Chapter 28: Interventional Radiology

Chapter 28: Interventional Radiology

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Select the diagnostic and interventional radiology procedure that is not classified as a vascular procedure.

a.	Percutaneous nephrolithotomy
b.	Carotid interventions
c.	Portal hypertension management (TIPS)
d.	Uterine artery embolization

 

 

ANS:  A

Percutaneous nephrolithotomy is classified as a nonvascular diagnostic or interventional procedure along with the following procedures: abscess drainage, chest tube placement, percutaneous gastrostomy tube placement, percutaneous jejunostomy feeding tube (J-tube) placement, cecostomy tube placement, gastrointestinal stent placement, varicocele interventions, lacrimal procedures, and percutaneous biopsies of solid organs.

 

REF:   Page 1237

 

2. Diagnostic and therapeutic procedures performed in a comprehensive cancer center interventional radiology department might include the injection of targeted antimetabolic drugs into the blood supply that feeds a tumor to block further blood flow and kill cancer cells. Select the appropriate procedure.

a.	Transarterial placement of yttrium-90 microspheres (90Y)
b.	Chemoembolization of the liver
c.	Brachytherapy delivery
d.	Tumor ablation with radiofrequency (RFA)/thermal, cryotherapy energy

 

 

ANS:  B

Chemoembolization: Delivery of cancer-fighting agents directly to the site of a cancer tumor while depriving the tumor of its blood supply; currently being used mostly to treat cancers of the endocrine system and liver cancers. Oncology embolotherapy procedures: chemoembolization of the liver, transarterial placement of yttrium-90 microspheres (90Y), tumor ablation with radiofrequency (RFA)/thermal, cryotherapy energy, and brachytherapy delivery.

 

REF:   Pages 1222, 1237

 

3. An interventional radiology procedure for the correction of a blocked or narrowed blood vessel is a(n):

a.	angiogram.
b.	arterial embolization.
c.	biliary stenting.
d.	balloon angioplasty.

 

 

ANS:  D

Balloon angioplasty: Opens blocked or narrowed blood vessels by inserting a very small balloon into the vessel and inflating it. Used by IRs to unblock arteries in the legs or arms, kidneys, brain, or elsewhere in the body. Angiography: An x-ray exam of the arteries and veins to diagnose blockages and other blood vessel problems. Biliary drainage and stenting: Uses a stent (small mesh tube) to open blocked ducts and allow bile to drain from the liver.

 

REF:   Page 1222

 

4. Select the statement that correctly describes the mechanism of action of contrast media.

a.	Contrast media are used to enhance visualization of anatomic structures by influencing tissue radiopacity with different concentrations of iodine.
b.	A contrast agent works by attenuating (absorbing) the x-ray beam either more than or less than the surrounding tissue.
c.	Contrast media radiopacity is related to its iodine concentration.
d.	A contrast agent works by the speed of delivery affecting blood flow and hemodilution.

 

 

ANS:  B

Since the beginning of radiographic imaging, contrast media have been used to enhance visualization of anatomic structures. Contrast agents can be positive or negative in effect. A negative contrast agent attenuates (absorbs) the x-ray beam less than surrounding tissue. A positive contrast agent attenuates the beam more than surrounding tissue. Visualization caused by contrast injection is affected by several issues. Iodine concentration is directly related to the radiopacity produced by the contrast medium.

 

REF:   Pages 1224-1230

 

5. Contrast media–induced nephrotoxicity (CIN) can occur as a result of a physiologic change when a transient increase in blood flow is then followed by a longer period of decreased blood flow to the kidneys, after the administration of contrast media. Which statement best describes a true risk factor for CIN?

a.	Biphasic renal flow has been shown to induce CIN.
b.	Underlying renal insufficiency is believed to be a predictor of CIN.
c.	Diabetic patients with concurrent use of nephrotoxic drugs and dehydration comprise the majority of patients with CIN.
d.	Vasodilatation, toxic stress, and tubular necrosis are known contributing factors as cited by a recent study.

 

 

ANS:  B

The most notable predictor of CIN is believed to be underlying renal insufficiency. The patient’s state of hydration and the existence of any preexisting renal insufficiency affect the likelihood of CIN. Biphasic renal flow has been described following contrast administration. This involves a transient increase in blood flow and then a longer period of decreased blood flow to the kidneys. Contrast media–induced nephrotoxicity (CIN) can occur as a result of this physiologic change. Patients with normal renal function tolerate contrast administration well given certain guidelines are observed. Tumlin and colleagues (2006) cite three contributing factors: vasoconstriction, oxidative stress, and direct tubular toxicity.