Free CAMRT RTR Exam Exam Flashcards

Consent is not a one-time signature. The patient must understand the procedure before it starts and may withdraw at any point, including part way through. If that happens, stop, make the patient safe, and notify the radiologist or referring provider instead of finishing the exam.

No. Interpreting images and giving a diagnosis sits outside MRT scope, so redirect the patient to the radiologist or referring physician. You must still alert the radiologist immediately to an urgent or unexpected finding, which is observation and escalation, not diagnosis.

Patient information is shared only with those who need it for care. Do not discuss cases in corridors, elevators or waiting areas, and open a PACS record only for a patient you are involved with. Looking up a record out of curiosity is a reportable privacy breach.

Patient identity, the procedure performed, any contrast or medication given and when, any reaction or complication, lines and drains, mobility limits, and outstanding instructions. Incomplete handover is one of the most common origins of downstream patient harm.

Confirm at least two person-specific identifiers, such as full name and date of birth, before any exposure. Ask open questions and let the patient state them. A room number, a bed number or the label on a chart is not an acceptable identifier.

Ask every patient of childbearing potential about possible pregnancy and document the answer. A confirmed pregnancy does not automatically cancel the exam: the referring physician and radiologist justify it, and you optimize technique to keep fetal dose as low as reasonably achievable.

Routine practices are the Canadian baseline used for every patient regardless of diagnosis: point-of-care risk assessment, hand hygiene, and personal protective equipment matched to the expected exposure. Additional precautions (contact, droplet, airborne) are layered on top for a specific suspected or confirmed organism.

Drop it directly into a puncture-resistant sharps container at the point of use, uncapped and unbent, and do it yourself rather than handing it on. Two-handed recapping is the classic route to a needlestick and a bloodborne exposure, so the default rule is simply never recap.

Resolve the discrepancy before exposing the patient. Check the ordered procedure against the clinical history, the side and the site, and contact the referring provider when they conflict. Working from an ambiguous order risks an unjustified exposure or a wrong-site exam.

Lock the wheels of both bed and table, lower the rails, bring enough staff for the patient's weight, and use a slider or transfer board. Move on a count with the load close to your body. Never lift or drag a patient by the arms or under the shoulders.

Reach for immobilization devices, sponges, sandbags and straps first. If someone must hold, choose a parent or escort rather than staff, and never the same person routinely. The holder wears a protective apron and gloves, stays out of the primary beam, and should not be pregnant.

Distance, because scatter obeys the inverse square law: stepping back from one metre to two metres cuts your exposure to about a quarter, and it costs nothing. Time and shielding still apply, so an apron and thyroid collar are worn as well, but the single step that removes the most dose is standing further from the patient.

Deterministic effects such as skin erythema, epilation and cataract have a dose threshold, and severity grows with dose once it is crossed. Stochastic effects such as cancer are assumed to have no threshold: dose raises the probability, not the severity. ALARA exists because of the stochastic model.

On the trunk, and, when a protective apron is worn, UNDER the apron: Health Canada Safety Code 35 (A.2.1) requires the dosimeter beneath the apron, with additional dosimeters where extremities may receive much higher doses. Some facilities add a second collar badge outside the apron for fluoroscopy; follow the dosimetry provider's instructions and never leave a badge in the x-ray room.

Hang aprons on racks. Folding one, or draping it over a chair rail, cracks the attenuating layer, and that damage is invisible from the outside. Inspect apparel visually and radiographically on a set schedule and remove from service any apron cracked over a critical organ area.

Absorbed dose is energy deposited per unit mass, measured in gray. Equivalent dose weights that for the type of radiation and is measured in sievert. Effective dose further weights each tissue for its radiosensitivity, also in sievert, and is the quantity used to compare risk between examinations.

Safety Code 35 adopts the ICRP limits: for a radiation worker, 20 mSv effective dose per year averaged over a defined 5-year period (100 mSv in 5 years) and never more than 50 mSv in any single year, with the same figures for the lens of the eye. A member of the public is limited to 1 mSv per year. Anyone likely to exceed one twentieth of the worker limit must be declared a radiation worker and monitored.

Photoelectric absorption creates subject contrast, becomes far more likely as photon energy falls, and deposits all of its energy in the patient. Compton interactions release scattered photons that fog the image and dominate as kVp rises. Raising kVp therefore lowers dose but costs contrast.

A grid sits between patient and receptor and absorbs scattered photons, restoring contrast on thicker body parts. Because it removes photons, technique must be increased to compensate. Off-level, off-centre, wrong focal range or an inverted focused grid all produce cutoff and lost density.

AEC ends the exposure once the selected chambers have received enough radiation. It does not choose kVp, and it cannot rescue poor centring: if the anatomy of interest is not over an active chamber, the exposure terminates at the wrong point. The backup timer only caps a runaway exposure.

It measures which images are repeated and why, so the department can attack the dominant cause, usually positioning, with training or equipment changes. It is a dose-reduction and quality tool for the service, not a means of disciplining individual technologists.

Erect lets air-fluid levels and free subdiaphragmatic air appear and lets the diaphragm descend. PA places the heart nearest the receptor, and a long source-to-image distance of about 180 cm minimizes magnification so heart size can be judged. A supine AP magnifies the mediastinum.

The heart lies mainly to the left, so putting the left side against the receptor reduces cardiac magnification and keeps retrocardiac lung sharper. A right lateral is reserved for occasions when the clinical question concerns the right lung specifically.

Free fluid falls and free air rises. For a suspected small pleural effusion put the affected side DOWN so fluid layers along the dependent chest wall. For a suspected small pneumothorax put the affected side UP so air gathers against the uppermost chest wall. Both need a horizontal beam.

Additive conditions such as pleural effusion, pneumonia, ascites and Paget disease raise attenuation and call for increased technique. Destructive conditions such as emphysema, osteoporosis and gas-filled obstructed bowel lower it and call for reduced technique. Reading it wrong produces an avoidable repeat.

Bend the elbow to 90 degrees with the humerus and forearm resting in one plane on the table, shoulder dropped to that level, and the hand in a true lateral with the thumb up. A true lateral shows the epicondyles superimposed and three concentric arcs: the trochlear sulcus, the outer ridges of the capitulum and trochlea, and the trochlear notch of the ulna.

Ulnar deviation swings the scaphoid out of its normal oblique lie so it is seen along its length rather than foreshortened and overlapped by adjacent carpals. It matters because the scaphoid's retrograde blood supply means a missed waist or proximal-pole fracture can progress to avascular necrosis and non-union.

Internally rotate the whole leg together with the foot, about 15 to 20 degrees, until the line joining the two malleoli is parallel to the receptor. The talus then sits in an evenly open joint space on all three sides. Twisting only the foot leaves the leg where it was and the lateral side of the mortise stays closed.

Do not internally rotate the affected leg and do not attempt a frog-leg lateral, because rotation can displace an undisplaced fracture. Image the AP with the limb as it lies, then take a cross-table lateral with a horizontal beam and the unaffected leg raised out of the field.

A cross-table lateral with the patient immobilized and unmoved, reviewed before any further positioning. It must show C7 and the C7-T1 junction, the level where injuries are most often missed. When the shoulders obscure that junction, add a swimmer's lateral.

A 45 degree oblique projects the posterior elements as a dog: the eye is the pedicle, the nose the transverse process, the ear the superior articular process, the front leg the inferior articular process, and the NECK the pars interarticularis. A lucent collar across the neck is spondylolysis.

An erect abdomen or erect PA chest shows free air beneath the hemidiaphragms. A patient who cannot stand is turned onto the LEFT side for a lateral decubitus with a horizontal beam, so that rising air outlines the right flank beside the liver, where no stomach gas can mimic it. Leave the patient in position for at least five minutes first.

Never reach across a sterile field or turn your back on it. Anything below waist level or beyond the field edge counts as contaminated. Approach face-on, keep the imaging equipment inside a sterile drape, and let circulating staff position that cover for you.

Avoid an arm with an arteriovenous fistula, on the side of a mastectomy with node dissection, or with a cast or local infection. Enter bevel up at a shallow angle, then release the tourniquet BEFORE withdrawing the needle so the vein is not pressurized, and apply direct pressure afterwards.

Where perforation, an anastomotic leak or imminent surgery is suspected, use a water-soluble iodinated agent, because barium escaping into the peritoneum causes a severe chemical peritonitis. Where aspiration is the greater risk, a non-ionic low-osmolar agent is preferred over an ionic hyperosmolar one.

Warmth, flushing, a metallic taste and mild nausea are expected physiologic effects that settle on their own. Urticaria, wheeze, stridor, facial swelling or hypotension signal an anaphylactoid reaction: stop the injection, keep the IV access, protect the airway, call for help and follow the epinephrine protocol.

mAs. Receptor exposure is directly proportional to it, so doubling mAs doubles the radiation reaching the detector. Reciprocity means 100 mA at 0.1 s and 200 mA at 0.05 s deliver the same exposure, so choose the shortest time that still yields the mAs you need.

Increasing kVp by about 15 percent has roughly the same effect on receptor exposure as doubling mAs, so halve the mAs to hold exposure steady. You gain penetration and lower patient dose, and you pay for it with reduced subject contrast and more scatter.

Digital processing rescales displayed brightness, so surplus dose no longer darkens the image the way film did. Only the exposure indicator exposes the error. Left unchecked this becomes dose creep: images continue to look acceptable while patients absorb steadily more radiation.

DI equals 10 log10 of the exposure indicator over its target value. A DI of zero means the target was hit; positive numbers mean too much exposure and negative numbers too little. Because the scale is logarithmic, each unit is a change of about 26 percent, so +3 means roughly twice the target and -3 roughly half of it.

A grainy, blotchy appearance caused by too few photons reaching the receptor, almost always from insufficient mAs. The remedy is more mAs, since no amount of windowing can create signal that was never recorded. Raising kVp instead simply adds scatter.

Select the small focal spot, which narrows the penumbra at the edges of structures, and reduce object-to-image distance by keeping the part of interest against the receptor. Magnification factor equals SID divided by SOD, so a larger OID both enlarges and blurs the anatomy.

Both are shape distortion caused by misalignment. Elongation makes a part look longer than it is, typically after angling the tube or the receptor. Foreshortening makes it look shorter, because the part itself is angled to the receptor. Size distortion from object-to-image distance is a separate effect.

X-rays leaving toward the anode side of the tube must pass through more target material and are partly absorbed there, so the beam is weaker at the anode end and stronger at the cathode end. Exploit it by placing the thicker end of a tapering part, such as the proximal femur or the lower thoracic spine, under the cathode. The gradient is largest at short SID with a wide field.

Motion. Voluntary motion yields to clear instruction, breathing coaching and immobilization, but involuntary motion from peristalsis, tremor or the heart can only be outrun. Use a high mA with the shortest exposure time that still delivers the required mAs.

The right or left marker belongs in the primary beam at the moment of exposure, which makes side identification part of the permanent record. Annotation added later can land on the wrong image and is a last resort only. If the side cannot be proven from anatomy, the image is repeated.

Only when the image cannot answer the clinical question, because every repeat is a second dose. Slight rotation or imperfect collimation on an otherwise diagnostic image is not a reason. Anatomy cut off, motion blur, a gross exposure error or an unverifiable side are.

Windowing, edge enhancement and inversion only change how captured data is displayed. They cannot recreate anatomy that was collimated out, restore detail lost to motion, or clear quantum mottle from an underexposed image. Whatever was not recorded at exposure is gone.

An accessory ossicle or sesamoid has smooth, rounded margins fully outlined by cortex, and often has a counterpart on the opposite side. An acute fracture line is sharp, irregular and lucent with no cortex along its edges, and usually carries overlying soft-tissue swelling.

On an erect chest film the tell-tale sign is a fine white line of visceral pleura separated from the chest wall, with no vascular markings outside it, most often at the apex. In a supine patient air rises anteriorly instead, so look for an unusually deep, dark costophrenic sulcus (the deep sulcus sign) rather than an apical line.