Buy Intravascular Contrast Agents Assignment

Buy Intravascular Contrast Agents Assignment
Buy Intravascular Contrast Agents Assignment
1 Contrast agents are known to cause adverse effects.
All of the following responses would be considered
anaphylactoid reactions, except:
(A) Bronchospasm
(B) Bradycardia
(C) Angioedema
(D) Urticaria
(E) Cardiovascular collapse
2 Which of the following is true regarding the mechanism of contrast media anaphylactoid reactions?
(A) They are due to immunoglobulin E (IgE)-
mediated degranulation of mast cells
(B) They are due to chemokine release from memory T-cells, which cause degranulation of mast
cells
(C) They involve iodine binding of vitronectin
receptor and basophil degranulation
(D) They involve degranulation of circulating basophils and tissue mast cells by direct complement activation
3 A 63-year-old woman suffered bronchospasm during diagnostic coronary angiography with a highosmolar contrast agent 2 years ago. She presents for
repeat coronary angiography secondary to angina
and a positive stress test. What is the likelihood
of another reaction when reexposed to a nonionic
low-osmolar contrast agent?
(A) <1%
(B) <10%
(C) <25%
(D) <50%
4 All of thefollowing are clearindicationsfor using lowosmolar contrast agents for coronary angiography,
except:
(A) Severe coronary artery disease (e.g., left main
disease)
(B) Severe emphysema
(C) Severe aortic stenosis
(D) Moderate-to-severe left ventricular dysfunction
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5 Side effects of high-osmolar contrast agents such
as a transient decrease in systolic blood pressure,
flushing, bradycardia, and nausea are thought to be
mediated by what properties?
(A) Hypertonicity
(B) Sodium concentration
(C) Iodine-mediated vasodilatation
(D) Low viscosity
6 Studies suggest that low-osmolar nonionic contrast
agents compared with high-osmolar contrast agents
reduce the incidence ofwhich of thefollowing adverse
effects?
(A) Thrombotic complications
(B) Bradyarrhythmias
(C) Postprocedure renal failure
(D) Anaphylactoid reactions
(E) A and B
(F) B, C, and D
7 What is the incidence of life-threatening reactions to
contrast agents?
(A) 1:100
(B) 1:1,000
57
58 900 Questions: An Interventional Cardiology Board Review
(C) 1:100,000
(D) 1:1,000,000
8 A 52-year-old man with a history of asthma and
hypertension receives his first injection of contrast
for his diagnostic cardiac catheterization. He immediately develops bronchospasm, laryngeal edema,
and hypotension. Immediate treatment should begin
with:
(A) 1 mg of 1:10,000 epinephrine intravenous
boluses every minute until pressure is restored
(B) 10 mg of 1:10,000 epinephrine intravenous
boluses every minute until pressure is restored
(C) 0.1 mg of 1:10,000 epinephrine intravenous
boluses every minute until pressure is restored
(D) 0.01 mg of 1:10,000 epinephrine intravenous
boluses every minute until pressure is restored
(E) None of the above
9 Match the following intravascular contrast agents
with the appropriate statement:
(A) Diatrizoate (Hypaque, Renografin, Angiovist)
(B) Iohexol (Omnipaque)
(C) Ioxaglate (Hexbrix)
(D) Iodixanol (Visipaque)
1. A nonionic, iso-osmolar agent
2. An agent with serum osmolality typically six
times that of blood
3. A nonionic, low-osmolar agent that is watersoluble
4. An ionic, low-osmolar agent with a dimeric
structure
10 Which of the following patients has the highest risk
of developing contrast-associated nephropathy following cardiac catheterization and/or percutaneous
coronary intervention (PCI)?
(A) A 72-year-old woman with diabetes mellitus and
a serum creatinine of 2.0 mg per dL who presents
with ST-elevation myocardial infarction and
hypotension
(B) A 48-year-old man without diabetes mellitus
and a serum creatinine of 2.6 mg per dL
undergoing elective PCI
(C) An 80-year-old man with diabetes mellitus and
a serum creatinine of 1.0 mg per dL who is also
taking metformin
(D) A 45-year-old woman with a history of a solitary
kidney and a serum creatinine of 0.9 mg per
dL who is undergoing a right- and left-heart
catheterization for a suspected atrial septal
defect
11 Potential strategies for reducing the risk of contrastassociated nephropathy in high-risk patients include
all of the following, except:
(A) Pre- and posthydration with half-normal saline
at the time of the procedure
(B) Limiting the volume of intravascular contrast
used
(C) Maintaining urine flow rates of 150 mL per hour
with close hemodynamic monitoring and the
use of fluid loading, dopamine, and furosemide
(D) Oral N-acetylcysteine (NAC) following the
procedure
(E) Use of nonionic, iso-osmolar contrast
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12 The mechanism by which intravascular contrast is
believed to cause nephropathy is:
(A) Direct cellular toxicity to renal tubular cells
resulting in acute tubular necrosis (ATN)
(B) Hypoxic injury due to localized hemodynamic
alterations including renal vasoconstriction
(C) Neither
(D) Both
13 In a 70-kg patient with a baseline creatinine of 2.0 mg
per dL who is undergoing cardiac catheterization and
PCI, there should be attempts to limit the contrast
dose to:
(A) 70 mL
(B) 105 mL
(C) 175 mL
(D) 210 mL
14 Patients with contrast-associated nephropathy typically have all of the following occur during their
clinical course with the exception of:
(A) An early rise in serum creatinine usually within
4 days
(B) Recovery of serum creatinine within 2 weeks
(C) Transient need for renal replacement therapy
with hemodialysis
(D) Urinalysis with active sediment showing ‘‘granular’’ muddy casts
15 Contrast-associated nephropathy can be differentiatedfrom atheroembolic renalfailure most clearly by:
(A) Absence of cutaneous findings like livedo
reticularis
(B) Absence of peripheral eosinophilia or eosinophiluria
(C) Recovery of serum creatinine within 2 weeks
(D) Presence of a normal urinalysis
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