Data interpretation

Question 1

What colour is bone on CT?

Answer 1

White

Question 2

What colour is air on CT?

Answer 2

Black

Question 3

What colour is soft tissue/fat on CT?

Answer 3

Grey

Question 4

What are the types of contrast for CT?

Answer 4

Iodine based (IV)
Barium / iodine (oral/rectal)

Question 5

When would you use IV iodine contract CT?

Answer 5

opacification of vascular structures and solid / pelvic organs

Question 6

When would you use barium/iodine oral/rectal contrast?

Answer 6

Bowel opacification for abdominal/pelvic CT scans.

Question 7

When would you do a non-contract CT?

Answer 7

• head trauma
• stroke
• bone trauma
• kidney stones

Question 8

How would a acute haemorrhage or calcification show on CT?

Answer 8

hyperdense - bright

Question 9

How would oedema or infarction show on CT?

Answer 9

hypodense - dark

Question 10

How does a subdural haemorrhage look on CT?

Answer 10

crescent-shaped (banana), spreads diffusely across affected hemisphere (hyperdense if acute, hypodense if chronic)

Question 11

How does a extradural haemorrhage look on CT?

Answer 11

lens-shaped (dome), does not cross suture lines (hyperdense)

Question 12

How does a subarachnoid haemorrhage look on CT?

Answer 12

hyperdense material in subarachnoid space (can fill sulci, fissures, basal cisterns and ventricles)

Question 13

imaging for suspected bowel perforation?

Answer 13

erect CXR

Question 14

how would left axis deviation show on ECG?

Answer 14

lead I - +ve
lead II - -ve
lead III - -ve

Question 15

Left axis deviation causes?

Answer 15

LV hypertrophy, left anterior hemiblock, LBBB, inferior MI, Wolff-Parkinson-White syndrome, VT)

Question 16

how would right axis deviation show on ECG?

Answer 16

lead I - -ve
lead II - +ve

Question 17

Right axis deviation causes?

Answer 17

tall and thin body type, RV hypertrophy (e.g. in PE, lung disease), left posterior hemiblock, lateral MI, Wolff-Parkinson-White syndrome)

Question 18

Dominant R wave in V1/2 could indicate?

Answer 18

right ventricular hypertrophy
posterior MI

Question 19

How would RBBB/LBBB present on ECG?

Answer 19

RBBB - MarroW (M (RSR) pattern in VI and W pattern in V6)
LBBB - QRS in V1 has W pattern and QRS in V6 has M pattern – WilliaM

Question 20

Which leads is T wave inversion normal in?

Answer 20

III, avR and V1

Question 21

Causes of T wave inversion?

Answer 21

ischaemia/post-MI, PE, right/left ventricular hypertrophy (right chest or lateral leads respectively), bundle branch block, digoxin treatment

Question 22

Causes of tented T wave?

Answer 22

hyperkalaemia

Question 23

Causes of flat T wave?

Answer 23

hypokalaemia

Question 24

Spirometry - obstructive pattern?

Answer 24

↓FEV1 (<80%)
N FVC (>80%)
↓FEV1/FVC ratio (<0.7)

Question 25

Spirometry - restrictive pattern?

Answer 25

↓FEV1 (<80%) ↓FVC (<80%) N or ↑ FEV1/FVC ration (>0.7)

Question 26

How to assess adequacy of CXR?

Answer 26

RIPE R - rotation I - inspiration P - picture area E - exposure

Question 27

How to assess rotation of CXR?

Answer 27

medial borders of clavicles should be an equal distance from spinous process

Question 28

How to assess inspiration of CXR?

Answer 28

at least 5-6 anterior ribs should be visible above diaphragm

Question 29

How to assess picture area of CXR?

Answer 29

lung apices and costodiaphragmatic recesses should be visible; scapulae should be out of the way

Question 30

How to assess exposure of CXR?

Answer 30

vertebral bodies should be just visible through the lower part of the cardiac shadow (overexposure = too black; underexposure = too white)

Question 31

How to interpret CXR?

Answer 31

ABCDE

Question 32

'A' in CXR interpretation - what to look for?

Answer 32

Airway - tracheal deviation

Question 33

'B' in CXR interpretation - what to look for?

Answer 33

Breathing: - lung fields (air, fluid, consolidation, lobar collapse, lesions) - Pluera (thickening, pneumothorax) - Hilar region (lymphadenopathy, masses, calcification)

Question 34

'C' in CXR interpretation - what to look for?

Answer 34

- Heart size: should be <50% thorax diameter on PA film (cardiomegaly suggests heart failure) - Heart position (may be displaced if there is lobar collapse or a large effusion) - Heart shape and borders (right border = right atrium; left border = left ventricle) - Great vessels: the aortic knuckle should be visible - Mediastinal width: should be <8cm on PA film (widening may indicate aortic dissection)

Question 35

'D' in CXR interpretation - what to look for?

Answer 35

Diaphragm: - Position and shape: right usually slightly higher due to liver (flat in COPD) - Costophrenic angles (blunting indicates effusion) - Air below diaphragm (abdominal viscus perforation)

Question 36

'E' in CXR interpretation - what to look for?

Answer 36

Extra things - bones and joints - soft tissues

Question 37

CXR findings for COPD?

Answer 37

- hyperinflation (>10 posterior ribs visible) - flat hemi-diaphragms, decreased lung markings - black lesions (bullae) - prominent hila

Question 38

CXR findings for heart failure?

Answer 38

A - alveolar shadowing ('bat wing' sign) B - B-lines (interstitial oedema) C - cardiomegaly D - diversion of blood to upper lobe E - effusion

Question 39

Hearing loss of 20-40dB - severity?

Answer 39

Mild

Question 40

Hearing loss of 41-70dB - severity?

Answer 40

Moderate

Question 41

Hearing loss of 71-95dB - severity?

Answer 41

Severe

Question 42

Hearing loss of >95dB - severity?

Answer 42

Profound

Question 43

No air-bone gap on audiogram - type of hearing loss?

Answer 43

sensorineural

Question 44

How to tell the difference between T1 and T2 weighted MRI scans?

Answer 44

T1 - ONE tissue is bright - fat T2 - TWO tissues are bright - fat and water

Question 45

What contrast is used in MRI's and why is it used?

Answer 45

Gadolinium - used to enhance vasculature or pathologically vasculised tissue (e.g. metastasis, meningiomas)

Question 46

Types of projections for abdominal XRAY?

Answer 46

AP - anterior posterior supine or erect

Question 47

What are the upper limits of normal bowel diameters?

Answer 47

3cm - small bowel 6cm - large bowel 9cm - caecum and sigmoid

Question 48

How do you interpret an abdominal XRAY?

Answer 48

B - bowel (small, large, faeces, gas, fluid levels) O - other organs ( liver, spleen, kidneys, gallbladder, calcification - pancreas, aorta, renal stones) B - bones (spine and pelvis)

Question 49

'coffee bean' appearance on abdominal XRAY?

Answer 49

Volvulus

Question 50

Standard projections for hip XRAY?

Answer 50

AP view lateral view (frog leg view) - hip os abducted and externally rotated

Question 51

How to interpret hip XRAY?

Answer 51

A - adequacy and alignment (coccyx tip and pubic synthesis are midline) B - bones - cortical outline, bony texture, symmetry, femurs, pelvic bones, shentons line C - Cartilage (and joint spaces) S - soft tissue

Question 52

Difference between intracapsular and extracapsular hip fractures?

Answer 52

Intracapsular - located at neck of femur Extracapsular - do not involve the neck of the femur - located below intertrochanteric line.