Safe Clinical Use of Fluoroscopy

Course #90472 - $60-


Self-Assessment Questions

    1 . Fluoroscopy can be traced back to around
    A) 1795.
    B) 1895.
    C) 1925.
    D) 1985.

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    2 . The absorbed dose of radiation is
    A) measured in Sieverts.
    B) a single recorded image.
    C) the amount of energy imparted into a tissue at a specific point.
    D) the amount of energy transferred from the x-ray beam into charged particles in the tissue of interest.

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    3 . Which of the following is NOT a factor that contributes to biologic variation in radiation dose?
    A) Ethnicity
    B) Patient age
    C) Underlying disease
    D) Idiopathic etiology

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    4 . The minimum radiation dose at which a specified deterministic effect can occur is the
    A) peak skin dose.
    B) threshold dose.
    C) reference point air kerma.
    D) significant radiation dose.

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    5 . All of the following are major parts of the standard fluoroscopy unit, EXCEPT:
    A) X-ray tube
    B) Hounsfield unit
    C) X-ray generator
    D) Image intensifier

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    6 . Higher kilovoltages are associated with
    A) higher quality images.
    B) lower radiation exposure.
    C) shorter radiation wavelengths.
    D) lower ability of x-rays to penetrate the target tissue.

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    7 . When operating fluoroscopy units, the "last image hold" feature
    A) stops the unit from recording images.
    B) pauses the x-ray beam in the on position.
    C) activates the "dead man"-type foot switch.
    D) allows the last recorded position of the device to be visualized.

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    8 . In fluoroscopy, vignetting
    A) is the result of flat-plane digital detectors.
    B) results in images that are sharper at the periphery.
    C) is the phenomenon of a falloff in brightness and spatial resolution.
    D) occurs because the x-rays emanate from a spherical surface and are detected on a flat surface.

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    9 . To date, the only element that has been deemed satisfactory as an intravascular radiographic contrast medium is
    A) iodine.
    B) barium.
    C) helium.
    D) hydrogen.

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    10 . Which of the following contrast mediums is categorized as non-ionic?
    A) Iodixanol
    B) Metrizoate
    C) Diatrizoate
    D) Iothalamate

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    11 . Which of the following procedures is associated with the greatest risk of contrast-associated cardiovascular side effects?
    A) Pyelography
    B) Uterine embolization
    C) Pulmonary angiogram
    D) Transjugular intrahepatic portosystemic shunt (TIPS) creation

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    12 . Which of the following factors put patients at increased risk for contrast-induced nephropathy?
    A) Diabetes
    B) Younger age
    C) Hypotension
    D) High hematocrit

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    13 . The side effects of extravasation of iodinated radiographic contrast materials are
    A) primarily the result of hypo-osmolality.
    B) not a risk for patients undergoing fluoroscopy.
    C) characterized by pain, edema, swelling, and cellulitis.
    D) always evident within the first few hours of administration.

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    14 . Which of the following statements regarding gadolinium-based contrast agents is TRUE?
    A) They are nephrotoxic at approved doses for MRI.
    B) They have greater radiopacity compared with iodinated agents.
    C) They have not been associated with changes in serum electrolytes.
    D) They are less likely than iodine-based reactions to cause adverse reactions.

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    15 . The major drawback of fluoroscopy is
    A) exposure to ionizing radiation.
    B) the capture of low-quality images.
    C) inability to continuously obtain images.
    D) the inability to apply the modality to older adults.

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    16 . The modified barium swallow is most often used to
    A) identify neoplastic masses.
    B) diagnose mucosal irregularities of the esophagus.
    C) assess patients for gastroesophageal reflux disease.
    D) determine the cause and severity of aspiration into the trachea.

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    17 . Which of the following is a major contrain- dication to endomyocardial biopsy?
    A) Heart transplant
    B) Cardiac arrhythmia
    C) Anticoagulation therapy
    D) Cardiomyopathy or myocarditis

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    18 . All of the following cardiology procedures use fluoroscopic techniques, EXCEPT:
    A) Heart transplantation
    B) Left heart catheterization
    C) Trans-septal cardiac catheterization
    D) Mitral balloon catheter valvuloplasty

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    19 . Retrograde pyelogram is indicated to evaluate
    A) hematuria.
    B) filling defects.
    C) congenital ureteral obstruction.
    D) All of the above

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    20 . Indirectly ionizing radiation
    A) is never naturally occurring.
    B) may be caused by gamma photons.
    C) reacts directly with biologic tissues.
    D) is less damaging to tissues than directly ionizing radiation.

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    21 . Which of the following is an example of non-ionizing radiation?
    A) X-rays
    B) Radio waves
    C) Gamma rays
    D) Higher spectrum ultraviolet waves

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    22 . The majority of radiation-induced DNA damage is attributable to
    A) hydroxyl radicals.
    B) genetic abnormalities.
    C) direct cellular damage.
    D) the cellular repair process.

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    23 . Which of the following is NOT one of the techniques cells use to address radiation injury?
    A) Repairing DNA
    B) Absorbing energy evenly
    C) Attacking reactive oxygen species
    D) Eliminating mutated or unstable cells

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    24 . The International Commission on Radiological Protection recommends that individuals should not receive more than 10% of the maximum permissible radiation dose to a given body part. The maximum permissible dose of radiation to the extremities is
    A) 5 mSv (0.5 rem).
    B) 150 mSv (15 rem).
    C) 500 mSv (50 rem).
    D) 1,000 mSv (100 rem).

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    25 . All of the following are potential deterministic effects of radiation exposure, EXCEPT:
    A) Hair loss
    B) Induction of cancer
    C) Bone marrow depression
    D) Spontaneous miscarriage

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    26 . Kerma area product
    A) correlates with operator and staff dose.
    B) is not recommended for fluoroscopic procedures.
    C) is a poor indicator of stochastic risk for the patient.
    D) is a good measure of skin dose for individual cases of a procedure and is therefore a good predictor of deterministic risk.

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    27 . According to the Society of Interventional Radiology, which of the following procedures is known to be associated with high radiation doses?
    A) TIPS revision
    B) Renal angioplasty
    C) Complex multilevel kyphoplasty
    D) All of the above

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    28 . For fluoroscopy units that provide estimates of peak skin dose, the operator should be notified when the peak skin dose reaches
    A) 500 mGy and then every 100 mGy after that point.
    B) 1,000 mGy and then every 100 mGy after that point.
    C) 2,000 mGy and then every 500 mGy after that point.
    D) 5,000 mGy and then every 1,000 mGy after that point.

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    29 . The major adverse effects of radiation exposure on the fetus
    A) do not include teratogenicity.
    B) include abortion and intrauterine growth restriction.
    C) are common even with normal diagnostic procedures.
    D) are not a significant risk with complicated interventional procedures.

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    30 . The threshold dose for deterministic effects to the fetus is in the range of
    A) 1–2 mGy (0.1–0.2 rad).
    B) 100–200 mGy (10–20 rad).
    C) 500–750 mGy (50–75 rad).
    D) 1,000–2,000 mGy (100–200 rad).

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