CIR Contrast Media Administration & Adverse Reaction Management 3

Question 1

According to ACR guidelines, at what eGFR threshold is the risk of contrast-induced acute kidney injury MOST significantly elevated?

Accepted Answer

eGFR < 30 mL/min/1.73m²

Answer

eGFR < 60 mL/min/1.73m²

Answer

eGFR < 45 mL/min/1.73m²

Answer

eGFR < 15 mL/min/1.73m²

Question 2

How long should metformin be withheld AFTER contrast administration in a patient with renal impairment (eGFR < 45)?

Accepted Answer

48 hours

Answer

12 hours

Answer

24 hours

Answer

72 hours

Question 3

The Laskey formula for estimating safe contrast volume in renally impaired patients uses which ratio?

Accepted Answer

Contrast volume ÷ eGFR (should be < 3.7)

Answer

Contrast volume ÷ serum creatinine (should be < 5)

Answer

Contrast volume × body weight ÷ eGFR

Answer

Contrast volume ÷ age in years

Question 4

A pregnant patient requires emergency coronary angiography. What is the PRIMARY contrast-related concern for the neonate?

Accepted Answer

Transient neonatal hypothyroidism from iodine exposure

Answer

Permanent renal dysplasia from contrast toxicity

Answer

Direct teratogenic chromosomal damage

Answer

Iodinated contrast is completely contraindicated in all trimesters

Question 5

Which contrast media property is MOST important for minimizing direct cardiac toxicity during intracoronary injection?

Accepted Answer

Low ionicity and low osmolality

Answer

High viscosity to slow flow rate

Answer

Maximum iodine concentration for opacification

Answer

High pH buffering capacity

Question 6

How is a delayed contrast reaction defined by timing of onset after contrast administration?

Accepted Answer

1 hour to 7 days after injection

Answer

Within 1 minute of injection

Answer

1 to 60 minutes after injection

Answer

More than 7 days after injection

Question 7

For an urgent procedure in a patient with a prior severe contrast reaction, which premedication regimen is recommended when full oral preparation is not possible?

Accepted Answer

IV methylprednisolone 40 mg and IV diphenhydramine 50 mg administered 1 hour before contrast

Answer

Defer the procedure until full 13-hour oral regimen is completed

Answer

Oral prednisone 50 mg given 30 minutes before the procedure

Answer

Epinephrine prophylaxis 0.3 mg IM given at the time of contrast injection