1. Radiographic Contrast Media
RAD TECH 255
SPECIAL PROCEDURES
WEBPAGE VERSION
MERRILLS VOL2
RTA BOOK
REV: SPRING 2010

2. Subject Contrast
Range of differences in the intensity of the x-ray beam, after it has been attenuated by the subject (patient).
For LOW CONTRAST stucures:
What can be done to attain medical information- see the difference between muscle, organs or vessels
Define and outline – organ structure and function
CONTRAST MEDIA used to:
enhance subject contrast or render high subject contrast in a tissue that normally has low subject contrast

3. Contrast media Defines subtle differences in subject contrast
Increases atomic number of area injected
Results in a SHORTER scale of subject contrast

4. Radiographic Contrast : Influenced by…
Radiation Quality (KVP)
Film Contrast
Radiographic object (Patient)
Atomic Number
Fat = 6.46
Water = 7.51
Muscle = 7.64
Bone = 12.31

5. KVP TYPE OF CONTRAST USED DETERMINES KVP RANGE
BARIUM _______kVp
IODINES ________kVp
(Ionic / Nonionic Water or Oil)

6. INJECTABLE CONTRAST MEDIA for RT 255 procedures
INVASIVE PROCEDURES
The “o-grams”

7. BEFORE CONTRAST INJECTION
ALWAYS TAKE
A “SCOUT”
BEFORE CONTRAST INJECTION
Why?
List 4 reasons

8. SPECIAL “o-grams” Venogram Arthrogram Sialogram Myelogram Arteriogram
Angiogram
Galactogram
Hystersalpingogram…….. etc

9. CONTRAST INJECTION
KNEE ARTHROGRAM

10. DOUBLE CONTRAST WITH IODINE - HIP Arthrogram

11. To check fertility can be oil or water based contrast

12. Myelogram

13. Myelogram Contrast
Pantopaque was introduced in 1944 as a oil contrast medium
The first low-osmolar contrast medium to be produced was metrizamide (Amipaque)
Oil never completely re –absorbed
(Pre-employment L.sp)

14. SIALOGRAM

15. Galactography - Breast Duct

16. Cerebral Angiogram

18. LYMPHANGIOGRAM
Now largely replaced by ________ ?

19. Dacryocystography
Now largely replaced by CT

20. SPECIAL PROCEDURES ARE INVASIVE
ALWAYS GET PATIENT’S HISTORY AND CONSENT BEFORE BEGINNING
OR GIVING ANY CONTRAST MEDIA

21. CONSENTS SIGNED AND WITNESSED AFTER PROCEDURE HAS BEEN EXPLAINED
CHECK DEPARTMENT PROTOCOL
WHO’S RESPONSIBLE ??????

22. CONSENTS ASSAULT verbal threat of harm BATTERY FALSE IMPRISONMENT
Unlawful touching - unauthorized treatment
“X-RAY” TAKEN ON WRONG PATIENT
FALSE IMPRISONMENT
Restraints require permission
from patient or authorized person

23. The ARRT has a published code of ethics.
The ARRT Code of Ethics provides the radiologic technologist with an operational blueprint of norms of professional conduct.

24. Review of Ethics (Pt Care Book –Professional Ethics)
The science of rightness and wrongness of human conduct and character is termed ethics.
__________is the ethical principle that means that “above all, do no harm.”
_________ principle that means that being truthful is right.
__________ is the ethical principle that means that actions benefit others.

25. Review of Contrast Agents
Types of Contrast
Routes of Adminstration
Chemical Components

26. Contrast Media changes the density of the organs
Therefore changing the
Subject contrast
will change the
Radiographic contrast and film contrast
May need to INCREASE TECHNIQUE FROM SCOUT IMAGE* f/s

27. Contrast Media (review)
Negative contrast
(AIR OR CO2)
Radiolucent
Low atomic # material
Black on film
Positive contrast
(all others)
Radiopaque
High atomic # material
White on film

28. Types of Contrast Media
Radiolucent-
negative contrast agent
x-rays easily penetrate
areas- appear ____ on films
Negative Contrast Media
Air and gas
complications
emboli-air pockets in vessels
lack of oxygen
Radiopaque-
positive contrast agent-
absorbs x-rays
areas- appear ____ on films
Positive Contrast Agents
BARIUM
IODINES
Both + & - can be used in same study

29. 2 BASIC TYPES OF CONTRAST material
BARUIM Z# 56
NON WATER SOLUABLE
GI TRACT ONLY INGESTED OR RECTALLY
KVP 90 – 120*
IODINE Z# 53
WATER SOLUABLE
POWDER
LIQUID
INTRAVENOUS OR
Intrathecal
GI TRACT
Also OIL based
KVP BELOW 90*

30. Methods of Administration of Contrast Material
INGESTED
(ORAL)
RETROGRADE
AGAINST NORMAL FLOW
INTRATHECAL
Spinal canal
PARENTERAL (IV, Intrathecal)
Injecting into bloodstream
(anything other than oral)

31. Contrast media for SPECIAL PROCEDURES
Diagnostic agents
that are injected into
Circulatory System, Joint Spaces, Ducts
Body orifices/organs: uterus, breast,
salivary & lymph glands

32. BLOOD WORK LAB TESTS to check function of kidneys prior to injection of contrast
WATCH THE UPPER LIMITS
BUN = BLOOD UREA NITROGEN
Merrills pg 214 range is 8 to 25
pg 242 range is
always check with RAD when level above 20
CREATININE levels range:
pg 214 ( ) pg 242 ( )
always check with RAD when level above 1.2
Indicates function of kidneys
Diseases / dehydration / kidney failure

33. EGFR (new test) Estimated Glomerular Filtration Rate
More advanced test for
CREATININE levels
Why is this important?

34. various water-soluble contrast media for urography and angiography
Both ionic and non-ionic monomers*
are all extracellular contrast media
are excreted unmetabolized by glomerular filtration
Approximately 85-90% of the injected dose is found in urine within the first 6 hours
95-100% within the first 24 hours

35. monomers* The ionic monomeric agents are salts that
dissociate into two molecules
one anion containing the radiopaque property due to three iodine atoms
and one cation without radiopaque properties
More on this later in the lecture…..

36. BARUIM SULFATE Not used in Special Procedures
BARIUM – a review
BARUIM SULFATE
Not used in Special Procedures

37. Barium Sulfate High atomic number Z #? ______ Not soluble in water
Used to coat the lining of organs
Supplied in different thicknesses
Used
Esophogram, UGI, Small Bowel,Lower GI or BE

38. EXTRAVASATION OF CONTRAST INTO PERITONEUM
Ba ADVERSE REACTIONS
BARIUM INERT
SUSPENSION MAY CAUSE ALLERGY
OCG TABLETS (IODINE) ALLERGY
AFTER EXAM – MAY SOLIDIFY DIFFICULT TO EVACUATE
INCREASE FLUIDS, MILD LAXATIVE
EXTRAVASATION OF CONTRAST INTO PERITONEUM

39. Extravasation of BA in abd

40. Ingested CONTRAST Gastrografin or Hypaque
High atomic #
Close to iodine
Water soluble
Similar usage as Barium

41. GASTROGRAFIN Adverse Reactions
Water soluble, safe in the abdominal cavity
Safe to use if perforation is suspected
Very harmful to the lung tissue
Do not use if aspiration is possible

42. Gastro – Pathology present
Bowel
Obstruction
Note contrast
Seen in kidneys as well

43. IODINE IONIC OR NON IONIC
WATER OR OIL BASE

44. IODINATED CONTRAST iodine z # 53
WATER BASED
INJECTED
VESSELLS/DUCTS
INGESTED
Organ function/flow
OPEN WOUNDS
OIL BASED
INJECTED
NEVER VESSELLS
ONLY DUCTS
NOT INGESTED
OPEN WOUNDS

45. INJECTION OF IODINE into Vessels
ALWAYS A WATER BASED IODINATED COMPOUND
BOLUS INJECTION
INFUSION DRIP
IONIC VS
NON IONIC
CONTRAST
% CONCENTRATE

46. IODINE WATER BASED CONTRAST
IONIC
LESS $$$
MORE REACTIONS
NON IONIC
MORE $$$
LESS REACTIONS

47. CONTRAST MEDIA IODINE is either: IONIC or NON-IONIC Osmolarity
# Of Particles (Cations + And Anions -)
In Solution Per Kilogram Of Water
High Osmolarity
=more Cations And Anions
Can Upset Homeostasis
Nonionic Have No Charged Particles

48. Contrast Agents IONIC High Osmolality (Higher risk of complications)
Diatrizoate sodium (Hypaque)
Iothalamate meglumine (Conray)
NON-IONIC
Low Osmolality (Lower risk of complications)
Gadodiamide (Omniscan)
Iodixanol (Visipaque)
Iopamidol (Isovue)
Iopromide (Ultravist)
Ioversol (Optiray)

49. More money
Less reactions
Less money
More reactions

50. OIL – BASED IODINE CONTAST Instilled in ORGAN – Not vessells
Oil-based iodine contrast media
are made from fatty acids
of poppy seed oil containing 48% and 37% iodine

51. FAT EMBOLUS IF IT GETS INTO BLOOD VESSEL
Oil Based Iodine
Fatty Acids
Insoluble in water
White on the radiograph = Radiopaque
Uses
Broncography (lungs)
Tear ducts
Salivary glands
Lymphatic system
Hysterrosalpingogram
Galactography (breast ducts)
FAT EMBOLUS IF IT GETS INTO
BLOOD VESSEL

52. CONTRAST MEDIA CHEMICAL PROPERTIES
TRIIODINATED COMPOUNDS
BASED ON THE BENZOID ACID RING
IODINE IS USED DUE TO THE HIGH ATOMIC NUMBER

53. The benzene ring is associated with the anion.

54. CONTRAST MEDIA
IONIC CONTRAST
NON IONIC CONTRAST

55. Iodine Contrast Material
Non-Ionic Contrast
Less patient allergic reactions
Ionic Contrast
Anion -
Cation +
More patient allergic reactions
Ionic contrast media dissociates into two molecular particles in blood plasma =
Causing pt reactions
The benzene ring is associated with the anion.
Nonionic contrast media is associated with low osmolality.

56. Iodine Contrast Material
ANIONS
- CHARGE IONS
Responsible For Stabilizing And Detoxifying The Contrast Media
CATIONS
+ CHARGED IONS
Responsible For Increasing The Solubility Of The Medium
The benzene ring is associated with the ________ ?

57. Newer Contrast Agents Balance Safety and Visualization
In addition to osmolality, toxicity is a concern
Although the mechanism of contrast medium toxicity is not completely understood
it is believed that "chemotoxicity" is related to the protein-binding capacity of the medium,
which is caused by non-specific weak interactions between the contrast medium and surrounding enzymes.

58. What contributes to discomfort, side effects, reactions:
VISCOSITY – (thick, sticky)
thicker – harder to inject, more heat and vessel irritation (higher = greater viscosity)
Warming contrast will help
TOXICITY - (higher = greater viscosity)
MISCIBILITY - easily mixes with blood
OSMOLALITY - is a measure of the total number of particles in solution.

59. Iodinated CONTRAST AGENTS Adverse Reactions
Osmolarities higher than body fluids
Viscous
Greater chance for contrast reactions
Anaphylatic shock is the most severe
Injection of ionic contrast media may lead to hypovolemia.

60. Hypovolemia basically means low blood volume
Symptoms of hypovolemia may include
cold hands and feet, light headedness, infrequent urination, increased heart rate, and weakness.
Low blood volume can result in multiple organ failure, kidney damage, brain damage, and death
hypovolemia differs from dehydration (which is excessive loss of body water
hypovolemia can lead to dehydration

61. Hypovolemia is the most common causeof
Orthostatic hypotension
What? __________

62. High osmolality of the contrast media is related to adverse reactions.

63. CONTRAST MATERIAL ADVERSE REACTIONS
ALWAYS GET PATIENT’S HISTORY BEFORE ANY CONTRAST MEDIA IS GIVEN
SEE Ch. 19 Table 19-7 pg 296
Carlton Pt Care (3RD ed)

64. Reaction classification
Immediate reactions were defined as those occurring within the department (within one hour)
Delayed as those occurring between the time the patients left the department and up to seven days later

65. Delayed Side Effects to Contrast
Skin effects included itching, rash, and hives.
Nausea, vomiting, and diarrhea were the gastrointestinal side effects
General side effects included headache, dizziness, and fever.
Infants and patients older than 60 years are at increased risk of developing a side effect.

66. General Factors for Contrast Reactions
Nonionic vs ionic Risk Factors Severity of Reactions Renal toxicity
Glucophage Diabetic?
Screening Creatinine
Pretreatment

67. CONTRAST MEDIA & ADVERSE REACTIONS
RISK
Any foreign substance introduced in the body
Chance the body will react negatively to the material
Minor to Life Threatening
Minor = 5% Major 0.1%

68. GOOD PATIENT HISTORY Kidney problems Diabetes Heart conditions
Allergies
Asthma
Previous reaction
Current medications
Beta Blockers
Antihypertensive medications
VITAL SIGNS

69. CONTRAST REACTIONS > 10 million diagnostic procedures per year
General
> 10 million diagnostic procedures
per year
Conventional ionic contrast reactions - 10%
1 in 1000 severe

70. Contraindiatons for Contrast
Renal Failure (Check BUN & Creatinine)
Elevated levels could cause renal shutdown
Anuria (no urine production)
Asthma (possible allergies)
Hx of Contrast Allergy / Reactions
Diabetes - get a hx of medications taken
glucophage must be stopped 48 hrs before contrast injection
Multiple Myeloma

71. MORE Risk Factors for Contrast Reaction
Older patient age
Allergic Rhinitis, medication or Food Allergy
Cardiovascular disease
WHO are at increased risk of developing a side effect? (2 age classifications?)

72. CONTRAINDICATIONS Pregnancy (risk of fetal Thyroid toxicity)
+ Radiation concerns
Allergic Reaction
Pathologic Conditions
Infection

73. Allergic to Iodine May or may not react if previous iodine given
General Rule:
No Iodine Contrast will be given
Pre – medication is available
May or may not react if previous iodine given

74. Aseptic Technique for injection
betadine scrub
Contains iodine

76. REACTIONS & Treatment USUALLY** WITHIN FIRST 5 MINUTES
Nausea & Vomiting & Urticaria
Hypotension (bradycardia)
Hypotension (tachycardia)
Bronchospasm
Anaphylactoid
Seizures
Extravasation

77. Uticaria (hives) rash – itching Flush face – feeling of warmth
Categories of Adverse Reactions MILD Carlton – Patient Care Book: Vol 3 Ch. 19 pg 297 or Vol 4 Ch. 20 pg 337
nausea, vomiting
Uticaria (hives) rash – itching
Flush face – feeling of warmth
Headace, Chills, Anxiety
Diaphoresis
Treatment – does not usually get worse
Watch patient and reassure
(cool cloth on forehead, emesis basin

78. Catagories of Adverse Reactions MODERATE Carlton Pt Care
Hypotension (bradycardia)
Hypertension (tachycardia)
Dyspnea
Bronchospasms /wheezing
Laryngeal Edema
TREATMENT:
Needs immediate treatment –GET RN/RAD
Needs Meds* – (Keep IV line in)
could lead to severe reactions

79. Catagories of Adverse Reactions SEVERE Carlton Pt Care
Laryngeal edema
Convulsions
Profound hypotension
Clinically manifested arrhythmias
Unresponsiveness
Cardiopulmonary Arrest
PROMPT TREATMENT – CODE BLUE!

80. Rx for REACTIONS have ready on Emergency cart or Crash Cart
UTICARIA (HIVES) –
Benadryl (diphenhydramine)
Vistaril (hydorxyzine)
Tagament or Zantac
Facial/Laryngeal Edema/Bronchospasms
Epinephrine , Oxygen

81. Contrast Reactions/MYTHS
not caused by iodine
Ionic vs non ionic - binding elements
not related to shellfish
not true allergy (no drug-antibody)
mechanism remains unknown

82. Anaphylactoid (idiosyncratic)
unpredictable
dose independent
prevalence 1-2% ( % severe)
fatal 1 in 75,000

83. RENAL TOXICITY (increased serum creatinine > 0.5 mg%) 2-7%
5 – 10 x increase with pre-existing renal insufficiency
direct relationship between serum creatinine and likelihood nephrotoxicity
Hydrate 100 ml/hr Normal saline 4 hrs prior to procedure, continue for 24 hours

84. GLUCOPHAGE Vol 4 Ch. 19 pg 297 or Pt is DIABETIC = oral diabetic agent
MUST STOP __ DAYS BEFORE EXAM
withhold drug for 48 hrs after contrast administration
patients with renal insufficiency may develop lactic acidosis
The signs of lactic acidosis are deep and rapid breathing, vomiting, and abdominal pain
What is the name of the medication given for GI peristalsis?

85. Benadryl (diphenhydramine) Epinephrine
Pre-Medications
Steroids (Prednisone)
Benadryl (diphenhydramine)
Epinephrine

86. EXTRAVASATION Contrast material has seeped outside of vessel
Local redness and swelling
Apply WARM Compress 1st 24 hours
Cool compress for swelling

87. EXTRAVASATION
The act of injecting a drug/contrast into an area other than the vessel (soft tissue)
RTA BOOK: Pharmacology Chapter
Defines as: Discharge or escape of fluid from a vessel into the surrounding tissue that can cause localized vasoconstriction, resulting in sloughing of tissue and tissue necrosis if not reversed with an antidote.

88. Extravasation of Contrast into soft tissue of arm

90. Contrast leaking from bladder

91. Summary - Delayed side effects persist in IV iodinated contrast media
History of asthma and allergy predisposes patients to increased incidence of adverse reactions
Intravenous iodinated contrast agents are generally safe.
Though the frequency of side effects has fallen significantly since the introduction of nonionic, monomeric contrast agents,however, side effects remain an important issue.
Late adverse reactions were first recognized in the mid-1980s

92. Summary of Contrast Reactions
Anaphylactoid reactions may present with
mild symptoms such as skin rash, itching, nasal discharge, nausea, and vomiting
moderate symptoms like facial or laryngeal edema, bronchospasm, dyspnea, tachycardia, and bradycardia
severe symptoms such as life-threatening arrhythmias, hypotension, bronchospasm, laryngeal edema, pulmonary edema, seizure, syncope, and death

93. Summary of Contrast Reactions
Nonanaphylactoid reactions are due to the ability of the contrast media to upset the body homeostasis, especially the blood circulation.
Increasing iodine concentration increases the risk of these reactions, which is also affected by the volume and route of administration of contrast.
Larger volumes or intra-arterial administration are more likely to produce a reaction.
The cardiovascular, respiratory, urinary, gastrointestinal, and nervous systems are most commonly affected by physiologic changes produced by contrast media.
The symptoms of nonanaphylactoid reactions are warmth, metallic taste, nausea, vomiting, bradycardia, hypotension, vasovagal reactions, neuropathy, and delayed reactions

94. SCHEDULING CONSIDERATIONS
Diabetics – first
(Insulin= low blood sugar occurs while fasting)
After Nuclear Medicine Tests
(iodine goes to thyroid and will alter results)
Iodine BEFORE Barium
BE before UGI ( IVP before BE)
WATER – OIL - BARIUM

95. SPECIAL PROCEDURS CONTRAST MEDIA
ARTHROGRAMS
Injected into JOINT SPACES
IODINE (positive contrast)
WATER soluble
(Ionic or Non-Ionic)
AIR (negavitve contrast)

96. SPECIAL PROCEDURS CONTRAST MEDIA
MYELOGRAMS
Injected INTRATHECALLY
(into the subarachnoid space)
Nonionic water-soluble contrast
(NO IONIC CONTRAST)

97. 31 y/o male DIES after Myelogram Procedure
Myelography is safely performed using
nonionic water-soluble radiographic contrast media intended for this route of administration
Misadministration of ionic contrast media intrathecally can result in a syndrome of spasms and convulsions, often leading to death
ISOVUE –M ( 20 or 30 cc)

98. mix-up between look-alike vials
ionic HYPAQUE (diatrozoate meglumine)
nonionic OMNIPAQUE 300 (iohexol)
Each type of contrast media should be stored separately, based on its use.

99. SPECIAL PROCEDURS CONTRAST MEDIA
SIALOGRAPHY
– injected into Salivary Ducts
IODINE –
WATER (ionic or nonionic)
OR OIL BASED
SINOGRAPHIN (OIL)
RENOVUE (WATER)

100. MRI Contrast

101. MRI with contrast Without With
What is the name of the contrast used for MRI ?

102. Gadolinium z# 64 Once injected, gadolinium accumulates
in abnormal tissues of the brain and body.
Provides a greater contrast between normal and abnormal tissues
MORE dilute
than used for Radiology

103. gadolinium
On its own gadolinium is toxic to the human body, but when coated in a special chelating agent, it is safe to use.
When the chelating agent breaks down prematurely, or the kidneys are unable to excrete the gadolinium from the body, gadolinium poisoning can occur

104. Gadolinium Side Effects
With impaired kidney function, gadolinium could lead to a serious and potentially fatal disorder called Nephorgenic Systemic Fibrosis. (NSF)
More common conditions associated with exposure includes
impaired kidney function
irritation of blood vessels
facial swelling
skin conditions, including rashes, itching and hives

105. CT Contrast Oral/Rectum IV: Iodine Usually less dilute
– Barium or Iodine
IV: Iodine
Usually less dilute
than for Radiology

106. CT w contrast

107. CT Contrast CT Scan Contrast Indications
History of tumor, cancer, or surgery
Looking for infection, inflammation
Evaluating blood vessels
Investigate a finding in a scan done without contrast
CT Scan Contrast Side Effects
Mild to life-threatening allergic reaction
Flushing/redness and hives
Shortness of breath
Nausea, vomitting
Blood clots
Dizziness

108. PATIENT PREP
COVERED WITH EACH EXAM

109. REVIEW SPECIAL PROCEDURS CONTRAST MEDIA
ONLY Water sol.
Arthrograms
Myelograms
Angio/Arterio grams
Cardiac Cath
Venograms
Water or OIL
Hysterosalpingogram
Sialogram
Lymphangiograms
Lasts longer – may cause
FAT EMBOLI

110. REVIEW (Bontrager Slides)

111. SEE : PT CARE : Pharmacology 4th Ed Ch.20 (charts p293/p.299 )

119. MEDICATION Atropine Benadryl Dilantin Epinephrine Heparin Lasix
PT CARE : Pharmacology 4th Ed Ch.20 (charts p293/p.299 ) Sample CRASH CART Medications
MEDICATION
Atropine
Benadryl
Dilantin
Epinephrine
Heparin
Lasix
Sodium Bicarbonate
Xylocaine
INDICATION
(used for what?_
______________
________________
_________________
___________________
__________________
Spring 2010

120. REVIEW TYPES OF CONTRAST & USES ADVERSE AFFECTS OF CONTRAST USAGE
CONTRAINDICATIONS FOR CONTRAST

121. RTA Book – Contrast Media
Review Questions
RTA Book –
Contrast Media

122. Contrast media are used in radiographic imaging to
a) increase the radiographic density of the area of interest
b) enhance the subject contrast of the area of interest
c) decrease the radiographic density of the area of interest
d) lower the subject contrast of the area of interest

123. Radiographic images that demonstrate few density differences define
a) low subject contrast
b) high subject contrast
c) low x-ray photon absorption
d) high x-ray photon absorption

124. A negative contrast agent will
a) increase density and is radiopaque
b) decrease density and is radiopaque
c) decrease density and is radiolucent
d) increase density and is radiolucent

125. Perforation of the colon during a lower GI barium study may result in complications resulting from
a) flocculation
b) bronchospasm
c) convulsion
d) extravasation

126. Depending on the environment of the barium sulfate,such as acid in the stomach, the powder may have a tendency to clump – this is called
a) flocculation
b) bronchospasm
c) convulsion
d) extravasation

127. 4. Perforation of the vessel while injecting a contrast media may resulting in
a) flocculation
b) bronchospasm
c) convulsion
d) extravasation

128. Barium sulfate:
1. is filtered by the kidneys
2. is absorbed by the stomach
3. coats the gastrointestinal lining
4. is absorbed by the jejunum

129. High atomic number elements absorb x-rays at a greater rate than low atomic number elements.
1. true
2. false

130. Barium sulfate is contraindicated if the patient is suspected of having a gastrointestinal tract perforation.
1. true
2. false

131. Radiolucent contrast media:
1. are positive contrast agents
2. appear dark on radiographs
3. are composed of elements with high atomic numbers
4. none of the above

132. Radiopaque contrast media:
1. are positive contrast agents
2. appear light on radiographs
3. are composed of elements with high atomic numbers
4. all the above

133. Each of the following is an example of a negative contrast media except:
1. air
2. soda water
3. barium sulfate
4. gas-producing crystals

134. An air embolus can form as a complication of negative contrast media administration.
1. true
2. false

135. An fat embolus can form as a complication of AN OIL BASED contrast media administration.
1. true
2. false

136. Ionic contrast media dissociates into two molecular particles in blood plasma.
1. true
2. false

137. Most adverse reactions associated with Ionic contrast media are significantly decreased with the non-ionic contrast media
1. true
2. false

138. Which of the following acute reactions to contrast media usually requires no medical treatment?
a) bronchospasm
b) laryngeal edema
c) urticaria
d) convulsions

139. Which of the following acute reactions to contrast media usually requires immediate medical treatment?
a) Bronchospasm / laryngeal edema
b) Nausea & Vomiting
c) Urticaria
d) Warn flush /metallic taste

140. What can be done for a patient who will receive water- soluble iodine contrast media to reduce allergic-like effects?
a) premedicate with steroids and antihistamines
b) give intravenous fluids
c) instruct the patient to drink warm salt water before the procedure
d) give a negative contrast agent with the iodinated medium

141. When you schedule multiple procedures, what examination is usually done last?
a) thyroid function tests
b) Upper GI
c) air-contrast colon (BE-AC)
d) Intravenous pyelogram (IVP)

142. When you schedule multiple procedures, what examination is usually done last?
a) thyroid function tests
b) Upper GI
c) air-contrast colon (BE-AC)
d) Intravenous pyelogram (IVP)
It will take the BA the longest to travel through the GI tract

143. When you schedule multiple procedures, using contrast media – which examination must be done first?
a) thyroid function tests (Nuc Med)
b) Upper GI
c) air-contrast colon (BE-AC)
d) Intravenous pyelogram (IVP)

144. When you schedule multiple procedures, using contrast media – which examination must be done first?
a) thyroid function tests (Nuc Med)
b) Upper GI
c) air-contrast colon (BE-AC)
d) Intravenous pyelogram (IVP)
WHY?

145. Antihistamines are used to prevent and treat nausea and vomiting.
1. true
2. false

146. Antihistamines are used to prevent and treat nausea and vomiting.
1. true
2. false
So what is it used for?

147. Antihistamines are used to prevent and treat ____________
Allergic reactions to contrast media

148. Glucophage is the brand name for
__________________________
What is it used for?
_________________________

149. Glucophage is the brand name for
METAFORMIN
What is it used for?
DIABETICS
RTA BOOK
PHARMACOLOGY CHAPTER

150. Which type of drug is used to prevent and control the occurrence of seizures?
1. anticonvulsants
2. antiemetics
3. antihistamines
4. antihypertensives

151. Which type of drug is used to prevent and control the occurrence of seizures?
1. anticonvulsants
2. antiemetics
3. antihistamines
4. antihypertensives

152. An intravenous push refers to a rapid bolus injection.
1. true
2. false

153. An intravenous push refers to a rapid bolus injection.
1. true
2. false
What is the name when it is injected slowly?

154. What is the name when contrast it is injected slowly?
INFUSION DRIP

155. The act of injecting a drug into a vein is termed extravasation.
1. true
2. false

156. The act of injecting a drug into a vein is termed extravasation.
1. true
2. false
What does it mean? ______________

157. extravasation What does it mean? ______________
The act of injecting a drug/contrast into an area other than the vessel (soft tissue) is termed extravasation.
RTA BOOK: see definiton

158. Contrast media are:
1. diagnostic agents
2. dyes
3. all radiopaque
4. all radiolucent

159. Contrast media are:
1. diagnostic agents
2. dyes
3. all radiopaque
4. all radiolucent

160. An air embolus can form as a complication of negative contrast media administration.
1. true
2. false

161. An air embolus can form as a complication of negative contrast media administration.
1. true
2. false

162. Oil-based iodine contrast media are used for each of the following except:
1. dacrycystography
2. bronchography
3. lymphography
4. myelography

163. Ionic contrast media dissociates into two molecular particles in blood plasma.
1. true
2. false

164. Iodinated contrast media dissociates into two molecular particles in blood plasma.
1. true
2. false

165. The benzene ring is associated with the:
1. anion
2. cation
3. positive charge
4. none of the above

166. LIST 4 TYPES OF HIGH RISK PATIENTS

167. Oil-based iodine contrast media are made from:
1. fatty acids
2. carbohydrates
3. amino acids
4. none of the above

168. Osmolality is a measure of:
1. the number of iodine atoms per molecule
2. particle density
3. the total number of particles in solution
4. none of the above

169. High osmolality of the contrast media is related to adverse reactions.
1. true
2. false

170. Injection of ionic contrast media may lead to hypervolemia.
1. true
2. false

171. Myelography most commonly uses ___ contrast media.
1. ionic
2. nonionic
3. nonionic and ionic
4. neither ionic nor nonionic

172. End of Contrast Media for Special Procedures
RT 255
Rev Spring 2010