Medical Students

Housekeeping

Computer access:

Use same login as MSH

PACS

Goals and Objectives

To understand what your patient will experience when they have a nuclear medicine study, an ultrasound, a CT scan, an MRI scan, a VIR procedure

To understand the use of IV contrast and what you may need to discuss with your patients.

To understand the issues involved with medical radiation and what you may need to discuss with your patients.

Order v request

http://www.jacr.org/article/S1546-1440(17)30678-6/pdf

Reading Assignments:

http://thehealthcareblog.com/blog/2017/05/17/bob-wachters-2017-penn-med-commencement-address-go-to-radiology/

CONTRAST

ACR manual

https://www.acr.org/Quality-Safety/Resources/Contrast-Manual

Package insert for gadobutrol (gadolinium)

http://www.medsafe.govt.nz/profs/datasheet/g/Gadovistinj.pdf

Package insert for Omnipaque (iodinated)

see attached file

Risk of "life threatening" reaction

Iodinated contrast 0.01-0.02 percent (1 in 5000 to 1 in 10,000) (NIS pg 22)

Gadolinium 0.001 to 0.01 percent (1 in 10,000 to 1 in 100,000) (NIS pg. 30)

Treatment:

Epinephrine our protocol is to start with 0.3 (the amount in an adult epipen) to 0.5 mg for an adult to start ACR manual says (.0.1mg/kg or 0.7 mg for 70 kg person)

1:1000 subq (1mg/ml) about 0.3-0.5 ml for 70 kg patient

1:10,000 IV (1mg/10 ml) so you give about 3 to 5 ml for 70 kg patient

ACR guide for R1 residents

http://www.acr.org/~/media/ACR/Documents/PDF/Membership/RFS/2015_RFS_Guide_Final.pdf

See our Bootcamp page or R1 residents

https://sites.google.com/site/neuroradiologyprimer/home/bootcamp

google NEJM Modic

ACR

Appropriateness Criteria

Image Gently (pediatric)

Image Wisely (adult)

http://www.imagewisely.org/

the radiation level is given by the number of "radiation danger symbols"

the new symbol is more explicit

http://www.iaea.org/newscenter/news/2007/radiationsymbol.html

the old symbol resembles the fallout shelter symbol

http://en.wikipedia.org/wiki/Fallout_shelter

ABIM

Choosing Wisely

http://www.choosingwisely.org/

from the ACR

"5 things"

http://www.choosingwisely.org/doctor-patient-lists/american-college-of-radiology/

MR Safety for Students

Magnet is always on

http://www.nytimes.com/2001/07/31/nyregion/boy-6-dies-of-skull-injury-during-mri.html

Radiology and the NYT

Babygram

CT Perfusion

Hair loss in the news

Double CT

All students

There is an "official" radiology patient portal

https://www.radiologyinfo.org/

ACR Appropriateness Criteria

Specialty Specific Content

Women's Imaging/Mammography

Video by our Alum Jordana Phillips

https://www.youtube.com/watch?v=dEdR4iOdLh0

For those going into Anesthesia

sprotte/whitacre needle

for those interested in Neurology

sprotte/whitacre needle

Choosing Wisely guideline for uncomplicated headache

http://www.choosingwisely.org/clinician-lists/american-college-radiology-imaging-for-uncomplicated-headache/

PRES

limbic encephalopathy

for those interested in OB/Gyn

PRES

Fascinoma Case Report

46 yo woman with myelopathy aggravated by menstruation

http://thejns.org/doi/full/10.3171/jns.1991.75.6.0947?prevSearch=berenstein%2Bkim%2Bchoi&searchHistoryKey=

For those going into PM and R

Gawande Overkill

For those interested in Radiology

Join the RSNA, ACR

consider a research project

e.g. Shingo Kihira ISSMS '17

Kihira S; Kagetsu NJ. Supplementation of Online Radiology Modules in Medical School Curriculum. (Poster presentation) AUR Hollywood, FL, 2017

Kihira S; Le TM, Kagetsu NJ. Parallel selection processes for medical school students and future radiologists. (Poster presentation) AUR Hollywood, FL, 2017

References/Resources

Websites:

ABR

Noninterpretive Skill (NIS) PDF

Anatomy

http://headneckbrainspine.com/index.php

CT is Us by Elliott Fishman at Hopklins

http://www.ctisus.com/redesign/default.asp

Radiology Assistant

http://www.radiologyassistant.nl/

Radiopaedia

https://radiopaedia.org/