RD radiodiagnosis 2018 march: formatted Flashcards
(44 cards)
- Clinodactyly enlarged finger
a. Macrodystrophia
b. Turners
c. Mucopolysaccharidosis
d. Marfans
Macrodystrophia
? localised gigantism with clinodactylyl
**LJS - correct.
Macrodystrophia lipomatosa - localised gigantism. One of the many associations with clinodactyly (curved finger, usually little finger)
Also T21 and other aneuploidy, plus many other syndromes (but none of the other answers that I can find)
Soft marker in isolation
- RUL consolidation with haemoptysis, chronic disease young person, tram track lucency, DSA
a. Dilated eroded vessel
b. Aneurysm
c. Dissection
b. Aneurysm
- Bladder injury least likely on cystogram
a. Extraperitoneal
b. Intra
c. Extra intra
d. Interstitial injury
e. Mucosal tear
e. Mucosal tear ?
**LJS - agree. Radiopedia has interstitial tear as serosal surface tear. But stat dx/papers say it is intramural/partial thickness tear with intact serosa
https://pubs.rsna.org/doi/10.1148/radiographics.20.5.g00se111373
- Chest pain high on NECT
a. IMH
b. Dissection
c. Other crap
a. IMH
- 60 well marginated
a. High grade IDC
b. Fibroadenoma
c. Cyst
d. Sebaceous
e. Mucinous
could be anything
probably Mucinous
- Liver lesion hypervascular hepatobiliary delayed normal other delayed abnormal
a. One is FNH
b. Other is Adenoma (q said low on opp phase)
FNH
- Sclerotic 50 year old vertebral test
a. Bone scan
b. MRI
c. XR
d. CT
a. Bone scan
- 2 year old not intersusseption
a. HSP
b. Crohns
c. Lymphoma
d. Meckels
**LJS - Crohns. Seems least likely in a 2yo. HSP, Meckels, lymphoma can act as lead points.
- 2 year old not intersusseption
a. HSP
b. Crohns
c. Lymphoma
d. Meckels
- High MCA in baby, rh +
a. Parovirus
b. Rhesus incomp
c. Normal
d. CPAM
**LJS - disagree.
Parvovirus - infects erythroid precursors = aplastic fetal anaemia
Assuming Q states mother is Rh+ve. Rhesus incompatability occurs in Rh -ve mothers.
*LW:
Agree with LJS…
Would depend on rhesus status in question wording, as high MCA Vmax diagnoses fetal anaemia for which parovirus and rhesus incompatability are causes.
Also, would assume rhesus status refers to mother, as although possible to ante natally test fetal blood group, it is difficult and risky with amniocentesis / expensive with latest blood tests (not readily available in NZ / fair game in Oz).
Previous
b. Rhesus incomp
- Nuchal 4mm in first trimester
a. Normal
b. High risk 20/70
c. Confirms T21
d. TV scan needed
e. Associated with cardiac abnormality
B. high risk 20/70
Risk of nuchael translucency vs chromosomal defects:
< 95th centile : 0.2%
95-99th centile : 3.7%
3.5- 4.4mm : 21%
4.5-5.4 mm : 33.3%
5.5 - 6.4 mm : 50%
> 6.5 : 64.5% .
19% fetal death.
46.5% major fetal anomaly. The results of the nuchal translucency scan will not be used alone to calculate the risk of a chromosomal abnormality. All your first trimester screening is combined to calculate your risk. The calculation based on the mother’s age, the nuchal translucency measurement of your baby, the gestational age of the baby, blood tests and the baby’s nasal bone.If your risk is less than 1 in 1000, you are considered low risk. If it is between 1 in 50 and 1 in 1000 you are considered intermediate risk. If it is greater than 1 in 50 you are considered high risk.If abnormal and screening test results show increased risk of less than 1 in 300, further workup may be carried out based on patient’s desire after counseling and which includes:amniocentesis and/or chorionic villus samplingfetal echocardiography
- Men breast cancer
a. IDC
b. ILC
a. IDC
- Men painful unilateral mass, lobulated posterior margin
a. Gynaecomastia
a. Gynaecomastia
- 3 cystic masses 40 female in neck, one in parotid 2 in neck, breast cancer
a. Sjogrens
b. HIV
c. Mets
*LW:
Unsure, in setting of breast cancer could represent multiple nodal mets, with parotid met / intra parotid nodal met.
Multiple parotid lesions can be due to Sjogren or HIV epithelial lesions, however, question states 2 lesions in neck, i.e. external to parotid, thus assuming nodes.
**LJS - HIV lymphoepithelial lesions often ass/w cervical lymphadenopathy. And given cystic ?most likely. Breast ca mets to parotid is extremely rare according to google. Radiopedia - mets to intraparotid nodes: melanoma, SCC, rarely testicular seminoma
***Combined preferred answer thus = HIV
- Mandibular unilocular with nodule
a. OKC
b. Dentigerous
c. Odontoma
d. Ameloblastoma
*LW:
Favoured answer is ameloblastoma.
**LJS agree - 20% unilocular and other things wouldn’t have solid component
- Weak muscle baby, no testis best next test
a. US renal
b. US testes
c. CXR
d. AXR
- *LJS - renal USS. Hypotonia + undescended testes ?prune belly syndrome. Look for evidence of renal dysplasia to complete the triad
- LW: As always, agree with LJS…. I think this question is going for next step idea such as ?prune belly, why else would they mention weak muscles…..
b. US testes
UltrasoundUltrasound has 45% sensitivity, 78% specificity, and 88% accuracy for localisation of an undescended testis and is more accurate than clinical examination 4,5
.MRI
MRI is the best cross-sectional modality to assess crypto-orchidism (replacing CT). It has a higher sensitivity than ultrasound (~90%) and a higher specificity (100%) 6.
- Kid unilateral lack of chest wall muscle
a. Polands
a. Polands
- 2cm mass in brain
a. Amyloid angiopathy
*LW:
Amyloid - possible if described blooming sequence, however unlikely if isolated mass as amyloid antipathy usually multi focal.
- Old guy confused BG mass int T1 high T2 what age bleed
a. 3hr
b. Sub early
c. Late sub
d. Chronic >14
*LW: unsure if correct signal details recalled:
Per the spiral graph:
Immediate / hyper acute is T1 iso, T2 iso, although T2 can be slightly hyper intense, with a peripheral rim of hypo intensity. So probably this is correct answer based on details recalled.
Acute (1-2days) is T1 iso, Low T2.
Early sub acute (2-7days) is high T1, low T2.
Late sub acute (7 days - 28days) is high T1 high T2.
Chronic: progressively reduces T1 signal and then T2 signal becoming low T1 and low T2.
previous answer:
a. 3hr
- Fibrous dysplasia, which is false
a. Mono less earlier than poly
b. Leontisis ossea extra
c. Spinal involvement 10%
d. Unilateral in mccune albright
e. No calc or ossification distinguish from other bony lesions
c. Spinal involvement 10%
- *LJS:
a. Mono less earlier than poly - not sure exactly what this means. Type of abn depends on when in embryogenesis mutation happened. Polyostotic syndromic occurs earlier than mono. If this is what is meant then correct.
b. Leontisis ossea extra - leontiasis ossea is a monoostotic form of FD (no extracranial lesions)
c. Spinal involvement 10% - rare in monoostotic, bottom of list of Robbins frequency in polyostotic. So could be true.
d. Unilateral in mccune albright - true
e. No calc or ossification distinguish from other bony lesions - ?true, inadequately mineralised bone
brain lesion cyst with a nodule
scolex = neurocysticercosis
- Not MEN 1
a. Phaeo
a. Phaeo
- Skull base lesion eroding jugular foramen
a. Paraganglioma
ok
- Wrong sticker put on request, that patient came up what question to ask
a. What are you having
b. Whats you name
c. DOB
d. Ward
e. NHI
b. Whats you nameuhhh
**LJS - what study are you having? Presume if the incorrect patient sticker is on the request form and that patient is brought to dept, then the name on form will match what they say and won’t pick up the error. Clinical hx/study requested won’t match pt hx. Hope the pt isn’t confused!
This happened to me once. 1st year colon heaven and this poor outpatient did full bowel prep as they received a letter stating they should, and didn’t question it. Something tweaked when I spoke to the patient, called the referrer and it was wrong sticker/patient put on form in OP clinic. Ooops.
- Child tracheomalacia
a. Expiratory wheeze
b. Wide trachea
c. Ballooning hypopharynx
- LW:
- no mention of clinical wheeze, but reports expiratory stridor….
- Collapsed trachea in AP diameter
- No mention of ballooning hypo pharynx
- *LJS - wide trachea in inspiratory CT (posterior bowing of membranous portion) and narrow cresentic in expiratory.
- Wheeze seems unlikely since it’s upper airway problem = stridor if anything.
- Ballooning occurs in croup