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OSCE > Data interpretation > Flashcards

Data interpretation Flashcards

1
Q

What colour is bone on CT?

A

White

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2
Q

What colour is air on CT?

A

Black

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3
Q

What colour is soft tissue/fat on CT?

A

Grey

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4
Q

What are the types of contrast for CT?

A

Iodine based (IV)
Barium / iodine (oral/rectal)

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5
Q

When would you use IV iodine contract CT?

A

opacification of vascular structures and solid / pelvic organs

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6
Q

When would you use barium/iodine oral/rectal contrast?

A

Bowel opacification for abdominal/pelvic CT scans.

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7
Q

When would you do a non-contract CT?

A
  • head trauma
  • stroke
  • bone trauma
  • kidney stones
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8
Q

How would a acute haemorrhage or calcification show on CT?

A

hyperdense - bright

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9
Q

How would oedema or infarction show on CT?

A

hypodense - dark

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10
Q

How does a subdural haemorrhage look on CT?

A

crescent-shaped (banana), spreads diffusely across affected hemisphere (hyperdense if acute, hypodense if chronic)

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11
Q

How does a extradural haemorrhage look on CT?

A

lens-shaped (dome), does not cross suture lines (hyperdense)

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12
Q

How does a subarachnoid haemorrhage look on CT?

A

hyperdense material in subarachnoid space (can fill sulci, fissures, basal cisterns and ventricles)

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13
Q

imaging for suspected bowel perforation?

A

erect CXR

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14
Q

how would left axis deviation show on ECG?

A

lead I - +ve
lead II - -ve
lead III - -ve

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15
Q

Left axis deviation causes?

A

LV hypertrophy, left anterior hemiblock, LBBB, inferior MI, Wolff-Parkinson-White syndrome, VT)

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16
Q

how would right axis deviation show on ECG?

A

lead I - -ve
lead II - +ve

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17
Q

Right axis deviation causes?

A

tall and thin body type, RV hypertrophy (e.g. in PE, lung disease), left posterior hemiblock, lateral MI, Wolff-Parkinson-White syndrome)

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18
Q

Dominant R wave in V1/2 could indicate?

A

right ventricular hypertrophy
posterior MI

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19
Q

How would RBBB/LBBB present on ECG?

A

RBBB - MarroW (M (RSR) pattern in VI and W pattern in V6)
LBBB - QRS in V1 has W pattern and QRS in V6 has M pattern – WilliaM

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20
Q

Which leads is T wave inversion normal in?

A

III, avR and V1

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21
Q

Causes of T wave inversion?

A

ischaemia/post-MI, PE, right/left ventricular hypertrophy (right chest or lateral leads respectively), bundle branch block, digoxin treatment

22
Q

Causes of tented T wave?

A

hyperkalaemia

23
Q

Causes of flat T wave?

A

hypokalaemia

24
Q

Spirometry - obstructive pattern?

A

↓FEV1 (<80%)
N FVC (>80%)
↓FEV1/FVC ratio (<0.7)

25
Q

Spirometry - restrictive pattern?

A

↓FEV1 (<80%)
↓FVC (<80%)
N or ↑ FEV1/FVC ration (>0.7)

26
Q

How to assess adequacy of CXR?

A

RIPE
R - rotation
I - inspiration
P - picture area
E - exposure

27
Q

How to assess rotation of CXR?

A

medial borders of clavicles should be an equal distance from spinous process

28
Q

How to assess inspiration of CXR?

A

at least 5-6 anterior ribs should be visible above diaphragm

29
Q

How to assess picture area of CXR?

A

lung apices and costodiaphragmatic recesses should be visible; scapulae should be out of the way

30
Q

How to assess exposure of CXR?

A

vertebral bodies should be just visible through the lower part of the cardiac shadow (overexposure = too black; underexposure = too white)

31
Q

How to interpret CXR?

A

ABCDE

32
Q

‘A’ in CXR interpretation - what to look for?

A

Airway - tracheal deviation

33
Q

‘B’ in CXR interpretation - what to look for?

A

Breathing:
- lung fields (air, fluid, consolidation, lobar collapse, lesions)
- Pluera (thickening, pneumothorax)
- Hilar region (lymphadenopathy, masses, calcification)

34
Q

‘C’ in CXR interpretation - what to look for?

A
  • Heart size: should be <50% thorax diameter on PA film (cardiomegaly suggests heart failure)
  • Heart position (may be displaced if there is lobar collapse or a large effusion)
  • Heart shape and borders (right border = right atrium; left border = left ventricle)
  • Great vessels: the aortic knuckle should be visible
  • Mediastinal width: should be <8cm on PA film (widening may indicate aortic dissection)
35
Q

‘D’ in CXR interpretation - what to look for?

A

Diaphragm:
- Position and shape: right usually slightly higher due to liver (flat in COPD)

  • Costophrenic angles (blunting indicates effusion)
  • Air below diaphragm (abdominal viscus perforation)
36
Q

‘E’ in CXR interpretation - what to look for?

A

Extra things
- bones and joints
- soft tissues

37
Q

CXR findings for COPD?

A
  • hyperinflation (>10 posterior ribs visible)
  • flat hemi-diaphragms, decreased lung markings
  • black lesions (bullae)
  • prominent hila
38
Q

CXR findings for heart failure?

A

A - alveolar shadowing (‘bat wing’ sign)
B - B-lines (interstitial oedema)
C - cardiomegaly
D - diversion of blood to upper lobe
E - effusion

39
Q

Hearing loss of 20-40dB - severity?

A

Mild

40
Q

Hearing loss of 41-70dB - severity?

A

Moderate

41
Q

Hearing loss of 71-95dB - severity?

A

Severe

42
Q

Hearing loss of >95dB - severity?

A

Profound

43
Q

No air-bone gap on audiogram - type of hearing loss?

A

sensorineural

44
Q

How to tell the difference between T1 and T2 weighted MRI scans?

A

T1 - ONE tissue is bright - fat
T2 - TWO tissues are bright - fat and water

45
Q

What contrast is used in MRI’s and why is it used?

A

Gadolinium - used to enhance vasculature or pathologically vasculised tissue (e.g. metastasis, meningiomas)

46
Q

Types of projections for abdominal XRAY?

A

AP - anterior posterior supine or erect

47
Q

What are the upper limits of normal bowel diameters?

A

3cm - small bowel
6cm - large bowel
9cm - caecum and sigmoid

48
Q

How do you interpret an abdominal XRAY?

A

B - bowel (small, large, faeces, gas, fluid levels)

O - other organs ( liver, spleen, kidneys, gallbladder, calcification - pancreas, aorta, renal stones)

B - bones (spine and pelvis)

49
Q

‘coffee bean’ appearance on abdominal XRAY?

A

Volvulus

50
Q

Standard projections for hip XRAY?

A

AP view
lateral view (frog leg view) - hip os abducted and externally rotated

51
Q

How to interpret hip XRAY?

A

A - adequacy and alignment (coccyx tip and pubic synthesis are midline)

B - bones - cortical outline, bony texture, symmetry, femurs, pelvic bones, shentons line

C - Cartilage (and joint spaces)

S - soft tissue

52
Q

Difference between intracapsular and extracapsular hip fractures?

A

Intracapsular - located at neck of femur

Extracapsular - do not involve the neck of the femur - located below intertrochanteric line.

OSCE (9 decks)

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