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Flashcards in Radiology Deck (51):
1

When is head CT with contrast an appropriate test? (2)

1.Evaluating for AV (arteriovenous) malformations 2. Evaluating for primary/metastatic tumors

2

When is an abdominal CT the best initial test?

Evaluating retroperitoneal structures (pancreas, nodal metastasis from colon/ prostate/ testicular/ renal cancer)

3

When is high resolution CT scan of the chest the test of choice? (2)

1. Evaluating for parenchymal lung disease (interstitial fibrosis) 2. Evaluating bony structure

4

What is the major contraindicator for a CT or MRI with contrast?

Renal failure (creatinine > 1.5)

5

What should be avoided when performing an CT to a pt with multiple myeloma?

IV contrast

6

Why should you avoid contrast with an MRI of a renal disease pt?

Can result in nephrogenic systemic fibrosis

7

What medication should be discontinued before CT scan with IV contrast and not restarted until 48 hours after the scan when renal failure has been ruled out?

Metformin

8

When is an MRI the best diagnostic test? (10)

1. Demyelinating disease (multiple sclerosis, dementia) 2. Posterior fossa 3. Base of skull 4. Orbit 5. Brain Tumors (acoustic neuromas, pituitary tumor, small intraparenchymal tumor) 6. Bone Tumors 7. Bone and soft tissue infections 8. Joint spaces 9. Aseptic necrosis of femoral head 10. Diseases of spinal cord and spinal column (herniated disc, spinal tumor, degenerative disc disease)

9

When is the HIDA (hepatobiliary) scan useful? (3)

1. Evaluating biliary obstruction vs. acute cholecystitis 2. Evaluating for biliary leaks postoperatively 3. Evaluating for congenital abnormalities of biliary tract (biliary atresia)

10

When is a bone scan useful? (4)

1. Metastatic bone lesions 2. Evaluating delayed fractures 3. Evaluating osteomyelitis 4. A vascular necrosis of the femoral head

11

When is an adrenal scan the test of choice?

Localizing a pheochromocytoma (when MRI/CT nondiagnostic

12

When is a V/Q (ventilation-perfusion) scan the test of choice?

Evaluating for pulmonary embolism (Normal scan rules out PE; indeterminate needs further eval with CT angiogram)

13

When should you not order a V/Q scan (for the evaluation of pulmonary embolism)? (2)

1. COPD 2. Extensive lung disease

14

When is a gallium scan the test of choice? (3)

1. Localizing abscesses 2. Staging lymphomas 3. Melanomas

15

When is an ultrasound the best initial test? (4)

1. Evaluating gallbladder for stones (pt with RUQ pain) 2. Assessing uterus, adnexa, ovaries (except cervical cancer) 3. Evaluate prostate and aids in obtaining biopsy 4. Evaluate for deep venous thrombosis (DVT)

16

What are likely causes of lyric lesions on a x-ray film of the bones? (3)

1. Multiple myeloma 2. Primary bone tumor 3. Metastasis (lung, renal, thyroid, breast)

17

What are likely causes of blastic bone lesion on bone x-ray? (3)

1. Metastasis (breast, prostate, lymphoma) 2. Paget's disease 3. Medulloblastoma in kid

18

What are likely causes of large mediastinum on chest x-ray? (2)

1. Aortic aneurysm 2. Lymphadenopathy

19

What are likely causes of lung infiltrated with effusion on chest x-ray? (4)

1. Staphylococcus pneumoniae 2. Streptococcus pneumoniae 3. Lung infarct 4. Tuberculosis

20

What are likely causes of small bowel obstruction on abdominal/pelvic radiography? (5)

1. Adhesions 2. Hernia 3. Intussusception in kid 4. Gallstone ileus 5. Carcinoma

21

What are likely causes of large bowel obstruction on abdominal/ pelvic radiography? (4)

1. Carcinoma 2. Hernia 3. Diverticulitis 4. Intussusception in kids

22

What are likely causes of gas in biliary system on abdominal/ pelvic radiography? (3)

1. Gallstone ileus 2. Gas forming infection 3. Instrumentation

23

What are likely causes of small kidneys detected by abdominal/ pelvic radiography? (4)

1. Renal artery disease 2. Chronic hydronephrosis 3. Chronic glomerulonephritis 4. Chronic pyelonephritis

24

What are likely causes of large kidneys detected on abdominal/ pelvic radiography? (5)

1. Acute pyelonephritis 2. Acute glomerulonephritis 3. Renal vein thrombosis 4. Carcinoma (if unilateral) 5. Wilm's tumor in kids

25

What are likely causes of ring enhancing lesions in the brain on brain imaging of an immunocompetent pt? (3)

1. Metastatic tumor 2. Demyelination disease 3. Pyogenic disease

26

What are the likely causes of ring enhancing lesions in brain on brain imaging of immunocompromised pt? (3)

1. Toxoplasma encephalitis (t. gondii) 2. Primary CNS lymphoma (EBV) 3. Tuberculosis (in endemic area)

27

What is the likely causes of hemorrhage into basal ganglia, cerebellum or pons on brain imaging?

Hypertensive brain hemorrhage

28

What are the likely causes of hemorrhage into the cerebral hemispheres on brain imaging? (7)

1. Arteriovenous (AV) malformations 2. Aneurysm 3. Trauma 4. Metastatic lesions 5. Vasculitis 6. Cocaine 7. Coagulation abnormalities

29

When is the noncontrast head CT the best initial test?

Rule out hemorrhage (trauma or acute neuro change)

30

What is the most likely diagnosis?

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Pneumothorax

31

What is the likely diagnosis?

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Pneumomediastinum

32

What is the likely diagnosis?

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Pneumoperitoneum

33

What is the likely diagnosis?

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COPD 

(Chronic obstructive pulmonary disorder)

34

What is the likely diagnosis?

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Pleural Effusion

35

What is the likely diagnosis?

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Bilateral pleural effusion

36

What is the likely diagnosis?

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Pulmonary embolism

37

What is the likely diagnosis?

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lobar pneumonia

38

What is the likely diagnosis?

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Aortic Dissection

39

What is the likely diagnosis?

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Aortic Dissection

40

What is the likely diagnosis?

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Aortic Aneurysm

41

What is the likely diagnosis?

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Small Bowel Obstruction

42

What is the likely diagnosis?

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Cecal Volvulus

43

What is the likely diagnosis?

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Toxic Megacolon

44

What is the most likely diagnosis?

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Carcinoma of the Colon

45

What is the most likely diagnosis?

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Epidural Hemorrhage

46

What is the most likely diagnosis?

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Subdural Hemorrhage

(with shifting)

47

What is the most likely diagnosis?

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Thalamic Hemorrhage

48

What is the likely diagnosis?

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Cholecystitis

49

What is the likely diagnosis?

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Congenital Diaphragmatic Hernia

50

What is the most likely diagnosis?

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Duodenal Atresia

(double bubble sign)

51

What is the most likely diagnosis?

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Foreign Body