DI Final Exam Material Flashcards
1
Q
What is the modality of choice for assessing the adrenal glands?
A
Abdominal Ultrasound
- Hypoechoic to surrounding fat; thin hyperechoic capsule; right adrenal is often more difficult to image in a dog due to overlying bowel gas*
- Normal adrenal glands have a diameter of <7 mm, require high resolution probes and ideal conditions*
2
Q
What anatomical structure is indicated by the red arrow?
A
Small Intestine
3
Q
Jejunal intussuception: detected or not detected?
(the probe is positioned over the mid-central abdomen on the ventral abdominal body wall)
A
Detected
4
Q
Splenic torsion: detected or not detected
A
Detected
- Splenic torsion is most common in large and giant-breed deep-chested dogs. The spleen twists on its pedicle and occludes venous return. You may notice a C shape on lateral radiograph. The fundus will be displaces caudally and medially (tension on the gastrosplenic ligament)*
- **Gas bubbles may indicate anaerobic bacteria***
5
Q
Hydronephrosis: detected or not detected?
(the probe is positioned over the left ventral abdominal body wall just caudal to the last rib)
A
Detected
6
Q
Which is more sensitive for determining hepatomegaly: radiographs or ultrasound?
A
radiographs
7
Q
T/F: On radiographs, the normal canine prostate gland may be minimally visible, but the prostate gland is essentially never seen in the cat
A
True
8
Q
Identify the anatomic structure indicated by the red arrow:
A
portal vein
9
Q
Pneumothorax: detected or not detected?
A
Detected
10
Q
What is the earliest age of gestation at which mineralized fetal skeletons may be evident in abdominal radiographs of a pregnant female cat?
A
~35 days
11
Q
T/F: The normal uterus is difficult to impossible to detect on normal survey radiographs
A
True
12
Q
Ureteral ectopia: detected or not detected?
A
Not detected
13
Q
What is the most common type of prostatic neoplasia?
A
adenocarcinoma
**usually responds quite well to radiation therapy**
14
Q
What is the modality of choice to evaluate the uterus?
A
Ultrasound
Ultrasonography can detect disease and pregnancy before radiographic or palpable changes are found
15
Q
What are we observing in this hepatic ultrasound?
A
Portosystemic shunt
Now with added Doppler - fancy!
16
Q
Acoustic shadowing: detected or not detected?
A
Not detected
17
Q
Enlarged esophagus: detected or not detected?
A
Detected
18
Q
Hepatomegaly may shift the gastric axis in what direction?
A
caudally
19
Q
What anatomical structure is indicated by the red arrow?
(The probe is parallel to the axis of the spine and is located on the ventral body wall at the xiphoid)
A
portal vein
20
Q
T/F: Most of the caudal margin of the liver is usually not detected as it silhouettes with the stomach’s wall and other adjacent organs
A
True
21
Q
What is considered the most reliable radiographic indicator of splenomegaly?
A
rounded or blunt margins
22
Q
Paraprostatic cyst: detected or not detected?
A
Detected
…the picture is labeled
23
Q
Compartmentalization: detected or not detected?
A
Detected
24
Q
What anatomical structure is indicated by the blue arrow?
(The probe is parallel to the axis of the spine and is located on the ventral body wall at the xiphoid)
A
liver
25
**Double Bubble Sign**: detected or not detected?
**_Not_ detected**
26
\_\_\_\_\_\_\_\_\_\_ is the most common cause of **prostatomegaly**
**benign prostatic hypertrophy**
27
**Acoustic enhancement**: detected or not detected?
**_Not_ detected**
28
T/F: Radiography is a very good way to assess changes in the external anatomy of the kidneys
**True**
29
T/F: If the **adrenal glands** are mineralized in the dog, it tends to be incidental
**False**
* If the adrenal glands are mineralized in the _cat_, it tends to be incidental*
* If the adrenal glands are mineralized in the _dog_, neoplasia is more likely*
30
What is the modality of choice to diagnose **splenic torsion**?
**Ultrasound**
*Spleen has enlarged lacy pattern; no blood flow (doppler); thrombosis of veins (grey rather than black)*
31
T/F: In cats, the spleen is considered enlarged if it is seen dorsally on lateral radiographs
**False**
*In cats, the spleen is considered enlarged if it is seen _ventrally_ on lateral radiographs*
32
What is the earliest age of gestation at which mineralized fetal skeletons may be evident in abdominal radiographs of a pregnant female **dog**?
**~42 days**
*creepy*
33
What anatomical structure is indicated by the red arrow?
(The probe is transverse to the acis of the spine and is located on the ventral body wall of the caudal abdomen at the level of L5)
**aorta**
34
T/F: The liver extends far beyond the costal arch in normal dogs
**False**
*The liver extends far beyond the costal arch in dogs with _hepatomegaly_*
35
What structure is *most likely* indicated by #1
**Paraprostatic cyst**
* Paraprostatic cysts are usually pedunculated, well marginated and often appear _cranial_ to the urinary bladder*
* #2 is most likely the urinary bladder. #3 is most likely the prostate*
36
What anatomical structure is indicated by the red arrow?
**Mesenteric Vein**
37
What is the modality of choice to assess normal and disease states in the **testes** and **ovaries**?
**Ultrasound**
38
What is the modality of choice for evaluation of the **prostate**?
**Ultrasound**
*Radiography and urethrography have limited utility other than to diagnose enlargement*
39
What anatomical structure is indicated by the red arrow?
**fundus**
40
What anatomical structure is indicated by the red arrow?
**cecum**
41
What anatomical structure is indicated by the red arrow?
**renal sinus**
42
**Jejunal foreign body**: detected or not detected?
(the probe is positioned over the mid-central abdomen on the ventral abdominal body wall)
**Detected**
43
T/F: The **adrenal glands** are in the peritoneal space
**False**
*The adrenal glands are in the **_retro_**peritoneal space, near the craniomedial borders of the kidneys. They are NOT usually seen radiographically*
44
T/F: Spondylitis of L5-L7 vertebral bodies or the bony pelvis is considered "classic" for metastasis of urogenital cancer
**True**
*Spondyl**_osis_** also is seen in this area and should _not_ be mistaken for an aggressive periosteal reaction*
45
In dogs, the __________ is the most likely source of a mass in the midventral abdomen
**spleen**
46
What is the earliest age of gestation at which the **fetal heart beat** may be evident in abdominal ultrasonography of a pregnant female **dog**?
**23-25 days**
47
T/F: Individual liver lobes can be seen radiographically
**Not usually**
* Except the lobe that points caudoventrally on the lateral projection (left lateral lobe in the dog & right lateral lobe in the cat)*
* Individual liver lobes can be seen _ultrasonographically_*
48
Microhepatia may shift the gastric axis *in what direction*?
**cranially**
## Footnote
* Microhepatia is reduction in liver size. Differential diagnoses for microhepatia include liver shunting, chronic hepatitis, cirrhosis, and diaphragmatic hernia.*
* According to Dr. Thrall's book, the two most common causes for microhepatia are congenital portosystemic shunts and hepatic cirrhosis*
49
Why is a VD view considered superior to a DV view when assessing the kidneys?
**In a VD view the kidneys are separated more and magnified less**
50
Which **kidney** is not consistently seen on radiographs?
**Right**
*The right kidney is not consistently seen because it lies in renal fossa of caudate lobe (silhouette sign)*
51
T/F: **Excretory urography** is a contrast procedure to evaluate the kidneys and ureters
**True**
52
T/F: A dehydrated patient should be rehydrated prior to performing excretory urography
**True**
53
Given the value of ultrasound to assess the kidneys, the best indication to perform an excretory urogram (EU) is:
**ureteral disease**
54
Using ultrasonography, what is the best plane for detecting **hydronephrosis**?
**Transverse plane**
55
What is your primary differential diagnosis?
**Peritoneal effusion**
56
What is the most common cause of lower urinary tract disease in dogs?
**Urinary tract infection**
57
T/F: **Bladder** wall thickness and mucosal surface is easily assessed on survey radiographs
**False**
*Bladder wall thickness and mucosal surface **_CAN NOT_** be assessed on survey radiographs*
58
What anatomic structure is indicated by the red arrow in this feline radiograph?
**Urethra**
*The urethra is often seen in cats as a linear opacity between the bladder neck and pubis.*
*_The urethra is typically not visible in dogs_*
59
**Urinary calculi** composed of __________ or __________ will appear radiopaque
Urinary calculi composed of **_phosphate_** or **_oxalate_** will appear radiopaque
60
**Urinary calculi** composed of __________ or __________ will appear *non-radiopaque*
Urinary calculi composed of **_cystine_** or **_urate_** will appear *non-radiopaque*
61
Are uroliths detected in this radiograph?
**Yes.**
62
The gas that is observed in the bladder wall in this radiograph is usually due to:
**glucose fermentation (diabetic)**
63
**Bladder rupture:** detected or not detected?
**Detected**
*Note the contrast medium leaking out of the urinary bladder*
64
**Cystitis**: detected or not detected?
## Footnote
*What contrast study was performed here?*
**Detected**
*negative cystogram*
65
Using the three images below, is the lesion attached to the wall?
**Yes**
* You should be able to determine this based on the lateral view alone. If the lesion was not attached, it would be more centrally located.*
* In the DV view the lesion is causing a filling defect, meaning it must be at the bottom (ventral), which correlates with the location on the lateral view. The lesion did not change position despite rotating the animal*
* In the VD view, the animal is in dorsal recumbency. In this view, we see the lesion as a very faint soft tissue opacity, which indicates that the lesion is still on the ventral aspect*
66
What is the main indication for a **urethrogram**?
**to detect urethral obstructions or urethral rupture**
67
**Prostatomegaly:** detected or not detected
**Not detected**
68
**Cystitis**: detected or not detected?
**Not detected**
69
**Cystitis**: detected or not detected?
**detected**
70
What is the most common urinary bladder tumor in the **biatch** and **male cat**?
**Transitional cell carcinoma (TCC)**
*Look for focal wall thickening; often in the trigonum area, but can be anywhere*
71
On a left lateral view, are you going to see gas or fluid in the **pylorus**?
**Gas**
72
Concerning the appearance of accumulated *fluid* and *gas* on the **right lateral** radiographs of the canine abdomen, what would you expect to see accumulated in the pylorus? What about the fundus?
**Fluid accumulates in the pylorus; gas accumulates in the fundus**
73
In a left lateral radiograph, would you expect fluid to go to the fundus or the pylorus?
**Fundus**
74
T/F: Regarding **GDV**, the source of air in the stomach is most likely from bacterial production
**False**
*Regarding GDV, the source of air in the stomach is from aerophagia and NOT likely from bacterial production*
75
What happens to the pylorus in the case of GDV?
**shifts dorsally, cranially, and to the left**
*Recognition of the location of the pylorus is the key to radiographic diagnosis of GDV*
76
What radiographic view is most helpful for diagnosing **GDV**?
**Right lateral**
*Depending on the fluid/gas content, other views may be necessary to confirm diagnosis*
77
**Double Bubble Sign:** detected or not detected?
**Detected**
*This is indicative of GDV*
78
What contrast study was performed in this radiograph?
**Positive contrast**
79
What is the most common **gastric neoplasia** in dogs? What about cats?
**Dogs: gastric carcinoma**
**Cats: lymphoma**
80
**Filling defect**: detected or not detected?
**Detected**
81
In what radiographic views will gas accumulate in the **fundus**?
**Right lateral and DV**
82
T/F: **Barium** can be safely given IV
**False**
*You would kill the animal and that would be sad. Don't do that.*
83
T/F: Small intestinal motility cannot be assessed radiographically
**True**
84
Identify the **cecum** in this canine radiograph:
**There.**
85
What is the preferred contrast medium for evaluating GI motility?
**Barium per os**
86
T/F: **Pseudoulcers** are found on the mesenteric surfaces of the canine duodenum
**False**
*Pseudoulcers are found on the **_antimesenteric_** surfaces of the canine duodenum*
87
If your patient has an enlarged bowel and radiographs show that the bowel is primarily gas-filled, is this more likely **mechanical ileus** or **paralytic ileus**?
**Paralytic ileus**
*With mechanical ileus, there is usually fluid and gas in the lumen. The bowel would also be much more greatly enlarged*
88
What is likely the underlying cause of endotoxemia in this patient?
**GDV**
*Check out that double bubble!*
89
**Mechanical ileus**: detected or not detected?
**Detected**
*Note the presence of some small bowel segments that are normal in diameter and others that are significantly (2-3x) larger*
90
**Stacking** of bowel loops is highly suggestive of __________ ileus
**mechanical**
91
That's the colon, right?
**Fuck no.**
*That's going in the wrong direction to be the colon. This is the small intestine and it is messed the fuck up, man. There are foreign contents all up in there, the diameter is way the hell too big... This is a mechanical obstruction for sure. Cut this dog open and kick that colon-imposter's ass.*
92
**Gravel sign** is indicative of:
**chronic partial obstruction**
93
**Intussusception:** detected or not detected?
**Detected**
94
This image is considered pathognomonic for:
**intussusception**
95
Which of these is most representative of a **pseudoulcer?**
96
What is the preferred contrast medium used in **myelography**?
**Non-ionic iodinated contrast medium**
97
What anatomic structure is indicated by the **blue star**?
**ascending colon**
98
What anatomic structure is indicated by the **red star**?
**transverse colon**
99
What anatomic structure is indicated by the **green star**?
**descending colon**
100
T/F: When evaluating radiographic images of the canine abdomen, the medial iliac lymph nodes are usually not detected unless they have undergone a pathologic change
**True**
101
You obtain an ultrasound image of a renal calculus. The region deep to the calculus is nearly anechoic (black). What is the phrase used to describe this black artifact?
**acoustic shadowing**
102
**Portosystemic shunt (PSS)**: detected or not detected?
**detected**
*Single, extrahepatic portocaval shunt*
103
Ideally, **thoracic radiographs** of dogs should be made at the time of full expiration
**False**
*Ideally, thoracic radiographs of dogs should be made at the time of full _inspiration_*
104
What principle explains why the caudal surface of the diaphragm and cranial margins of the liver can not be distinguished from each other in an abdominal radiograph?
**silhouette sign**
105
This is a sagittal image of the left kidney. Which side is **cranial**?
That one.
106
If you see a "bow-legged cowboy sign" on a DV view, what is your DDx?
**left atrial enlargement**
107
This presentation is most often associated with _______ insufficiency
**mitral insufficiency**
*Turbulent flow (regurgitation); often bright and a mixture of colors*
108
If the distance between the film and the x-ray source decreases from 40" to 30", how much does radiation intensity at the film change?
**By 402/302**
Intensity of radiation (x-rays/unit area) decreases with the square of the distance from the source
109
Identify the structure indicated by the red star:
**caudal vena cava**
110
The number of electrons accelerated across an x-ray tube is determined by:
**filament current**
111
Employees that are occupationally exposed to radiation can receive:
**50 mSV/yr**
## Footnote
*Be smart and keep this to a minimum. If you get pregnant you can still receive some dose (\<5 mSv during gestation) and you must notify your employer in writing of pregnancy*
112
The spleen is ______ to the liver in the normal dog
(hyperechoic, hypoechoic, anechoic, isoechoic)
The spleen is **_hyperechoic_** to the liver in the normal dog
113
\_\_\_\_\_\_\_\_\_\_ is the growth center for the **epiphysis**
**articular cartilage**
114
What structure is indicated by the red arrow?
**cecum**
115
FCP or UAP?
**FCP**
* Fractured coronoid process*
* Note the new bone formation on proximal aspect of anconeal process. THIS IS NOT UNUNITED ANCONEAL PROCESS*
116
11-month-old German Shepherd presented with lameness and pain. Based on the image & what you know about bone diseases, what is the most likely diagnosis?
**Panosteitis**
*Note the increased opacity of the medullary cavity*
117
For abdominal radiographs, what should your mAs and kVp settings be?
low kVp, high mAs
118
Radiographically, what do you expect to see with a **bronchial pattern**?
**ring shadows (donuts)** and **tram lines**
## Footnote
*You should also see increased conspicuity of the bronchial tree*
119
**atelectasis** or **consolidation**?
**Atelectasis**
*Note the shift of the heart toward the rib (mediastinal shift), as well as less volume of the lung on the left hand side*
120
What artifact is shown here?
**Slice Thickness Artifact**
121
This characteristic 'wagon wheel' appearance is characteristic for what portion of the intestine?
**Ileum**
122
Identify the artifact:
**mirror image artifact**
123
If the distance from a radiation source is halved, the radiation intensity will be quadrupled. What is the name of the principle that explains this phenomena?
**Inverse Square Law**
124
A radiograph made using 20 mAs and 80 kVp is too dark or overexposed. What are reasonable settings of the x-ray machine for a second attempt?
* 20 mAs, 160 kVp
* 20 mAs, 40 kVp
* 10 mAs, 80 kVp
* 40 mAs, 80 kVp
* 40 mAs, 60 kVp
**10 mAs, 80 kVp**
125
Protective lead aprons and gloves:
* Should be worn whenever holding a patient or cassette during radiography
* Should only be worn when the part of the body is in the primary beam
* Should be worn when mAs values are greater than 10
* Are specially designed for protection from the primary beam
* Have essentially an infinite useful life
**Should be worn whenever holding a patient or cassette during radiography**
126
Detail is the degree of sharpness of an object on a radiograph. Which of the following does NOT affect detail?
* Time of exposure
* Focal spot size
* Object film distance
* Film screen distance
* Focal spot object distance
**Time of exposure**
127
T/F: Ultrasound is reflected when there is an acoustic impedance difference between two adjacent structures
**True**
128
T/F: Regarding the **small intestine** in the normal dog or cat, only the serosal layer is hyperechoic; the other layers are hypoechoic.
**False**
129
T/F: Regarding the **small intestine** in the normal dog or cat, you cannot detect the muscularis layer unless pathologic changes are present
**True**
130
What vascular structure within the normal liver has circular or linear anechoic core representing the vessel lumen and a hyperechoic margin representing the vessel wall and surrounding connective tissue?
**portal vein**
131
You want to perform an upper gastrointestinal contrast series on a dog with suspected perforation of the jejunum. What is the contrast agent of choice for this procedure?
**a water soluble organic iodine agent because it will not result in additional irritation to the peritoneum**
132
What is an important CONTRAINDICATION to intravenous excretory urography?
* renal calculi
* pyelonephritis
* hyposthenuria
* absence of one kidney
* severe dehydration
**severe dehydration**
133
Radiographic signs of acute gastric torsion include all of the following EXCEPT:
* gas and fluid accumulation of the stomach
* displacement of the pylorus dorsally and to the left
* compartmentalization of the stomach
* displacement of the spleen
* accumulation of the fluid in the pylorus on the right lateral view
**accumulation of the fluid in the pylorus on the right lateral view**
*With GDV, the pylorus shifts dorsally, cranially and to the left, and the fundus shifts to the right. So on a right lateral view the fluid would accmulate in the fundus rather than the pylorus*
134
Concerning the use of **grids** in veterinary radiology, grids are placed between __________ and \_\_\_\_\_\_\_\_\_\_
**patient & cassette**
*Concerning the use of grids in veterinary radiology, grids are placed between the patient and the cassette*
135
**Sublumbar lymphadenopathy:** detected or not detected?
**not detected**
136
T/F: Ultrasound has ~95% sensitivity for diagnosing acute pancreatitis
**False**
*US sensitivity about 68%*
137
This radiograph is from a 12-year-old German Shepherd with acute abdomen. What is your diagnosis?
**Gastric rupture**
138
In which two radiographic views will there be gas in the **pylorus**?
**left lateral & VD**
139
Which is the most frequent site of osteochondrosis in the stifle?
**lateral trochlear ridge of the femur**
140
The image shows ultrasound image of two intestinal loops. What artifact is indicated by the red star?
**Dirty Acoustic Shadowing**
