Radiology

Question 1

CXR is best initial test for

Answer 1

All forms of pulm complaints
- Cough, SOB, CP, sputum, hemoptysis
All forms of physical exam abnormalities
- Rales, rhonchi, wheezing, dullness to perc, chest wall tenderness, tracheal deviation, SVC syndrome

Question 2

How man ribs in NL on CXR in inspiration

Answer 2

10-11

Question 3

What should the pt do to better visualize PTX

Answer 3

Exhale

Question 4

Important for PA films

Answer 4

Pt must be standing/Able to stand

Therefore pt is likely stable

Question 5

CXR on unstable pts

Answer 5

AP - lying down, esp in ICU

Question 6

Difference between AP and PA

Answer 6

Heart is bigger on AP

Question 7

When to do decubitus CXR

Answer 7

Evaluate pleural effusion

Pt lies on each side, and effusion will freely move

Question 8

What do we do instead of lordotic CXRs

Answer 8

Chest CT

Question 9

When to do lateral CXR

Answer 9

Determine precise location of lesion seen in PA

Question 10

Best initial test for pleural effusion

Answer 10

Lateral CXR (can detect 50-75mL)
PA needs 200-300

Question 11

Only time to do ABD XR

Answer 11

Ileus or SBO - multiple air fluid levels

Question 12

The ONLY time to ABD XR for evaluation of stones

Answer 12

Emergency when U/S or CT are not available

Question 13

Imaging for Bowel perforation

Answer 13

Upright CXR

Question 14

Best initial test for osteomyelitis

Answer 14

Bone XR - elevation of periosteum

Question 15

When to do MRI or bone scan for osteomyelitis

Answer 15

XR shows nothing

XR takes 2 weeks to become abnormal

Question 16

When is skull XR the right answer

Answer 16

Never

Question 17

When is head CT w/o contrast the best initial test

Answer 17

Severe head trauma
Stroke
Intracranial bleeding

Question 18

When is head CT w/ contrast used

Answer 18

Cancer and Infection

BIT for any kind of intracranial mass lesion

Question 19

Important points about CT w/ contrast

Answer 19

Never in severe renal failure
Hydrate w/ saline and give bicarb or NAC for mild insufficiency
Stop metformin before giving contrast

Question 20

Essential when doing ABD CT

Answer 20

Oral and IV contrast

Question 21

What is ABD CT good for

Answer 21

Retroperitoneal structures (PANCREAS)
Appendicitis and other ABD infections
Most accurate test for nephrolithiasis (no contrast)
Masses in ABD organs
Most accurate test for diverticulitis

Question 22

When is Chest CT the answer

Answer 22

Hilar nodes
Mass lesions
Cavities
Interstitial lung disease
Parenchymal lung disease
PE

Question 23

What is MRI used for

Answer 23

Most accurate test of all CNS disease (except hemorrhage)

Question 24

When is MRI the answer on the test

Answer 24

Demyelinating diseases
Posterior fossa lesion
Brainstem
Pituitary
Facial structures
Bone lesions
Spinal cord and vertebral lesions

Question 25

With CA and infection what is the most accurate test

Answer 25

Bx

Question 26

When is U/S the answer

Answer 26

Gallbladder disease Renal disease Gyn organs Prostate (transrectal)

Question 27

Endoscopic U/S is the most accurate test for

Answer 27

Pancreatic lesions (esp in the head) Pancreatic and billiary ductal disease Gastrinoma localization

Question 28

What is HIDA for

Answer 28

Cholecystitis

Question 29

What is a bone scan for

Answer 29

CA mets | Not nearly as specific as MRI

Question 30

What is Gallium scan for

Answer 30

Fever of unknown origin | Checks Fe metabolism

Question 31

What is Indium scan for

Answer 31

Fever of unknown origin in ABD | Tagged WBCs

Question 32

What is V/Q scan for

Answer 32

PE | Replaced by Spiral CT

Question 33

What is MUGA for

Answer 33

EF