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Last Leg > Radio > Flashcards

Radio Flashcards

1
Q

Bamboo spine

A

AS

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2
Q

Ivory vertebra

A

Pagets

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3
Q

Highly RadioSENSITIVE

A 
WELMS 
Wilms 
Ewing’s
Lymphoma 
Myeloma 
Seminoma
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4
Q

Least RadioSENSITIVE

A 
HOMP 
Hepatoma
OS
Melanoma 
Pancreatic Ca
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5
Q 
Most RadioSENSITIVE 
1 stage of cell cycle 
2 organ 
3 tissue 
4 cell type
A
  1. G2M
  2. Ovary testis
  3. Bone marrow
  4. Undiff well nourished quickly dividing metabolically active
  5. Lymphocyte
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6
Q 
Least RadioSENSITIVE 
1 stage of cell cycle 
2 organ 
3 tissue 
4 cell type
A
  1. M
  2. Vagina > bone > cns
  3. Nervous tissue
  4. Quiescent
  5. Platelets
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7
Q

Radiotherapy by Beta rays

A

SPY
Strontium
Phosphorus
Yt

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8
Q

RadioRx by Beta and Gamma

A

Gold
I131
Radium

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9
Q

Radiotherapy by gamma

A

ALL except 🧟‍♀️

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10
Q

Brachytherapy is INVASIVE RadioRx

A

Mc Interstitial
Intracavitary (GYNE)
Mould (skin ocular )

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11
Q

Interstitial brachy
1. Temporary
2 permanent

A

Temp- Ir. Cs. Sr. Co. Ra. Y

Permanent - Au. Pd. Cs. I

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12
Q

Used in both teleRx and brachyRx

A

Cs > Co > Ir

Cs - temp and permanent

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13
Q

Systemic radionuclides

A

I131

Only in well diff nodule

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14
Q

P32

A

PV

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15
Q

Cancer Rx by tele+brachy

A

Prostate CA

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16
Q

TeleRx

A

Image guided RT

Helmet on brain - directed rays to tumor

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17
Q

Proton beams radiation

A

BRAGG Peak ➕

Most advanced

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18
Q

Use of proton

A

When tumor surround by RadioSENSITIVE tissue

  1. Post op CHORDOMA
  2. SACROCOCYGEAL TERATOMA
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19
Q

Types of RadioRx

A

Tele
Brachy
Systemic

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20
Q

TeleRx - EBR

A

With cyclotron
Linear accelerators;
1. With anode
2. Wo anode

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21
Q

Cyclotron

A

Gamma rays on body
Co60 Cs 127

Cumbersome

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22
Q

Mc used TeleRx EBR

A

Linear acceleration with Anode
(LINAC)

=Xrays
Used now also

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23
Q

LINAC

A

With anode - 1. X
Wo anode - 2. Electron rays
Others
3. Proton beam

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24
Q

Cyber knife

A

X Ray

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25
Q

Gamma knife

A

Gamma

Photon

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26
Q

Penetrating power

  1. High
  2. Low
A

High - X and Gamma
(photon based treatment)

Low - electron

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27
Q

Use of low penetration e rays

A

Superficial CA

  1. Mycosis fungoides
  2. Intra op Pancreatic CA
  3. Breast
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28
Q

Photon based Rx

A

X and gamma show INVERSE SQUARE LAW

I=1/r2

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29
Q

Skin erythema

A

EBR

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30
Q

Radiation interaction with metals types

A

Photoelectric effect

Compton effect

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31
Q

Low energy interaction from Innermost shell of atom

A

Photoelectric

  1. Release characteristic energy
  2. Bound e interaction.
  3. Complete transfer of energy
  4. DIAGNOSTIC radiation
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32
Q

High energy interaction with outermost or valence shell

A

Compton effect

  1. Incomplete energy transfer
  2. Scatter radiation
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33
Q

Earliest inv confirmation of preg

A

Beta hcg

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34
Q

Earliest inv confirmation of INTRA UTERINE preg

A

TVS
GS
41/2 wks

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35
Q

Earliest sono feature of IU Preg

A

Thickening of endometrial at 21d

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36
Q

Earliest inv for confirming viability of preg

A

TVS
Beating heart
51/2 wks

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37
Q

1st dating scan

A

6 wks
No anomaly detected
EDD BEST

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38
Q

8-10 wks shows

A

Anencephaly

Failure of ossification of frontal bone

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39
Q

Reliable anencephaly

A

After 14wks

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40
Q

2nd scan

A

NT

11-13+6 wks

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41
Q

USG anomaly scan

A

18-20

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42
Q

Growth scan

A

28-32

IUGR - Doppler

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43
Q

EDD
T1
T2
T3

A

T1 - CRL
2- BPD
3 - COMBO of multiple parameters + EFW

FL + AC

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44
Q

Most sensitive for IUGR

A

AC

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45
Q

FL and AC different by ——- wks indicated IUGR

A

2

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46
Q

S/D ratio
Normal?
IUGR?

A

<2.5 Normal

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47
Q

Diastolic notch on umb a Doppler

A

<22wks Normal

>22wks PE ?

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48
Q

No AV on Doppler testis

A

Torsion

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49
Q

Uterine anomaly

Gold Std

A

🥇 lap hysteroscopy

2nd MRI

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50
Q

Necklace on ovary

A

Pcos

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51
Q

Radiolucent kidney stone

A

Uric acid
Xanthine
INDINAVIR
Orotic aciduria

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52
Q

Cystine stones?

A

Opaque

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53
Q

Calcified kidney

A

Putty / cemented

TB

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54
Q

Stippled kidney

A

Neohrocalcinisis

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55
Q

Xanthogranulomatous pylenonephritits

A

Proteus
Staghorn MAP stone

Xanthoma cells on clear cell RCC
Radiological diagnosis👩‍🎤

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56
Q

Emphysematous pyelonephritis

A

E. coli
DM
Air in kidney

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57
Q

KUB

A

IVP

  • Xray
  • CT - only indicated in early TB kidney MOTH EATEN PELVIS
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58
Q

Bladder and urethra

A

MCU

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59
Q

Urethra only

A

RGP

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60
Q

Colourful CT

A

3D CT

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61
Q

Key hole

A

PUV

Enlarged prostatic urethra

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62
Q

Cristmas tree bladder

A

LMN bladder

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63
Q

Angiomyolipoma

A

Tuberous sclerosis

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64
Q

Rice grain calcification

A

Myocysticercosis

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65
Q

Lytic lesion
Epiphysis
Metaphysis

A

Epi- GCT

Meta - SBC(fallen leaf). ABC

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66
Q

IOC acute pancreatitis

A

Biochemistry

S. Lipase and amylase

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67
Q

IOC assess severity of acute pancreatitis

A

Cect

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68
Q

Irreg dilated beaded ap pancreatic duct

CHAIN OF LAKE

A

Chronic pancreatitis

IOC - EUS

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69
Q

Atrophy of Pancras wo or w calcification

A

Chronic pancreatitis

IOC - CT

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70
Q

Colon cut off
Sentinel loop
Renal halo
Gas less abdomen

A

Chronic pancreatitis

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71
Q

T tube cholangiography

A

No endoscope or MR

Percutaneous

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72
Q

Cart wheel sign

A

Hydatid

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73
Q

Nectrotising pancreatitis

A

CECT

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74
Q

Non invasive
Even lumen distal SI seen
No biopsy tho

A

Virtual colonoscopy

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75
Q

Acute appy IOC

A

CT (dia>6mm no contrast or air in lumen. Appenlith enhancing wall mucosal edema)

Peds- UGS (blind non compressible >7mm)

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76
Q

Pencil in cup

A

Psoristic arthriits

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77
Q

IO suspected 1st iNv

A

X Ray abd
Air under diaphragm
⬇️
➕ emergency lap

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78
Q

No gas under dia

A

CT 🥶 100%

Left lat decubitus 90%

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79
Q

Riggler sign
Triangle
Cupola
Football

A

Perf peritonitis

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80
Q

Oral contrast

A

BaSO4

  • not absorbed in git
  • muscoal coating

Only Swallow and follow through done now.

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81
Q

Mc site of ischemic colitis

A

Splenic flexure

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82
Q

1st inv motility dis

A

Swallow Ba

Meal- endoscopy!

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83
Q

Due to overlap of loops and incomplete dilation in follow through

A
  1. Double balloon 🎈

2. Capsule endo (COSTLY ❌) - occultbleed Dx

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84
Q

See distal SI

A
  1. Meal follow through (1-1.5)
  2. Ba enteroclisis
  3. CT enteroclisis
    4 CT enterography (IOC)
  4. MR enterography (follow up after CT)
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85
Q

Ba enteroclisis

A 
Small vowel enema 
Inject Ba into DJ junc 
Fluoroscopy 
* only lumen 
* long tube
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86
Q

CT enteroclisis

A

Do CT instead of fluoroscopy

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87
Q

CT enterography

A

Drink mannitol instead
Causes distension
Inject iv dye

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88
Q

Cecal volvulus

A

Colon collapsed

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89
Q

Non progressive dysphasia

To SOLIDS

A

Peptic structure

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90
Q

energy comes from a source and travels through some material or space

A

radiation

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91
Q

types of radiation

A
  1. ionising

2. non ionising

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92
Q

ionising rads

A

beta
x
gamma
alpha

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93
Q

non ionising rads

A 
uv
ir
visible
micro
radio
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94
Q

order of cosmos rays

  1. freq dec
  2. energy dec
  3. wavelength inc
A

cosmic -> gamma -> x -> uv -> visible -> ir -> micro -> radio

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95
Q

all EM have same vel

A

no mass
no charge
3x10^8

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96
Q

x vs gamma rays

A

gamma - produced INTRA nuclearly

x - produced EXTRA nuclearly/mechanically

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97
Q

particle rays

A

alpha - +ve He
e- Beta rays
Proton BRAGG peak
Neutron 0 charge

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98
Q

x rays

Radiological scans

A 
radio
CT
PET
Mammo
HSG
MCU
RGU
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99
Q

gamma rays

Nuclear scans

A

Scinti
RAIU
Bone scan
SPECT

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100
Q

for all Iodinated dyes

A

x rays used

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101
Q

ercp vs mrcp

A

ercp - ionising (Iodine)

mrcp - non ionising (water in bile)

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102
Q

2 inv NOT GIVING off radiation

A

USG
MRI
old ( thermography)

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103
Q

ioc choledochal cyst

A

MRCP

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104
Q

minimally invasive

A

cath angio
laparoscopy
arthroscopy

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105
Q

non invasive

A

CT angio

MR angio

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106
Q

Tc 99 MDP

A

bone scan
osteoblast binding and gamma camera to detect gamma rays
SCINTIGRAPHY

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107
Q

fluroscopy

A

c arm
Ba swallow
angio for PCI

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108
Q

fistulography

A

x rays

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109
Q

thallium for

A

gamma rays

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110
Q

non ionising for liver cirrhosis

A

elastography USG

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111
Q

chest xray cxr TB primary

A 
latent infection
ghons complex
- LN pathy + (mediastinal enlargement)
-subpleural focus -ve 
-lymphatics -ve
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112
Q

post primary TB CXR

A

reactivation

  • cavitation
  • fibrosis (septal thickening)
  • apical predominance
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113
Q

hematogenous spread

A

milliary nodules

  • primary
  • post primary
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114
Q

tree in bud

A

endobonchial tb

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115
Q

pulmonary edema

A

inc in PCWP (pul venous HTN)

  • normal 8-12 mm Hg
  • LL>UL
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116
Q

PCWP 12-20 mmHg

A 
loss of gravity
ANTLER sign 
reverse MUSTACHE sign 
cephalisation of vessels
EARLIST SIGN OF PUL EDEMA
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117
Q

PCWP 20 -25 mmHg

A

interstitial edema
thin PARALLEL LINES at base of lung
Kerley B lines(perp to pleura)
VENOUS HTN (NOT ARTERIAL!!!)

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118
Q

PCWP > 25

A

alveolar edema
PERIHILAR OPACIFICATION
“Bat Wing”

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119
Q

Lung layers normally barely visible on CT but in pul edema

A

VISIBLE

thickenend inflammed fibrosis

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120
Q

SPLIT PLEURA sign

A

infected EMPYEMA

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121
Q

INfection in post BM transplant

TREE IN BUD on CT

A

RSV pneumonia

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122
Q

necrotic LN in dx tB

A

CECT

normally enhancing LN are now not enhancing due to necrosis

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123
Q

normal pancreas on ct

A

enhancement +

necrosis -ve

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124
Q

signet ring
tram tract
cluster of grapes

A

hrct

cronchiectasis

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125
Q

honey comb lung

A

ILD
- mc usual interstitial pneumonia
- NSIP non specific interstitial pneumonia with GGO
+ve COVID

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126
Q

mc mediastinal mass

A

thymoma

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127
Q

neuroenteric cyst

A

always ass with vert anomaly
ant - eso
post - spinal cord

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128
Q

PCA branch of

A

ICA

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129
Q

1st branch of AA

A

inf phrenic a

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130
Q

mc site of CoA

A

post ductal in descending aorta

- BL 3-11 ribs inf notching

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131
Q

rib notching

  • sup
  • inf
  • both
A 
sup = VASCULAR 
inf = NON VAScular
both = NF
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132
Q

fig of 8

A

supracardiac TAPVC

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133
Q

sitting duck

A

PTA

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134
Q

X ray sign of LA enlargement

A

bedford sign

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135
Q

LA enlargement

1st sign

A

1st - straightening of LHB

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136
Q

LAE other signs

A
  • LA appendage enlarged
  • SPLAYing of carina
  • post displacement of eso (earliest NOT SEEN CXR seen only on Ba swallow)
  • elevation of LMB
  • DOUBLE DENSITY SIGN
  • Bedford sign
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137
Q

NUcelar scans use ____ rays

A

gamma
Tc 99
DTPA

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138
Q

radionucleide
ISOMETRIC TRANSITION
t1/2 = 6h
energy 140 keV

A

Tc 99
Needs gamma camera
Th activated

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139
Q

DMSA

A

to see Scarring only.
cannot measure GFR
IOC: VUR

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140
Q

carrier for Tc99

excreted via GFR

A

Tc DTPA
used for GFR assessing
FUNCTIONAL RENAL TISSUE

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141
Q

Tc 99 MAG3

A

gamma rays
excreted via
- GFR
-Tubular sec *better for renal func status

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142
Q

Tc pertechnate affinity for

A
  • gastric mucosa
  • thyroid tissue
  • salivary glands
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143
Q

Meckels

A

+ve Tc 99

at periumb and RIF

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144
Q

Parotid gland Tc99
-Warthin
Adenolymphoma

A

-Warthin +ve

Adenolymphoma -ve

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145
Q

bleeding meckels

RBC scan vs Tc scan

A

Tc 99&raquo_space;» RBC

sensitive

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146
Q

Tc positive

A

black
Hot spot
thyroid - benign

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147
Q

Tc 99 negative

A

white
COLD spot
thyroid - malig

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148
Q

t1/2
I131
I123

A

I131 - 8days. Beta and gamma (ablative)

I123 - only Gamma. 12 hours RAIU scan

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149
Q

in india thyroid scan

A

done with Tc 99 not I123

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150
Q

I125

A

RIA

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151
Q

MIBG

A

NE analog

pheochromocytomas

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152
Q

Sestamibi

A

PTH adenoma

myocardial viability

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153
Q

HIDA

A

Biliary atresia

GOLD STD- acute cholecystitis (ioc-usg)

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154
Q

MDP

A

bone scan
-osteoblastic activity
mets, #, osteomyelitis

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155
Q

Se methionine scan

A

pancreas

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156
Q

Octreotide scan

A

NET

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157
Q

Thallium scan

A

myocardial perfusion (viable vs non viable)

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158
Q

MUGA

A

Vent fuction

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159
Q

Vent function most practical

A

ECHO (op dependent)

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160
Q

Vent function OBJective tests

A

MUGA

Cardiac MR MOST accurate

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161
Q

viable non fucntioning cardia

A

Stunned (acute)

Hibernating (chronic)

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162
Q

non func cardia

viable vs non viable diff via

A

Thallium
sestamibi
cardiac mr
fdg pet

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163
Q

18FDG t1/2

A

110 min
emits positrons and undergoes annihilation releases 511keV
Glucose meta by hexokinase

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164
Q

in fdg pet gamma rays

A

produced INSIDE cells 550 keV

No role of gamma camera (140 keV)

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165
Q

tumor expresses GLUT

A

3

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166
Q

Normal tissue showing high activiity FDG pet

A

Brain

Brown fat

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167
Q

2 tissue no activity fdg pet

A

carcinoid

bronchoalv ca

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168
Q

mc mimicker of fdg activity

A

TB

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169
Q

Staging of cancer

A

PET CET > CECT

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170
Q

18 F DOpa

A

Parkinson

Pheochromocytoma

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171
Q

A beta amyloid

A

Parkinson

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172
Q

Ga PSMA

A

prostate ca

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173
Q

Ga 68
DOTA TOC
DOTA NOC
DOTA TATE

A

NET

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174
Q

diff brain mets from

  • radiation necrosis
  • tumor recurrance
A

radiation necrosis - WHITE

Tumor - BLACK

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175
Q

CSF spaces

A

ventricles
cisterns
fissure
sulci

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176
Q

hematoma

  • hyper
  • iso
  • hypo
A

hyper - acute
iso - subacute
hypo - chronic

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177
Q

SWIRL sign

A

acute EDH
SIGN of ACTIVE bleed in EDH
Rx even wo waiting for midline shift

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178
Q

middline shift

A

> 0.5cm

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179
Q

ambient cistern contains

A

PCA

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180
Q

after RTA NCCT
80%
20%

A

80% DAI

20% punctate focal hemorrhage

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181
Q

DAI

A

shearing type of injury exercted in axons resulting in #axonodend junction

182
Q

IOC DAI

A

MRI

183
Q

punctate focal hemorrhage

A
  • grey white jn
  • corpus collosum
  • dorsolat brain stem
184
Q

MRI
T1
T2
FLAIR

A

T1
T2 WW2
FLAIR = T2 - H2O (water is black)

185
Q
  • inc contrast btw dis and background
  • supress CSF
  • doesnt suppress edema
A

FLAIR

186
Q

CSF filled
T2 white
Flair black

A

Arachnoid cyst

187
Q

Inclusion cyst
T2 white
Flair white

A

Epidermoid cyst

188
Q

Fat

A

black on T1and 2

189
Q

STIR

A

T2 - Fat

190
Q

earliest inv to check AS of sacroiliac jt

A

Subchondral marrow edema

STIR

191
Q

Brain and rest of body

A

Brain - Flair

Rest - Stir

192
Q

for blurry image

A

DWI

193
Q

access brownian motion of water molecules.

some diseases brownian motion is BLOCKED -> Restricted diffusion

A

DWI

194
Q

areas of restricted diffusion seen _____ on DWI

A

white

195
Q

Causes of restricted diffusion on DWI

A
  • ACUTE ISCHEMIC INFARCT (most useful)
  • high cellular tumor
  • abscess
  • epidermoid cyst DWI >FLAIR
  • encephalitis
196
Q

spl type of angio w/o dye

A

MR angio

TIME OF FLIGHT imaging

197
Q

mc dye for angio

A

Gd

MR - spectroscopy

198
Q

abcess on MR angio

A

central necrosis with peri enhancing lesion

HALLMARK of GBM

199
Q

death at Dx

A

GBM

Pancreatic ca

200
Q

tech of MR wich assess biochem environment of tissue

A

NAA
Choline
Creatinine

201
Q

NAA

A

N acetyl aspartate
HIGHLY NON SPECIFIC
Neuronal injury — dec NAA
* NAA dec inn all brain dis

202
Q

increase NAA

A

Canavan dis
- leukoencephalopathy failure to meta asp
demyelination

Alexander dis

203
Q

c/o macroenceph + developmental delay
inc NAA
Diffuse demyelination

A

Canavan

204
Q

co macroenceph + develop delay
Dec NAA
FRONTAL demyelination

A

Alexander

205
Q

Phosphatidyl choline

A

increase in Cancer = Cell turnover from cell memb

206
Q

marker of energy stores

A

Phospho creat in ATP

207
Q

small ring enhancing lesion

A
  • with eccentric scolex NCC

- w/o scolex NCC or TB

208
Q

Spectroscopy - extra peak from lipid rich TB lesion

A

diff NCC and TB

209
Q

caseous necrosis on spectroscopy

A

rich in mycolic acid (lipid) LIPID LACTATE peak

diagnostic for tuberculoma

210
Q

no lipid peak on spectroscopy in

A

NCC

211
Q

SWI

A

susceptibility weighted MRI

- best for Ca and microhemorrhages

212
Q

stroke IOC

A

NCCT

  • ischemic normal (4 1/2 h thrombolysis)
  • hemorrhagic +
213
Q

ischemic CT <6h

A

normal

214
Q

ischemic CT > 6h

A

HYPO dense

215
Q

HYPER dense intracerebral hematoma IOC

A

MRI < DWI

216
Q

NCCT >4.5h normal

A

mech thrombectomy

do CT ANGIO in same sitting upto 24h to save ischemic penumbra

217
Q

CT perfusion studies

A

normal 60-70/100g tissue

218
Q

ischemia core

  • cbf
  • cbv
  • mtt mean transit time
A

cbf - <6ml/100g/min
cbv - decreased
MTT - increased

219
Q

penumbra

  • cbf
  • cbv
  • mtt
A

cbf - 10-15ml/ 100 g
cbv - normal INC
Mtt - increased
MECH THROMBECTOMY

220
Q

NCCT HYPER dense

  • dense mca sign
  • sylvian dot sign
A

blood static in vessel

Acute ischemia sign

221
Q

empty triangle sign

A

picket fence fever
LST
hyperdense walls with hypodense central thrombus

222
Q

psudo delta sign

A

SAH

223
Q

Physio calcification on CT

A 
mc PINEAL
choroid plexus 
interhemi falx
ant and post clinoid lig 
habenular 
basal ganglia
224
Q 
patho calcification in CT
Periventricular Ca 
diffuse nodular
bracket calcification 
subependymal calcific nodules - 
starry sky 
Gyral pattern TRAM TRACK -
A

Periventricular Ca - CMV
diffuse nodular TOXOPlasmosis
bracket calcification - corpus callosum lipoma
subependymal calcific nodules - tuberous sclerosis
starry sky NCC
Gyral pattern TRAM TRACK - struge weber

225
Q

mc brain tumor

A

mets

226
Q

mc primary brain tumor q

A

meningioma

227
Q

mc primary intraparenchymal

A

glioma
astrocytoma
GBM

228
Q

intra axial brain tumor

A

oligodendro
GBM
Mets

229
Q

extra axial brain tumor

A

meningioma
shwannoma
mets

230
Q

mc intraparenchymal to show calcification

A

craniopharyngioma

mc SUPRAsellar

231
Q

mc intraparenchymal to show calcifi

A

oligodendroglioma

232
Q

mc brain tumor showing necrosis

mc crossing midline (buttergly glioma)

A

GBM

233
Q

mc tumor of pineal gland

A

germinoma

234
Q

MRI tumor originating from meninges DURAL TAIL sign

A

meningioma

235
Q

tumor blush on angio

A

meningioma

236
Q

pineal gland location

A

post - sup to brainstem

237
Q

micro and macro adenoma of pituitary

A

micro <1cm

macro >1cm

238
Q

sellar + supra +Ca

A

craniopharyngioma

239
Q

mc infratent primary tumor children

A

vermis - medulloblastoma

240
Q

mc 2nary infratent in adults

A

mets

241
Q

lat extn from midline vermis

A

ependymoma

242
Q

midline solid tumor cerebellar peds

A

medulloblastoma

ependymoma

243
Q

cystic lat to midline cerebellar in peds

A

pilocytic astrocytoma
cerebellar hemangioblastoma
SAME ON T1W

244
Q

VHL

A

cerebellar hemangioblastoma

245
Q

ice cream cone

A

vest shwannoma CP angle tumor

BL on NF 2

246
Q

fever + neck rididity

A

meningitis

LEPTOMENINGEAL ENHANCEMENT

247
Q

only neck stiffness

A

meningismus

SAH

248
Q

fever + convulsions + alt sensorium (parenchymal#)

A

encephalitis

249
Q

best way to dx meningitis

A

LP CSF examn

250
Q

ENCEPHALITIS

  • brainstem and thalamus
  • fronto temporal lobes
A
  • JE

- HSV type 1

251
Q

neurotropic viruses

A
  • HIV enceph

- PML

252
Q

HIV
dementia
forgetfullness
cognitive impairment

A

HIV encephalitis

ADC

253
Q

JC virus

focal deficits MONOPARSIS

A

PML

254
Q

triad of TB meningitis

A
  • basal exudates BASAL MENINGITIS
  • hydrocephalus
  • vasculitis infarcts
255
Q

BASAL MENINGITIS

A
  • TB
  • syphillis
  • crytococcal meningitis India ink stain + HIV+ve
256
Q

prominent virchow robin spaces (vascular)
cryptococci in brain
SOAP BUBBLE

A

Cryptococcal MRI

257
Q

on MRI

  • asymm SUBCORTICAL white matter involvement
  • symm DEEP white matter involvement
A
  • JCV

- HIV

258
Q

lemon sign

A

lumbar meningomyelocoele

259
Q

banana sign

A

Arnold chiari 2

260
Q

geographic lesion + bevelled edges

A

eosinophilic granuloma

LCH

261
Q

silver or copper beaten skull

A

raised ICT

262
Q

pepper pot skull

A

hyper PTH

263
Q

MRI eye of tiger

A

heller vorden spatz disease

264
Q

MRI

face of panda

A

wilsons

265
Q

Ga scan Panda sign

A

sarcoidosis

266
Q

hot cross bun

A

MSA

cerebellar type

267
Q
  • molar tooth ap

- bat wing

A

Jouberts

268
Q

dawson finger ap

A

MS

269
Q

mount fugi

A

tension pneumocephalus

270
Q

box car ventricle

A

huntingtons

271
Q

ice cream
triangle
dural tail

A

ice cream ACOUSTIC NEUROMA
triangle LST
dural tail MENINGIOMA

272
Q

bag of worms

A

AV malformation

273
Q

tigroid patten

skin of tiger ap

A

1st Metachromatic keucodystrophy

2nd pelzius mers becker dis

274
Q

spine #

A

defines wrt PROXImal seg unlike all other # in body

eg. spondylolisthesis

275
Q

frontal x ray spine ?

A

cervical rib

276
Q

not seen in waters view

A

POST ETHM sinus

2nd sphenoid

277
Q

IOC for PNS #

A

CT PNS coronal plane

  • air fluid level acute sinusistis
  • thickening - chronic
278
Q

hyperdense content of sinusitis

A

fungus ball
DOUBLE DENSITY SIGN
heavy metals

279
Q

mammo

30y —-> 60y

A

dense parenchyma
heterogenous
scatteref fibroglandular
fat

280
Q

benign on mammo

A

well defines
wide
no Bx

281
Q

malig on mammo

A

ill defined
taller
Bx

282
Q

linguinine wavy line on mr angio

A

rupture of intracapsular breast implant

283
Q

CXR erect?

A

sup fundic bubble

PA view

284
Q

if ant end of >5ribs cross diaph then ____ phase

A

inspiratory

285
Q

clavicle oevrlies lung fields
T1 IVERTED V
high FFD
less magnification

A

PA view

286
Q

clavicle free of lunf fields
transverse spino laminar line
inc OBJECT-FOCUS distance
MAGNIFIED

A

AP view
app cardiomegaly
a/b x 100 = CT ratio
>50% cardiomegaly

287
Q

rotated film

A

spoino clav dist

288
Q

TOF apex?

A

RV apex

289
Q

base of heart

A

LA > RA

290
Q

if 2 strs of same density are touching each other ANAT CONTACT their intervening border not seen

A

silhoutte sign

  • arch of aorta
  • descending aorta
291
Q

blunting of cp angle

A

150-200 ml fluid in pleural effusion

292
Q

air + vascular markings

air + no vas markingings

A 
normal 
PENUMOTHORAX
- simple - no shift
- tension - TRACHAe and diaph shift 
- hyrdothorax AIR FLUID LEVEL
293
Q

more lucent and deep CP angle in supine xray

A

deep sulcus sign

294
Q

loss of sliding pleural sign or stratosphere sign

A

ICU DX of pneumothorax

295
Q

air fluid level

  • parenchyma
  • pleura
A
  • parenchyma LUNG ABSCESS

- pleura HYDROPNEUMOTHORAX

296
Q

focal oligemia in PE

A

westermark sign

297
Q

vessel and mus SAME COLOR

vessel&raquo_space; ms WHITER

A

no contrast

CECT

298
Q

suppen dyspnea

A 
CXR 
- ro pneumothorax 
PALLAS SIGN
WESTERMARK SIGN -most characteristic 
HAMPTONS HUMP 
S1Q3T3
299
Q

Low probab of PE

A

r/o by screening for d dimer

300
Q

high prob PE

A 
trauma 
prolonged immobility 
preg 
ocp
hypercoag 
IOC - CT pul angio
301
Q

mc vessel in hemoptypsis

A

bronchial a
embolise with PV alcohol particles
NEVER GEL FOAM

302
Q 
MRI
CT
USG 
Fluroscopy
X ray
A

inc order of resolution

303
Q

positive contrast

A

white tissue and black background

304
Q

negative contrast

A

black tissue against white background

  • air
  • water
  • mannitol
305
Q

MR contrasts

A

Gd mc
given iv —> ECF and excreted via kidney
post contrast always T1 MRI

306
Q

no given to each tissue depending on deg of attenuation of xray by that tissue

A

HU

307
Q 
\+1000
\+100
0
-100
-1000
A 
metal coin
\+1000 CORTICAL BONE 
\+100 acute hematoma 
0 water
-100 fat 
-1000 air
308
Q

pt should hold still (hold breath) in seq or conventional CT except

A

ILD
normal = 0.1mm
ILD = 0.3/0.4 mm

309
Q

principle of hrct

A
  • thin slice thickness (beam collimation)
  • uses narrow field of view
  • uses bone algorithim for image recon
310
Q

hrct uses

A
  • ild
  • bronchiectasis
  • miliary tb
  • ent
311
Q

multiplanar ct

A

spiral ct

SLIP RING TECH

312
Q

width of detector determines the slice thickness

A 
MDCT 
latest 
- angiography
- phasic scans 
- ecg gating
313
Q

IOC PE

A

CT pul angio MDCT

gold - catheter angio

314
Q

ddx solid lesion in liver

A
  • hcc
  • hemangioma
  • mets
  • hep adenoma (ocp and steroids)
315
Q

HCC phasic scan

A

DUAL in HCC

  • inc HA
  • low PV
316
Q

normal liver phasic scan

A

triphasic scan

  • inc PV
  • dec HA
317
Q

HIGHLY SPECIFIC for HCC

A
  • # arterial enhancement and PV washout in HCC

- #peri nodular enhancement in arterial phase with centripetal filling is hep angioma

318
Q

T coronary angio
64 slice min
70-72bpm

A

ecg gating

preRx with BB

319
Q

dual source CT

A

always MDCT

  • renal stones characterisn
  • hear scan at any rate
320
Q

hardest stone in kidney

A

cystiene
brushcite
caoh.h20

321
Q

IOC

  • Dx renal stone
  • charactersn of renal
A
  • Dx renal stone NCCT

- charactersn of renal stone dual source CT

322
Q

NCCT

A
  • Acute hemorrhages
  • stroke in elderly
  • cortical bone
  • calculi calcifn
  • air
323
Q

CECT

A
  • staging
  • LN
  • infection, inflamm, deep abscess
  • trauma (NOT UNSTABLE or HEAD TRAUMA)
  • CT angio
324
Q

IOC Dx SAH

A

angiography

325
Q

MRI disovery

invented

A

edward prusell

lauterbery and mansfield

326
Q

faraday cage

A

made of Cu to block earths mag field with MRI scanner

327
Q

reason for MRI image formn

A

relaxation time

  • main magnets
  • rf coil
328
Q

in mri all path have

A

inc h2o

inc T1 and T2 relaxn time

329
Q

T1

T2

A

1 - Longi

2- transverse

330
Q

normal whiteon T2

A

csf
bile
urine

331
Q

brain T1
grey matter
white matter

A

grey matter - grey

white matter - white

332
Q

brain T 2
grey matter
white matter

A

grey matter - white

white matter - gery

333
Q

T1 hyper

A 
fat 
blood prod
proteinaceous subs 
melanin
paramag Gd
334
Q

T1/2 Hypo both black

A

DRY tissues

  • cortical bone
  • air
  • bloof FLWOING
  • Ca
  • lig, tendon and dense fibrous
  • hemosiderin
335
Q

C/I MRI

A 
free lying body Ferromag (eye or bullet)
NOT ORTHO IMPLANT 
cardiac pacemaker
aneurysmal clip 
cochlear implant 
met cardiac valves 
DBS
336
Q

relative CI MRI

A
  • claustrophobia

- T1 preg

337
Q

uses of mri

A 
Nervous tissue (pancoast) 
bm, medulla, cancellous 
intraos extent of skeletal tumor 
stress # 
OM 
AVN earliest 
inflamm condn MARROW EDEMA eg. AS
osteochondritis dessicans 
lig, tenson, dense fibrous tissue
338
Q

ct>mri

A

block vertebrae

339
Q

bright lesion on T2W with imperceptable wall

A

simple renal cyst

340
Q

Gd BBB?

A
  • doesnt cross BBB
    ENHANCEMENT OF LEPTOMENINGEAL sign of meningitis
  • CI preg
  • CI lactation
341
Q

se of Gd

A

nephrogenic systemic fibrosis FATAL
scleroderma like illness
GFR < 30ml

342
Q

Gd excreted via liver?

A

gadoxetic acid

gadobenate dimeglomine

343
Q

levovist

sonoview

A

USG contrast

  • gas flled microbubbles iv
  • inc echogenicity
  • prop to vascularity
  • SAFE IN CKD
344
Q

usg constrast use

A

diff solid from solid in liver focal lesion

345
Q

I2 contrast

A 
X rays 
IONIC 2
- monomer 
- dimer
NON IONIC 1
- monomer 
- dimer
346
Q

ionic monomer

A 
3:2 
1600 Osm HIGHEST 
- urograffin
- gastrograffin 
- diatrizoate
347
Q

ionic dimer

A

6:2
800 Osm
low osm IOXAGLATE

348
Q

non ionic monomer

A 
3:1 
low osm 
800 osm 
- iohexol OMNIPAQUE
- iopalmidol
349
Q

non ionic dimer

A

6:1
ISO osmolar 290-310
IODIXANOL (VISIPAQUE)

350
Q

ionic —-> non ionic

  • purpose
  • cost
  • SE
A
  • purpose RESOLN DEC
  • cost COST INC
  • SE DEC
351
Q

SE of ionic contrast

A
  • anaphylaxis (lactoid reacn Non IgE)
  • cin (RFT!!!)
  • MM
352
Q

deterioratn of liver func <48-72 h of contrast admin in asence of any other patho

A 
CIN 
contrast induced neohropathy 
- pre exist renal #
- kidney exc 
- osm of contrast
353
Q

RFT deranged

  • normal
  • mild
  • gross
A

mild - NID non ionic dimer

gross - NO DYE

354
Q

prevent CIN

A 
- adeq fluids 
use of ISO osm 
- SOD BICARB DOC 
no use of mannitol / diuretics 
- theophylline helpful and ascorbate useful 
HEMOFILTRN HELPS no use of hemodialysis
355
Q

CI baso4

A
  • SI obs (I2 monomer )

- intest perf (same)

356
Q

TEF contrast?

A

due to ARDS ionic mono CI they cause pul edema. Use non ionic instead

357
Q

myelography

A

NON ionic contrast

due to risk of arachnoiditis

358
Q

NON renal indicaton of non ionic contrast

A
  • TEF

- Myelography

359
Q

loss of post pit bright spot

A

central DI

360
Q

younger age
post fossa small
tonsilar henation
lumbar meingomyelocoele

A

Arnorld chiari 2

361
Q

elder
large post fosaa
no tonsilar hernia
cystic post fossa

A

dandy walker

362
Q

pre pontine cistern

A

basilar a

363
Q

fever
convulsion
vomiting

A

JE

thalamus #

364
Q

x ray tube setting

MADE OF PYREX in VACUUM

A

cathode (-ve) gets heated via electricity
releases electrons THERMIONIC EMMISION
reaches anode

365
Q

Target window

A

THINNED out pyrex
allows xray to come out
INHERENT FILTER for tube

366
Q

order of x ray tube

A

x ray tube
collimater
patient
casette

367
Q

neg electrode
most imp - FILAMENT made of
THUNGSTEN
generats e- by heating to >2000deg

A

cathode
very high MP
add THORIUM for stability

368
Q

+vely charged electrode
recieves e-
generates x rays
TARGET = THUNGSTEN

A

ANODE

369
Q

Beta rays strike anode at speen of?

A

c/2

370
Q

interaction with

  • NULEUS
  • orbital shell
A
  • NULEUS BREMSTRAUNG
  • orbital shell CHARACTERISTIC
    both resp for XRAYS
371
Q

knock off e- from k shell

A

bremhstaulung

MOST IMP FOR XRAYS IN ALL except mammo

372
Q

e- bends and loses energy and releases photons as x rays

A

CHARACTERISTIC

mammography +

373
Q

e- goes to anode and produces x rays

A

moa
e- 99%
x rays 1%
HIGHLY INEFFICIENT

374
Q

methods of heat loss

  • conventional
  • modern
A
  • dissipation by CONDUCTION of heat
  • rotating target:
    1. conductn
    2. convection (oil bath)
    3. radiatn
375
Q

high energy x arys

low energy x rays

A

high - FORMS IMAGE + radiatn to pt

low - onyl radiatn to patient ( removed by filter)

376
Q

FILTER

A
  • doesnt afect image quality
  • dec dose of radiatn to patient
    ALUMINUIM
377
Q

COLLIMATER

A

beam restrictor
DEC SCATTER
gives direction to beam
MADE OF LEAD

378
Q

CASETTE vs GRID

A

grid not a part of casette

  • not compulsory to use grid
  • made of parallel lead strips
379
Q

fILM

A

made of AgBr in casette

380
Q

GRID

A
  • prevents scatter from reaching film
  • improves sharpness
  • inc dose od rad to pt
381
Q 
prop to voltage 
V=E
E= penetration 
prop to WHITE on xray 
invesely to CONTRAST
A

KVP

382
Q 
current x exposure time 
no effect on energy 
no effect on penetration 
= photons per unit area 
= background blackness (film density)
= contrast
A

MAS

383
Q

COntrast depends on

A

noth kvp and mas
tube current
ex time

384
Q

contrast predom depends on

A

KVP (image > background)

385
Q

mod in heavy built

A

kvp

386
Q

imp contrast in heavily built

A

mas

387
Q

caTHode

A

Thorium

388
Q

Anode to inc tensile strength

A

Rhenium

389
Q

Mammo

A

Molybdenum

390
Q

mammo tube vs others

A
  • v high contrast (low kvp high mas)
  • low energy
  • high amperage
391
Q

mammo target

A

Mb

others - Thungsten

392
Q

mammo target window

A

Berrylium

others - thinnned glass

393
Q

mammo filter

A

Mb

others elements

394
Q

views in mammo

total4

A

CC

MLO (better) more breast tissue axillary tail

395
Q

benign on mammo

A

well defined
encapsulated
macrocalcification
POPCORN FADENOMA

396
Q

Malig on mammo

A
  • spiculated
  • articular distortn
  • microcalc (>5 foci, <0.5mm in 1com2)
  • loss of retromammary space
397
Q

popcorn

  • cxr
  • mri
  • hand x ray
A
  • cxr HAMARTOMA
  • mri CAV ANGIOMA
  • hand x ray ENCHONDROMA / CS
398
Q

screenig for breast ca age

A

40 y no risk factor

risk = 30y

399
Q

mammo screen

  • <30
  • 30-40
  • > 40
A
  • <30 MRI (angiogenic activity )
  • 30-40 MRI + mammo
  • > 40 mammo
400
Q

lump

A

< 30 - usg solid/cyst?

>30y - mammo benign/malig?

401
Q 
age irrelevant 
preg
breast abscess 
breast implant 
prev sx 
best
A 
preg USG
breast abscess USG 
breast implant MRI
prev sx MRI
best Bx
402
Q

RADS

A 
0- incomplete
1 normal 
2 - normal CRS 
3 prob benign SHORT follow up 
4 sus malig Bx
5 highly sus Bx 
6 Bx proven Ca
403
Q

non palpable

palpable

A

non - steriotactic B x

palpable - Sx bx

404
Q

dynamic contrast curve
type 1
2
3

A

1- linear normal
2 - plateau indeterminate
3 - WASHOUT MALIG

405
Q

FFD

  • radio
  • cxr
A

radio - 100m

cxr - 180m

406
Q

inc FFD

A

small image size

PA cxr

407
Q

supine cxr

A

non ambulatory
sick
c spine #
peds

408
Q

left lat decubitus

A

min pleural effusion
10 ml seen
erect - 100m

409
Q

single coated MORE HARM

dounle coated LESS

A

ALL HIGH END single coated

410
Q

double coated

A

conventional radio

DENTAL

411
Q 
non ionising 
non invasive 
easily available 
cost effective 
real time 
posrtable
A

USG

operator dep

412
Q

ioc aortic dis

A

tee

stable - ct

413
Q

round probe DEEP

flat probe SUP

A

2-7

7-15 MHz

414
Q

principle of usg

A

PZT
Pb , Zirconium, Ti
piezoelectric

415
Q

usg tvs vs tas

A

depth comes at cost of resolution in usg

416
Q

prostate usg

A

PR>PA

417
Q

most sens inv see layers of git till date

A

EUS

luminal + extraluminal or intramural prob

418
Q

EUS 5 layers

A

useful for T staging

  • mucosa
  • mus mucosa BLACK
  • submucosa
  • muscularis BLACK
  • serosa
419
Q

T staging
breast
bladder

A

breast MRI

bladder MRI

420
Q

hyperecho on usg

A

air
fat
calculus

421
Q

whnever calculus comes in path theres complete refln and shadow seen post

A

acoustic shadow
- cal
- bone
+- air

422
Q

acoustic enhancement

A
  • cyst
  • fluid
    NEVER SOLID
    NO EXCEPTION TO THIS RULE
423
Q

TEE

  • ant
  • post
A
  • ant LA enlargement

- post DESC AORTA dysphagia lusoria

424
Q

COMET TAIL

  • usg
  • ct lung
A

usg - adenomyomatosis of GB

ct - round atelactesis asbestosis

425
Q

most sens to locate nodule in pancreas

A

endo US

426
Q

doppler

A

presence or absence
direction of flow
vel
pattern

427
Q

POWER DOPPLER

A

extremely slow flow of blood

428
Q

vessel transducer angle

A

cos theta

optimal <60 deg

429
Q

pattern of flow

  • peri a
  • visceral a
  • vein
A
  • peri a TRIPHASIC +-+
  • visceral a MONOPHASIC W PULSATION
  • vein MONOPHASIC WO PULSATION
430
Q

peri a doppler

SPECTRAL WAVEFORM

A

systole
diastole
PR
all a of appendicular skeleton

431
Q

visceral a doppler

= peri a if vasodilated

A

hepatic
splenic
renal a
umbilical a

432
Q

hepatic vein
IJV
SVC IVC

A

triphasic

valveless

433
Q

elastography

A

hyperechoic
- mc fatty liver
- early cirrhosis
METAVIRS SCORE fibroscan

434
Q

harms in usg

A

acoustic cavitation

HIFU - Rx fibroid

435
Q 
tissue harmonic imaging 
cound imaging 
extended field of vision 
time sector scan 
abd steth
A

usg

436
Q

normal in lungs

A

sliding pleura sign

lost in pneumo

437
Q

USG ‘
B mode
M mode

A

B - sliding pleura

M - sea shore Normal, pneumo - stratosphere sign

438
Q

ioc gb stones

A

usg

439
Q

retroperi ioc?

A

CT

440
Q

pre req for usg

  • full bladder
  • empty stomach
  • drink water
A
  • push ileal loops up
  • see gb stones
  • just before to see pancreas and >1h to see bladder
441
Q

IOC locasie intra abd testis

A

lap fb MR

442
Q

mc se of rad

A

skin erythema
fatigue mc
PSSC

443
Q

Deterministic

A 
DOSE dep 
Dose threshold exist 
Dose rel severity 
- cataract 
- infertility 
- alopecia
444
Q

Scholastic se

A

CHANCE PROBABILITY

  • cancer
  • genetic se
  • terato
445
Q

ALARA

10 day rule

A

patient precausiton
- 50msev/y
preg - 5/term

446
Q

operator

  • > 100 msev / 5y
    • 30msev /y
A

time
dist
shielding
TLD

447
Q

gen public

A

<1msev/y

448
Q

exposure

A

SI C/kg

conventional - roentgen

449
Q

absorption

A

SI Gray

Conventional - Rads

450
Q

Equivalent

A

SI Sievert

Conventional - Rem

Last Leg (9 decks)

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