Order Intravascular Contrast Agents Essay

Order Intravascular Contrast Agents Essay
Order Intravascular Contrast Agents Essay
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
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
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