File 17 Flashcards
Patient done CT scan for chronic liver disease you find well defined
renal mass pre contrast 8 HU post contrast 18 HU what is your action?
A) Follow-up
B) Do Nothing
B) Do Nothing
Answer: B
Notes:
- Its likely pseudoenhancment.
- Homogeneous simple renal cysts can have mean attenuation values of up to 30 HU.
- Homogeneous RCCs have mean attenuation values as low as 42 HU
- ata suggest that further evaluation of a homogeneous renal mass with a mean attenuation
value of 30 HU or less on a contrast-enhanced CT scan likely is unwarranted.
Patient post-MVA, complaining chest and back pain mediastinal
widening, D7 fracture, and weakness in lower limb his BP 80/60 what do
next?
A) CTA
B) MRI spine
A) CTA
Answer: A
Notes:
- Aortic dissection.
- Stanford classification:
o Type A: ascending Aorta and Arch.
o Type B: descending aorta.
Chamberlain line used to assess:
A) Basilar invagination
Which of the following stable fracture:
A) Jefferson’s
B) Burst
C) Avulsion
D) Unilateral facet dislocation
D) Unilateral facet dislocation
Male with prostate cancer he has unilateral breast hypoechoic mass that showed on mammography flame shaped appearance what is the diagnosis:
A) Gynecomastia
B) Fibroadenoma
C) Intraductal carcinoma
D) Intra-lobular carcinoma
A) Gynecomastia
May appear as an increased Sub-areolar density, which may be flame shaped.
Which of the following sequences are more sensitive in detecting SAH:
A) FLAIR
B) T2WI
C) T1 with saturation
D) STAIR
A) FLAIR
Answer: A
Notes:
- Hyperintense in the first 12 hours.
42-year-old Female with 2x3 cm mass in the breast it is well-defined and fat density encapsulated lesion what is the BI-RADS classification:
A) II
B) III
C) IV
D) V
A) II
Female with a history of breast cancer post local excision came with
palpable mass in the breast mammography show calcification along the
surgical bed / ultrasound show dystrophic calcifications what is it and
what’s your recommendation:
A) Fat necrosis, biopsy
B) Recurrence, biopsy
C) Fat necrosis, for annual mammography
D) Recurrence ultrasound
C) Fat necrosis, for annual mammography
Question about calcification of the breast that shows tea in cup
appearance what is the cause?
A) Milk of calcium
Answer: A
Notes:
- Milk of calcium within a breast cyst. It is typically observed as “teacup” or “crescent shaped”
calcifications on a true lateral (LM or ML) view on occasionally on an MLO view.
Child with fracture at the metaphysical plate extending to the growth
plate what is the salter harries classification in this patient:
A) II
B) III
C) IV
D) V
A) II
Patient with right knee pain and swelling at the medial side there is
history of twisting what is the likely seen:
A) Medial meniscus injury with parameniscal cyst
B) Bucket handle injury with meniscal something
C) Medial collateral ligament tear with hematoma
D) Villous synovitis
A) Medial meniscus injury with parameniscal cyst
Answer: A
Notes:
- C → Direct blow from the lateral aspect, valgus injury.
Old patient with right hip pain on x-ray there is cortical thickening and
sclerosis affecting the iliopectineal line what is the diagnosis?
A) Paget’s disease
B) Multiple myeloma
C) Ankylosing spondylitis
A) Paget’s disease
Patient with shoulder pain for the past month, she cannot brush her
hair, on examination she cannot abduct over 30- 40 degrees, the patient is claustrophobic and cannot do an MRI what is the next step?
A) US shoulder
B) CT shoulder
C) Radiography
D) CT arthroscopy
A) US shoulder
Subacromial impingement is by far the most common form of shoulder impingement and occurs secondary to attrition between the coracoacromial arch and the underlying supraspinatus tendon or subacromial bursa, leading to tendinopathy and bursitis, respectively.
Facture of ulna with dislocation of radius?
A) Monteggia fracture
B) Galeazzi fracture
A) Monteggia fracture
Answer: A
Notes:
- Hint: MUGR.
- Monteggia → fracture of the ulna with proximal radial dislocation
- Galeazzi i → fracture of the radius with distal radioulnar dislocation
A CSF like density brain mass that cause skull thinning?
A) Arachnoid cyst
B) Epidermoid cyst
A) Arachnoid cyst
Patient with unilateral loss of eye red reflux by ophthalmologist he
suspects retinoblastoma which of the following is favor retinoblastoma?
A) Hyperdense with clumped calcification
B) Poorly enhancing without calcification.
C) Poorly enhancing with calcification.
D) Avidly enhancing with no calcifications
A) Hyperdense with clumped calcification
A heterogeneous retinal mass with calcifications, necrotic components, and increased
vascularization on Doppler ultrasound/enhancement on CT/MRI.
What is the blood supply of Posterior limb of internal capsule?
A) Anterior choroidal artery
B) Recurrent artery of Huebner
A) Anterior choroidal artery
What is responsible for motor?
A) Precentral gyrus
B) Postcentral gyrus
C) Cingulate gyrus
A) Precentral gyrus
Answer: A
Notes:
- The precentral gyrus → primary motor cortex.
- The postcentral gyrus → primary somatosensory cortex.
- The Cingulate gyrus → limbic system which has functions in emotion and behavior.
Optic canal formed by?
A) Lesser wing of sphenoid
Answer: A
Notes:
- The optic foramen is the opening to the optic canal. The canal is located in the sphenoid bone;
it is bounded medially by the body of the sphenoid and laterally by the lesser wing of the
sphenoid.
Infant with chest x-ray shows opacification of the right hemi thorax and
mediastinal ipsilateral shift, on V/Q scan which of the following is favors
hypoplastic lung over complete obstruction of the right bronchus?
A) Normal ventilation with decreased perfusion
B) Normal perfusion with decrease ventilation
C) Matched decreased perfusion and ventilation
D) More decreased perfusion than ventilation
D) More decreased perfusion than ventilation
Answer: D
Notes:
- Both should decrease.
Patient with Meckel’s diverticulum while scintigraphy with
pertechnetate which of the following is used to increase sensitivity?
A) Give the patient histamine
B) Give the patient perchlorate
C) Laxative to empty the bowel
D) Keep the bladder full
A) Give the patient histamine
Answer: A
Notes:
- Histamine → ↓ secretion by parietal cells → limit release of tracer (stays more) → ↑
sensitivity.
- ↑ false positive → Oral Barium + Previous RBC study.
In assessing active GI bleeding with scintigraphy which of the following
is abnormal?
A) Progressive uptake in small bowel 3 min post-injection
B) 1-hour persistent uptake in stomach
C) 24 hours seen in colon
A) Progressive uptake in small bowel 3 min post-injection
Answer: A
Notes:
- Active → angiogram
o detect 1 ml/min, diagnostic and therapeutic
While doing indium 111 WBC radiolabeled scan dor occult sepsis which of the following is abnormal uptake?
A) Bone marrow
B) Spleen uptake
C) Diffuse lung uptake
C) Diffuse lung uptake
Answer: C
Notes:
- Normal distribution
o Liver
o Spleen
o Bone marrow
10 days old newborn with bilious vomiting while down upper GI study
what is the most important view?
A) Left lateral
B) Right lateral
C) Prone
D) Supine
B) Right lateral
Answer: B
Notes:
- Midgut volvulus.
