Certifying BV Flashcards
1
Q
what is the increased risk of breast cancer with dense breasts?
A
4.7 fold increased risk
2
Q
What is the specificity of a type 3 curve for breast ca?
A
90%
3
Q
by what percent does tomo reduce the false positive callback rate?
A
6-67%
4
Q
What are risk factors for male breast cancer?
A
BRCA 1/2, age, exposure to XRT young, cryptorchidism, testicular injury, Klinefelters, liver dysfunction
5
Q
what is the most chemosensitive ovarian tumor?
A
serous ca
6
Q
what is ulnar negative variance associated with? ulnar positive?
A
negative is associated with Kienbock (lunate osteonecrosis), positive is associated with ulnar impaction syndrome
7
Q
what is a case control study?
A
retrospective, looking at cases vs controls. good at finding the odds ratio.
8
Q
what is a cohort study?
A
retro or prospective, follows subjects over a period of time
9
Q
who makes the universal protocol rule?
A
Joint commission
10
Q
what are the US features of Hasimotos?
A
“white knight”, normal or big gland, hyper vascular, low T4 and T3
11
Q
who made measures “never” or “sentinel” events?
A
national quality forum and joint commission
12
Q
what are the US features of subacute thyroiditis?
A
enlarged thyroid and focal hypo echoic area with normal or decreased blood flow
13
Q
what does the double PCL sign mean?
A
bucket handle tear of meniscus with an intact ACL
14
Q
what are the three types of dens fractures?
A
Type 1: tip of dens, stable, Type 2: base of dens, unstable, Type 3: through odontoid into lateral masses -> best prognosis
15
Q
what tendon does avulsion fx of olecranon affect?
A
triceps tendon -> inserts at posterior proximal ulna - treatt with surgical management tension band technique
16
Q
what is the difference between homolateral and divergent lisfranc fracture?
A
homolateral: 1st MTP statys congruent with medial cuneiform, divergent: medial displacement of 1st metatarsal. 2nd through 5th MT always go laterally
17
Q
what is LIP associated with and what are the findings?
A
Sjogrens and AIDS, see pulmonary nodules and cysts
18
Q
what is UIP associated with and what are the findings?
A
RA. see honeycombing, GGO, bronchiectasis, basilar predominant
19
Q
what is the most common cause of spontaneous peri renal bleed?
A
AML
20
Q
what are the nucs findings of GB dyskinesia? how is it difference from chronic cholecystitis?
A
see prompt uptake of tracer -> give CCK and GB does empty but it is less than normal (GBEF less than 35%) in chronic cholecystitis there is no GB uptake of tracer
21
Q
what is the definition of standard communication?
A
written reports
22
Q
what is the management of simple ovarian cysts in pre vs post menopausal women?
A
pre: less than 5 cm no follow up - 5 to 7 cm is annual follow up, more than 7 cm is MRI or surgery. post menopausal less than 1 cm no follow up, 5-7 cm is annual follow up, more than 7 cm is MRI or surgery
23
Q
what are the US findings of thyroid colloid vs micro calcifications?
A
colloid: comet tail artifact, microcalcs: no comet tail
24
Q
what is the diagnosis of bilateral BG enlargement with edema?
A
hypoxic ischemic encephalopathy (restricts on DWI and see low ADC)
25
What are the euro findings in MRI of hepatic cirrhosis?
increased T1 signal in BG - also seen in manganese poisoning
26
what is a check sheet?
counts different types of defects
27
what are the indirect signs of aortic injury (i.e. seen on CXR)
mediastinal fat stranding,
28
what is the most common location for a sinonasal mucocele? least common?
frontal sinus is most common, sphenoid sinus is least common
29
what is the most common cause of pleural carcinomatosis in a middle age female?
breast cancer
30
what is the 24 hour uptake of I123 in Graves?
Graves: 40-70%
31
which has more problems bilateral left sidedness or bilateral right sidedness?
bilateral right sidedness (no spleen, duplicated IVC, 3 fissures in both lungs, etc)
32
what effect does SLE have on the heart?
pericardial effusion
33
what are the neuro findings of storage weber
ipsi cortical volume loss, frontal hyperostosis, pial angiomatosis
34
what is rasmussen encephalitis?
chronic encephalitis of one cerebral hemisphere
35
what is dyke davidoff
unilareal cerebral hemiatrophy with thick ipsilateral calvarium and increased air in paranasal sinuses and mastoid air cells
36
what is contrast induced nephropathy defined as?
absolute increase in creatinine of 0.5 mg/dl or 25% increase from baseline 2 to 3 days after getting contrast
37
how do you distinguish between schizzencephlay and porencephaly?
schizzencephaly is lined by gray matter
38
what are the differeny types of holoprosencephaly
alobar, semilobar, lobar. alobar is the worst with a single ventricle, semi lobar has separation of the temporal lobes and lobar has separation of the posterior structures and the splenium of the CC is present. there is NO FALX in any of them.
39
what is scimitar syndrome
scimitar: small right lung, right inferior pulmonary vein drains into the IVC, systemic arterial supply to the right lower lobe
40
what is the drainage in extra lobar vs intralobar sequestration
extralobar: own pleural covering, systemic arterial supply and systemic venous drainage, intralobar is fed by a systemic artery but has pulmonary venous drainage
41
what are the features of pulmonary contusion and when is it seen on CXR vs CT
GGO with sub pleural sparing, seen right after injury on CT, seen after 6 hours on CXR. always develops within 24 hours of injury.
42
what are the MRI features of an endometrioma? what can it progress to?
T2 shading, can progress to clear cell or endometroid cancer
43
what is the ideal hepatic vein pressure gradient after TIPS?
less than 12 mm Hg
44
what is joubert syndrome
abnormal cerebellar vermis, with no decussation of midbrain tracts leading to molar tooth appearance of the midbrain and bat wing like fourth ventricle shape.
45
what are the findings in dandy walker?
vermian agenesis, large/cystic 4th ventricle, torcular lambdoid inversion
46
what is rhomboencephalosynapsis?
fusion of the cerebellar hemispheres, with no midline vermis
47
what are the findings in barrettes esophagus
hiatal hernia with mid esophageal stricture
48
what are the findings in lye ingestion
long segment stricture with pseudodiverticula
49
what are the organisms responsible for emphysematous cholecystitis? is it more common in men or women? what are the physical signs?
clostidium and e coli, more common in men. there is no sonographic murphy sign bc of denervation of the GB wall.
50
which is worse emphysematous pyelonephritis or pyelitis?
pyelonephritis
51
from what age and what size range do the fleshier criteria apply?
above 35 and for nodules up to 8 mm.
52
what are the MRI vs CT imaging features of adrenal myelolipoma?
it has macroscopic fat so will not show signal drop out on OOP but will show drop out on fat sat CT images.
53
how do you characterize an adrenal adenoma?
less than 10 HU on non contrast study, more than 60% absolute washout or more than 40% relative washout. also can be defined when there is signal loss on OOP imaging (intracytoplasmic lipid)
54
what is the prognosis for kidneys vs liver in ADPKD?
renal failure almost always occurs but liver failure does not occur regardless of liver involvement by cysts and enlarged liver
55
what is the Rx for autoimmune pancreatitis? what is the serological marker?
steroids (very responsive), IgG4
56
what is the management for choroid plexus cysts?
do nothing - reassure that it is an incidental finding. should go away by 32 weeks. in cases of advanced maternal age it can be associated with trisomy 18.
57
what is the most common aortic arch anomaly and what else it is associated with>
left arch with aberrant right subclavian, associated with absence of the left recurrent laryngeal nerve
58
what is the hypo perfusion complex?
small IVC and aorta, dilated fluid filled bowel with hyper enhancing mucosa, dense nephrogram,
59
what are the HU units of a benign renal cyst?
less than 10 HU on non contrast
60
how do you measure an AAA?
outer wall to outer wall
61
what percent of patients with AAA have iliac aneurysms? what is the incidence of AAA in a first degree relative?
10-15% have iliac aneurysms. incidence of AAA is 20% in a first degree relative.
62
at what size do you recommend FNA of a thyroid nodule with micro calcifications?
1.0 with micro calcifications, 1.5 if coarse calcifications
63
where do you see diaphragmatic attenuation artifact?
inferior wall (RCA territory)
64
in what lung cancer is cavitation most common?
squamous cell
65
what is the blood supply to the descending colon? to the cecum?
IMA, cecum is iliocolic artery from the SMA
66
what is the cutoff for endometrial thickness in a post menopausal female without bleeding? with bleeding?
without bleeding is 8 mm, with bleeding is 5 mm.
67
what is the most common cause for pneumoperitoneum in a young patient without history of surgery?
duodenal ulcer
68
what is seen in olliers disease? what can it progress to?
multiple enchondromas can progress to chondrosarcoma
69
what is the best initial test for new onset seizure?
MRI brain with and without contrast
70
what is lateral epicondylitis?
tendinosis of extensor carpi radials brevis - see high signal on MRI along the lateral compartment, aka tennis elbow
71
what is the ABI at which peripheral arterial disease is diagnosed?
if less than 0.9. 0.9-1.1 is normal. 0.8-0.9 is mild, 0.5-0.8 is moderate, 0.3 or less is severe.
72
what are the measurements used for pyloric stenosis?
4 mm transverse, 14 in length
73
what is the size of a mega cava? what filter should be placed?
28 mm or more. place birds nest filter or two common iliac filters
74
what are the environmental risk factors for pancreatic ca?
smoking, obesity, diets rich in animal fat and protein. alcohol is NOT a strong RF for pancreatic ca.
75
which side should you place a patient for renal biopsy?
ipsilateral side down (right renal mass - place patient right lateral decubitus)
76
where does a bakers cyst form?
between the medial head of the gastrocnemius and the semimebranosus
77
what goes thru foramen ovale?
V3 and accessory meningeal artery
78
what goes thru foramen rotundum?
V2 (R2V2)
79
what goes through foramen spinosum?
middle meningeal artery
80
what goes through the superior orbital fissure?
V1, CN 3,4,6
81
what goes through the inferior orbital fissure?
V2
82
what goes through the optic canal?
CN2 and ophthalmic artery
83
what runs through the cavernous sinus?
CN 3,4,V1, V2 and CN6 and the carotid artery. CN2 and V3 do NOT go through it.
84
what are the MR findings of PRES?
high T2 and FLAIR in the parietal and occipital lobes, with NO restriction
85
what are the findings of wernicke encephalopathy?
enhancement f the mammilary bodes and high T2 in the medial thalamus and periaqueductal gray
86
what are the findings of marchava bignami?
high T2/FLAIR in the CC
87
what are the findings of CO poisoning?
CT low and T2 bright globus pallidus
88
what is always preserved on FDG PET in dementia?
motor strip
89
what are the FDG findings of AD dementia?
temporal horn atrophy and low FDG PET in the posterior temporoparietal lobe
90
what are the FDG PET findings of lewy body dementia?
low activity in the lateral occipital lobes
91
what are the FDG findings in Huntingtons?
low activity in the caudate and putamen
92
what is the difference in MRI findings of HIV encephalitis vs PML?
HIV encephalitis: CD4 less than 200, T1 normal, symmetric T2 bright in deep white matter, sparing the U fibers. PML: CD4 less than 50, T1 LOW, asymmetric high T2 with U fibers
93
what is the most common opportunistic infection in AIDS in the brain? most common fungal brain infection?
toxo, crypto. Toxo: bright T2 ring enhancing lesions with lots of edema, NOT restricting on diffusion, thallium cold.
94
what are the differences between too and lymphoma in the brain?
Toxo: Thallium cold, PET cold, decreased CBV, elevated lipid peak. Lymphoma: Thallium hot, PET hot, variable CBV, elevated choline peak, hyper dense on CT
95
what is the best sequence for HSV1 in the brain. what part of the brain does HSV 1 spare?
DWI - earliest sign is restricted diffusion in the temporal lobe. HSV 1 spares the basal ganglia
96
what is limbic encephalitis? what does it look like?
encephalitis due to small cell lung cancer. looks like HSV1.
97
what are the findings of CJD?
cortical gyro restricted diffusion and in the medial thalamus (hockey stick sign).
98
what is the most common cause of a subdural empyema?
frontal sinusitis
99
what is a favorable gene in oligodendroglioma?
1p 19q deletion
100
what are the hyper vascular mets?
MRCT: melanoma, renal cell, chorioca/carcinoid, thyroid
101
what are the FDG findings of round atelectasis?
not FDG avid
102
what is the most common finding of asbestos exposure? what percent has pleural effusions?
pleural plaques. 20% have pleural effusions.
103
what is haglund deformity?
insertional achilles tendinosis, retrocalcaneal bursitis, superficial retro achilles burisits
104
what makes pancreatic ca unresectable? what vascular involvement makes it still resectable?
more than 25% involvement of hepatic artery, celiac axis or SMA makes it un resectable. If portal vein or SMV is involved, it is still resectable.
105
what is mucoepidermoid tumor?
salivary gland tumor that can arise in bronchi, 50% calcify, are well rounded like bronchial carcinoid
106
what is a pulmonary sling? what is the most common vascular ring?
left PA from right PA - goes between the T and E and is not a true ring. most common vascular ring is double aortic arch
107
what is may turner syndrome
iliofemoral thrombosis secondary to compression of left common iliac vein by right common iliac artery
108
what are the indications for drain removal of an abcess? what should you do if output suddenly goes down within a 24 hours period?
less than 10 mL output in 24 hours, resolution of WBC and fevers. if output suddenly decreased, flush with 3-5mL saline.
109
what is pseudo obstruction on MRCP?
pulsation artifact in the extra hepatic bile duct caused by right hepatic artery coursing between common hepatic duct and portal vein
110
what is the most common organism isolated from brain abcess?
streptococci
111
what is pelvic congestion syndrome and what is the treatment?
engorged adnexal veins and collaterals - treatment is gonadal vein embolization
112
what is the time period for diagnosing post thrombotic syndrome after treatment with anticoagulation for a DVT?
diagnose after 3-6 months
113
what is pseudomyxoma peritonea?
gelatinous ascites due to ruptured mucinous tumor
114
what is budd chair syndrome and what are the causes?
hepatic vein obstruction due to idiopathic, sepsis, trauma, pregnancy, hypercoaguable state leading to venous thrombosis
115
at what size is a pulmonary nodule much more likely to be malignant? at what size is it considered definitely malignant?
8 mm, 3 cm
116
what is the grading of ICA stenosis in terms of PSV?
PSV < 125 cm/s: less than 50% stenosis. PSV 125-229 cm/s: 50-69% stenosis. PSV>230 cm/s: more than 70% stenosis.
117
what is the treatment for autoimmune pancreatitis?
steroids
