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3rd year medicine > CLASP - radiology > Flashcards

CLASP - radiology Flashcards

1
Q
A

3 - CXR (if AP will usually say)

4 - rounded mass extending from left hilum, left heart border visible

5 - left lower lobe (because PA)

6 - lung cancer

7 - biopsy

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2
Q
A

8 - CT

9 - lung mass

10 - left pulmonary artery (hilum)

11 - left pulmonary artery, left atrium, pulmonary veins

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3
Q
A

12 - emphysema (black cystic holes)

13 - liver, brain, bone, andrenal glands

* lymph nodes = hilar, bronchial

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4
Q
A

14 - liver

15 - metastases, dark and round (streaks are thehepatic veins)

16 - 7th and 8th liver segments

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5
Q
A

osteolytic lesion (costal metastases)

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6
Q
A

18 - left and right renal masses

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7
Q
A

19 - CT contrast (remember T1 and T2 is MRI)

20 - mass in RIGHT frontal lobe

21 - right frontal lobe

22 - metastasis

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8
Q

X-ray density of air? fat? soft tissue/muscle? bone? metal?

A

air = black

fat = grey

soft tissue/muscle = grey/white

bone = white

metal = bright white

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9
Q

how is CTR measured?

normal?

A

PA CXR

normal = <50%

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10
Q

how to tell is CXR is adequately inspired?

correctly centred?

A

will be able to see at least 6 ribs

centred = medial ends of clavicles equal distance from spinous processes of vertebrae

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11
Q

borders that should be visible on CXR?

A
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12
Q

contents of lung hila?

which hilum sits higher?

A

contents = pulmonary arteries, pulmonary veins + bronchi

left hilum sits higher than right

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13
Q

are diaphragms normally same height?

A

no - right diaphragm sits 1.5cm above left

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14
Q

review areas on X-ray

A

review areas are often missed - so special attention paid to them

* lung apices e.g. pancoast tumour, pneumothorax

* behind heart e.g. consolidation, masses, hiatus hernia

* below diaphragm e.g. free gas, lines and tubes, bowel obstruction

* bones and soft tissue e.g. fractures, masses, subcutaneous emphysema

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15
Q

lung lobes

A
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16
Q

Ax lobar collapse?

A

obstrcution of lobar bronchus - tumours, aspirated foodstuffs, mucous impaction

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17
Q

left lower lobe collapse

A

sail sign!!

also left hemi-dipahragm higher than right

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18
Q

left upper lobe collapse

A

veil-like heart border

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19
Q

right upper lobe collapse

A

increased desnity + volume loss

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20
Q

right middle lobe collapse

A

loss of right heart border

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21
Q

right lower lobe collapse

A

preservation of heart border

loss of hemi-diaphragm

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22
Q

what is the diagnosis

A

right middle + lower lobe collapse

cant see diaphragm or heart border + volume loss

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23
Q

diagnosis?

A

right middle lobe consolidation

* loss of clarity of right heart border but preservation of right hemi-diaphragm

* follows same pattern of collpase without volume loss

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24
Q
A

left lingular consolidation (part of left upper lobe)

* consolodation of lingula causes left heart border to become obscured

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25
Q
A

left upper lobe consolidation

* volume preserved

* can still see heart border

* loss of clarity of left upper mediastinum

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26
Q
A

pleural effusion - meniscus sign

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27
Q
A

right pneumothorax - cant see lung markings

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28
Q
A

tension pneumothorax - mediastinal shift

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29
Q

diagnosis?

A

heart failure - pulmonary oedema

ABCDE

A - alveolar effusion (batwing opacities)

B - kerley B lines

C - cardiomegaly

D - dilated upper lobe vessles

E - pleural effusion

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30
Q
A

heart failure - pulmonary oedema

* ABCDE

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31
Q

endotracheal tube position?

most common malposition?

A

normal = tip 5cm above carina

malposition = tip extends past carina

most common malposition = tip in right main bronchus

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32
Q

ET tube positioned correctly?

A

no - it is in the right main bronchus

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33
Q

ideal position for nasogastric tube?

malposition examples?

A

ideal position = subdisphragmic, overlying gastric bubble, at least 10cm beyond gastro-oesophageal junction

malposition: remains in oesophagus, bronchus

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34
Q

is NG tube correctly placed?

A

no it’s in right lower lobe bronchus

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35
Q

central venous catheter vs peripheral venous catheter insertion

A

CVC = inserted via right and left internal jugular or subclavian veins

PVC = via cephalic, basilic or brachial veins

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36
Q

position of central venous catheter?

malposition?

A

tip should be in cavoatrial junction

malposition = tip too high (proximal SVC), tip too low (RA or RV)

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37
Q

CVC placed correctly?

A

no it has gone into subclavian vein

should be in cavoatrial junction

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38
Q

Dx?

A

cannon ball metastasis from renal cell cancer

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39
Q

lung cancer staging

A

T - tumour size

N - intrathoracic lymph node

M - metastases

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40
Q

imaging modalities for staging lung cancer

A

contrast enhanced CT

PET CT

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41
Q

Dx?

A

pneumoperitoneum

perforation of GI tract results in gas in the peritoneal cavity

radiograph must be taken in the ERECT position (allows gas to rise up under diaphragm)

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42
Q

first line Ix for pneumoperitoneum?

A

erect CXR

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43
Q
A

1 - CVA, TIA (recovery is quick)

2 - non-contrast CT

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44
Q
A

3 - non-contrast CT

4 - thrombus in right middle cerebral artery

5 - right MCA

6 - ischaemic stroke

7 - age, hypertension, angina, irregular HR

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45
Q
A

8 - thrombolysis

9 - no bleed

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46
Q
A

10 - hypodense region (ischaemia), hypoattenuation

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47
Q
A

11 - haemorrhage

12 - CT without contrast

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48
Q
A

13 - haemorrhage, midline shift

14 - right parietal lobe

15 - haemorrhagic stroke

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49
Q
A

16 - NG tube in correct position

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50
Q
A

17 - gliosis (scarring of brain tissue)

18 - AF

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51
Q

fissures CT brain

A

supracellar = above sella turkica

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52
Q

suprasellar cistern contains?

A

circle of willis

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53
Q

familiarise anatomy MRI

A
54
Q

vascular territories

A
55
Q

circle of willis

A
56
Q

imaging in stroke?

A

non contrast CT scan

57
Q

findings stroke CT?

A
58
Q
A

gliosis

59
Q
A

acute on chronic subdural haematoma

see fluid level

60
Q
A

subarachnoid haemorrhage

can see blood in sulci, suprasellar cistern, sylvian fissures

61
Q
A

left MCA

62
Q

coning?

A

tonsillar herniation

63
Q
A

….

64
Q
A

…

65
Q

spinal cord compression?

Ax?

A

surgical emergency!!

Ax

  • disc prolapse
  • trauma
  • tumour
  • epidural abscess/haematoma
  • spinal meningioma
  • nerve sheath tumour
66
Q

Ix spinal cord compression?

A

MRI spine!!

67
Q

what does this CT show

what should be done now?

A

fracture at L2

MRI must be done to Ix cord compression

68
Q
A

1 - pancreatitis, bowel ischaemia, perforation, ectopic rupture, leaking AAA

2 - ABCDE

3 - erect CXR (perforation)

69
Q
A

8 - acute pancreatitis

9 - USS to check for gallstones

70
Q
A

12 - CT, it shows necrosis of the pancreas

13 - venous thrombosis, ARDS, renal failure, sepsis, abscess

vessles = splenic artery + vein, SMA, hepatic arteries + portal vein

71
Q
A

liver

stomach (fasted)

gallbladder

CBD

pancreatic duct

15 - ECRP (gallstones)

72
Q
A

peri-pancreati fluid compression (can see compressing stomach anteriorly)

Tx = percutaneous drainage

73
Q
A

pancreatic pseudocyst compressing stomach

74
Q
A

NJ tube (not NG)

lies in jejunum

75
Q

acute abdominal pain DDx?

A
76
Q

Dx acute appendicitis?

A

CT and USS

no role for X-ray

77
Q

USS findings acute appendicitis

A

aperistaltic = not moving

78
Q

CT findings acute appendicitis

A
79
Q

gold standard imaging for ureteric stones?

A

non-contrast CT (CT KUB)

80
Q

LIF pain DDx?

A

diverticulitis

colitis

colorectal cancer

tubo-ovarian pathology

renal colic

81
Q

acute diverticulitis s/?

as disease progresses?

A

LIF pain

unremitting pain with associated tenderness

sometimes ill-defined mass

as disease progresses symptoms become more generalised

82
Q

gold standard Ix for acute diverticulitis?

A

CT with IV contrast

83
Q

epipolic appendagitis can mimic?

what is it?

A

can mimic diverticulitis

part of colon is torsioned and infarcts

84
Q

acute cholecystitis Ax?

S/s?

Dx?

A

almost always secondary to gallstone

s/s = RUQ pain, fever, raised WCC and CRP

Dx = USS first line

85
Q

where is gallbladder located?

A

tucked under 5th liver segment

86
Q

2nd line Ix cholecystitis?

findings?

A

2nd line = CT

(1st line USS as CT can miss gallstones)

87
Q
A

….

diagnostic?

88
Q

Tx options acute cholecystitis

A

most common cause is gallstones remember

89
Q

pancreatitis s/s?

Dx?

A

acute onset severe epigastric pain

poorly localised, tender

exacerbated by supine position

radiates to back in 50% of pateints

Dx = serum amylase increased

90
Q

Ix pancreatitis?

Dx?

A

USS + CT are not diagnostic

  • USS is to look for CAUSE i.e. gallstones
  • CT is to look for complications e.g. necrosis, vascular comps

Dx = elevated serum amylase

91
Q

Ix of choice for perforation?

A

erect CXR

92
Q

abdominal pain and distention DDx?

A

bowel obstruction

masses

ascites

93
Q

Ax small bowel obstruction?

Symptoms?

signs?

Ix?

A

Ax = adhesions, cancer, hernia, gallstone ileus

symptoms = vomiting, pain, distention

signs = increased (tinkling) bowel sounds, tenderness, palpable loops

Ix = x-ray, CT (USS has no role)

94
Q

small bowel obstruction x-ray features?

A
95
Q

small bowel obstruction CT features?

A
96
Q
A

small bowel obstruction caused by gallstone ileus

97
Q

large bowel obstruction Ax?

Ix?

A

colorectal cancer (most common)

volvulus

diverticulitis

Ix = x-ray and CT

98
Q

large bowel obstruction features x-ray?

A
99
Q

large bowel obstruction CT features?

A

not great pic but can see pneumotosis coli (blakc dots = gas in wall of caecum)

100
Q

sudden abdominal pain and shock DDx?

A

bowel ischaemia

perforation

pancreatitis

leaking AAA

ruptured ectopic pregnancy

101
Q

Ax bowel ischaemia?

A

arterial occlusion (majority) - SMA, coeliac, IMA

venous occlusion - hepatic portal vein, IMV, SMV, splenic vein

non-occlusive hypoperfusion

102
Q

bowel ischaemia symptoms?

signs?

A

symptoms = severe abdominal pain, vomiting, diarrhoea

signs = raised WCC, metabolic acidosis, borderline amylase

103
Q

Dx bowel ischaemia?

A

CT!!!!

x-ray and MRI have no role

104
Q

CT appearance bowel ischaemia?

A
105
Q

leaking AAA s/s?

Ix of choice?

what will you see?

what can mimic?

A

S/s = pain, hypotension, pulsatile abdominal mass

CT is investigation of choice

on CT will see retroperitoneal haemorrhage next to aneurysm

renal colic can mimic this

106
Q
A

red = pneumothorax

green = blood (consolidation)

107
Q
A

plane = coronal

organ = spleen

injury = splenic laceration

Tx = embolisation (splenic artery + shot gastric artery - dual supply)

108
Q
A

catheter angiogram

splenic artery

originates from coeliac trunk

other branches of coeliac trunk = splenic artery, common hepatic, left gastric

109
Q
A

sagittal plane

injury = T12 fracture

spinal cord impingement

110
Q
A

distal radius + ulna

colles

dinner fork deformity (like a fork)

111
Q

Tx?

A

tibia + fibula (ankle)

dislocation - fibula and talus normally articulated

Tx = relocation, cast

112
Q

flail segment?

A

more than 3 adjacent ribs are fractured in 2 or more places

113
Q
A

…

114
Q

when do you do AXR?

A

bowel obstruction/ileus

pneumoperitoneum

115
Q

signs of pneumoperitoneum AXR?

A

rigler sign! = pneumoperitoneum

(also known as double-wall sign, gas outlines both sides of bowel wall i.e. gas within bowel’s lumen and gas within peritoneal cavity)

116
Q

most commonly injured solid organ?

A

spleen

117
Q

types of fracture?

which of these are seen in children?

A

torus and greenstick seen in children

118
Q

anatomical vs surgical neck humerus fracture

A
119
Q

signs of radial head fracture?

A
120
Q
A

greenstick fracture

121
Q
A

smiths fracture

122
Q

blood supply to scaphoid?

A

at risk of AVN

123
Q
A

….

124
Q
A

intracapsular fracture - hip replacement

125
Q
A

intertrochanteric fracture - dynamic hip screw

126
Q
A

double malleolar fracture

+ fibula dislocation?

127
Q

Dx?

next steps?

A

RUL collapse

next Ix = CT

128
Q

Dx?

A

Hila should look like chevrons (arrow pointing in the way)

Sarcoidosis!! Or TB, or lymphoma

Bilateral hilar lymphadenopathy

129
Q
A

Ng tube gone into right bronchus

130
Q
A

lateral tibial plateau fracture

131
Q
A

posterior dislocation - lightbulb sign

132
Q
A

large bowel obstruction

3rd year medicine (13 decks)

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