Osce

Question 1

Standard Precautions — Examples

Answer 1

Applied to all patients, regardless of diagnosis or infection status — e.g., during any patient contact, blood/body fluid handling, or imaging procedures.

Question 2

Standard Precautions — PPE

Answer 2

Gloves (for contact with body fluids), gown/apron if splashing is likely, and hand hygiene before and after contact.

Question 3

Contact Precautions — Examples

Answer 3

MRSA, VRE, C. difficile, norovirus, and impetigo.

Question 4

Contact Precautions — PPE

Answer 4

Gloves and gown; perform hand hygiene after removal.

Question 5

Droplet Precautions — Examples

Answer 5

Influenza, pertussis, mumps, rubella, and meningococcal meningitis.

Question 6

Droplet Precautions — PPE

Answer 6

Surgical mask, gloves, gown, and eye protection if splashing likely. Maintain a 1–2 m distance where possible.

Question 7

Airborne Precautions — Examples

Answer 7

Tuberculosis (TB), measles, chickenpox (varicella), and disseminated shingles.

Question 8

Airborne Precautions — PPE

Answer 8

N95 or P2 respirator, gloves, gown, and negative pressure room if available.

Question 9

Droplet + Contact Precautions — Examples

Answer 9

RSV, adenovirus, and COVID-19 (when not performing aerosol-generating procedures).

Question 10

Droplet + Contact Precautions — PPE

Answer 10

Surgical mask, gloves, gown, and eye protection.

Question 11

What should you do before putting on PPE (donning)?

Answer 11

Perform hand hygiene, ensure PPE is correct size, remove jewellery, tie hair back, and ensure hydration.

Question 12

What is the correct order for putting on PPE for aerosol-generating procedures (AGPs)?

Answer 12

1️⃣ Gown 2️⃣ Respirator (fit check) 3️⃣ Eye protection 4️⃣ Gloves

Question 13

What is the correct order for removing PPE (doffing)?

Answer 13

1️⃣ Gloves 2️⃣ Gown 3️⃣ Eye protection 4️⃣ Respirator 5️⃣ Wash hands

Question 14

Why is the order of PPE removal important?

Answer 14

To minimise cross-contamination and prevent self-contamination during removal.

Question 15

When should hand hygiene be performed when removing PPE?

Answer 15

After removing gloves, and again after all PPE is removed (with soap and water).

Question 16

Gastrografin

Answer 16

Gastrografin is a high-osmolality, water-soluble iodinated contrast used in gastrointestinal (GI) studies such as barium swallow, meal, follow-through, or enema, especially when bowel perforation or obstruction is suspected.

Question 17

Why is Gastrografin preferred for GI studies?

Answer 17

Because it is water-soluble and absorbable, making it safe if leakage into the peritoneum occurs (unlike barium). It also has an osmotic effect, drawing water into the bowel to help clear obstructions and enhance mucosal visibility.

Question 18

Why is Gastrografin not used for cystograms?

Answer 18

It has high osmolality and irritates the bladder mucosa, causing pain, burning, and potential chemical cystitis.

Question 19

What are the benefits of Gastrografin?

Answer 19

Safe in suspected perforation Clears partial small bowel obstruction Provides strong contrast and mucosal detail

Question 20

What are the contraindications/risks of Gastrografin?

Answer 20

Aspiration risk (can cause pulmonary edema) Dehydration risk due to osmotic effect Not suitable for bladder or intrathecal use

Question 21

Urografin

Answer 21

Urografin is a water-soluble iodinated contrast (moderate osmolality) used in urinary tract imaging, such as IVP, retrograde pyelogram, and cystogram (when appropriately diluted).

Question 22

What are the benefits of Urografin?

Answer 22

Excellent urinary tract opacification Safe when diluted for bladder use Water-soluble and rapidly excreted renally

Question 23

What are the contraindications/risks of Urografin?

Answer 23

Iodine allergy Renal impairment Dehydration or cardiac disease (osmotic effects)

Question 24

Omnipaque (Iohexol)

Answer 24

Omnipaque is a non-ionic, low-osmolality iodinated contrast used for CT contrast studies, angiography, myelography, and cystography.

Question 25

What are the benefits of Omnipaque?

Answer 25

Low osmolality → less patient discomfort and reduced adverse reactions Safe for intrathecal, intravascular, and bladder use Produces high-quality images with minimal irritation

Question 26

What are the contraindications/risks of Omnipaque?

Answer 26

Iodine hypersensitivity Severe renal impairment (risk of CIN – contrast-induced nephropathy)

Question 27

Visipaque (Iodixanol)

Answer 27

Visipaque is a non-ionic, iso-osmolar iodinated contrast used in CT, angiography, and urography, especially for patients at risk of contrast-induced nephropathy.

Question 28

What are the benefits of Visipaque?

Answer 28

Iso-osmolar → excellent patient tolerance Minimizes renal stress Low incidence of allergic or vascular reactions

Question 29

What are the contraindications/risks of Visipaque?

Answer 29

Iodine allergy Expensive, so often reserved for high-risk patients

Question 30

What is the purpose of an analgesic in a radiology department?

Answer 30

To relieve pain before, during, or after a procedure to help the patient remain comfortable and still.

Question 31

What is an example of an analgesic used in radiology?

Answer 31

Paracetamol, ibuprofen, or morphine (for stronger pain relief).

Question 32

What is the purpose of sedation in a radiology department?

Answer 32

To reduce anxiety, restlessness, or movement during procedures such as MRI, CT, or interventional imaging. It helps patients remain calm and still for image quality and safety.

Question 33

What is an example of a sedative used in radiology?

Answer 33

Midazolam (a short-acting benzodiazepine).

Question 34

What is the purpose of a steroid in a radiology department?

Answer 34

To reduce inflammation, allergic reactions, or swelling, especially before or after contrast administration or interventional procedures.

Question 35

What is an example of a steroid used in radiology?

Answer 35

Prednisone.

Question 36

What are some minor reactions to iodine-based contrast?

Answer 36

Flushing, Nausea, vomiting, Pruritus (itching), Metallic taste, Light-headedness, Mild urticaria (hives)

Question 37

How are minor contrast reactions managed?

Answer 37

Close observation and reassurance.

Question 38

What are some moderate reactions to iodine-based contrast?

Answer 38

Moderate to severe urticaria, Tachycardia or bradycardia, Hypotension, Bronchospasm & wheezing

Question 39

How are moderate contrast reactions managed?

Answer 39

Prompt treatment with close observation (e.g., antihistamines, IV fluids, oxygen if needed).

Question 40

What are some severe reactions to iodine-based contrast?

Answer 40

Laryngeal edema (swelling of the throat), Marked hypotension, Loss of consciousness, Cardiopulmonary arrest

Question 41

What pulse rate is used for a lateral SLT view?

Answer 41

30 pulses per second (30 p/s).

Question 42

What pulse rate is used for an AP SLT view?

Answer 42

15 pulses per second (15 p/s).

Question 43

List ways to reduce radiation dose in theatre.

Answer 43

Tight collimation, Increase staff distance (inverse square law), Use pulsed fluoroscopy, Keep detector close to patient, Keep X-ray tube as far away as possible, Avoid holding patients, Use lead shielding (aprons, thyroid shields), Minimise screening time, Use correct exposure factors.

Question 44

List methods to reduce dose in fluoroscopy.

Answer 44

Use low pulse rates, Minimise fluoroscopy time, Use last-image hold, Avoid magnification mode, Tight collimation, Keep detector close to patient, Additional filtration, Use low-dose/stored fluoro modes, Optimise kVp/mAs.

Question 45

List methods to reduce dose in paediatric imaging.

Answer 45

Tight collimation, Size-based exposure charts, Immobilisation to avoid repeats, High-speed/low-dose detectors, Avoid magnification, Optimal communication with child/parents, Shielding only when appropriate, Short exposure times to reduce motion, Use PA instead of AP where possible (e.g., CXR).

Question 46

What should the greater trochanter look like on a correctly positioned lateral hip?

Answer 46

The greater trochanter should be superimposed over the femoral neck. Cortical outlines should appear smooth and aligned.

Question 47

What does it mean if the greater trochanter appears posterior on a lateral hip?

Answer 47

The patient is under-rotated. Correction: Rotate the patient more anteriorly.

Question 48

What does it mean if the greater trochanter appears anterior on a lateral hip?

Answer 48

The patient is over-rotated. Correction: Rotate the patient posteriorly.

Question 49

Gastrografin 2 Examples

Answer 49

- CT / Fluoro Oral Contrast for GI studies (e.g., SBO assessment) - Contrast swallow or oesophagram (especially if perforation suspected)

Question 50

Urografin 2 Examples

Answer 50

- Retrograde pyelogram - Hysterosalpingography (HSG)

Question 51

Omnipaque 2 Examples

Answer 51

- Myelography - Arthrography (e.g., shoulder, wrist)

Question 52

Visipaque 2 Examples

Answer 52

- Cardiac catheter angiography - Endovascular procedures (e.g., EVAR, angioplasty)