Special Procedures Test 1

What are the two types of special procedures?

Diagnostic and Interventional

What is a special procedure?

Demonstrating structures without natural contrast, done under local anasthesia and are minimally invasive

What is a diagnostic procedure?

Done to identify a particular pathology process

What is an interventional procedure?

Done to treat a pathological process, minimally invasive, and analyzes special equipment.

What should be charted during a procedure?

Basic patient information, type/amount of contrast, any other meds, flouro time, images taken.

What is respondent superior?

“Let the master answer”, negligence while performing trained job duties, hold employer accountable

What is Res Ipsa Loquitor?

“The thing speaks for itself”, negligence so apparent there isn’t need for evidence.

What does HIPAA Stand for?

Health Insurance Portability Acountability Act of 1996

What are common HIPAA violations when it comes to PHI?

Health Conditions, Photographs, Treatment, Billing.

What are the three types of concent?

Informed, Express, Implied.

When is Informed concent required?

Higher risk of bleeding or complication, exam requires a scalpel, or require a needle longer then 1.5”

What are the steps to informed concent?

1. Disclose Risk involved with the procedure

2. Confirm Understanding

3. Voluntary Permission

4. Signing a document

What are the methods for administering contrast?

Orally, IV, or IM

What is osmolarity?

Concentration per volume of solution

What is osmolality?

Weight per kilogram of water

What is a hypotonic solution?

Having lower concentration of fluid, sugars and salt then physiologic fluids. Fluid moves into the cells causing them to pop.

What is a Hypertonic solution?

Having higher concentration of fluid, sugars and salt then physiologic fluids. Fluid moves out of the cells causing them to shrivel.

What is an isotonic solution?

Having a concentration similar to physiologic fluids.

What is miscibilitiy?

The property of two substances to mix together. High miscibility=easily mixes

What is viscosity?

Resistance to flow. Temperature effects viscosity

What is the blood brain barrier?

Function to protect the central nervous system from most blood impurities. 99% cannot cross the BBB.

What is Barium Sulfate?

BaSO4, non water soluble suspension, non iodinated. Not recommended for suspected perforation or fistula.

What is an ionic agent?

Consist of iodine salts, when injected salts break up into cations and anions that can cross the BBB.

What are ionic monomers?

Includes a benzene ring with three ions one atoms and a side chain containing a carboxylic group. Has the Highest osmolality, 2-7x greater than that of plasma.

What are the Brand names for ionic monomers?

Gastrographin, Cystographin, conray

What are ionic dimers?

Two tri iodinated benson. Acid groups joined by a linking bridge. Used for peripheral ateriography. Low Osmolality, less then 3 x of plasma.

What is the brand name for an ionic dimer?

Hexabrix

What is a non ionic diner?

Composed of two covalently bonded tri iodinated benzene rings. Highly viscous, same osmolality as plasma.

What is the brand name for non ionic dimers?

Visipaque

What is a non ionic monomer?

Composed of tri iodinated benzene rinds with various side chains, water soluble, closer to osmolarity of plasma than ionic, less toxic, does not cross the BBB.

What are the brand names for non ionic monomers?

Omnipaque, optiray

What is water insoluble contrast media

Oil based and iodinated, limited use, used in small amounts where quick absorption would be an issues.

What are brand names for water insoluble contrast media?

Lipids and pantopaque

70% of reaction happen when?

Within the first 5 minutes of injection. The rest occur within 15 minutes

What are the most common drugs for allergic reactions?

Benadryl, prednisone, or epinephrine

What are th two main excretory pathways?

Urinary and hepatic portal

What is an ideal BUN?

7-21

What does high BUN show?

high- low kidney function

Low- liver damage, malnutrition, overhydration,

What is the ideal GFR?

90-120

What does a Hugh GFR show?

Proper filtration

What is the ideal creatine level?

0.7-1.5

What does high creatinine show?

Low kidney function

What is an agonist drug?

Drug that turns receptors on

What is an antagonist drug?

Turns receptors off