Get through question reviews Flashcards
1
Q
most commoin cardiac mass
A
thrombus
2
Q
how to distinguish thrombus on MR
A
no enhancement of contrast and adjacent wall poor motion
3
Q
most common bengin primary tumour cardiac for adults
A
myxoma
4
Q
where are myxomas typically found
A
left atria, inter atrial septum near fossa ovalis.
5
Q
MRI myxoma volaues
A
T1 akin to myocardium.
t2 hyperintense
can get calc and hemosiderin deposition
6
Q
caridac lipomas usually found where?
A
right atrium
7
Q
histological difference of LHIS (septal lipoma) vs actual lipoma
A
lipoma has a capsule on histopathology
8
Q
which is the tumour of the cardiac valves?V
A
papillary fibroelastoma
9
Q
malignant cardiac masses - common type is
A
sarcoma
10
Q
features of malignant cardiac tumours
A
more than one chamber
necrosis
invasion of pericardium and epicardial fat
extension
pericardial effusion
mets
11
Q
cardiac angiosarcomas typically affect where
A
right atrium
12
Q
appearance of angiosarcoma on the MRI
A
cauliflwoer like
13
Q
Aortic aneurysm sizes
A
Ascending >4
descedning >3.5
14
Q
GCA produces stenoses that are
A
long and smooth
15
Q
Infections that can cause aortitis
A
Staph A
Salmonella
Pneumoccus
Ecoli
16
Q
2 types of Takayasou
A
Pre-pulseless (fveres)
Pulseless (ischaemic)
17
Q
Oesophagus - shaggy borders
A
infection with haemorrhage
think candida
18
Q
Short pedicles
reduced interpeduncular distance
champagne glass pelvis
bullet shaped vcertebra
A
Achonddraplasia
19
Q
inferior vertebral beaking
A
Hurlers / Hunters syndromes
20
Q
Which MRI sequence is useful for haemorrhage
A
Gradient Echo
21
Q
What are implications of brain - infarcted core
A
not salvageable
22
Q
what are the implications of brain for penumbra
A
tissue at risk - that could be saved
23
Q
lentiform nucleus contains
A
putamen and globus pallidus
24
Q
MRI - thrombus best seen on
A
Gradient recall echo
25
MRI - stroke best seen on
DWI
26
Subacute stroke - cellular response
cytotoxic
27
acute stroke - cells become
vasogenic
28
Post stroke mass effect peaks at
3-4 days
29
Cortical laimnar necrosis happens due to
lipid laden macrophages
30
high attenuating sub arachnoid space
ddx
bleed
meningitis
letomeningeal mets
31
Sub arachnoid on MRI
hyperintense FLAIR
32
MRI appearnce of superficial siderosis
dark sulci on T2
33
Perimesencephalic subarachnoid haemorrhage found where
anterior to the brainstem
34
cingulate gyrus found where
above the corpus callosum
35
central sulcus seperates
motor (frontal)
sensory (parietal)
36
if T1 is elongated due to pathology it will be
T1 black
37
what things are T1 bright
fat
melanin
proteinacious fluid
methamglobin
Contrast
ions
flow voids
38
What is the pattern of true restricted diffusion
Bright on DWI
dark on ADC
39
Causes of restriction by category
Neoplasm
Inflammation
Infection
Vascular
Toxins
Metabolic
Congenital
Treatment
seizure
Trauma
VITAMIN C
Vascular
infection
Trauma
Autoimmune
Medications
inflammation
neoplasm
Congenital
40
SWI is also called
GRE
41
if bright on SWI what are the ddx
hypertensive microangiopathy
cerebral amyloid angiopathies
vasculopath
haemorrhagic mets
fat emobolism
42
location of HoCM
asymmetric septum in heartat 15mm ort thickert
43
Appearance of an endometrioma
thick walled cyst / fluid ;level / cysts
44
what imaging MRI sequences are needed for macroadenoma
pre and post contrast
45
most likely brian tumour to haemorrhage is
glioblastoma
46
How to differentiate ABC from a siomple bone cyst
ABC have a periosteal reactoin
47
fallen fragment sign of
simple bone cyst
48
Menetriers get what in stomach
thickening of the rugal folds
49
which patient groud gets amyloid arthropathy
renal dialysis
50
demyelinating feature
Long T2 but no mass effects
51
Virchow robins found where
lower 3rd of the basal ganglia
52
what are the different types of MS
relapse remitting
primary progressive
progressive
53
How to discern McDonalds criteria for time
give GAd
acute enhacne non acute don;t
54
best examination for SUFE
MRI
but can see them on frog leg
55
Gastric ulcer - malignant features
irregular
nodular
rolled edges
super flat
Hampton's (Harmless = benign) and Carman (Carcinoma = malignant)
56
what is in the prostate central zone fro young men vs old
young is mostly the central gland
old men the transitional gets huge and comes in
57
id have seminal vesicle hypoplasia / cysts
what is assocaited
ipsilateral renal agenesis
ADPKD
58
Prostate
midline cystic structure is going to be a
Urticle cyst
59
urticle cysts are ax with
hypospadias
60
Prostatitis affects which zone
peripheral zone,
low T2 and restriction on DWI
61
If the prostate cancer is localised in the prostate it will be a Gleeson
T2
62
peripheral zone is what signal
cancer will therefore be
normal is bright
cancer is dark
63
Porstate cancer with contrast
early enhancement
64
PIRADS scoring uses what parameters
T2wi, DWI/ADC, dynamic contrast
65
MS in the eye mostly affects where
retrobulbar intraorbital
high T2 signal
chronic will atrophy
66
skene glands are found where
para urethral
67
bartholin glands are found where
vulva, lubricating fluid
68
Gartner cysts are found where
under the bladder, anterolateral
69
list the vagina lymph drainage
deep third - external iliacs
middle third - internal iliacs
superficial third of vagina - inguinal
70
MS brain atrophy hits the
corpus callosum
71
what are the features of cardiac amyloid ?
Left ventricle
delayed enhancement to the subendocardial layer
granular echngenic myocardium
72
what is common channel syndrome in the pancreas
reflux between the CBD and duct of Wisreng
73
Pancreas phase imaging is
late arterial
74
pre contrast T1 imaging is useful for what
r/v of the parenchymal bulk
75
T1 post contrast is useful for what in pancreas imaging
unform enhancement
76
MRI subtraction is useful in pacnreas for
pancreatic necrosis
77
Appearance of chronic pancreatitis is
atrophied gland
calc
dilated / beaded duct
78
lipase hypersecretion syndrome get what
sub cut fat necrosis
bone infarcts
eosinophilic
79
pancreas - bunch of grapes
serous cystadenoma
80
serous cystadenoma has what appearance
central enhancing scar
grapes
stellate calc
81
mucinous cystic
pancreas
capsule
some peripheral calc
found in body / tail
elevatedCEA and CA19-9
82
IPMN can be found where
main duct or side branch
83
IPMN sizes
>5mm
84
IPMN - bad / ,malignant features
cyst > 3cm
mural nodule
dilated MPD 5 - 9 mm
lymphadenopathy
high Ca 19-9
85
What are the normal measurements of a pylorus
muscle < 3mm x17mm.
transverse less than 13mm
volume less than 1.5mcc
86
Cholecystitis wall thickening - what size
3mm
if distended will be >4cm
hyperaemic wall
87
GB adneomyomatosis - what is it
cholestrol in rekitansky-ascoff sinuses
comet tail
bubbly T2 high signal
88
GB polyp
6 's'
Size - > 1cm
single - single bad
sessile - bad, stalk good
stones - inflammation, bad
Primary sclerosing cholangitis
sixty - age
89
MRCP acquisiation uses what
high T2wi for fluid.
fast spin echo
contrast can be used - Esocist for T1 brightness
90
most common neoplasm of the cardiac valves
fibroelastomas
91
What is wermer syndrome also known as
MEN 1
this of course is autosomal dominant
92
What is involved in Men 3A
Medullary Thyroid carcinoma
phaeo
ganglioneuromatosis
93
Men 1 what is inovled
Pituitary adeno
parathyroid adeno
pancreatic islet cell
94
Osteoid osteoma >2cm is called
osteoblastoma
95
how does CT blood change over time?
dense for a week then reduces
2 weeks isodense to brain
96
Anaemia value of what can cause acute bleed to appear as brain isodense
<100
97
Most child intussecption is located
ileocolic
98
What is cronkhite - canada syndrome
GI polyps in stomach
hair loss
nail dystrophy
diarrhoea
cystic dilatation
inflamed lamina propria
99
What is eye of the tiger sign?
low signal intensity of flobus palladus on T2, around a hyperdense area
PANC2
haemachromatosi
100
caudate atrophy - disease is
huntingdons
101
MELAs will have what appearance
multiple focal white matter signal changes
posterior parietal
102
CADASIL will have what appearance
extensive white matter signal changes
103
Claw of normal renal tissue around mass
Wilms
104
Wilms, how does it behave arund vessels
Vessels are displaced / vasc invasion
105
What are the types of endoleak
T1 - outside the graft
T2 - reversal of flow from eg lumbar
T3 - leaking graft defect
T4 - porous graft, nor around anymore
T5 - unknown
106
The isoenzyme NSE is asosciated with
Small cell lung cancer
107
What is the difference between modic type 1 and modic tpye 2 and type 3
Modic Type 1 - Low T1, high T2, fibrovascular invasion of tissues. OEDEMA
Modic Type 2 - fatty replcaement of red marrow. (bright T1/T2),
Modic tpye 3 - sclerosis
108
What is an andersons lesion in spine
disc involve in spondyloarthritis ank spond
109
Normal atlanto axial distance
<5mm
110
lateral mass displacement by age
can be 6mm up to 7 years old
111
what are the grades of ureteric reflux
1 - 5
1 - to distal ureters
2 - up to collecting system
3 - + mild dilatation
4 - Clubbed dilatation of calices
5 - severe tortuous urter
112
which grades of urteric reflux need surgery
4 and 5
113
What is the debakley criteria and what are the categories
1 - superior and inferior
2 - superior only
III a - proximal descending
III b - all the way down descending
114
foraminal impingement will affect which spinal nerve
exiting
115
neuronal impingment will affect wich spinal nerve
traversing
116
Diastematomyelia
saggital splitting of the spinal cord and rejoin s
women more than men
117
diplomelia
splitting of cord and doesn't rejoin
118
doliocephaly
dolio means long
Saggital suture closes early
119
Scaphocephaly
another term for doliocephaly
120
Brachycephaly
bicoronal suture early fusio n
121
Anterior plagiocephaly
unicoronal suture fusion
122
Turricephaly
bilateral lamboid
123
Posterior plagiocephaly
UNilateral lambdoid
124
Trigonocephaly
metopic suture of forehead closes
get triangle shape
125
oxocephaly / turricephaly
sagittal and coronal
126
differentials for plulsatile portal vein wave form
right heart failure
tricuspid regurg
cirrhosis
fistula
127
how to classify portal hypertension
pre - sinusoidal
sinusoidal
post sinussoidal
128
max portal vein diameter
13mm
129
recanulized paraumbilical vein is diagnostic of
portal hypertension
130
TIPS surveillance schedule is
1 month, every 3 months for a year and then every 6 - 12 months.
131
what will flow in the portal veins be like post TIPS
retrograde in the veins distal to the tips as will come back to find the TIPS entry point.
132
TIPS indi cations
acute variceal bleed or recurrent
refractory ascites
hepatic hydrothorax - refractory
portal hypertensive gastropathy
hepatorenal syndrome
lower GI varices
bad compression of portal veins
moderate buddchiari of moderate level disease
133
TIPS
absolute contraindications
severe chronic liver disease - wont cope with new nutrient delivery
severe encephalopathy - can worsen
severe right heart failure - will worsen
uncontrolled sepsis
134
TACE indications
unresectable HCC - palliative or bridge to tx
hepatic mets
intrahepatic cholangiocarcinoma
135
TACE - absolute contraindications
extensive tumour in liver
extra hepatic disease burden
enephalopathy
allergy to contrast
136
post embolisation syndrome lasts
3 days
137
Uterine fobroid embolization blood flow is assesed on
3D contrast enhanced MRA
138
how will endometritis appear on MRI
uterine enlargement
T1 bright intracavitatory haematoma
gas assocaited with endometritis.
139
Aortic aneurysm - measurements that need to be given are
proximal landing zone
aneurysm sac
distal landing zone
vascular access
Diameters
- size at the inferior renal artery
- aortic neck 15mm distal to renal artery
- bifurcation
- largest sac size
- sizxe of iliac arteries
140
unfavourable aneurysm CT findings
length >32mm
diameter <7
angulation >60
sac
- residual lumen <18mm
- distal aorta diameter <20mm
- extension, involvement of common iliac arteries
iliofemoral vessels
- common iliac artery diameter >25mm
- landing zone length <10mm
- external iliac artery diameter <6mm
141
malignant breast calc patterns
pleomorphic
clustered
linear/ductal distribution
142
benign breast calcificaitons
coarse popcorn
eggshell
tramline
broken needle
lead pipe
puncate stellate
143
how can you distinguish between metastatic and osteoporotic compression fractures
DWI - adc will be different
convex posterior margin for mets
signal abnormal in pedicsl - mets
144
main finding of pyklnodysostosis
cortical thickening with narrowed medullary cavity
shortstature
frontal bossing
hypoplasia nails
wormian bones
stubby hands
obtuse mandible
bad clavicles
145
how does radio frequency abblation work
cell death at 49 degrees
immediate death 60, chars at 105.
denatures proteins
tip should be at the deep margin of the tumour
146
what is the heat sink phenomenona
reduced tissue temperatures due to blood vessels carrying heat away
explains weird margins and poor ouitcome in large tissues
147
how to reduce heat sink effect
reduce blood flow to the tumour in some way.
balloon occlusion
embolise
pringle maneouvre
148
calcaenous - ant eaters nose
calcaneonaviluclar coalition
149
C spine in foot on lateral
talocalcaneal coalitions
150
does melanoma have drop mets
NO
151
what tumours do have drop mets
medulooblastoma
PNET
Ependyomoma
Pineocytoma
152
deaf
blue eyes
bad teeth
osteogensis imperfefta
153
causes of pneumotosis
primary
secondary
- obstruction
- COPD / Asthma
- iswchaemic bowel/ infarct
- corhns / UC
- nec enterocolitis
- steroids / chemo
- collagen vascular disease like scleroderma
- SLE . Dermatomyositis
154
unilateral delayed nephrogram differential
acute ureteral obstruction
renal artery stenosis
renal vein thrombosis
acute pyelonephritis
155
bilateral peristent nephrogram
low bp
ATN
contrast nephropathy
acute urate nephropathy
proetinuria
bilateral obstructive uropathy
156
unilateral striated nephrogram
acute urinary obstruction
acute pyelo
renal infarct
renal vein thrombosis
renal contusion
acute radiation therapy
157
bilateral striated nephrograms
acute urinary obstruction
acute pyelo
ATN
low bp
ARPKD
158
kidneys - paintbrush like streaks
Tubular ectasia
159
how does corticol necrosis happen ?
acute ischaemia from small vesel vasospasm or systemic hypotension
160
papillary necrosis can cause which symptom
bleedy urine
161
POSTCARD mnemonic for causes of papillary necorsis
Pyelo
Obstruction
Sickle cell
TB
Cirrhosis
Analgesia NSAIDS
Renal vein thrombosis
Diabetes mellitus
162
signs of papillary necroiss
signet ring sign
ball on a tee sign
lobster claw sign
163
primary vs secondary synovial osteochondromatosis
seocndary assocaited with articular surface disintegration due to loose intra-articular bodieswhich are calcified.
164
synovial chondromatosis is also called what syndrome?
Reichel syndrome
165
erlenmeyer flask deformity assocaited with
Gauchers, thalassaemia, osteopetrosis, and rickets
166
desmoid tumours are assocaited with
Gardners syndrome
167
pointed proximal 5th metacarpal base
Morquio
168
anterior vertebral body beaking by location
inferior - Hurlers / Hunters
central - Morquio
rounded anterior beaking still inferior 0 achondroplasia
169
klippel - Trenaunay triad
port wine naevus
overgrowth of distal digits
varicose veins on the lateral aspect of the limb
170
TACE
abdolute contraindications
decomp liver failure - C
Jaundice
encephalopathic
refractory ascites
both lobe extensive tumour
reduced portal vein flow
renal insufficiency
171
bladder TB cuases
thimble bladder
172
discplacemetn of the 4th ventricle is typical of
brainstem glioma
173
indications for TIPS
variceal bleeding
refractory ascietes
hepatorenal syndrome
budd chiari syndrome
hepatic veno occlusive diseease
hepatic hydrothorax
portal hypertensive gastropathy
174
rectal cancer T staging
Tis - in situ
T1 - to submucosal
T2 - muscularis propria
T3 - mesorectum
a <5mm
b - 5- 10mm
c - >10mm
T4 - visceral peritoneum
b - other organs
175
rectal cancer N staging
1c - tumour in regional. subserosa, mesentery.
N2a - four to six regional nodes
176
what is Stills disease
polyarticular rheumatoid juvenile arthritis.
fever rash heptasospelnomegaly pericarditis
6 weeks or longer
some have rheumatoid factor
177
Stills disease in the hands
periosteal reaction of the hands
boradened bones
cortical thickening
fevers + joint pain + salmon pink rash
178
Lyme disease vs Stills in joints
Lyme disease is normally monoarticular
179
do haemangioblastomas calcify
NO
180
microadenoma mri appearance
low on T1 and non-enhancing post gadolinium
normal pituitary is iso anteriorly. Posterior is high T1 and low T2.
181
"mulberry-like" cluster of hyalinized dilated thin-walled capillaries, with surrounding haemosiderin
cavernous malforations
182
dilated capillaries and are interspersed with normal brain parenchyma with a thin endothelial lining but no vascular smooth muscle of elastic fibre lining.
capillary telangiectasia
183
cavernous malforamtions and capillary telegievtasia are similar
distinguished by
telangiectiasia is interpseresed with normal brain parenchyma
184
most common type of paeds brain tumour is
astrocytoma
or
medulloblastoma
185
doppler criteria of renal artery stenosis
(post transplant)
v > 2m/s
velocity gradient over stenosis greater than 2:1
marked distal turbulence
186
causes of increased bladder volume
enlarged prostate
strictures
amrions disease (obsdtructed bladder neck )
187
4th ventricle
location of medulloblastoma and ependymoma
medulloblastoma from the roof
ependymoma from the floor
188
features of inactive long standing crohns disease
submucosal fat deposition
pseudosacculation
fibro-fatty proliferation
fibrotic strictures
189
haemangioblastoma vs pilocystic astrocytoma
haemangioblastoma in adults
jpa in kids - cyst wall enhances. some calc. v avid mural nodule enhancement.
190
how to treat a pseudo aneurysm
mainly via US thrombin injection
but if greater than 3mm neck or the size is greater than 5cm needs operation
191
How does the location of the 4th ventricle change in chiari I vs II
II it is displcaed caudally
192
what are the Ax of Chiari II
Lumbar myelomeningocele
syringohydromyelia
dysgenesis of corpus callosum
obstructive hydrocephalus
absent septum pellucidem
excessive cortical gyrations
193
Ax of chiari 1
basilar impresison
occipitalisation of the atlas
pltaybasia
Klipperp-Feil anomaly
194
Which Crohns ulcers does MR enteroggraphy allow visualisation of
Deep
not apthous
195
Indications of skeletal survey
MM
NAI
Eosinophilic grnulomatous
SKeletal dysplasia
196
What is the imaging appearance of medulloblastoma
Midline
Non-calc
Solid/dense
obstruct 4th ventricloe
arise from 4th vetrricle roof
enhances with contrast
197
How does a colloid cyst appears
attenuates on CT
high T1 from fat
flair postive
198
what is the most common pure germ cell tumour
Seminoma
199
What is the US appearance of teratomas
Well circumscribed complex mass
200
Alobar holoprosencephaly
single frontal lobe , single ventricle
201
lobar haloprosencephaly
there is division
but no septum pallucidem
202
What is hamartoma of tuver cinerum
tuber cinerum is around the hypothalamus
get gelastic seizures
203
Parahypothalamix hamartomas are found where
also called tuber cinereum hamartomas
floor of hypothalamus
204
Most common soft tissue sdarcoma of later adulthood
Pleomorphic undifferentiated Sarcoma
205
Common mets to small bowel is
melanoma
206
Sertoli cell tumour is asscoaited with which systemic condition
Peutz-Jeghers
207
Apperance of CJD on MRI
high singal in head of caudate and putamen
208
Down get which ASD
ostium primum
209
Radiation induced bone cancer is
Sarcoma then osteosarcoma (in terms of likelihood)
210
Kidneys Brodel Bloodless line is found where
Posterolateral to the kidney
211
Most common bilateral testicular tumour
lymphoma
212
Peripheral neurofibromatosis is
NF1
213
triad of NF1
cutaenous lesions
skeltal deformity
mental deficiency
214
Which eye lesion is found in TS
optic nerve hamartoma
215
features of benign thyomoma
Mild homogenous enhancement
216
invasive thyomoma
heterogenous enhancement
egg shell calcification
217
Best sign for perorated appendicixsits
focal absense of wall enhancement
218
Erlenmeyer flask deformity is ax with what condition
LORA CHONG
leukameia
osteopetrosis
RA, rickets
achondroplasia
craniometaphyseal dysplasias
hypophosphatasia
niemann pick
gauchers disease
219
fracture to hook of hamate can happen how
and cause what
in racket sports
causes compression of the nerve ulnar
do MRI
220
tail gut cyst vs rectal duplication cyst
tail gut cyst - mucinous therefore high T1
rectal duplication cyst - high T2
221
TS triad
mental retardation
adenoma sebaceum
epilepsy
ax with pckd1
get lots of amls
hamartomas in spleen
222
cd4 levels and lung infections
500 + normal
200 - 500 - karposi, candidiasis
100 - 200: PCP, histoplasmosis, coccidioidomyocosis, pml
50 - 100: toxoplasma, cryptospiridiosis, cryptococcosis, cmv
<50: MAC
223
weigert meyer rule
up obstructs - infero medial ectopic insertion with ureterocele
low flow - reflux due to horizontalinsertion
224
posterior iliac horns think
nail patella syndrome
225
fragmented/absent/hypoplastic patellae with a tendency for recurrent patellar dislocation
hypoplasia of the radial head and/or capitellum leading to subluxation or dislocation dorsally
bilateral posterior iliac horns ("Fong prongs")
flared iliac crests with protuberant anterior iliac spines
nail patella syndrome
226
paeds UTI imaging guidelines
3 categories based on age
<6 months - do a routine 6 week scan for a normal UTI. Do everything for atypical/recurrent.
6 months to 3 years - acute scan if atypical, 6 week if recurrent. DMSA for both.
3+ - Acute if atypical. 6 week us and dmsa if recurrnet.
227
what proportion of bening mesothelioma becomes malignant?
8 - 30%
227
benign mesothelioma is now called
solitaory fibroma
228
imaging appearance of solitary fibroma
move on repsiration
T1 dark
T2 iso to bright if necrotic bits
big avid enhacnement with contrast
229
imaging appearance of toxic colitis / toxic megacolon
typically transverse colon
pneumoeritoneum if perf
CT - loss of haustra markings, pleudopolyps / mucosal ilslands extend into the lumen due to ulceration of colonic wall. thumbprinting.
230
list the schatzker classification for tibial fractures
1 - split
2 - split + depression
3 - central depression
4 - split fracture medial!
5 - bicondylar fracture
6 - dissociatin of metaphysis and diaphysis
231
what is an Agger Nasi cells
anterior ethmoidal air cells. can cause sinusitis
232
what is a haller cell
infraorbital ethmoid air cells
233
what are the imaging features of constrictive pericarditis
will cause increased pressure in the IVC/svc and azygoes.
the interventricular septum will bow to the left due to increased right sided pressures.
234
causes of constrictive pericarditis
post surgery
tb
coxsackie b
uraemia
235
A hallmark finding of ascending cholangitis on ultrasound is
thickening of the walls of the bile ducts in the appropriate clinical setting
236
acute choleCYSTITIS vs acute cholangitis
acute choleCYSTIitis - just the gallbladder
cholangitis is the biliary tree
237
The development of acute calculous cholecystitis follows a sequence of events:
gallstone obstruction of the gallbladder neck or cystic duct
inflammation from chemical injury of the mucosa by bile salts
reactive production of mucus, leading to increased intraluminal pressure and distention
increased luminal distention restricting blood flow to the gallbladder wall (gallbladder hydrops)
increasing wall thickness from oedema and inflammatory changes
secondary bacterial infection in ~66% of patients
238
The most sensitive US finding in acute cholecystitis is
the presence of cholelithiasis in combination with the sonographic Murphy sign
Both gallbladder wall thickening (>3 mm) and pericholecystic fluid are secondary findings.
239
Heterotopic ossification refers to
the presence of bone in soft tissue where bone normally does not exist (extraskeletal bone).
Lesions range from small clinically insignificant foci of ossification to large deposits of bone that cause pain and restriction of function.
240
dentigurous vs odontogenic kerato vs radicular
odontogenic - unilocular, has ax to Gorlin if multiple.
dentigurous - ax to the base of teeth
radicular - big expansile, no scalloping or septation
241
adamantinoma
what and where are they found
often in the tibial diaphysis
soap bubble
no periosteal reaction
aggressive therefore surgically removed
242
partly solid and ground glass pulomonary nodules are most likely to represent which type of cancer
adenocarcinoma
243
uterus - submucosa vs subserosal
mucosa is on the inside
subserosa is outside
244
types of lisfrance injury
divergent
homolateral
divergent - get medial dislocation of the 1st metatarsal joint
homolateral - either 2nd -5th is move lateral or 1st to 5th move latera.
245
what is a tornwald cyst
midline
oropharynx cyst
get drip or halitosis
246
what is cherubism
a bit like fibrous dysplasia get seling of the jaw and maxilla.
get exapnsile
247
what is breast pappilloma
duct ectasia and a papilloma within it . benign hyperplastic epithelium.
most common cause of blood/serous discharge from nipple
248
what is the normal enhancement of the prostate
transitional and central zone is lower than the peripheral zone.
hence in the peripheral zone get low T2 and restricting adenocarcinoma
249
What is olliers disease
Multiple enchondromas.
Random mutation
There is an ax with gliomas and granulosa of ovary.
250
enchondroma (also called chondromas) appearance
ring and arcs
hand and wrist most common.
narrow transition.
sharp edges.
expansile
251
prostate T staging
T1 a and b - 5% over under. incidental
T2 - palpable. a - less than half.
T3 - outside prostate. b is into the seminal vesicles.
T4 - into adjancent tissue
252
astrocytoma vs haemangioblastoma
kids vs adult
haemngioblastoma cyst wall DOESN'T enhance.
- astro can have
Haemangioblastoma - no calc.
- astro can have
253
common compication post gastric banding
stomach stenosis
254
most commmon cuase of pulmonary artery aneurysm
Behcets
255
behcets vasculitis triad
ocular
oral ulcers
genital ulcers
256
Wolman prognosis
die in 6months
lots of internal fat. Bilateral adrenal calcification possible
257
Thymic epithelial tumours
(ie thyomoma, invasive thyomoma and thymic carcinoma)
cysts and calc are common in malingnant
A :medullary histology thymomas - round and smooth
B: Calc
C: carcinoma - invade mediastinal fat
258
Thyomoma ax conditions
Myasthenia gravis
red cell aplasia
hypogammaglobulinaemia
SLE
RA
Graves
PA
Dpolymyo
cushings
259
erlenmayer flask deformity ax with what conditions
Lysosomal storage disease
haemoglobinopathies
Ollier
achondroplasia
FD
260
herpes simplex encephalitis affects where
limbic system, mid temporal lobes. asymmteric, insular cortices.
spares the basal ganglia - differentiation from middle cerebral artery infarction.
261
what is blounts disease
from abnormal stress - calssic obese kids.
no pain
Tibia Vara (also called)
262
Bladder cancer - at what stage to do radical cystectomy
invasive.
T1 or carcinoma in situ is resection WITH chemo.
only Ta can be trated by resection alone
MRI needed for differentiating T1 from T2
263
osteosclerosis is ax with what hyperparathyroidism
Secondary
264
mechanism of hyperparathyroidism
parathyroid hormone lead to increased osteoclastic activity.
bone resorption produces cortical thinning (subperiosteal resorption) and osteopenia.
265
hyperparathyroidism sub perisosteal bone resoorption
classically affecting where>
radial aspects of the proximal and middle phalanges of 2nd and 3rd fingers
266
rugger jersey spine, browns tumours
hyperparathyroidsm
267
post lung transplant infections
intermediate period - candida, CMV, aspergillus
late - RSV, TB
268
what is dandy wlaker malformation
vermis agenesis
4th ventricle dilatation
enlarged posterior fossa
269
LAM affects who
young women (20-30s)
270
LAM is ax with what
TS
chyloous effusion
271
What are the CT features of LAM
diffuse thin walled cysts surrounded by normal lung
272
Hand Schuller Christian is a type of
LCH
classicly kids.
triad of Diabetes inspidus, proptosis and lytic bone disease.
273
Rathke on MRI
can be T1 bright if high protein content.
T2 mostly bright.
non enhancement as cust.
274
pituitary adenoma imaging features
basically sio to brina unless have haemorrhage or cystic componenet
contrast moderate to bright enhancement
275
US kidneys
lesion with central stellate appearance
Oncotycoma (seen in a third)
but look similar to RCC so taken out.
276
Carmesistine and lung injury
Dose dependant
most other drugs aren't dose dependnant
277
RA lung disease is typically what pattern
UIP or NSIP
can be COP
reticulonodular
278
How to grade liver trauma
1 - <1cm. <10%
2 - <10cm in diameter. 1-3cm in depth
3 - >3cm, >10cm in diamater. >50% surface area
4 - 25% - 75% lobe disruption, bleed to peritoneum
5 - major disruption, >75%
279
bone changes in RA chest XR
reposroption of DISTAL clavicles
superior rib notching
rotator cuff tear
279
most common tumour of the oseophagus
Leiomyosarcoma
280
which stages of mesothelioma do you operate on
1 - 3
4 don't
281
Most common site of GI duplication cyst
Ileum
282
what is transient synovitis of hips
common cause of hip pain in kids.
3-8 years old
1-3 days of hip pain
283
What are the features of Wilsons on US
cirrhosis present age 10-13
therefore
ascites
varices
284
extraintestinal features of IBD
Ank spond
single joint
clubbing
periostitis
285
how to differentiate intramural haematoma vs mural thrombus
haematoma will be subintimal
dense on non contrast CT
mural thormbus is on top of the intima.
286
osteoid osteoma on MRI
nidus will have a low T1
there will be oedema in the marrow adjacent
287
How to reduce artefact in a hip prostheiss MRI
FSE over GE.
lower field strength
increase bandwith
thinner slices.
align prosthesis to magnetic field
288
Disc calcification from
CPPD, haemachromatosi, high Vit D affect which bit
Annulus fibrosis
289
describe the two types of gastric volvulus
Organo - axial.
- reversed greater and lesser curvatures
Mesentero - axial.
- antrum above the goj
290
what is a brenner tumour
epithelial tumour of ovary
- normally women 50-70s.
benign
291
imaging appearance of a brenner tumour
hypoechoic masses
half calcify in them
T2 dark as fibrous
292
Write out the ovarian cancer/masses classifiers
functional vs endometrioma vs malignant
293
types of ovarian malignant
ovarian epithelial
germ cell
sex cord
294
which ovarian tumours are ax with endometrial hyperpalsia
endometrioid carcinoma
granulosa cell turnover (permenopaus)
- can secrete oestrogen
thecoma / fibrothecoma
- also oestrogen
295
fibrothecoma on imaging
delayed enhancement.
t1 low
t2 - homogenous and lwo
296
meigs syndrome from
Ovarian fibromas (benign)
but get the ascites and pleural effusion
297
what is homocystinuria
metabolism disorder
eye lens - down and in (marfans up/out)
CNS - seizures, delay
Skeletal: scoliosis, pectus excavatum, long limbs, biconcave vertebrae.
Vascular: thromboembolism, annuloaortic ectasia
298
what is sotos syndrome
large baby. big ehad.
big first year growth.
low intellect
299
Lissencephaly appearance
smooth brain
no guri
300
features of osteochondromas
cartilagenous cap (<2cm) covered by periosteum. away from the joint.
medullary cavity is continuous
- form as kid. persist.
can be part of multiple exostoses and trevor disease.
301
pachygyria means
broad gyru
pachymeans fat or thick
302
what are the causes of crazy paving?
Lipoid pnuemonia
proetinosis
COP
PCP
beonchialveolar carcinoma
sarcoid
NSIP
pulmonary haemorrhage
303
PCOS how many cyst required
20cyst or >10ml.
304
ovarian tumour with solid enhancing component what are the differentials
Sclerosing stromal tumour
sertoli-leydig
Struma ovarii
Cystadenofibroma
305
what is the appearance of haemangiomas on different imaging
US - homogenous, hyperechoic, posterior enhancement
CT - blood pool. centripetal enhancement. Persist on delayed.
MRI - bright T2
306
when is eovist used in Liver MRI
to discern FNH from Adenomas
- FNH, will take up and persist into delayed.
307
when can steatosis be called on a CT
plain if liver is 10HU less than spleen.
with contrast about 25 less than spleent
normal liver is brighter than the spleen
308
out of phase imaging is done on which sequence
GRe
309
primary vs secondary haemachromatosis
primary - deposition
secondary - RES so spleen and marrow involved. haemosiderosis. frewuent transfusion.
310
causes of a hyperintense liver
wilsons
iron
medications
glycogen
311
why does FNH enhance with Eovist
it will on delayed as will uptake but can't get rid of the contrast
Gad it will enhance with a central scar
312
sulfur collid study used for
splenosis
313
HIDA scan is used for
biliary tree
314
what are the types of adeno
Inflammatory - common and bleedy
B Catenin - least common, glycogen storage disease. FAP
HNF Alpha - multiple, contraceptives
other
315
causes of nephrocalcinosis
high calc - sarcoid, parathyroidism
renal acidosis
Medullary sponge kidney
papillary necrosis
Furosemide kids
Crohs
Osteoporis
drug induced
316
C/I to liver biopsy
biliary duct dilataion
cholangitis
abnormal coagulation
thrombocytopenia
ascites
cysitc lesion
317
resorbed calvicles think
hyperparathyrodism
but distal ones can be RA
318
eccentric bone lesions
GCT
Chondroblastoma
ABC
NOF
Chondromyxoma
319
central bone lesions
SBC, enchondroma, FD
320
Mets to pericardium
lung
breast
lymph
melanoma
321
Uterus on MRI by different layers
Endometrium is high
Myo - iso
junctional is LOW
322
causes of posterior vertebral scalloping
achdronplaisa
mets
acromegaly
marfan
neurofibromatosis
ependymomomas
dural ectasia
323
what are the signs of an open globe injury
contour change
loss of volume
flat tyre
air
fb
deep anterior chamber
324
horseshoe kidney ax
Cardiovascular, skeletal, CNS, genitourinary,down, trisomy and turners
325
congenital lobar emphysema preference for which lobes
LUL then RML then RUL
326
ank spond fibrosis which lung zone
upper
327
malignant GIST requires histopathologic analysis, but certain characteristics suggest malignancy 15:
exogastric growth
diameter >5 cm
central necrosis
extension to other organs
328
optimal view of mitral in
2 chamber mid diastole
329
prostate bone mets on MRI
low T2 and T1
330
GPA diagnosis by 2 of the following 4
positive biopsy for granulomatous vasculitis
urinary sediment with red blood cells
abnormal chest radiograph
oral or nasal inflammation
331
how do grade germinal matrix haemorrhage
1 - confined
2 - intraventricular extension
3 - big extension or dilated ventricle
4 - intraparenchymal extension
332
Sonographic features favoring a benign nodule
thyroid
large cystic component
hyperechoic solid
comet tail artefact
spongiform appearance / sponge-like appearance 7,8
333
Sonographic features favoring a malignant nodule
hypoechoic solid
presence of microcalcifications: almost always warrants biopsy
local invasion of surrounding structures
taller than it is wide
large size: the cutoff is often taken as 10 mm to warrant biopsy
suspicious neck lymph nodes suggesting metastatic disease
intranodular blood flow
334
when to FNA a thyorid nodule
Solitary
- 1cm with micro calc
- 1.5cm with coarse calc or if solid.
- 2cm mixed solid cyst. mural componanet. grown in size.
multiple
- choose one based on above criteria
335
thoracic duct starts where and moves to the left side where
starts T12 and moves to the left at T5
336
rockwood ACJ disruption
1 - 6
1 - looks normal, ac sprain
2 - small elevation/widened. AC rupture. CC sprain. join rupture. deltoid min detached
3 - elevated, all ruptured / detached
337
Hashimotos thyroiditis is what
autoimmune thyroiditis.
painless large thyroid. get hypothyroid as a result.
coarsened micronodular ghypoechoic on US
338
classic featureless stomach is caused by
atrophic gastritis
339
linitis plastica history would include
anaemia
340
what vein thing can happen in graves
superior orbital vein can get enlarged due to poor outflow
341
tracheomalcia can be a complciation of
polychondritis relapsing
COPD
intubation
342
tracheomalcia is diangosed as
expiratory CT
collapse of 50%
343
small bowle lymphoma can replicate crohns by
causing fistula.
crohns would be skip lesions though
344
what is Potte puffy tumour
subperiosteal abscess of the frontal bone with frontal osteomyeltitis.
345
Prostate Ca will do what on DWI
restrict
346
prostate Ca - how to measure up the cancer
pirads 1-5
T2 DWI and kinetics
Peripheral
1: uniform high signal intensity (normal)
2: linear or wedge-shaped hypointensity or diffuse mild hypointensity, usually indistinct margin
3: heterogeneous signal intensity or non-circumscribed, rounded, moderate hypointensity; includes others that do not qualify as 2, 4, or 5
4: circumscribed, homogeneous, moderate hypointensity, and <1.5 cm in greatest dimension
5: same as 4 but ≥1.5 cm in greatest dimension or definite extraprostatic extension/invasive behavior
347
causes of NAFL
DM
low thyroid
obese
high lipids
wilsons
348
how does sagittal sinus thrombus cause small ventricles
cerebral oedema can compress the ventricles
349
liver - anechoic lesion is a
cyst
350
which hernia goes through hesselbachs triangle
direct
351
Regeneration nodule vs dysplastic nodule
regenerative nodule has a lot of iron in it
dysplastic ones can have fat in them (t1 bright, often low T2)
352
scirrhosis adenocarcinoma of stomach causes what appearance
small stomach
linitsplastica
353
Menetriers triad
thickened stomach rugi
achloridia
low protein
354
rhizo
meso
acro
femur / humerus
meso is the arm / leg
acro is hand/feet
355
describe the adrenal washouts
review
356
features suggestive of an adrenal carcinoma
large, calcification, necrotic centre
peripheral nodular enhancement
357
osteosarcoma vs Ewings on location
Ewings appendicular but also CENTRAL axial
osteosarcoma diaphysis apendicular
358
imaging appearance of scurvy
pelkin spurs around the metaphysisi
osteopenia
haemarthoris
cortical thinning
359
cupping of metaphysis
rickets
360
medullary spong kidney is ax with what
Ehlors - Danlos
PTH adenoma
carolis
361
replaced right heaptic artery means what
the right haptic artery comes off the SMA
362
Accessory hepatic artery means
comes from the SMA but with anormal right hepatic artery also
363
replaced left hepatic artery comes from where
Left gastric
364
where does the IMA terminate
superior rectal artery
365
what is the pathway of winslow
anastomosis from the epigastric to external iliac
366
draw out liver laceration
1 - 5(shattered)
367
fat embolism timeframe
72 hours, gone by 2 weeks
368
squaring of the patella think
Chronic haemarthrosis
369
most common peritransplant fluid collections are
lymphoceles
370
causes of lower zone fibrosis
Asbestos
aspiration
cryptogenic alveolitis
NF1, TS, RA, scleroderma, SLE, Drugs
371
stages of neurocysticerosis
vesicular
colloidal - intense contrast
granular - oedema
calcified nodular
372
DNETs are found in the
temporal bones
373
PDOG -
ganglioglioma appearance
cyst with strong enhancing nodule
calcify in 50%
374
DNET vs Astrocytoma
DNET as a rim on FLAIR
DNET T2 buibbly
375
DNET cuase
seizures
376
supernumaeray teeth, borad mandible,poorly developed calvicles
cleidocrnaial dysplasia
377
cyst, mural nodule with a dural tail
PXA
378
what do serous cystadenomas contain
Glycogen due to being lined by glycogen trich epithelium
379
mx of serous cystadneomcarcinoma
benign, leave them alone
380
mucinous cystadencarcinoma mx
surgery
381
Solid pseduopapillary lesion of the pancreas mx
15% malignant so I think remove
382
retinoblastoma on MRI
high T1 and low T2
383
mcCune albright can get what endo diseases
prettyy much all of them --> raised
384
Primary ciliary dyskinesia get bronchiectasiss where
lower lobes
385
mortons neuroma is located where
between the 3rd and 4th metatarsals
386
Melanoma on MRI
high T1 and low T2
387
fetal MRI sequence to choose
only from the second trimester
indications: equivocal US
high risk pathology not seen on US
Single SHot Fast Spin Echo T2
T1
Steady state free precession for heart and blood vessels
388
bone within a bone appearance
endosteal new bone formation
Pagets
sickle cell
thalassaemia gauchers
acromegaly
high vt D
scurvy rickets
389
breast within a breast appearance
breast hamartoma
390
investigate urethral diverticula how
double-balloon catheter urethrography (DBU)
or
MRI more common
391
