Radiology

Question 1

How would metastatic lung nodules differ from a fungal miliary interstitial pattern?

Answer 1

(Metastatic dz will have a wider variation in nodule size with some being larger than your expected 1-3 mm in cases of fungal pneumonia)

Question 2

How can you tell which lung is most likely the location of a nodule?

Answer 2

(If it is bigger on a certain view, that means it is closer to the x-ray machine so that means it will be in whichever lung was up in that view (so if the lesion looked bigger on a right lateral, it would be located in the left lung); also check a VD)

Question 3

How can ultrasound aid in detection of the location of a lung lesion?

Answer 3

(If the lesion is deep to air filled lung, it cannot be seen on ultrasound so if you can see if on ultrasound, it means it is periphery to the lungs)

Question 4

(T/F) When nodular lesions are seen on lung rads of dogs/cats, neoplasia often jumps to the top of the Ddx, whereas in horses, it is more likely to be benign/abscesses.

Answer 4

(T)

Question 5

What would you be looking for on a limb radiograph of a foal with R. equi?

Answer 5

(Osteomyelitis, septic physitis, and/or septic arthritis)

Question 6

What is the purpose in choosing a DV radiograph over a VD radiograph in patients you suspect have heart/lung abnormalities?

Answer 6

(You get a better image of the caudal lung field and everything contained there)

Question 7

What radiographic findings would indicate left heart enlargement on a lateral?

Answer 7

(Tall heart +/- a more vertically oriented heart)

Question 8

What causes the increased lung opacity sometimes seen on radiographs of heartworm cases?

Answer 8

(Acute and chronic parenchymal inflammation and thromboembolism secondary to inflammatory reaction subsequent to the arrival and death of adult heartworms)

Question 9

If organs are being pushed away from the dorsocranial portion of the abdomen on a lateral, where could your mass be located?

Answer 9

(Right lateral or caudate liver lobes, head of the spleen, fundus of the stomach, right adrenal, or right kidney)

Question 10

If organs are being pushed away from the ventrocranial portion of the abdomen on a lateral, where could your mass be located?

Answer 10

(Right or left liver lobes, pyloric or antral region of the stomach, pancreas, gallbladder, and hepatic lymph nodes)

Question 11

If organs are being pushed ventrally away from the dorsal central portion of the abdomen on a lateral, where could your mass be located?

Answer 11

(Left kidney, left adrenal, mesenteric lymph nodes, ovaries, and intestines)

Question 12

If organs are being pushed dorsally away from the ventral central portion of the abdomen on a lateral, where could your mass be located?

Answer 12

(Spleen, pancreas, intestine, and ventral liver)

Question 13

If organs are being pushed away from the dorsocaudal portion of the abdomen on a lateral, where could your mass be located?

Answer 13

(Medial iliac lymph node, colon/rectum, and uterus)

Question 14

If organs are being pushed away from the ventrocaudal portion of the abdomen on a lateral, where could your mass be located?

Answer 14

(Urinary bladder, prostate, uterus, retained testicle, or small intestine)

Question 15

If organs are being pushed away from the right cranial portion of the abdomen on a VD, where could your mass be located?

Answer 15

(Pyloric region of the stomach, right liver lobes, gallbladder/biliary tract, pancreas, right kidney, right adrenal, or duodenum)

Question 16

If organs are being pushed away from the left cranial portion of the abdomen on a VD, where could your mass be located?

Answer 16

(Fundus, left liver lobes, head of spleen, and left adrenal)

Question 17

If organs are being pushed away from the central portion of the abdomen on a VD, where could your mass be located?

Answer 17

(Spleen, pancreas, mesenteric ln, intestine, left kidney, ovary, and uterus)

Question 18

If organs are being pushed away from the caudal portion of the abdomen on a VD, where could your mass be located?

Answer 18

(Urinary bladder, prostate, uterus, colon, and medial iliac lymph node)

Question 19

What are some of the common locations for metastasis from splenic tumors?

Answer 19

(Liver, peritoneal cavity, heart, lungs, and sternal lnn)

Question 20

What shape does a torsed spleen take on lateral radiographs?

Answer 20

(A reverse C shape)

Question 21

Is a torsed spleen more hypoechoic or hyperechoic when compared to a normal spleen?

Answer 21

(Hypoechoic bc of all the congested blood, also will have a lacy or mottled appearance)

Question 22

How can you distinguish between hepatic and portal veins on ultrasound?

Answer 22

(Portal veins are hyperechoic, hepatic veins are not)

Question 23

How do liver abscesses tend to appear on ultrasound?

Answer 23

(They typically contain a lot of gas so will have hypoechoic spots)

Question 24

What types of focal liver parenchymal lesions can be ruled out using doppler and why?

Answer 24

(Hematomas and necrosis → both will lack blood flow)

Question 25

If small intestines are dilated beyond what ratio value (compared to L5 midbody in dogs and L2 endplate in cats) does foreign body move higher on your differential list?

Answer 25

(If the ratio to the vertebrae is >2 = foreign body is present)

Question 26

What finding on abdominal radiographs would be supportive of ileus?

Answer 26

(If you have gas distended bowel, if the animal has ileus the walls of the bowel will be straight, if they do not have ileus it will have the normal invaginations caused by peristalsis (looks like how you would draw intestine if someone asked you to))

Question 27

A cat’s spleen should measure less than how many centimeters on abdominal ultrasound, otherwise splenomegaly is indicated?

Answer 27

(Should be less than 1 cm in thickness)

Question 28

State the echogenicity of the following intestinal wall layers:

• Lumen
• Mucosa
• Submucosa
• Muscularis
• Serosa

Answer 28

• Lumen (Hyperechoic)
• Mucosa (Hypoechoic)
• Submucosa (Hyperechoic)
• Muscularis (Hypoechoic)
• Serosa (Hyperechoic)

Question 29

What vessel will the anomalous PSS vessel typically anastomose with?

Answer 29

(The caudal vena cava)

Question 30

The portal vein will be smaller/larger (choose) in diameter cranial to the branching of a PSS.

Answer 30

(Smaller)

Question 31

What type of stones are typically caused by PSSs and can you view them on radiographs?

Answer 31

(Urate and typically no, urate stones are radiolucent but sometimes other mineral can attach to them making them slightly radiopaque)

Question 32

A normal VHS in a cat is less than what number?

Answer 32

(8.1)

Question 33

What type of drug can cause transient left heart enlargement?

Answer 33

(Alpha 2 agonists)

Question 34

What are differentials for bilateral nephropathy with subcapsular fluid in cats?

Answer 34

(FIP, lymphoma, and histoplasma)

Question 35

What are the most frequent ultrasound findings associated with FIP?

Answer 35

(Abdominal effusion, abdominal lymphadenopathy, and hypoechoic subcapsular rim on one or both kidney)

Question 36

Right sided heart failure, hypoalbuminemia, volume overload, IMHA, blood transfusions, cholecystitis, and anaphylaxis can all cause a ‘halo sign’ in which organ and what does that indicate?

Answer 36

(In the gallbladder, indicates gallbladder wall edema)

Question 37

What can cause pancreatic edema characterized by tiger striping on ultrasound?

Answer 37

(Portal hypertension and hypoproteinemia, pancreatitis also on the list but more likely to cause diffuse hypoechogenicity)

Question 38

What can indicate hepatic congestion on ultrasound?

Answer 38

(Rounding of the liver lobes, stuff that can cause it are right sided heart disease and administration of fluids)

Question 39

What are the most common ultrasound findings associated with leptospirosis infections?

Answer 39

(Renomegaly, pyelectasia, increased echogenicity of renal cortices, and perinephric effusion but the kidney can also be entirely normal so not perfect)

Question 40

What are differentials for progressive alveolar disease?

Answer 40

(Leptospiral pulmonary hemorrhagic syndrome and non-cardiogenic pulmonary edema)

Question 41

The thyroid gland will be located between which two structures on a transverse view of the neck?

Answer 41

(Between the trachea and the carotid artery)

Question 42

The parathyroid glands are hyperechoic/hypoechoic (choose) on ultrasound and CT.

Answer 42

(Hypoechoic)

Question 43

Describe a normal parathyroid gland.

Answer 43

(Oval to round, well marginated, hypoechoic, 2-3 mm in length, located within or adjacent to the thyroid gland)

Question 44

The left adrenal gland is associated with which vessels?

Answer 44

(Aorta and phrenicoabdominal vein)

Question 45

The right adrenal gland is associated with which vessel(s)?

Answer 45

(Caudal vena cava and aorta)

Question 46

The adrenal gland is typically less than what value in mm in thickness?

Answer 46

(8mm, if < 10 kg should be 6 mm, length varies too much to have a set measurement but usually 1-5 cm)

Question 47

(T/F) In a Cushingoid dog, though their adrenals may be enlarged, they will maintain their shape.

Answer 47

(T, tumors usually obliterate the normal tissue, they just look like extra large peanuts for cushings)

Question 48

What organ do you assess when looking for an insulinoma?

Answer 48

(Pancreas, if cannot find or looks normal also assess liver and local lymph nodes bc insulinomas associated with high rates of metastasis)