A 70 year old patient with chronic renal failure has been scheduled for a coronary angiography examination.

Q1: A 70 year old patient with chronic renal failure has been scheduled for a coronary angiography examination. Discuss the possible adverse reactions to the iodinated contrast media that the patient may encounter and how they can be prevented.
Introduction: 200 WORDS
•    Renal failure (General statement about the renal failure + Definition)
•    What is the coronary angiography (what is the purpose of it)
•    Contrast media (what is the purpose of it)
Body1: 350 WORDS
•    Chronic renal failure (what– How– why)
Body 2: 300 WORDS
•    Coronary angiography (what– How– why)
Body3: 350 WORDS
•    Iodinated Contrast Media (what is it – types )
•    The most important factors in contrast media:
1.    Osmolality
2.    Ionic or non-ionic
3.    Strength
4.    Viscosity
5.    Chemotoxicity
Body 4: 300 WORDS
•    Discuss the possible adverse reactions to the iodinated contrast media that the patient may encounter
1.    Minor: Flushing-Nausea-Vomiting-Mild rash-Arm pain.
2.    Moderate: More severe-urticaria Facial oedema-Hypotension-Bronchospasm
3.    Severe: Hypotensive shock-Laryngeal oedema-Convulsions-Respiratory and cardiac arrest
Body 5: 300 WORDS
•    prevention methods of the adverse reactions:
1.    Compared with HOCM, LOCM result in less nephrotoxicity but still can cause nephropathy.
2.    The radiologist or cardiologist should use the smallest volume of contrast needed to obtain the imaging
3.    Nonsteroidal anti-inflammatory drugs should be discontinued before contrast exposure.

Conclusion: 200 WORDS
•    Summarise the key points
•    Recommendation (another imaging modality which is nuclear medicine) and (another contrast medium)

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