Review Exercise C

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1

A KUB radiograph reveals that the symphysis pubis was cut off along the bottom of the image. Is this an acceptable radiograph? If not, how can this problem be prevented during repeat exposure?

No. center CR to iliac crest, palpate symphysis pubis or greater trochanter to ensure it is above the bottom of the cassette.

2

A radiograph of an AP projection of an average-size adult abdomen was produced using 90kV, 400mA, 1/10 sec, grid, and 40 inch SID using film/screen system. The overall density of the radiograph was acceptable, but the soft tissue structures were not visible. Which adjustment to the technical considerations will enhance the visibility of these structures on repeat exposure?

lower kV to 70-80

3

A radiographic image of an AP projection of the abdomen demonstrates motion. The following exposure factors were selected: 78kV, 200 mA, 2/10 sec, grid, and 40 inch SID. The technologist is sure that the patient did not breathe or move during the exposure. WHat may have caused the blurriness? What can be done to correct the problem on repeat exposure?

Blurriness could be due to involuntary motion and can be corrected by doubling mAs

4

A radiograph of an AP abdomen reveals the left iliac wing is more narrowed than the right. What specific positioning error caused this?

Patient was rotated into a slight RPO

5

A patient with a possible dynamic ileus enters the ER. The patient is able to stand. The physician has ordered an acute abdominal series. What specific positioning routine should be used?

PA erect, AP supine, AP erect abdomen

6

A patient with a possible perforated duodenal ulcer enters the emergency room. The ER physician is concerned about the presence of free air in the abdomen. The patient is in severe pain and cannot stand. What positioning routine should be used to diagnose this condition?

AP supine abdomen, left lateral decubitus

7

The ER physician suspects a patient has a kidney stone. The patient is sent to the radiology department to confirm the diagnosis. What specific positioning routine would be used to rule out the presence of a kidney stone?

KUB, AP supine

8

A patient in intensive care may have developed intra-abdominal bleeding. The patient is in critical condition and cannot go to the radiology department. The physician has ordered a portable study of the abdomen. Which specific position or projection can be used to determine the extent of the bleeding.

Left lateral decubitus

9

A patient with a history of ascites comes to the radiology department. Which position best demonstrates this condition?

Erect AP abdomen

10

A KUB radiograph reveals that the gonadal shielding is superior to the upper margin of the symphysis pubis. The female patient has a history of kidney stones. What is the next step the technologist should take?

Repeat the exposure without the use of gonadal shielding.

11

A hypersthenic patient comes to the radiology department for a KUB. The radiograph reveals that the symphysis pubis is included on the image, but the upper abdomen, including the kidneys, is cut off. What is the next step the technologist should take?

repeat the exposure. Use two 14x17 IRs crosswise to include the entire abdomen

12

A patient comes into the ER with a large distended abdomen caused by an ileus. The physician suspects that the distention is caused by a large amount of bowel gas that is trapped in the small intestine. The standard analog technique for a KUB on an adult is 76 kV, 30 mAs. SHould the technologist change any of these exposure factors for this patient? (AEC is not being used)

Yes. Decrease the mAs

13

A child goes to radiology for an abdomen study. It is possible that he swallowed a coin. The ER physician believes it may be in the upper GI tract. Which of the following routines would best identify the location of the coin?

KUB and lateral abdomen