CIR Contrast Media Administration & Adverse Reaction Management 2

Question 1

According to ACR classification, which clinical presentation defines a SEVERE anaphylactoid contrast reaction?

Accepted Answer

Bronchospasm, laryngeal edema, or cardiovascular collapse

Answer

Severe anaphylactoid reactions are defined by life-threatening airway compromise (bronchospasm, laryngeal edema) or cardiovascular collapse requiring immediate resuscitative intervention.

Question 2

What is the FIRST-LINE treatment for a severe anaphylactic reaction occurring during cardiac catheterization?

Accepted Answer

IM epinephrine 0.3–0.5 mg (1:1000)

Answer

Intramuscular epinephrine (1:1000) in the anterolateral thigh is the gold standard first-line treatment for anaphylaxis due to its rapid alpha and beta-adrenergic effects.

Question 3

A patient develops diffuse urticaria and mild itching 5 minutes after contrast injection with no respiratory or hemodynamic changes. How is this classified?

Accepted Answer

Mild anaphylactoid reaction

Answer

Cutaneous symptoms (urticaria, pruritus) without airway involvement or hemodynamic compromise are classified as a mild anaphylactoid reaction under ACR guidelines.

Question 4

During contrast injection, a patient develops bradycardia to 38 bpm, diaphoresis, and hypotension without urticaria or bronchospasm. What is the MOST likely reaction type?

Accepted Answer

Vasovagal reaction

Answer

Bradycardia with diaphoresis and hypotension in the absence of cutaneous or respiratory symptoms is characteristic of a vasovagal reaction triggered by pain, anxiety, or vagal stimulation.

Question 5

What is the appropriate treatment for a vasovagal reaction with persistent bradycardia and hypotension during a catheterization procedure?

Accepted Answer

Atropine IV and IV fluid bolus

Answer

Vasovagal reactions are treated with atropine to reverse vagally-mediated bradycardia and IV fluids to restore preload and blood pressure.

CIR - Cardiac Interventional Radiology Practice Test

CIR - Cardiac Interventional Radiology Practice Test

CIR Contrast Media Administration & Adverse Reaction Management 2