General Surgery Questions which have not been asked in NEET SS so far but have a high likelihood
Q1. Not true about hazards of contrast medium use in radiological interventions?
a) Use of newer agents have improved the risk of sudden death
b) Low osmolar contrast agents are better than previously used high contrast medium
c) After contrast injections, patients should be observed for 30 mins
d) Metformin can be continued in patients with normal renal function
Answer 1
- a
Reactions with contrast agents are rare: serious reactions occur in about 1:2500 cases and life- threatening reactions in about 1:25 000 cases. The risk of sudden death, however, has not changed with the new agents.
Advice from the Royal College of Radiologists (RCR) in the UK does not recommend routine steroid prophylaxis for patients at increased risk of allergic reaction, but rather the use of low osmolality contrast media(LOCM) or iso-osmolar media, and observation of the patient for 30 minutes after injection with the intravenous cannula still in situ,
Guidelines from the European Society of Uroradiology (ESUR), however, continue to advocate the use of steroids
Concerns about lactic acidosis in patients on metformin receiving contrast led to various recommendations for stopping the metformin. The latest RCR recommendations are that it can be continued in patients with normal renal function.
Ref Bailey 27th page 191