By Stephen Chapman MB BS MRCS MRCP FRCR, Richard Nakielny MA BM BCh FRCR
This booklet provides a synoptic description of the sensible information of ways to hold out the typical techniques in imaging on which an exam candidate can be anticipated to be universal. It doesn't try to conceal rarer strategies past the scope of the examination or to teach the ensuing photos. each approach is defined lower than a suite of normal headings (for instance: tools, symptoms, apparatus, sufferer instruction, procedure, aftercare, issues, extra reading).
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Obstructive nephropathy a. Cytoplasmic vacuolation in tubules b. Precipitation of Tamm-Horsfall protein c. Precipitation of Bence Jones protein in multiple myeloma. Experimental work and theoretical considerations suggest that LOCM are less nephrotoxic. However, the available evidence, including a review of 43 clinical trials comparing LOCM and HOCM, concluded that there was no difference. 20 21 Neurotoxicity 1. Contrast medium delivered to the brain via the arterial route may cross the blood-brain barrier.
GENERAL NOTES References 1. The Ionising Radiation (Medical Exposure) Regulations (2000) London: HMSO. 2. Administration of Radioactive Substances Advisory Committee (1998) Notes for Guidance on the Clinical Administration of Radiopharmaceuticals and use of Sealed Radioactive Sources. Didcot: NRPB. 3. Oldendorf, W . H . , Kitano, M. & Shimizy, F. (1 965) Evaluation of a simple technique for abrupt intravenous injection of radionuclide. J. Nucl. Med. 6, 2 0 5 - 2 0 9 . 4. Working Party of the Radiation Protection Committee of the British Institute of Radiology (I 999) Patients leaving hospital after administration of radioactive substances.
Convulsions may also occur secondary to the cerebral hypoxia caused by hypotension ± cardiac arrest. 22,23 Thyroid function 1. Thyrotoxicosis may occur in patients with non-toxic goitres, or be exacerbated in those with pre-existing thyrotoxic symptoms. 2. Contrast media may interfere with thyroid function tests. INTRAVASCULAR CONTRAST MEDIA IDIOSYNCRATIC REACTIONS Excluding death, adverse reactions can be classified in terms of severity as: 1. e. those that interfere with the examination and require treatment.