Preparing for your Exam

Biopsy Studies

Avoid aspirin or similar blood thinning products for 5 days prior to procedure unless otherwise instructed at time of scheduling.

  • Breast Biopsy: Light meal only before procedure.
  • MRI Guided Breast Biopsy: No solid food 4 hours before your study. Clear fluids are allowed up to 2 hours before your study.

Breast Studies

Do not use deodorant, powder or lotion in the breast or underarm area. For your comfort, 2-piece outfits are recommended. It is imperative that you bring any previous mammography films or images stored on digital media to your appointment. If you are bringing outside films, please arrive 15 minutes prior to your appointment time to allow for image processing.

CT Studies

WRA Contrast Policy For CT Exams: For contrast patients who are diabetic, have kidney issues, or age 65+, please fax BUN/Creatinine lab results to WRA prior to the appointment.

CT Premedication Protocol for Patients with
Allergies to Non-Contrast Products or Food

A two-drug pretreatment regimen is recommended to help reduce the likelihood of an allergic reaction in patients requiring IV contrast. This pretreatment regimen is necessary for your care if you have ever had an allergic reaction to ANY substance (medication or food) that involved moderate-to-severe allergic-like reactions such as marked facial or body swelling, severe difficulty breathing, laryngeal edema, body hives/diffuse rash, profound drop in blood pressure, cardiopulmonary arrest or other allergic-like reactions requiring hospitalization, ER treatment, or the need to carry an Epi pen. If you have any questions about your CT study or preparations, please contact the WRA office where your exam is scheduled and ask to speak with the Nurse.

Premedication Regimen

  1. Medrol (Methylprednisolone) 32mg Tablet
    • Take one tablet 12-14 hours prior to exam and one tablet 2 hours prior to your exam. If the Medrol strength per tablet is less than 32 mg, multiple tablets may be taken to equal 32 mg (i.e. 8 tablets of 4 mg strength).
    • WRA will provide a written prescription for Medrol which can be picked up at any WRA office. We can also fax the prescription to the pharmacy of your choosing. Please have this phone number available for us. If your exam includes oral contrast (Barium), the written prescription for Medrol and the Barium can be picked up at the same time.
    • Medrol is a corticosteroid. You must check with your referring physician for any contraindications or medical conditions before taking Medrol.
  2. Benadryl (Diphenhydramine) 50mg (Liquid or Tablet)
    • Take 50mg (liquid or tablet) 1 hour before your scheduled CT scan.
    • Benadryl is available as an over-the-counter (OTC) medicine; no prescription is needed.
    • Benadryl causes drowsiness; read package instructions carefully. You must arrange for transportation to and from your appointment.

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CT Scan with IV Contrast

This examination lasts approximately 30-60 minutes.

The day of your appointment:
Four hours prior to your exam drink ONLY CLEAR LIQUIDS. See list of suggested clear liquids.

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CT of the Abdomen, Abdomen/Pelvis or Pelvis with
IV Contrast and Barium (Oral Contrast)

See listing of WRA offices where preparations may be picked up. This examination lasts approximately 30-60 minutes.

Morning Appointments:

  • At 9 pm the evening prior to your examination drink 1/2 bottle of barium.
  • Four hours prior to your examination drink ONLY CLEAR LIQUIDS. See list of suggested clear liquids.
  • Two hours prior to your examination drink 1/2 bottle of barium.

Afternoon Appointments:

  • At 8 am the day of your appointment drink 1/2 bottle of barium.
  • Four hours prior to your examination drink ONLY CLEAR LIQUIDS. See list of suggested clear liquids.
  • Two hours prior to your examination drink 1/2 bottle of barium.

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CT Virtual Colonoscopy

To ensure the highest quality study, it is very important that you strictly follow the directions below. The prep consists of 4 parts:

  1. Follow the low fiber/low residue diet which begins 3 days before your CT Virtual Colonoscopy.
  2. Drink the Barium Smoothie.
  3. Take MoviPrep.
  4. Drink the MD-Gastroview or Gastrografin oral contrast agent.

Before you can prepare for this exam, you must first:

  1. Pick up from a WRA office 2 bottles of flavored Barium Smoothie (a flavored solution), and 1 bottle of MD-Gastroview or Gastrografin. See listing of WRA offices where preparations may be picked up.
  2. Purchase MoviPrep from your pharmacy. Our office will give you a prescription.

If you have a history of severe constipation or have had difficulty with bowel preparations previously, please speak with your physician or with one of the WRA physicians before taking this preparation.

Three days before your exam:
A low fiber/low residue diet is required for best results beginning 3 days prior to your CT Virtual Colonoscopy. Follow this diet for 2 days, and then have only clear liquids the day before the exam. For example, if your CT Virtual Colonoscopy study is on Thursday, you would follow the low fiber/low residue diet on Monday and Tuesday, and then have clear liquids only on Wednesday. See list of recommended and non-recommended low residue foods.

Two days before your exam:

  • Follow the low residue diet all day.
  • Drink one bottle of Barium Smoothie at lunch.

The day before your exam:

  • Do not eat any solid foods; drink only clear liquids.
  • Drink one bottle of Barium Smoothie at lunch.
  • Take the MoviPrep that you purchased from the pharmacy. Begin between 4-7 pm, the earlier the better. (Follow the "Evening-Only" (full dose) MoviPrep regimen in the directions that come with the MoviPrep.
  • After completing the MoviPrep, drink the entire 30 ml bottle of the MD-Gastroview or Gastrografin mixed with either Sprite, Ginger Ale, Cranberry or other juice of your choosing.

The morning of the exam:

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CT Virtual Colonoscopy: Iodine Allergy

To ensure the highest quality study, it is very important that you strictly follow the directions below. The prep consists of 3 parts:

  1. Follow the low fiber/low residue diet which begins 3 days before your Virtual Colonoscopy.
  2. Drink the Barium Smoothie.
  3. Take MoviPrep.

Before you can prepare for this exam, you must first:

  1. Pick up from WRA 2 bottles of Barium Smoothie, a flavored solution. See listing of WRA offices where preparations may be picked up.
  2. Purchase MoviPrep from your pharmacy. Our office will give you a prescription.

If you have a history of severe constipation or have had difficulty with bowel preparations previously, please speak with your physician or with one of the WRA physicians before taking this preparation.

Three days before your exam:

A low fiber/low residue diet is required for best results beginning 3 days prior to your Virtual Colonoscopy. Follow this diet for 2 days, and then have only clear liquids the day before the exam. For example, if your Virtual Colonoscopy study is on Thursday, you would follow the low fiber/low residue diet on Monday and Tuesday, and then have clear liquids only on Wednesday. See list of recommended and non-recommended low residue foods.

Two days before your exam:

  • Follow the low residue diet all day.
  • Drink one bottle of Barium Smoothie at lunch.

The day before your exam:

  • Do not eat any solid foods; drink only clear liquids.
  • Take the MoviPrep that you purchased from the pharmacy. Begin between 4-7 pm, the earlier the better. Follow the “Evening-only” (full dose) MoviPrep regimen in the directions that come with the MoviPrep.
  • At 9 PM, drink one bottle of Barium Smoothie.

The morning of the exam:

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Cardiac CT Imaging

Coronary Artery Calcium Scoring

The actual CT exam takes just a few minutes and there is no patient preparation or contrast administration. However, patients should avoid caffeinated drinks at least four hours prior to their appointment.

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Cardiac Computed Tomography Angiography

No alcohol one day prior to your scan. Increase fluid (water) intake the day prior to the study. No caffeine 12 hours prior to scan. Nothing by mouth 4 hours prior to scan (except beta blocker 2 hours prior). Eating solid foods or liquids during this time may require rescheduling your appointment. Do not take Insulin or oral hypoglycemic medications 4 hours prior to scan. Take other medications as usual with a small amount of water. Take beta blocker as prescribed by your doctor. If available, please bring a copy of your recent EKG and blood work (BUN/Creatinine if diabetic or over age 60).

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DXA/VFA

Avoid wearing clothing with metal snaps, buttons, etc. No calcium supplements on day of scan. No x-ray contrast studies 5 days before scan.

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General X-Rays

General x-ray is offered as a walk-in service from 8:00 a.m. - 3:30 p.m. in Sterling, Fairfax, Bethesda and on the 9th floor at 2141 K Street in DC. No preparation is required. However, weight restrictions do apply to some diagnostic x-ray studies at WRA. If you are a patient that weighs more than 300 pounds, please call the WRA office nearest you to confirm that your exam can be performed.

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Fluoroscopy Studies

Barium Enema

See listing of WRA offices where preparations may be picked up. This examination lasts approximately one hour. Please follow the directions carefully to ensure that you have a clean colon. Do not eat any fruit or vegetables for two days before the exam. In addition:

The day before your appointment:

The day of your appointment:

  • In the morning you may have ONLY CLEAR LIQUIDS. See list of suggested clear liquids.
  • Adequate bowel cleansing is essential to perform this exam. If you are passing any stool or stool particles, please call the office where your appointment is scheduled (see list of office phone numbers) on the morning of your exam. You may need a second day of bowel preparation prior to your exam.

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Hysterosalpingogram (HSG)

For premenopausal women, this exam must be performed between day 5–10 of the patient’s menstrual cycle (day 1 is the first day of menstrual flow). Thirty to sixty minutes prior to exam, take 800 mg of Ibuprofen (if allowed by your doctor) with food. This exam cannot be performed if there is a possibility of the patient being pregnant, patient is pregnant, or patient has a pelvic infection.

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Upper GI or Upper GI with Small Bowel

The Upper GI exam lasts approximately one hour. The Upper GI with Small Bowel exam lasts two to five hours. We ask our patients to not take medications by mouth on the day of the exam as this could interfere with the quality of the exam. However, please consult with your physician if there are medications that you feel are necessary to take.

Morning Appointments

  • After 8 pm the day prior to your exam, do not eat any solid food.
  • After 8 pm and until midnight the day prior to your exam, drink ONLY CLEAR LIQUIDS. See list of suggested clear liquids.
  • After midnight, do not eat, drink (NOT EVEN WATER), smoke or chew gum until your examination is completed.

Afternoon Appointments

  • Do not eat, drink (NOT EVEN WATER), smoke or chew gum for six hours prior to your study and until it is completed.

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MRI Studies

MRI WITH AND/OR WITHOUT CONTRAST: Inform us if you have a pacemaker, artificial heart valves, have any metal objects in your body, are pregnant, or are nursing. No food or fluids 2 hours prior to your exam. WRA Contrast Policy For MRI Exams: Prior to injection, WRA performs Creatinine testing on all gadolinium cases. If test results prohibit the use of contrast media, a non-contrast study will be performed in most cases.

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Ultrasound Studies

Abdominal Sonogram

Do not eat or drink after midnight the night before your morning appointment, or for at least 6 hours prior to your afternoon appointment.

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Renal, Pelvic or Obstetric Ultrasound

Renal and/or Pelvic Ultrasound, Obstetric Ultrasound patients less than 16 weeks, or Nuchal Translucency (NT) patients: To accurately perform this procedure you must have a full bladder. Please follow these instructions carefully. One hour prior to your appointment, drink 16 ounces of water. Hold your bladder and do not urinate until instructed to do so after your exam. For premenopausal women who have heavy/irregular bleeding, schedule exam between days 5–10 of menstrual cycle (day 1 is the first day of menstrual flow).
Pregnant patients more than 16 weeks: No preparation necessary.

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Sonohysterogram (SHG)

For premenopausal women, this exam must be performed between days 5–10 of the patient’s menstrual cycle (day 1 is the first day of menstrual flow). For all patients, 30–60 minutes prior to exam, take 800 mg of Ibuprofen (if allowed by your doctor) with food. To accurately perform this procedure you must have a full bladder. Please follow these instructions carefully. One hour prior to your appointment, drink 16 ounces of water. Hold your bladder and do not urinate until instructed to do so after your exam. This exam cannot be performed if there is a possibility of the patient being pregnant, patient is pregnant, or patient has a pelvic infection.

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Transrectal Prostate Ultrasound

Use a “Fleet” enema 1 hour before your appointment. This preparation with instructions can be purchased from your local pharmacy.

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Nuclear Medicine

Female patients should tell their doctor if they may be pregnant or breast-feeding.

Bone Scan

After receiving an injection you will be asked to drink plenty of fluid during a 2-4 hour period. You will return for a scan 2-3 hours after the injection.

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Thyroid/Parathyroid Scans

Do not eat/drink after midnight the night prior to your scheduled appointment. No seafood should be eaten for 3 days prior to the study. You should not have any study or medication that contained Iodine within the past 3 weeks. This should be arranged through your referring physician. You will be given a capsule in the morning and asked to return 5-6 hours later for your scan. The scan will take about 1 hour.

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Hepatoboliary (HIDA) Scans, Gastric Emptying

Do not have anything to eat/drink 6 hours prior to your appointment. Your scan will take 60-90 minutes.

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Gallium Scans

No preparation is necessary for the injection portion of this exam. We will supply you with instructions involving preparation for your scan at the time of your injection. You will receive an injection and then depending on your specific diagnosis will return 24, 48 or 72 hours later for your scan.

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Renal Scans

Inform your doctor or our nuclear medicine staff if you are taking any medications when you make your appointment. This study requires that you avoid Captopril or diuretic medication for 48 hours prior to your appointment. No other preparation is necessary. Your scan will take about 30 -60 minutes.

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Myocardial Imaging

Do not have anything to eat/drink 6 hours prior to your appointment. Check with your Cardiologist about taking any medication.

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Iodine Whole Body

Inform your doctor or our nuclear medicine staff if you are taking any medications when you make your appointment. This study requires that you avoid iodine contrast for 6 weeks prior to your appointment.

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Indium Scan

No preparation is necessary. You will be asked to come in the morning to have your blood drawn. You will return 4 - 5 hours later for an injection. You will then return the following day for your scan, which will take about 1 hour.

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Thyroid Scan/Uptake

Inform your doctor or our nuclear medicine staff if you are taking any medications when you make your appointment. Different medications require different waiting periods to perform this study.

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