Imaging SBAs unit 1

Question 1

Obese pt, large epicardial fat pad on CXR

Answer 1

Mediastinal Lipomatosis

Question 2

Recurrent lymphoma vs Thymic hyperplasia

Answer 2

In/out of phase MRI. Thymic hyperplasia will demonstrate fat

Question 3

Important consideration for angioplasty site of access

Answer 3

Needs sufficient distance between puncture site and target

Question 4

Hilum overlay sign

Answer 4

Hilar vessels still visible through mediastinal mass, proving mass is not in middle mediastinum

Question 5

Aplastic anaemia most commonly caused by

Answer 5

Thymoma

Question 6

Pericardial calcifications often caused by

Answer 6

Constrictive pericarditis

Question 7

Pulmonary nodule follow up <8mm

Answer 7

High risk –> PET
Low risk –> CT 1 year

Question 8

Post procedure thrombosis of arterial graft, Rx

Answer 8

Recombinant tissue plasminogen activator, 15mg bolus + 2mg/hr infusion

Question 9

Fluoro appearance of successful canalisation of portal vein in TIPS

Answer 9

Contrast flows via large vessels to liver periphery

Question 10

Bilateral, subpleural and lower zone patchy ground glass and centrilobular nodules.
Associated with connective tissue disorders and transplant

Answer 10

Bronchiolitis Obliterans

Question 11

General tips for injection rates/volumes for angiography

Answer 11

Larger vessels need higher rates and volumes of contrast.
Distal lower limb needs more volume but somewhat limited rate due to pain

Question 12

Centrilobular, poorly defined peribronchiolar nodules, sparing the bases. Normal intervening lung

Answer 12

Langerhans Cell Histiocytosis

Question 13

Aortic sinuses of valsalva - location

Answer 13

2cm above the coronary vessels

Question 14

Widened upper mediastinum, high density material adjacent to aorta with preserved fat plane between them

Answer 14

Ligamentum arteriosum (developmental remnant)

Question 15

IR wire - Cobra

Answer 15

Reverse facing curve, good for general use and visceral angiography

Question 16

Sidewinder wire

Answer 16

Shepherd’s crook, good for visceral angiography

Question 17

Benson

Answer 17

Angulated tip, good for arch vessel cannulation

Question 18

SOS Omni

Answer 18

Reverse facing curve, good for renal artery angiography

Question 19

Marfans pt, 1cm pneumothorax, Rx

Answer 19

Cardiothoracic team referral (May need bullectomy)

Question 20

Osteosarcoma, ?mets. Next Ix

Answer 20

Bone scan, followed by CT chest for staging

Question 21

Tuberous sclerosis vs LAM

Answer 21

Tuberous sclerosis has lower zone fibrosis

Question 22

Endoleak types

Answer 22

Type 1: leak at graft attachment site
Type 2: Sac filling from branch vessel
Type 3: leak through defect in graft
Type 4: Leak through graft fabric porosity
Type 5: Expansion of sac without demonstrable leak

Question 23

Type 1 endoleak Rx

Answer 23

Coil or glue embolisation (angiographically)

Question 24

Hodgkin Lymphoma staging

Answer 24

Ann Arbor
1: discrete area of lymphadenopathy
2: More than one area on one side of diaphragm
3: Lymphadenopathy on both sides of diaphragm
3E: Adenopathy above diaphragm with extralymphatic involvement
3S: Adenopathy above diaphragm with splenic involvement
4: Adenopathy on both sides of diaphragm with extralymphatic spread

Question 25

Dyspnoea, responsive to steroids. Mosaic attenuation in middle zones with focal basal opacities

Answer 25

Hypersensitivity pneumonitis

Question 26

Previous radiotherapy. Fibrosis with an area of focal consolidation

Answer 26

Radiation induced tumour

Question 27

Lung tumour T staging

Answer 27

T3: 2 tumours in same lobe T4: Tumours in different lobes M1: Tumours in different lungs

Question 28

Minimal common iliac artery diameter for EVAR

Answer 28

8mm

Question 29

Commonest interstitial lung disease picture in RA

Answer 29

NSIP

Question 30

Round pneumonia vs round atelectasis

Answer 30

Round pneumonia occurs in kids Round atelectasis occurs with asbestos

Question 31

Lupus pernio

Answer 31

Purple rash on ears and cheeks, associated with sarcoid

Question 32

Histology: Gland like sheets with calcification and amyloid deposition

Answer 32

Carcinoid

Question 33

Cavitating lung mass with spontaneous pneumothorax in young person

Answer 33

Osteosarcoma met

Question 34

Young, pulmonary and hepatic nodules, liver failure

Answer 34

Sarcoid

Question 35

Smoker, widespread ground glass and early fibrosis sparing upper lobes

Answer 35

Desquamative interstitial pneumonia

Question 36

Trauma, rib fractures, extravasation from intercostal vessel, Rx

Answer 36

IR embolisation

Question 37

Contraindication to uterine fibroid embolisation

Answer 37

Current use of GnRH, causes the uterine artery to become too small to catheterise. Wait 3 months without them

Question 38

Pt with central line, diaphragmatic elevation, cause

Answer 38

Phrenic nerve palsy, associated with central line insertion