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Describe how windowing (width and level) affects the contrast and density of the diagnostic image (p symptoms 5 days after conception discount 100mg solian. What term is commonly used to describe the range of grays a particular digital system is capable of resolving (p medicine ball workouts purchase solian 100 mg otc. List at least six fluoroscopic equipment features designed to reduce patient and personnel exposure (pp treatment vertigo solian 100mg cheap. Identify by what means the image intensifier compensates for varying body thicknesses (p 5 asa medications solian 50 mg. Identify the sizes of cine film available and compare each with regard to patient dose and image quality (p. Identify the spot film sizes available and relate each to patient dose and image quality (p. Advantages of digital radiography (computed radiography) include all of the following, except the ability to: (A) compensate for exposure factors (B) make changes in contrast characteristics (C) improve geometric detail (D) store images in binary form 2. The resulting image looks like a: (A) series of dots or dashes, each representative of a radiation pulse (B) solid arc, the angle (in degrees) representative of the exposure time (C) series of gray tones, from white to black (D) multitude of small mesh-like squares of uniform sharpness 3. In the production of Bremsstrahlung radiation, the incident electron: (A) ejects an inner shell tungsten electron (B) ejects an outer shell tungsten electron (C) is deflected with resulting energy loss (D) is deflected with resulting energy increase 4. Which of the following will occur as a result of decreasing the anode target angle The device used to ensure reproducible images, regardless of tissue density variations, is the: (A) phototimer (B) penetrometer (C) grid (D) rare earth screen 7. Changes in window width in digital imaging result in changes in: (A) contrast (B) density (C) resolution (D) distortion 8. If the primary coil of the high-voltage transformer is supplied by 220 V and has 150 turns, and the secondary coil has 75,000 turns; what is the voltage induced in the secondary coil Which of the following circuit devices operate(s) on the principle of self-induction But because three-phase equipment is almost constant potential, a synchronous spinning top must be used, and the result is a solid arc (rather than dots). The number of degrees formed by the arc is measured and equated to a particular exposure time. An aluminum step-wedge (penetrometer) may be used to demonstrate the effect of kV on contrast (demonstrating a series of gray tones from white to black), with a greater number of grays demonstrated at higher kV levels. The incident high-speed electron, passing through a tungsten atom, is attracted by the positively charged nucleus; therefore, it is deflected from its course with a resulting loss of energy. This is advantageous because it will improve radiographic detail without creating a heat-loading crisis at the anode (as would be the case if the actual focal spot size were reduced to produce a similar detail improvement). With a smaller target angle the anode heel effect increases; photons are more noticeably absorbed by the "heel" of the anode, resulting in a smaller percentage of x-ray photons at the anode end of the x-ray beam and a concentration of x-ray photons at the cathode end of the image. As in traditional radiography, spatial resolution is measured in line pairs per mm (lp/mm). As matrix size is increased, there are more and smaller pixels in the matrix, which means improved resolution. Fewer and larger pixels result in a poor resolution "pixelly" image, that is, one that you can actually see the individual pixel boxes. Radiographic results should be consistent and predictable, not only in positioning accuracy but with respect to exposure factors as well. Automatic exposure devices (phototimers and ionization chambers) automatically terminate the x-ray exposure once a predetermined quantity of x-ray has penetrated the patient, thus ensuring consistent results. Image manipulation postprocessing can be used for windowing, contrast and/or density modification, or image subtraction. Windowing is a process of changing the contrast and density setting on the finished image. The window width controls the number of shades of gray in the image (contrast), while the window level corresponds to the image density. The amount of increase or decrease depends on the transformer ratio, that is, the number of turns in the primary coil to the number of turns in the secondary coil. Two x-ray circuit devices operate on the principle of self-induction: the autotransformer operates on the principle of self-induction and enables the radiographer to vary the kilovoltage. The choke coil also operates on the principle of self-induction; it is a type of variable resistor that may be used to regulate filament current.
Multifocal neuropathy/ mononeuritis multiplex An asymmetrical neuropathy affecting two or more peripheral nerves at one time medications given during dialysis order solian with a visa, producing symptoms of numbness medications for schizophrenia solian 100 mg on-line, paraesthesiae and sometimes pain in their sensory distribution with associated muscle weakness and wasting medications recalled by the fda order solian 100mg amex. It is characterised by pain and tingling paraesthesia in the hand or arm symptoms 5 days post embryo transfer purchase solian with american express, typically worse at night, with wasting of the muscles of the thenar eminence and sensory loss in the distribution of the median nerve (radial three-and-a-half digits). Diagnosis can be confirmed with electromyography, and secondary causes should be sought. Treatment depends on severity, but may include splinting (especially at night), local injection of corticosteroids and surgical decompression. Peripheral polyneuropathy Diffuse disease of the peripheral nerves classified according to whether there is sensory or motor involvement or both, and whether the site of disease is the myelin sheath (demyelinating neuropathy) or the nerve fibre (axonal neuropathy). Long-standing disease may result in claw deformities of the foot (pes cavus) and hand and sensory loss may lead to neuropathic ulceration and joint deformity (Charcot arthropathy). It is characterised by pain and/or paraesthesiae radiating along the ulnar border of the forearm, with wasting of the small muscles of the hand but sparing of the thenar eminence; there is also sensory loss in the hand in the distribution of the ulnar nerve. Electromyography can be used to confirm the diagnosis; treatment may involve splinting and/or diabetes mellitus carcinomatous neuropathy vitamin B deficiency (including B12) drugs or toxins. Symptoms of numbness, paraesthesiae and sometimes pain in the feet are associated with loss of vibration and position sense and loss of the ankle reflex. In vitamin B12 deficiency the peripheral neuropathy may be associated with megaloblastic anaemia and subacute combined degeneration of the cord (p. Metabolic Nutritional Drugs Toxins Clinical presentation Painless muscular weakness is produced by repetitive or sustained contraction (fatigability typically worse at the end of the day or after exercise). This is most marked in the face and eyes, producing Neoplasia Neurology 197 a symmetrical ptosis and diplopia. Proximal muscles are more often affected than the distal, and the upper limb more than the lower. It differs from classical myasthenia gravis in that the eyes are less frequently affected, proximal limb muscle weakness is common and their strength is initially increased by repeated movement. Long-acting anticholinesterases orally: neostigmine or pyridostigmine, preferably titrated by increasing the dosage slowly until measured muscular strength is optimised. Corticosteroids: an alternate-day regimen (between 10 and 80 mg of prednisolone) should be started in hospital at a low dosage as there is a risk of increasing weakness in the early stages of therapy. Plasmapheresis or intravenous immunoglobulin may be valuable in intractable cases, but the effect is short-lasting and best reserved for those preparing for thymectomy. Myotonic dystrophy (dystrophia myotonica) this is a rare autosomal dominant (chromosome 9) disorder producing progressively more severe symptoms and signs with succeeding generations, i. Prognosis Myasthenia gravis may never progress beyond ophthalmoplegia and periods of remission of up to 3 years occur. On examination lordotic posture and waddling gait are seen because of weakness of the muscles of the pelvic girdle and proximal lower limb. Subsequent leg muscle contracture may produce talipes equinovarus and muscle weakness may spread to the upper limbs. Affected individuals usually die in their teens and 20s from associated complications including chest infections and cardiomyopathy. Less severe mutations may present in adolescence or adulthood (Becker muscular dystrophy) and are compatible with a normal life span but may be associated with progressive disability. Neurological infections Bacterial meningitis Bacterial meningitis is usually caused by infection with one of three organisms: Neisseria meningitidis, Haemophilus influenzae type b and Streptococcus pneumoniae. Physical examination reveals signs of infection (fever, tachycardia, hypotension) and there may be a characteristic purpuric/petechial rash.
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Sometimes gray hair appears in younger people or may appear suddenly after extreme terror medications in spanish order 50mg solian free shipping, grief or shock medicine lyrics order solian amex. Localized areas of gray hair may be due to neuralgia or other diseases of the fifth cranial nerve medications that cause pancreatitis buy discount solian 50 mg on-line. Grade or year in school or college: Usually children enter the primary school at the age of 7 medicine 8 capital rocka cheap solian 100mg with mastercard. Graduation in a collegiate course depends on the number of years required for the course. Menstruation in women: Menstruation usually commence at the age of 12 but in warm countries it may start at an earlier age. Atheromatous changes of blood vessels, opacity of the lens and cornea (arcus senilis). Disputed paternity may arise: (1) When the wife committed adultery and the husband denied to be the father of the child. Examination of the weapon showed that the stain was blood of human origin and belonging to the same group as that of the deceased "A". With such result of the examination, the investigating authorities have a very strong presumption that " B " was the one who committed the crime. Usually, in small drops, the tapering end of the blood spot is towards the direction of the moving source of blood. For small and discolored stains, the use of a lens or ultra-violet light may be useful. Solubility test: Recent blood shed is soluble in saline solution and imparts a bright red color. Stains which have been exposed to air become dry; hemoglobin is transformed to meth-hemoglobin or hematin. If the stain has been kept in damp places for a long time; hemoglobin is transformed to hematin. Heat test: Solution of the blood stain when heated will impart a muddy precipitate. Saline extract of the blood stain plus ammonia will give a brownish tinge due to the formation of alkaline hematin. Benzidine test: A piece of white filter paper is pressed firmly on the suspected stain. Benzidine reagent is dropped on the paper, then followed by drops of active hydrogen peroxide. A positive result is not conclusive, because an oxidizing agent will give a positive blue color reaction. Benzidine reagent: Benzidine sulphate is dissolved in glacial acetic acid to form 10% solution. It is not conclusive like the benzidine test because potato skin, iron rust, cheese, blue and indigo may give a positive reaction to the test. Leucomalachite Green test: this test which was recommended by Adler in 1904 is quite useful, but it is not so sensitive as the benzidine test. It depends upon the fact that leucomalachite green is oxidized to malachite green with a bluish-green or peacock-blue color by hydrogen peroxide solution. On the other hand, the reaction is negative when iron is removed from hemoglobin forming hematoporphyrin. Note the presence of red blood cells, leucocytes, epithelial cells and microorganisms. By microscopic examination, we can differentiate the origin or the part of the body it came from. Hemochromogen crystal or Tokayama test: A fragment of the suspected material is placed on a slide glass and a drop of hemochromogen reagent is added. A cover glass is placed on top and heated gradually for a time, then examined under the microscope. Crystals varying from salmon color to dark brown and pink and which are irregular rhomboids or in clusters, may be seen.
It blurs and diminishes the field of vision medicine of the wolf discount solian 50mg free shipping, blunts the senses of hearing and makes sluggish response to an impending danger treatment uti order solian paypal. Depressant drugs symptoms joint pain fatigue purchase solian on line amex, like sedatives symptoms 0f heart attack purchase cheap solian, tranquilizers, and narcotics do prolong the reaction time, impairs the power of decision and rational thinking. Smoking marijuana may interfere with time and space perception, and attention to complicated task of driving. A leak in the exhaust system of the vehicle may cause entry of carbon monoxide into the passengers compartment, especially in the air-conditioned cars, and may cause unconsciousness of the occupants including the driver due to poisoning. Other drugs, especially psychotrophic, may cause delirium, unconsciousness which may cause impairment of reaction to a traffic situation. Environmental Factor: Bad or poorly maintained roads, poor visibility, atmosphere, rain, blind intersection, parked vehicle obstructing the view, trees too close to the road, absence of road signs, etc. In highways, the absence of railing on the side of the road beside a deep ravine, precaution signs and speed limits, curve or narrow strip have been responsible for many fatalities. Sked time is the space of time between the actual application of the brake and the stopping of car. Sked time is influenced by the condition of the tire, condition of the ground and the amount of weight of the load. Cars moving with worn out tires, on a sloping and slippery road have the tendency to prolong the sked time. Mechanical Factor: Defect in the steering wheel, poor brake, transmission failure, worn out tires, unstable body are potential source of vehicular crash. The advent of modern high power engine and high octane fuel are conducive to high speed sometimes beyond the control of the driver. This is further enhanced with automatic transmission which diminishes human factor in the control of the vehicle. Modern car manufacturers develop high compression, fuel economy and high speed which are improvements of their new cars. Does car insurance develop "devil may care" attitude on the driver inasmuch as he will not be financially held liable for damages as a consequence of a crash Statistics has shown that automotive accidents have increased tremendously recently. First Collision - the impact of the moving vehicle with another vehicle or a fixed object. The degree of damage on the vehicle depends on the speed and part of the vehicle involved. Second Collision - this is the impact of the unrestrained occupants with the interior of the vehicle. Immediately, after the first collision, the occupants move in the same direction and at the same velocity towards the point of impact. That is, in the front impact, the occupants moves forward and in the side impact the passengers or driver moves towards the side that was involved in the first collision. If the vehicle is not put into a stop after the first collision, the unrestrained occupants will continue to strike to some parts of the interior of the vehicle. Distribution of the passengers in the compartment resulting in direct impact injuries. Driver - the driver may strike, the steering wheel, the hub of the steering column, the windshield, the rear view mirror, the column between the windshield and the side window, or the dashboard. The windshield glass is manufactured as two glass shields separated by and adherent to a sheet of plastic. Impact of the lower extremities against the dashboard may cause fracture of the tibia, fibula, femur or pelvis as well as lacerations and abrasion of the skin of (he area. When the car is running with a high velocity before the impact, the front portion of the car may be shortened or "accordioned" and the steering wheel may be driven back into the passenger compartment. The impact of the face to the circular rim of the steering wheel may cause fractures of the teeth, jaw and facial bones. Front Seat Passenger - Like the driver, the front seat occupant may strike the dashboard, windshield, rear view mirror, radio, air conditioner or the windshield wiper knobs which may protrude from the dashboard.
