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86 Cards in this Set
- Front
- Back
For esophagrams, what form of barium should be used if suspecting a mass or FB? |
barium paste |
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What weight-to-volume suspension is advised for esophagrams? |
60% w/v |
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List two contraindications to the use of barium during an esophagram. |
1. perforation 2. esophagoscopy |
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In what portion of the esophagus can a normal "herringbone" appearance be seen in the cat and why? |
the caudal third exhibits this pattern due to obliquely-oriented smooth muscle in the distal 1/3. the cranial 2/3 are skeletal muscle. |
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What sedative has the least impact on GI transit times in cats? |
Ace |
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What recumbency is advised for esophagrams? |
right lateral |
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During a dynamic esophagram, how many events should be evaluated at the cricopharynx, and how many events should be followed down the esophagus? |
5 @ cricopharynx 3-4 @ esophagus |
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In addition to the cat, which species has skeletal and smooth muscle along its esophagus? |
Horse |
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Name two species in which the esophagus is entirely skeletal muscle. |
Dog and ruminant |
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For an upper GI series, how should iohexol be diluted and why? |
1:3 will cause vomiting otherwise |
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What is the dose of barium for an upper GI study? |
13 mL/kg |
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For upper GI studies, when should radiographs be taken and when is the study considered complete? |
1. Survey rads (4-views) 2. 15m, 30m, 1hr, 2hr, 4hr (2-views) 3. Continue until barium clears the SI |
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During an upper GI study, when does the stomach begin to empty? |
almost immediately |
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When does the duodenum become filled? |
15-30 minutes |
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When is most of the jejunum filled? |
1 hour |
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When does barium reach the cecum? |
1.5 - 2 hours |
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When should barium be seen filling the colon? |
3-4 hours |
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In dogs, what is the answer for the following? a. gastric emptying time b. SI transit time c. SI emptying time |
a. 30 minutes - 2 hours b. 30 minutes - 2 hours c. 3-5 hours |
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What is the complete gastric emptying time of barium in cats? |
15 minutes - 2 hours (usually 30 minutes) |
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What is the iohexol dose used for upper GI studies in cats? |
10 mL/kg (diluted 1:3) |
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Name a sedative that will often increase gastric contractions (especially in cats). |
Ketamine |
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What weight-to-volume suspension, barium dose, and dose of air are advised for double-contrast gastrography? |
1. 30% w/v (via orogastric tube) 2. 1.5-3 mL/kg barium 3. 20 mL/kg air |
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Which study is the best choice (offers the greatest sensitivity and specificity) if a gastric mucosal lesion is suspected? |
double-contrast gastrography |
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List two indications for negative-gastrography. |
1. gastric wall evaluation 2. gastric contents evaluation *NOT mucosal lesions |
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What dose of air is used for a pneumocolon? |
1-3 mL/kg |
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What is the dose of contrast media for excretory urography? |
880 mgI/kg |
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Which media is more toxic to renal tubules? iohexol or iopamidol |
iohexol |
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What are the indications for excretory urography? |
Evaluate renal structure and the collecting system |
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List the 4 phases of urography and when they occur. |
1. Arteriogram - instantaneous 2. Nephrogram - < 20 seconds 3. Pyelogram - < 3 minutes 4. Cystogram - < 40 minutes |
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Nephrogram phase duration is dependent upon what factors? |
1. GFR 2. contrast dose 3. renal concentrating ability 4. patency of renal outflow tract 5. patency of renal vessels 6. systemic BP and hydration |
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In a normal patient, over what time-frame should the nephrogram phase decline? |
steady decrease over the course of 3 hours |
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Regarding the following nephrogram appearance, list all potential associated renal diseases. good opacification but filling defects in the parenchyma? |
1. neoplasia 2. infarcts 3. cysts 4. calculi |
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Regarding the following nephrogram appearance, list all potential associated renal diseases. poor initial with progressively decreasing opacity? |
1. polyuric renal failure 2. inadequate contrast dose |
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Regarding the following nephrogram appearance, list all potential associated renal diseases. poor initial with progressively increasing opacity? |
1. acute extra-renal obstruction 2. renal ischemia 3. hypotension |
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Regarding the following nephrogram appearance, list all potential associated renal diseases. poor initial followed by persistent opacification? |
1. acute pyelonephritis 2. primary glomerular dysfunction 3. severe generalized renal disease |
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Regarding the following nephrogram appearance, list all potential associated renal diseases. fair-to-good initial followed by persistent opacity? |
1. acute renal tubular necrosis 2. hypotension |
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Regarding the following nephrogram appearance, list all potential associated renal diseases. fair-to-good initial followed by progressive increase? |
1. hypotension 2. acute renal obstruction 3. contrast-induced renal failure |
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Regarding the following nephrogram appearance, list all potential associated renal diseases. complete failure of opacification? |
1. traumatic avulsion 2. occlusion of renal artery 3. severe chronic hydronephrosis 4. renal aplasia |
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At what point is the pyelogram phase considered delayed? |
> 3 minutes |
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What defines the beginning of the pyelogram phase? |
after contrast has passed thru the tubules and enters the collecting system |
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What condition can create the appearance of irregular/distorted pelvic recesses? |
pyelonephritis |
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If the patient is azotemic, how should this affect your dose? |
It should be increased by 10% |
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With regard to the pyelogram phase, what disease causes pelvic dilation? |
hydronephrosis |
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With regard to the pyelogram phase, what disease causes short, blunted pelvic recesses? |
chronic pyelonephritis |
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With regard to the pyelogram phase, what diseases can cause ureteral dilation? |
pyelonephritis and hydronephrosis |
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What is one, valid, proposed explanation for contrast-induced renal failure and what is the proposed first line of treatment? |
renal vasoconstriction Dopamine |
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What potential abnormality could a urinalysis reveal from a patient within 24 hours after his excretory urogram? |
proteinuria |
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What would the appearance of contrast-induced renal failure be on excretory urography? |
a positive nephrogram phase but no pyelographic opacification after 20 minutes |
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List a few indications for positive-contrast cystography. |
bladder leaks/rupture! |
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What is the contrast dose for positive-contrast cystography in the dog and cat? |
dog = 5 mL/kg cat = 3 mL/kg |
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In the case of double-contrast cystography, what protocol reduces the likelihood of bubble formation? |
administer air before positive-contrast |
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What dose of air is recommended for negative or double-contrast cystography and how should the patient be positioned? |
LEFT LATERAL! dog = 5 mL/kg cat = 3 mL/kg |
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List two indications for negative-contrast cystography. |
1. evaluate wall thickness 2. detect structural abnormalities NOT for mucosal lesions or small luminal defects. |
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If you suspect an air embolism, you should... |
1. suck it out of the bladder 2. clamp off the catheter 3. do not remove the catheter 4. place in left lateral recumbency* 5. elevate their butt 45 degrees* *(to trap air in the right ventricular apex and prevent it from entering pulmonary circulation) |
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In the case of double-contrast cystography, what dose of contrast should be given to dogs and cats? |
dog = 5-10 mL total cat = 3 mL total |
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For positive contrast urethrography, what is the dose of contrast for the dog and the cat? |
dog = 10-30 mL total cat = 5 mL total |
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During positive-contrast urethrography, will paraprostatic cysts become opacified? |
No. (they do not communicate with the urethra) |
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True or False: All of the following outcomes of urethrography are common. a. hemorrhage into the urinary bladder b. urethral submucosal hemorrhage c. vesiculoureteral reflux d. small, linear contrast reflux into prostate |
all true |
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For myelography, what type of contrast media is advised? |
non-ionic only (iohexol) |
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Answer the following questions re. myelographic dosage: a. what concentration of media is advised? b. dose for cisternal injection? c. dose for lumbar injection? |
a. 200-300 mg/mL (usually 240 mg/mL) b. 0.3 mL/kg c. 0.45 mL/kg |
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Did you touch your myelography needle with your gloves? Why do you need a new needle? |
talcum powder can cause arachnoiditis |
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Where should your needle be placed for a cisternal puncture? |
cerebellomedullary cistern (bevel forward) |
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Where should your needle be placed for a lumbar puncture? |
L5-6 sub-arachnoid space |
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What is one form of myelographic evidence that a patient has an intradural-extramedullary lesion? |
"golf-tee" sign |
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In the rare case of seizure activity secondary to myelography, when is it typically expected to occur? |
~2 hours later |
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During myelography, what type of injection is suspected if you see a sharp, dorsal contrast margin and an undulating ventral margin that 'drapes' over the cord? |
subdural |
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During myelography, what type of injection is suspected if you see wavy dorsal and ventral contrast columns? |
epidural |
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For angiography, what is the proposed dose per injection and per study? |
~400 mgI/kg
~1000 mgI/kg |
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List 4 indications for a right ventricular injection. |
1. tricuspid insufficiency 2. pulmonic stenosis 3. heartworm disease 4. right-to-left PDA |
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List 3 indications for a left ventricular injection. |
1. mitral insufficiency 2. sub-aortic stenosis 3. VSD (left-to-right) |
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List 3 indications for an aortic injection. |
1. PDA 2. aortic insufficiency 3. anomalous coronary artery 4. Ao aneurysms |
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In addition to non-selective angiography, what is one sort of injection that yields non-specific results? |
right atrial however... 1. ASD 2. right atrial tumor 3. tricuspid stenosis |
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List several indications for non-selective angiocardiography. |
1. aortic stenosis 2. reverse PDA 3. persistent right aortic arch (PRAA) 4. PPDH 5. pericardial disease 6. Tetralogy of Fallot |
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What diagnostic is required to differentiate Tetralogy of Fallot from Eisenmenger's Syndrome? |
pulmonary arterial pressures (*they are normal in Tetralogy) |
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What defines Eisenmenger's Syndrome? |
left-to-right VSD that reverses -> becoming a right-to-left VSD *The reversal is secondary to pulmonary hypertension* |
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What is the recommended dose for non-selective angiocardiography? |
200 mgI per 0.45 kg |
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On a VD view, where does gas accumulate in the stomach? |
the body |
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During mesenteric portography, where must a part of the shunt be found in order to be considered most likely extrahepatic? |
at or caudal to T13 |
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What must the cholesterol : triglyceride ratio be in cases of chylothorax? |
< 1 |
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Regarding hepatofugal flow, with what shunt type is it most commonly found and what is it secondary to? |
Multiple acquired portosystemic shunts (MPSS) portal hypertension |
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Where are MPSS commonly found? |
adjacent to the left kidney *flow will extend caudal to the cranial renal pole |
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What must the systolic gradient exceed to warrant balloon valvuloplasty in patients with pulmonic stenosis? |
50 mmHg |
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In what case is balloon valvuloplasty contraindicated and why? |
sub-valvular pulmonic stenosis due to the potential presence of an aberrant left coronary artery (encircling the RVOT just below the pulmonic valve) arising from a single right coronary artery |
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If your patient is a Bulldog and/or if there is any suspicion of an aberrant left coronary artery, what angiographic procedure would be strongly advised prior to balloon valvuloplasty for a stenotic lesion? |
coronary angiography |
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With regard to positive-contrast arthrography of the shoulder, when should radiographs be acquired? |
< 5 minutes (dogs) (in horses, take immediately) |
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Do any equine carpal joints communicate and if so, which ones? |
carpometacarpal and intercarpal (rarely radiocarpal) |