diagnostic imaging

Question 1

Presenting an image considerations

Answer 1

details: name, DoB, weight (+C contrast).
Type, mode. technical quality.

obvious abnormalities, lines, leads or tubes. , asymmetry.

differential diagnosis.

Question 2

X-Ray presenting terminology

Answer 2

radiodensity.

Question 3

US presenting terminology

Answer 3

echogenicity.

Question 4

CT presenting terminology

Answer 4

attenuation.

Question 5

MRI presenting terminology

Answer 5

signal intensity.

Question 6

four cardinal elements of CXR

Answer 6

bone, air fat and water (Soft tissue).

Question 7

technical aspects of a CXR

Answer 7

rotation: sternal ends of clavicles should be symmetrical overlie the 4/5th thoracic vertebrae.
inspiration: 5-7 ribs visible.

Exposure: definition of image

position: lung margin should be visible.

Question 8

CXR nodules differentials to consider

Answer 8

neoplasia (metastatic), septic emboli, abscess, granulomas, sarcoidosis , pneumoconiosis

Question 9

reticular opacification on a CXR refers to

Answer 9

lung parenchymal changes.

Question 10

reticular opacification CXR differentials

Answer 10

acute interstitial oedema, infection, fibrosis, malignancy

Question 11

alveolar opacification CXR differentials

Answer 11

pus, blood, water, cells or protein.

Question 12

ring opacities CXR differentials

Answer 12

abscess, tumour or pulmonary infarct (wedge shaped)

Question 13

linear opacities CXR differentials

Answer 13

Septal lines, pleural plaques (asbestosis)

Question 14

SVC begins at

Answer 14

right 1st anterior intercostal space

Question 15

right atrium lies at the level of the

Answer 15

3rd intercostal space

Question 16

the carina should be visible at the level of

Answer 16

T5-T7 thoracic vertebrae

Question 17

the right atrial appendage sits at the level of

Answer 17

the 3rd intercostal space

Question 18

indications for an AXR

Answer 18

obstruction or intussusception, acute flare of IBD, renal colic with stones, ingestion of foreign body.

Question 19

AXR thumb printing seen in

Answer 19

large bowel ischaemia and colitis - protrusion of thickened mural folds into lumen.

Question 20

AXR coffee bean sign seen in

Answer 20

sigmoid and caecal volvulae - grossly dilates segments of bowel

Question 21

small bowel gas patterns

Answer 21

smaller calibre, smaller central loops, folds that go from wall to wall, grey

Question 22

large bowel gas patterns

Answer 22

larger, peripheral, semi lunar folds, blacker

Question 23

ileus gas pattern

Answer 23

both large and small bowel, no clear transition.

Question 24

AXR Rigler’s sign

Answer 24

gas on both sides of the bowel wall.

Question 25

Hounsfield Scale HU is for

Answer 25

greyscale of the pixel in a CT

Question 26

CT ideal for

Answer 26

monitoring and staging, intracranial pathology, trauma, pre-operative assessment of complex masses, acute abdomen and following abdominal surgery.

Question 27

MRI enable us to see the distribution of what in the body

Answer 27

fat, tissue and water through the body

Question 28

the most common weight of MRI image is

Answer 28

T1 weight (anatomy) or T2 (disease)

Question 29

MRI is ideal for

Answer 29

soft tissues, MSK, intracranial, neck

Question 30

contraindications for MRI

Answer 30

pacemakers, metallic foreign bodies, shrapnel, surgical clips etc

Question 31

cardiac CT routine in

Answer 31

suspected dissections, ruptured aneurysms and thrombosis

Question 32

1st line imaging choice for abnormal LFT's, jaundice, hepatomegaly, renal dysfunction, abdominal masses

Answer 32

US.

Question 33

ideal imaging for liver, biliary system, pancreas, and pancreatic duct

Answer 33

MRI.

Question 34

1st line imaging choice for renal colic

Answer 34

CT

Question 35

ureterograms useful for

Answer 35

ureteric anatomy, transitional cell carcinoma

Question 36

CT in acute stroke is often used to exclude

Answer 36

haemorrhage

Question 37

medical emergencies for imaging

Answer 37

``` cauda equina syndrome thoracic aortic dissection/ leaking aortic AKI acute Pulmonary oedema Acute abdomen with signs of peritonism traumatic midline cervical tenderness acute focal neurology. ```

Question 38

emergencies that shouldn't be delayed with imaging

Answer 38

testicular torsion tension pneumothorax intrabdominal haemorrhage or viscous rupture

Question 39

sodium reference level

Answer 39

135-145mmol/L

Question 40

potassium reference level

Answer 40

3.5-5.3 mmol/L

Question 41

glucose reference level

Answer 41

3.5-5.5mmmol/L

Question 42

ABG PH

Answer 42

7.35-7.45

Question 43

ABG PAO2

Answer 43

>10.6kPa

Question 44

ABG PACO2

Answer 44

4.7-6.0kPa

Question 45

male haemoglobin

Answer 45

130-180g/L

Question 46

female haemoglobin

Answer 46

115-160g/L

Question 47

Mean cell volume

Answer 47

76-96fL