitted to perform venipuncture for the administration of contrast media?
    state statutes and institutional policy
  6. who determines that the administration of contrast materials and radiopharmaceuticals is a responsibility of a registered technologist?
    • ACR - American College of Radiology
    • (1987 Resolution #27)
  7. give examples of some radiolucent/negative contrast agents:
    • oxygen
    • CO2 (gas crystals)
    • air
    • nitrogen
    • hydrogen
    • helium
    • the normally present gas bubble
  8. give some facts about CO2 as a contrast agent:
    • available in small cartridges for individual use
    • available in pressurized cylinders for departmental use (ex. BEs)
    • it is absorbed in the body much faster than the nitrogen in the room air
  9. name common sources used to produce CO2 gas:
    calcium and magnesium citrate carbonate crystals
  10. give two main forms of radiopaque contrast media (ROCM)
    • aqueous agents (ionic, non-ionic, iodinated oral agents for GI tract) 
    • non-aqueous agents (barium, ethiodized oils)
  11. Aqueous agents:
    have __________ as the principle solvent
    consists of most ___________ contrast agents
    __________ miscibility
    __________ viscosity
    • water
    • iodinated
    • high
    • low
  12. Non Aqueous agents:
    ______________ as the principle solvent
    __________ miscibility
    __________ viscosity
    • does not have water
    • low
    • high
  13. pertaining to treatment introduced into the body other than through the digestive system:
  14. within the small intestine, or via the small intestine:
  15. name two common radiopaque contrast medias and give their atomic number and mass:
    • barium: Z#56, atomic mass 137.33
    • iodine: Z#53, atomic mass 126.9
  16. what is the most common gastrointestinal radiopaque contrast? describe it.
    • barium sulfate
    • non-aqueous, relatively inert, chemically pure
  17. when barium is mixed with water it forms a _____________, not a _______________.
    • colloidal suspension
    • solution
    • (hygroscopic in nature)
  18. name three aqueous iodinated contrasts for the GI tract (trade and generic names):
    • gastrografin: diatrizoate meglumine and diatrizoate sodium
    • hypaque sodium oral powder: diatrizoate sodium
    • MD gastroview: diatrizoate meglumine and diatrizoate sodium
  19. how is water-soluble iodinated contrast for the GI tract different from Barium?
    • used when pt is to have surgery
    • used if there is a risk of impaction
    • used for neonatal studies
    • used for suspected rupture of GI tract
    • used if there's a perforated ulcer
    • used if there is a rupture of the appendix
    • it is very bitter
    • is more expensive
    • produces less radiographic contrast
    • can cause serious dehydration/hazardous if aspirated
  20. describe some key points concerning oral cholecystopaques:
    • aqueous
    • taken by mouth, demonstrate the biliary
    • binds with albumin in blood, so can only be excreted by liver (not kidney)
    • bilirubin levels need to be checked prior to using
  21. name some common cholecystopaques:
    • telepaque - iopanoic acid
    • bilopaque
    • oragrafin - sodium or calcium ipodate
    • cholebrine - iocetamic acid
  22. describe some key points concerning ethiodized oils:
    • intravascular
    • used when it is undesirable for contrast to mix with blood, body fluids, or be absorbed
    • greater risk of embolism
    • high persistence
    • low miscibility
    • tend to decompose when exposed to air, heat, light
    • clear, pale amber, or yellow in color
    • inflammation may occur with extravasation
  23. name some common ethiodized oils (oily agents):
    • dionisil
    • ethiodol
  24. name some procedures that require an oil based contrast:
    • lymphography (primary use)
    • dacryocystography
    • hysterosalpingography(HSG)
    • sialography
    • fistulas
  25. with what instrument should oily contrast agents be administered?
    glass syringe
  26. aqueous agents have a ________ miscibility factor and a ________ persistency factor than oily agents.
    • higher
    • lower
  27. the _________ the persistence, the ________ the contrast is eliminated from the body.
    • lower, faster
    • OR
    • higher, slower
  28. two categories of intravascular iodinated contrast:
    • ionic
    • nonionic
    • (both are aqueous and contain iodine)
  29. a contrast media category that is composed of carbon-based organic materials:
    aqueous iodine contrast media
  30. ROCMs used for roentgenography are derivitives of the ________________ molecule, with the exception of ___________.
    • triodinated benzoic acid
    • barium
  31. žit is the ________________ that absorbs the photons, not allowing them to pass through to the film, therefore leaving a silhouette of the structure it is in.
    iodine molecules
  32. in an aqueous iodine contrast media, a positive side chain is added to the molecule called a(n) _________ which is a __________________. they increase the ___________ of the contrast.
    • cation
    • salt, usually sodium or meglumine or both
    • solubility
  33. _________ contrast exist in salt form.
    _________ contrast exist in non-salt form.
    • ionic
    • nonionic
  34. common anions in aqueous iodine solutions are:
    • ždiatrizoate (hypaque)
    • iothalamate (conray)
    • metrizoate (isopaque)
    • help stabilize the contrast by joining to the cation molecule
  35. name some common intravascular ionic media:
    • conray: iothalamate meglumine (high osmolality)
    • hypaque: diatrizoate meglumine and/or diatrizoate sodium (high osmolality)
    • hexabrix: sodium meglumine ioxaglate (low osmolality)
    • cystografin: diatrizoate meglumine (high osmolality)
    • MD-76: diatrizoate meglumine and diatrizoate sodium
    • renografin-60: diatrizoate meglumine and diatrizoate sodium
  36. name some common intravascular nonionic media:
    • imagopaque: iopentol
    • iomeron: iomeprol
    • isovue: iopamidol
    • omnipaque: iohexol
    • optiray: ioversol
    • visipaque: iodixanol
  37. žcontrast media whose molecules disassociate into two charged particles called the cation (+) and the anion (-) are considered to be __________, while media whose molecules remain whole in the solution are ___________.
    • ionic
    • nonionic
  38. the movement of water across a semipermeable membrane:
  39. ž_________ osmotic substances, such as ROCMs, placed into the bloodstream will cause fluid from ____________________  to be drawn _____________________.
    • highly 
    • outside the bloodstream (extravascular)
    • into the bloodstream (intravascular)
  40. the concentration of molecules per weight of water:
  41. has greater osmolality than body fluids:
  42. has lower olsmolality than body fluids:
  43. has equal osmolality to body fluids:
  44. žthe ___________ the osmolality of a contrast medium is to the osmolality of body fluids, the ___________ potential there is for adverse reactions caused by differences in osmolality
    • closer, less
    • OR
    • farther, more
  45. ____________ compounds cause more direct endothelial damage:
  46. ionic contrast has a ________ osmolality than nonionic contrast, and this ___________ the risks of adverse side effects.
    • higher
    • increases
  47. high osmolality ionic contrast media have _______ iodine atoms per molecule.
  48. žthe ratio of the iodine atoms to particles with higher osmolality is _______ or a ratio media of ________.
    • 3:2
    • 1.5
  49. compounds that contain more iodine atoms per molecule have _____ osmolality.
  50. low osmolality ionic contrast media have ________ iodine atoms per molecule.
  51. the ratio of the iodine atoms to particles with less osmolality is ________ or a ratio media of __________.
    • 6:2
    • 3
  52. low osmolality nonionic  contrast media have _______ iodine atoms per molecule.
    • three
    • (and do not dissociate in solution)
  53. žwith low osmolality nonionic contrast media, there is a ratio of iodine to osmoticaly active particle of _______ or a ratio media of _______.
    • 3:1
    • 3.0
  54. when the ratio of particles to iodine atoms is low, there indicates a(n) __________ in osmolality.
    • increase
    • (which increases the risk of adverse side effects)
  55. three characteristics of contrast that may vary:
    • iodine concentration
    • osmolality
    • viscosity
    • toxicity
  56. žthe higher the concentration of iodine, the _______ attenuation of the beam and the _______ degree of positive contrast.
    • greater
    • greater
  57. iodine concentration usage depends on:
    the degree by which the contrast will be diluted by body fluids
  58. the osmolality of human blood:
    300 milliosmoles/kg
  59. the osmolality of aqueous contrast:
    600-1300 milliosmoles/kg
  60. rapid fluid movement may cause:
    • flushing
    • nausea/vomiting
    • dehydration
  61. resistance of fluid to flow:
  62. amount of viscosity is determined by:
    • number of particles
    • size of particles
    • attraction of particles
    • amount of iodine
  63. reactions are influenced by:
    • physical properties
    • iodine concentration
    • total dose or volume of contrast
    • rate or speed of injection
  64. for the aorta, a _________ concentration is used and for the veins and smaller arteries, a __________ concentration is used.
    • higher
    • lower
  65. as the concentration of iodine rises, name three other factors that also rise:
    • viscosity
    • osmolality
    • toxicity
  66. an IV would be a ___________ concentration, while a bolus would be a ___________ concentration.
    • lower
    • higher
  67. if you increase the number of iodine atoms in the molecule and keep the same number of molecules, the concentration:
    is increased
  68. if you increase the number of iodine atoms in the molecule but decrease the number of molecules, the concentration:
    stays the same
  69. the higher the numerical value of the ratio, the  ________ the osmolality for a given iodine
  70. describe how nonionic contrast is different from ionic contrast:
    • they are less toxic and less neurotoxic
    • less likely to cause anaphylactic shock
    • less heat and discomfort during injection
    • used to be more expensive
  71. both nonionic and ionic contrasts contain:
  72. why are there less reactions when using nonionic contrast as compared to ionic contrast?
    • less osmotic
    • low iodine concentration
    • injected more slowly
    • (less reactions when injecting into an artery rather than a vein)
  73. is a high iodine concentration more or less viscous?
  74. how is viscosity determined?
    • molecular size
    • molecular concentration
    • frictions of molecules in the solution
  75. name three things affected by viscosity:
    • flow rate
    • injection time
    • needle size
  76. what helps to reduce viscosity?
    warming the contrast to body temperature
  77. name two common aqueous iodine compounds:
    • diatrizoate meglumine
    • diatizoate sodium
  78. what is the difference between sodium salts and meglumine salts?
    • sodium salts are more radiopaque
    • meglumine salts are somewhat less toxic and more soluble in water, and more viscous
  79. name two common high osmolar contrast agents (HOCAs):
    • renografin 60
    • hypaque 76
  80. high osmolar contrast agents (HOCAs) contain:
    sodium and meglumine salts
  81. name one of the first agents used in myelography and what it was replaced with:
    • metrizamide (amipaque)
    • replaced with hexabrix (meglumine ioxaglate)
  82. name some low osmolality contrast agents (LOCAs):
    • iopamidol (isovue, niopam)
    • iohexol (omnipaque)
    • ioversol (optiray)
  83. is a severe allergic reaction, may end in cardiac arrest or respiratory arrest, and less often seizures:
    anaphylactic shock
  84. Iodixanol (visipaque) is often the contrast of choice when patients have mild to moderate renal insufficiency:
    • iodixanol (visipaque)
    • for high risk patients
    • it is isoosmolar
  85. _______ osmolality agents are routinely used and _________ are used for high risk patients.
    • low
    • isoosmolar
  86. total volume is dependent on:
    • concentration
    • type (ionic or nonionic)
    • weight and age of pt
    • anatomical structure
    • speed of injection
  87. žminimum amount of iodine needs to be given in order to have a satisfactory contrast enhancemnt of vascular stuctures and various tissues:
  88. factors affecting flow:
    • concentration
    • viscosity
    • temperature
    • catheter/needle diameter and length
  89. a study of the effects of drugs on the normal physiological function of the body; how a drug or contrast agent acts on the living system:
  90. the study of the preparation properties, uses, and the actions of drugs:
  91. the ________________ is sensitive to increased ions in the blood.
    central nervous system
  92. normal responses to ionic media:
    • sensation of warmth
    • light-headedness
    • nausea
    • vomiting
  93. allergic or anaphylactoid responses are caused by:
    • a release of histamine
    • (suggested that this is a CNS response)
  94. the result of interactions between the contrast medium and the blood, causing the suppression of certain enzymes:
    molecular toxicity
  95. the study of how drugs enter the body, are absorbed, reach their site of action, are metabolized, and exit the body:
  96. name a diabetic medication that can be contraindicated after the administration of contrast media:
    • metformin (glucophage)
    • can cause acute renal failure
    • withheld 48 hours after contrast administration
  97. a chemical change that results in solid particles:
    • precipitation
    • (can cause a thrombus/stationary clot or embolus/moving blood clot)
  98. name four incompatible medications known to cause precipitation when mixed with contrast:
    • diaphenhydramine (benedryl): antihistamine
    • papaverine HCl: smooth muscle relaxer
    • cimetidine (tagement): inhibits gastric secretions
    • protamine (protamine insulin): to neutralize the anticoagulant action of heparin
    • (always flush IV before and after these)
  99. be familiar with pre-contrast history items:
    • žhistory of renal failure
    • history of diabetes
    • history of glucophage if patient is a diabetic
    • history of heart disease or high blood pressure
    • contrast study performed within 48 hours
    • žhistory of allergy
    • history of asthma
    • previous allergic reaction to contrast medium
    • note current medications
  100. give normal BUN and creatinine levels:
    • BUN: 8-25 mg/dl
    • creatinine: 0.6-1.5 mg/dl
  101. an increase in the diameter of blood vessels, which increases blood flow and lowers blood pressure:
  102. dangers of overdose:
    • repeat injection during arteriography
    • multiple exams scheduled in various depts.
    • change of doctor
  103. what type of patient is three times more likely to have an anaphylactoid reaction?
    asthma patient
  104. what courses of action my be taken when a contrast study is scheduled for a high risk patient?
    • exam canceled
    • exam preceded by antihistamine or corticosteroid
    • use of a nonionic contrast
  105. minute amount of contrast injected intravenously, followed by a pause during which the patient is observed carefully:
    test injection
  106. reactions have occurred with as little as _______ of contrast.
  107. signs of allergic reaction:
    • žrestlessness and a sense of apprehension
    • increased pulse rate
    • pallor accompanied by weakness or a change in thinking ability
    • cool, clammy skin or itching skin
    • red rash, urticaria (hives)
    • throat constriction
    • dyspnea (shortness of breath)
    • fall in blood pressure of 30 mm below the baseline systolic pressure
    • NOTE: vomiting is a common reaction, not an allergic response
  108. when a contrast is administered, how long must the patient be observed for signs of an allergic response?
    fifteen minutes
  109. for a PET/CT prep, the pt should be:
    • no glucose in IV and/or NPO for 6 hours (water only)
    • no sugar beverages for 24s
    • no exercise 24 hours prior to study
    • no chewing gum on day of study
    • diabetic: blood glucose level less than 200 mg/dl and fast for 4 hours (eat and take insulin before beginning fast)
  110. the medical abbreviation for four times a day:
  111. the medical abbreviation for twice a day:

Card Set Information

Unit 3 (Contrast)
2013-03-04 00:29:56
Procedures IV

Unit 3: contrast
Show Answers:

What would you like to do?

Home > Flashcards > Print Preview