Important Short Notes

Question 1

Imaging findings of pituitary hypoplasia

Answer 1

Small shallow sella torcica
Small adenohypophysis
Ectopic neurohypophysis
Midline facial& cranial anomalies

Question 2

DDs of macroadenoma ( or suprasellar or sella torcica mass)

Answer 2

Lipoma
Pars intermedia cyst(rathk’s cleft cyst)
Meningioma
Arachnoid cyst
Aneurysm
Apoplexy
Craniopharyngioma
Sheehan’s syndrome

Question 3

Localization of parathyroid gland:

Answer 3

Sonography and 99mTc-sestamibi scintigraphy are the dominant imaging techniques for preoperative location of parathyroid adenomaa

Question 4

Differentiating benign from malignant adrenal mass by CT

Answer 4

Intracellular lipid content of adrenal mass represents the histological difference between adenomas and metastases.

Difference in vascular enhancement pattern represent the physiological difference.
(Adenomas vigorously anhance and exhibit early washout of contrast material compared with metastases

Question 5

DDs of Adrenal gland mass

Answer 5

Pheochromocytoma
Adrenal hyperplasia
Adrenal hemorrhage
Adrenal cyst
Adrenal myelolipoma

Question 6

DDs of dens vertebra

Answer 6

Metastases
Lymphoma
Paget’s disease
Healing fracture
Haemangioma

Question 7

Radiological findings of tension pneumothorax:

Answer 7

• Air (black) in pleural space
• No lung markings in pleural space
• collapse lung at affected side
• mediastinal shifting to the opposite side
• lying diaphragm
• ++ density of the opposite lung
• ++ intercostal space

Next step : Chest tube

Question 8

Types of bronchiectasis

Answer 8

Cylindrical (tubular)
Varicose
Cystic

Question 9

Cuases of pleural effusion:

Answer 9

HF
Pneumonia
Malignancy
Pulmonary embolism

Question 10

Types of emphysema

Answer 10

Centrilobular
Panlobular
Paraseptal

Question 11

Cuases of Pneumoperitoneum (needing surgery)

Answer 11

Bowel perforation 90%
Duodenal ulcer
Colon diverticulum

Question 12

Causes kf pneumoperitoneum (not needing surgery)

Answer 12

• Postoperative, (air can last up to 4wks)
• Thoracic - pneumothorax
• Abdominal - pneumatosis
• Gynecologic - transvaginal

Question 13

Types of diaphragmatic hernia:

Answer 13

Morgagni hernia
Bochdalek hernia

Question 14

Mention radiological difference between benign and malignant esophageal strictures:

Answer 14

Benign stricture has tapering ends with smooth outline
Malignant stricture has overhanging edges or shouldering with irregular outline

تقدر تفسوي من عندك زي اتقوله hx of weight loss والا الpeptic تلقاه في الlower esophagus وهكذا

Question 15

Mention radiological difference between benign and malignant gastric ulcer
It’s going to be a long day.

Answer 15

Benign:
• Often along the lesser cuvature of stomach, in the gastric body and antrum region.
• Outpouching of ulcer crater beyond the gastric contour (exolumina)
• smooth rounded and deep ulcer crater
• smooth ulcer mound
• smooth gastric folds that reach the margin of the ulcer
• hampton’s line
Malignant:
• Doesn’t protrude beyond the gastric contour (endoluminal)
• irregular and shallow ulcer crater
• Nodular and angular ulcer mound
• Nodular gastric folds that don’t reach the ulcer margin
• Carman meniscus sign
• more often along the greater curvature of stomach

Summary
Crater, Mond, site, gastric contour,
Remember Hampton’s (Harmless = benign) and Carman (Carcinoma = malignant)

Question 16

What are radiological signs of esophageal atresia:

Answer 16

• Non-progression of an orogastric catherter in the blind esophageal pouch with the presence of air in the stomach (with fistula)
• the radio-opaque tube jn the blind esophageal pouch and the absence of air in the stomach (without fistula)
•On barium study, the esophagus ends as blind pouch in the upper mediastinum
•

Question 17

What are radiological signs of congenital hypertrophic pyloric stenosis:

Answer 17

Uss: target sign, cervix sign, antral nipple sign with Exaggerated peristalsis
Barium meal: shoulder sign, mushroom sign, mucosal nipple sign, and string sign

تبي تفسوي زيادة تذكر القياسات : 3mm, 14mm, 17mm

Question 18

Radiological signs of duodenal atresia

Answer 18

US: double bubble sign
Pain CAXR: larger double is air in dilated stomach, and smaller bouble is air in dilated proximal duodenum
There is little or no air distal to the obstruction

Question 19

Radiological signs of **Malrotation with a midgut volvulus

Answer 19

Pain x-ray: double bubble sign
Barium meal: corkscrew sign
US: whirlpool sign

Question 20

Radiological signs of Hirschprung’s disease HSD (Congenital megacolon)

Answer 20

Contrast enema: abrupt transition zone from the small distal aganglionic segment to dilated normally innervated bowel

Question 21

Write short notes about pneumoperitoneum radiology:

Answer 21

Erect CXR: sub diaphragmatic air (crescent sign)
Supine AXR: the rigler sign (double wall sign): the gas is outlining both sides of the bowel wall
The football sign: in case of massive pneumoperitoneum (inflant with necrotizing enterocolitis)

Question 22

Causes of small bowel obstruction

Answer 22

congenital:
Jejubal atresia
Midgut volvulus
Meconium ileus
Meckel diverticulum
Aquired:
Adhesions
Hernia
Tumor
Gallstone ileus
Intussusception

Question 23

Causes of large bowel obstruction :

Answer 23

Carcinoma (60%)
Diverticulitis (20%)
Volvulus
Stricture, such as from crohn’s d
Faecal impact
Hernia
Imperforate anus kr meconium ileus in paediatric population

Question 24

CT acute appendicitis:

Answer 24

> 8-9 mm outer-to-outer
Wall thickening (>3mm), enhancement and stratification if no gangrene
Thickening of the cecal apex
Periappendiceal inflammation fat stranding.
Extraluminal fluid
Phegmon (inflammatory mass) or abscess

Question 25

Large bowel obstruction vs. Small bowel obstruction, fight !

Answer 25

**Large bowel**: • Peripheral • Haustral markings don't extend from wall to wall • Max diameter 6cm (9cm cecum) **Small bowel**: • Central • Plica extends across lumen • Maximum diameter of 3cm

Question 26

Classification of splenic injury

Answer 26

I - Capsular disruption, subcapsular hematoma II - Peripheral laceration, hematoma < 3cm III - Fracture extending to the hilum, hematoma > 3cm IV - Shattered spleen, vascular disruption

Question 27

DDs of multiple liver lesions:

Answer 27

Multiple abscess Regenerating nodules in cirrhosis Multiple cysts Multiple hemangioma Metastases

Question 28

What are the radiological feature of pulmonary fibrosis??

Answer 28

Irregular interlobular septal thickening. Interlobular reticular opacity Irregular pleural thickening - honeycombing traction bronchiectasis lung architectural distortion

Question 29

What are the CT finding of empyema?

Answer 29

Typically appears as a fluid density collection in the pleural space (pleural effusion) with locules of gas , that shows thick enhancing pleural lining with typical split pleura sign

Question 30

What are the x-ray findings of a collapsed lung?

Answer 30

displacement of a fissure/s occurs towards the collapsing lobe. a significant amount of volume loss is required to cause air space opacification. the collapsed lobe is triangular or pyramidal in shape, with the apex pointing to the hilum

Question 31

mention radiological modalities used in GIT imaging.

Answer 31

Plain X-ray. Ultrasound. Contrast studies (Barium, water-soluble). Computed tomography (CT). Magnetic resonance imaging (MRI). Scintigraphy.

Question 32

give short not about normal constriction of the esophagus

Answer 32

Esophagus has four constrictions 1st constriction At the beginning of esophagus, at the level of C6 vertebra (15 cm from incisor teeth). 2nd constriction Where the arch of aorta crosses it, at the level of T3 vertebra ( 22.5 cm from incisor teeth) 3rd constriction Where the left bronchus crosses it, at the level of T6 vertebra ( 27.5 cm from incisor teeth ) 4th constriction Where it passes through the diaphragm, at the level of T10 vertebra ( 40 cm from incisor teeth)

Question 33

short note about Esophageal atresia.

Answer 33

An absence in the continuity of the esophagus due to an inappropriate division of the primitive foregut into the trachea and esophagus This is the most common congenital anomaly of the esophagus. May associated with duodenal atresia or pyloric stenosis.

Question 34

radilogical finding of congenital hypertrophic pyloric stenosis by ultrasound

Answer 34

Pyloric muscle wall thickness >3 mm Pyloric transverse diameter >14 mm with pyloric channel closed Elongated pyloric canal >17 mm in length Exaggerated peristaltic waves

Question 35

short notes about gastric ulcer

Answer 35

An infection with Helicobacter pylori (H. pylori) bacteria Taking non-steroidal anti-inflammatory drugs (NSAIDs) Complications: POB Perforation Gastric Obstruction Bleeding Ulcer location 90-95% of gastric ulcers are located on the lesser curvature and posterior stomach wall in the gastric body and antrum They are uncommonly seen on the greater curvature (~5%)

Question 36

What are the anatomical classification of fractures?

Answer 36

Fractures are classified by their complexity, location, and other features. Common types of fractures are transverse, oblique, spiral, comminuted, impacted, greenstick, open (or compound), and closed (or simple).

Question 37

What are the radiological signs of rickets?

Answer 37

1) metaphyseal cupping and fraying 2) poor mineralization of epiphyseal centers, 3) splaying (widening of the metaphyseal ends

Question 38

D/D of dense vertebrae

Answer 38

• Metastases • Lymphoma • Paget’s disease • Haemangioma • Healing fracture

Question 39

What are the main radiological modalities used in obstetrics imaging , and the role of each modality

Answer 39

1 -Ultrasound: The primary imaging modality, Trans abdominal , endo vaginal, Doppler , 3D,4D utilizing sound waves to visualize the fetus, uterus, and ovaries without ionizing radiation. It is essential for monitoring fetal development, assessing congenital abnormalities, and determining gestational age. 2 - Magnetic Resonance Imaging (MRI): Used for detailed imaging of the fetus and placenta, particularly in high-risk pregnancies. MRI is considered safe throughout pregnancy and provides valuable information regarding fetal and maternal conditions.--

Question 40

What are the key features that indicate a malignant lesion in mammography

Answer 40

1- Shape: Malignant lesions typically present as irregular shapes, while benign lesions are often round or oval14. 2- Margins: Spiculated or indistinct margins are highly suggestive of malignancy. benign lesions usually have well-defined, circumscribed margins25. 3- Density: Malignant lesions often appear as high-density masses compared to surrounding breast tissue. Low-density lesions are more likely to be benign. 4- Calcifications: Microcalcifications associated with malignancy tend to be small, Pleomorphic, or clustered, whereas benign calcifications are larger and more uniform in appearance

Question 41

What are the difference in sonographic imaging feature between benign and malignant ovarian cysts? mention at least 3 differences

Answer 41

Benign Ovarian Cysts: 1 - unilocular, Regular multilocular, . 2- thin septation , 3-Solid components are usually less than 7 mm in diameter. 4- Vascularity: No detectable Doppler signal. Malignant Ovarian Cysts: 1- Shape: Often irregular and multilocular. 2- thick septation Solid components (nodules) . 3- Ascites: Presence of ascites is common. 4- Vascularity within the : High Doppler signal indicating increased blood flow.

Question 42

Imaging modality for pulmonary embolism and which is best

Answer 42

1. **chest computed tomography pulmonary angiography (CTPA)** 2. echocardiography 3. MRI 4. nuclear imaging

Question 43

causes of enlarged cardiac silhouette

Answer 43

1. cardiomegaly (most common cause by far) 2. pericardial effusion 3. anterior mediastinal mass 4. prominent epicardial fat pad 5. expiratory radiograph توا تلقى تفاصيل و mcq ع الموضوع هذا https://radiopaedia.org/articles/enlargement-of-the-cardiac-silhouette

Question 44

DD of Single liver nodule

Answer 44

? I know DDs of multiple liver nodules

Question 45

Radiologic signs of arthritis

Answer 45

**Narrowing + erosion + bone formation** 1. joint space narrowing 2. subchondral sclerosis 3. osteophytosis 4. joint erosions 5. subchondral cysts 6. bone marrow lesions 7. synovitis