Radiology 1 Flashcards
(93 cards)
1
Q
Ionizing radiation damages cells in what two ways?
A
Direct and indirect
2
Q
Define Roentgenogram
A
X-ray
3
Q
Define Attenuation
A
Process of tissue absorbing energy. High - more opaque, low - more translucent
4
Q
Define Spatial resolution
A
Imaging modality’s ability to visually contrast objects/structures
5
Q
Define contrast resolution
A
Imaging modality’s ability to visually contrast color or shades
6
Q
What is a coronal view
A
Parallel to the coronal suture/From the front or back
7
Q
What is a sagittal view
A
Parallel to the sagittal suture/From the side
8
Q
What is an axial view
A
“From the feet looking up”
9
Q
What is a houndsfield unit?
A
An arbitrary unit of attenuation used in CT scans. High - high attenuation.
10
Q
What is the order of modality from high spatial resolution to low?
A
X-ray > CT > US > MRI
11
Q
What is the order of modality from high contrast resolution to low?
A
MRI > CT > US > X-RAY
12
Q
What are the pros of X-ray (plain film)?
A
Inexpensive Readily available Portable Quick Highest spatial resolution
13
Q
What are the Cons of Xray (plain film)?
A
Ionizing radiation
Low contrast resolution
14
Q
What examples are given for X-Ray uses in the slides?
A
Chest tube and line placement Bowel obs. and free air in ABD Fracture and arthritis Foreign bodies Trauma
15
Q
IV or IA contrast for plain film will be what?
Oral/Rectal?
Cavity/Space?
A
Iodine
Barium
Iodine
16
Q
Iodinated agents pose a risk to what organ? What steps can we take to minimize this risk?
A
Kidney
Discontinue nephrotoxic medication 2 days prior, get renal function panel, ensure adequate volume and perfusion
17
Q
What is contrast induced nephropathy related to? How can we diagnose?
A
Iodinated agents
25% increase in serum creatinine from baseline or .5mg/dl or higher increase (absolute) @ 2-7 days
18
Q
Define extravasation in regards to a liquid (IE contrast)
A
Leakage from expected container
19
Q
What are the pros of CT imaging?
A
Cross-sectional images expanded gray scale data manipulation (3D) Widely available Contrast AND spatial resolution
20
Q
What are the cons of CT imaging?
A
Still ionizing radiation
Stationary machine
21
Q
What are the uses of CT imagine
A
Abdominal pathology Coronary angiography Trauma Virtual bronch and colonoscopy Joint Fx
22
Q
Contrast agents for CT are different than X-ray, True or False?
A
False, they are the same.
23
Q
What are the pros of mammography
A
Inexpensive Readily available portable quick Spatial resolution is high
24
Q
What are the cons of mammography
A
Ionizing rads
contrast resolution is low
25
What is mammography used for?
Screening breast exams in high risk
26
How does an MRI machine work?
RF pulse changes orientation of protons in body (hydrogen). RF stops, protons realign. This releases energy (RF) that is read by receiver coils.
27
What are the pros of MRI
```
No ionizing rads
Cross-sections
expanded gray scale
Data manipulation
Contrast resolution is high
```
28
What are the cons of MRI?
```
Expensive
Not as readily available
Magnetic objects will fly around like missles
stationary
slow
Spatial resolution is low
```
29
What are the uses of MRI?
Neurologic imaging
Soft tissue around joints
Soft tissue masses
female pelvic organs
30
IV or oral contrast agents for MRI are what?
Gadolinium
31
Gadolinium based contrast still caries a risk for what organ? What can it cause?
Kidney
| Nephrogenic systemic fibrosis
32
What imaging modality uses a transducer. What does this transducer do?
Ultrasound
| Emits and absorbs/converts acoustic energy
33
Objects with high density/attenuation? will cause what to appear posterior to them on ultrasound?
Acoustic shadow
34
What are the pros of ultrasound?
Static AND motion images
Inexpensive
mobile
No rads
35
What are the potential uses for ultrasound?
```
Pelvic organs
Peds
Superficial lesions
Noninvasive vascular studies
Pregnancy
Image guidance
```
36
What type of contrast would be used IV with ultrasound?
Microbubble
37
What are the 3 variations of ultrasound?
Doppler
Elastography
Therapeutic
38
What are the pros of nuclear medical imaging?
Function as opposed to anatomy
39
What are the cons of nuclear medical imaging?
Patient is source of ionizing radiation
40
Iodine radiopharmaceuticals are used in study of what?
Glucose?
Phosphates?
Flourodeoxyglucose?
Thyroid scan
Brain
Bone scan
Cancer
41
What are the variations of nuclear medicine?
```
Bone scan
Myocardial perfusion
Hepatobiliary iminodiacetic acid scan
Ventilation/Perfusion
Thyroid scan
PET
SPECT
```
42
What is the format for ordering studies?
SBAR
Situation
Background
Assessment
Recommendation
43
System for storage of digital images
PACS
| Picture archiving, communication, and storage
44
What 3 things are needed for a plain film?
X-Ray source, Recording method, Processing method
45
What is the name of the rotational frame containing the recorder for a CT machine
Gantry
46
Can a patient be given an MRI with a metallic pacemaker or connected O2?
No, they will die or the O2 canister will become a missile and you will feel dumb.
47
Define sclerotic
Rigid, non compliant, scarred
48
Define lytic
destructive
49
Define osteopetrosis
Bone hardening like rock
50
Define osteomalacia
bone softening
51
What are the two listed causes of increased generalized bone density?
Diffuse osteoblastic metastases
| Osteopetrosis
52
What are the three causes of decreased generalized bone density
Osteoporosis
Hyperparathyroidism
Rickets/osteomalacia
53
What are the 3 causes of focal increased bone density
Localized osteoblastic metastases
Avascular necrosis
Paget disease
54
What are the 3 causes of decreased focal bone density?
Localized osteolytic metastases
Multiple myeloma
osteomyelitis
55
What is a butterfly fragment
Wedge shaped fragment of bone resulting from Fx
56
Define pseudoarthrosis
Bone segments becoming fake joint (articulating)
57
Define ankylosing
Bones connecting/fusing/sclerosing together
58
In the hands and feet, how are dislocations and subluxations described in terms of direction
Hand: palmar vs dorsal and Radial vs Ulnar
Foot: Plantar vs dorsal and fibial vs tibial
59
What areas/portions of the body have sesamoid bones that can be mistaken for fractures?
1. Distal potion of 1st metacarpal (sometimes on other metacarpals and phalanges)
2. Distal 1st metatarsal (uncommonly on other metatarsals)
3. Fabella (posterolateral aspect of the knee)
60
What are the indirect signs of Fx? (3)
1. Soft tissue swelling
2. Blood in the joint (hemarthrosis)
3. Periosteal rxn (after 7-10 days)
61
Sail sign and posterior fat pad sup to olecranon are hallmarks of what?
Radial head Fx
62
Devascularized bone becomes more ______. This results in a more sclerotic appearance.
dense
63
What is paget disease?
Chronic bone disease resulting in increased bone resorption and increased bone formation. End result - denser bone.
64
What are the four parameters used to describe fractures?
1. Number of fragments (simple vs. comminuted)
2. Direction of Fx line (transvers, oblique, spiral)
3. Relationship of fragments (displaced, angulated, shortened, rotated)
4. Communication with atmosphere (open vs. closed)
65
How are abnormalities in the position of bone fragments or in subluxation/dislocation described? Ie prox/distal etc...
Distal fragment or portion as it relates to proximal
66
What is a Salter-Harris fracture? Describe type 1-5
A fracture involving physeal plate.
1. Just the plate
2. Plate plus metaphysis (toward dia) (most common)
3. Plate plus Epiphysis (3 for E)
4. All 3, Plate plus epi, plus meta/dia
5. Crush (least common)
67
What are the four stages of fracture repair?
1. Fracture hematoma
2. Fibrocartilaginous callus
3. Bony callus
4. Bone remodeling
68
What are the three classifications of arthritis?
Hypertrophic
Erosive
Infectious
69
What are the types of Hypertrophic arthritis?
```
Primary osteoarthritis
Secondary osteoarthritis
Erosive osteoarthritis
Charcot arthropathy
Calcium pyrophosphate deposition disease
```
70
What are the types of Erosive arthritis?
Rheumatoid arthritis
Gout
Psoriatic Arthritis
Ankylosing Spondylitis
71
What are the two types of Infectious arthritis?
Pyogenic (usually Staph Aureus)
| Non-pyogenic (Usually Mycobacterium TB in the T-spine)
72
Primary Osteoarthritis is the most ________ form of arthritis. What joints does it primarily involve?
Most common
Hips, knees, hands
73
On imaging, what is the hallmark of osteoarthritis?
marginal osteophytes (bony protrusion at/near the joint)
74
Besides marginal osteophytes, what will generally be seen on imaging of osteoarthritis?
Subchondral sclerosis
Subchondral cysts
Narrowing of joint space (not unique)
75
How do you differentiate primary and secondary osteoarthritis?
Secondary is the result of something (trauma etc...)
Atypical age *young*
Unilateral
Atypical location (joint w/ infrequent use)
76
What are the most common joints involved with Hypertrophic-Erosive arthritis?
Prox and Distal IP joints
77
A gullwing joint appearance is a hallmark of what arthritis?
Hypertrophic-erosive
78
In charcot arthropathy, what is the relationship of pain to presentation on x-ray? Why?
Pain is far less than degree of destruction seen.
Neurvous system pathology has caused sensory disturbances which could lead to decreased sensation among other things.
79
What is the most common cause of charcot arthropathy? What are the most common joints affected? What will it mimic on imaging?
Diabetes
Feet and ankles
Osteomyelitis
80
CPPD is most common where? What will you see on film?
Triangular fibrocartilage of the wrist, menisci of the knee or metacarpal heads
Bone formations/depositions
81
Rheumatoid arthritis is associated with ___________ joints of the hand. It is characterized by the hand's _______ deviation
proximal
Ulnar
82
What type of ligamentous laxity is associated by name with rheumatoid arthritis?
Atlantoaxial subluxation
83
Gout is the result of what?
Calcium urate crystal deposition
84
Rat bitten appearance (Sharply marginated, juxtaarticular erosion with a sclerotic border) is a hallmark of what arthritic condition?
Gout
85
DIP joints are typically associated with what erosive arthritis characterized by a pencil in cup appearance (juxtaarticular erosions) of the phalanges?
Psoriatic Arthritis
86
Bamboo spine (bony bridges from one vertebrae to the next) is indicative of what type of arthritis?
Ankylosing spondylitis
87
This type of arthritis is characterized by very rapid joint destruction compared to other forms
Infectious
88
Compare direct to indirect pyogenic arthritis
Direct = continuous with local infection outside joint
Indirect = spread via blood
89
Non-pyogenic infectious arthritis is generally ______-articular and shows _________ loss of joint space. Most common in the _______ of children and _______ of adults
Mono
Gradual
Spine
Knee (Just one knee? think TB)
90
Define a linear, depressed and basilar skull fracture
Linear - line, most common
Depressed - depression, assoc w/ brain injury
Basilar - linear fx at base of skull (most serious)
91
Plain film is the initial study of choice in many conditions. What is a notable exception where Unenhanced CT would be #1?
Acute head trauma
92
Define the 4 types of Coccyx anatomy
1. Slightly curved forward
2. More curve than one w/ a forward "point"
3. Sharp forward angle (like 90 degrees)
4. subluxation at sacrococcygeal or intercoccygeal joint
93
A fracture of the pelvis at 2 or more locations means what needs to be assumed?
Unstable pelvis
