Radiology

Question 1

When are CXRs the best initial radiologic test?

Answer 1

for all forms of pulmonary complaints and physical exam findings

Question 2

What is the best initial test for aortic dissection?

Answer 2

CXR showing mediastinal widening

Question 3

When should you get a decubitus x-ray?

Answer 3

when the diagnosis of an infiltrate from pneumonia cannot be distinguished from an effusion

Question 4

What is the most sensitive test for pleural effusions?

Answer 4

A lateral decubitus x-ray

Question 5

For what diseases, is abdominal radiograph the best first test?

Answer 5

there are very few; really only ileus and small bowel obstruction

Question 6

What study should you order for suspected bowel perforation?

Answer 6

an upright CXR because abdominal x-ray does not reliably visualize the top of the diaphragm

Question 7

What is the best initial test for osteomyelitis? What is the most sensitive?

Answer 7

x-ray is the best initial but will not be positive for 2 weeks, so if it is negative, get an MRI which is more sensitive

Question 8

When is CT head with or without contrast the best initial test?

Answer 8

• head CT without is the best initial test for severe head trauma and suspected stroke or intracranial bleed
• head CT with is the best initial test for any form of intracranial mass lesion

Question 9

When is abodminal CT the best initial test? For what two conditions is it the most accurate test?

Answer 9

• best initial when looking at retroperitoneal structures, for intra-abdominal infections, and nephrolithiases
• it is the most accurate for diverticulitis and nephrolithiasis

Question 10

The most accurate test for cancer is what?

Answer 10

biopsy

Question 11

The most accurate test for infection is what?

Answer 11

biopsy and culture

Question 12

What are the indications for MRI?

Answer 12

• demyelinating disease and spinal cord lesions
• lesions of the brainstem, pituitary, or posterior fossa
• facial structures like orbits and sinuses
• osteomyelitis (after x-ray has been done)

Question 13

When is ultrasound the best test?

Answer 13

• gallbladder disease
• kidney disease apart from nephrolithiasis (CT abdomen)
• gynecologic disease

Question 14

Endoscopic ultrasound is the most accurate method for examining what structures?

Answer 14

pancreatic lesions, biliary ductal lesions, and gastrinomas

Question 15

What is a HIDA scan?

Answer 15

a nuclear scan and the only functional test of the biliary system that allows detection of cholecysitis

Question 16

Bone scans are highly sensitive for what?

Answer 16

occult metastases

Question 17

What is a gallium scan?

Answer 17

a great test for fever of unknown origin because it follows iron metabolism and is transported on transferring

Question 18

What is an indium scan?

Answer 18

a great test for fever of unknown origin because it is a tagged WBC scan

Question 19

What is a multiple-gated acquisition scan (MUGA)?

Answer 19

a nuclear ventriculogram and the most accurate method for measuring EF