CAMRT Fluoroscopy and Interventional Radiography 3

Question 1

In percutaneous transluminal angioplasty (PTA), what is the mechanism by which the balloon catheter restores blood flow?

Accepted Answer

It is inflated within a stenotic vessel segment to mechanically dilate the narrowing and restore luminal diameter

Answer

It injects thrombolytic drugs directly into the clot

Answer

It aspirates plaque material from the vessel wall

Answer

It delivers localized thermal energy to dissolve atherosclerotic deposits

Question 2

In digital subtraction angiography (DSA), what is a 'mask' image and how is it used?

Accepted Answer

A pre-contrast baseline image electronically subtracted from contrast-filled frames, leaving only opacified vessels visible

Answer

A lead shield placed over the image intensifier to reduce off-axis scatter

Answer

A post-processing filter that enhances vessel edge sharpness

Answer

A protective cover for the flat-panel detector during fluoroscopy

Question 3

What are the key steps of the Seldinger technique for vascular access in interventional radiology?

Accepted Answer

Needle puncture of vessel, guidewire insertion through needle, needle removal, catheter advancement over guidewire

Answer

Cut-down onto the vessel, direct catheter insertion, suture closure

Answer

Transvenous approach using a long sheath without a needle

Answer

Surgical anastomosis of catheter directly to vessel wall

Question 4

Which combination of radiation protection measures is most important for the interventional radiologist who must stand near the patient during fluoroscopic-guided procedures?

Accepted Answer

Wearing a full lead apron, thyroid collar, and leaded glasses, and maximizing distance from the beam when possible

Answer

Using the highest possible kVp to reduce procedure time

Answer

Limiting total procedure time to exactly 5 minutes regardless of clinical need

Answer

Positioning the X-ray tube above the table to increase tube-to-patient distance

Question 5

In percutaneous nephrostomy, which anatomical approach and calyceal target are preferred to minimize vascular injury?

Accepted Answer

Posterior flank approach targeting a posterior calyx, typically in the lower pole

Answer

Anterior abdominal approach targeting the renal pelvis directly

Answer

Transureteral approach via cystoscopy

Answer

Lateral flank approach targeting the renal cortex mid-pole

Question 6

What is the primary function of an endovascular stent placed after balloon angioplasty?

Accepted Answer

To provide a permanent structural scaffold that maintains vessel patency and prevents elastic recoil or restenosis

Answer

To continuously inject anticoagulants into the vessel lumen

Answer

To measure intravascular pressure continuously after the procedure

Answer

To serve as a conduit for tissue biopsy collection

Question 7

During an interventional procedure a patient develops urticaria and bronchospasm following contrast injection. What is the correct immediate management priority?

Accepted Answer

Administer epinephrine (adrenaline) immediately, call for emergency assistance, and provide airway and circulatory support

Answer

Inject additional contrast to dilute the reaction and continue the procedure

Answer

Administer an oral antihistamine and observe for 10 minutes before deciding on further action

Answer

Place the patient in Trendelenburg and wait for spontaneous resolution