DI Final / Quiz 4 Flashcards
What type of contrast material do you use for myelograms?
Non-ionic
What type of contrast material is safer? Which is used more commonly?
Non-ionic
Ionic; barium (cheaper)
Which phase of the EU is used to assess the functional renal parenchyma?
Nephrogram (1st)
Which phase of the EU is used to asses the pelvic recesses, renal pelves and ureters?
Pyelogram (2nd)
T/F Renal lymphoma is normally bilateral.
True
Which kidney is usually visible?
Left (more caudal and ventral than the right)
What vertebrae is used to provide a relative measurement of the length of the kidney?
L2
(Dog 2.5-3.5x
Cat 2.4-3.0x)
What does a constant or increasing nephrogram opacity without collection system visualization indicate when doing a renal contrast study?
Contrast medium induced renal failure (Give IVF)
T/F The location of renal/urinary calculi can be determined on the lateral view.
False. Need 2 views (at least).
While looking at an abdominal x-ray, a colleague exclaims “There are clearly three kidneys seen here. How odd!”
Other than the strong sudden urge to smack them in the head, what artifact name pops into your head?
Summation
Phosphate and oxalate calculi are radioopaque. Which cystic calculi are non-radiopaque?
Cystine and Urate
Can’t C U
T/F Glucose fermentation in the bladder results in a radioopaque fluid accumulation. This indicates diabetes.
False. Abnormal gas formation occurs.
T/F Survey radiographs should be done within 48 hours of a contrast study.
False. Should be done just before the contrast is administered.
T/F Non-ionic contrast material is less hyper-osmolar than ionic.
True.
They have an osmolality 5-8 times lower than ionic. This makes them safer.
What does a filling defect that is seen centrally in the bladder in all views indicate?
A free object (stone, clot)
What does a filling defect that is seen in the periphery of the bladder in at least 1 view indicate?
A wall lesion, something adherent to the wall (could be a stone), or air bubbles if using double contrast
In a dog, when is the earliest that fetal mineralization can be detected on an x-ray? In US?
42 days
33-39 days
In a cat, when is the earliest that fetal mineralization can be detected on an x-ray?
35 days
When can a fetal heart beat be detected using US?
23-25 days
How fast should the fetal heart rate be compared to the mother’s?
1.5 - 2 times
What part of the male urethra is the most narrow?
Prostatic
Where are the earliest and often most severe signs of cystitis seen?
Cranioventral aspect, apex (thickened, irregular wall)
What type of shadowing do you expect to see with multiple, separate uroliths?
Dirty
What type of shadowing do you expect to see with a single, large urolith?
Clean +/- edge
Where is the pylorus of the dog positioned? What about in the cat?
Dog-Right.
Cat-Central.
What radiographic technique (mAs/kVp) do you use for examining the stomach?
High mAs, low kVp
Why is some medication radioopaque in the stomach?
Calcium
Where in the stomach is gas seen on a right lateral?
Fundus
Where in the stomach is gas seen on a left lateral?
Pylorus
Where in the stomach is gas seen on a DV?
Fundus
Where in the stomach is gas seen on a VD?
Pylorus (but if there is a lot of gas, it will be in the body of the stomach as well)
What is the best modality to assess gastric motility?
US
With GDV, where is the pylorus located?
Craniodorsally and to the left.
Fundus shifts to the right (with the spleen in tow)
What disease are gastric ulcers associated with?
Gastric carcinomas (neoplasia)
What gastric tumor type is more common in the dog? In the cat?
Dog- Gastric carcinoma
Cat- Lymphoma
Which modality is more sensitive for detecting gastric neoplasia?
US
What are the top differentials for a palpable mid abdominal mass?
Lymph node mass, Splenic mass, Intestinal mass
What structure is regurgitation usually associated with?
The esophagus
What 2 bones are used to estimate the diameter of the small intestines in dogs?
(Height of ) L2
(2 x width of a ) Rib
Cat: 2 x height of central part of L4, approx 12mm)
What modality is best for assessing the character of the wall of the small intestines? What is the only other modality that could be used?
Best: US
Alt: Contrast study
T/F Asymmetric distribution of the intestines usually indicates pathology.
False, usually not significant.
Where is a linear foreign body often lodged in a cat?
Base of the tongue
What contrast medium is counter-indicated for an intestinal foreign body assessment? What is the alternative?
Barium
(Risk of rupture, potential emergency surgery)
Alternative: Iodine
What are indications for a barium study?
Persistent vomiting with unknown cause
Inconclusive radiographs
Not having US available
T/F Barium sediments in the GIT.
False
In a barium study, when will barium be in the duodenum? When should the jejunum be filled? When should the stomach be empty? When should the jejunum be empty?
15min-> Duodenm
30min-> Jejunum filled
1-2hrs-> Stomach empty
6 hrs-> Jejunum empty
What does a ‘sting of pearls’ on a feline barium study indicate?
Normal
What is it called when the outline of the intestines during a barium study is poorly defined or rough-looking?
Fimbriation (or possibly pseudoulcers if they are smooth defects)
Normal- not a sign of disease
What does the term “ileus” mean?
Intestinal obstruction
What type of ileus is caused by electrolyte imbalances, ischemia, peritonitis, and shock?
Paralytic
What type of ileus is caused by foreign bodies, tumors, scarring, adhesions, hernias and volulus?
Mechanical
Which type of ileus presents with 2 populations of bowel, normal and enlarged?
Mechanical
Which type of ileus tends to cause a larger degree of enlargement?
Mechanical
What disease is the “sentinel loop sign” associated with and what organ does it occur in?
Pancreatitis Duodenum (pushed toward the body wall)
What type of ileus is often only associated with gas (rather than gas and fluid in the lumen)?
Paralytic
What causes a gravel sign?
Collection of foreign material in the small intestines due to a CHRONIC PARTIAL OBSTRUCTION
What type of intestinal pathology causes bunching, plication, and/or comma/crescent-shaped gas bubbles?
Linear foreign body
Where is a linear foreign body often lodged in a dog?
The pylorus
What type of intestinal pathology is associated with “thumb-printing”?
Infiltrative bowel disease-eccentric mural lesion, neoplasia
What type of intestinal pathology is associated with an “apple core sign”?
Infiltrative bowel disease- a circumferential mural lesion, neoplasia
What is your primary differential for a thickened intestinal wall with a loss of layers?
Neoplasia
What is your anatomic landmark separating large from small intestines in a dog?
Cecum (often gas filled)
T/F There is usually more feces in the colon than in the rectum.
True
How would you distinguish whether a small radioopaque structure is in the ureter or in the large intestines (other than taking a different view)?
Compression (if in ureter, it will not move with the displaced colon)
T/F Feces in a chronic impaction is often less radioopaque than normal.
False, more radioopaque
What is usually the underlying cause for perineal hernias in a male dog?
Prostatomegaly
What modality for evaluating abdominal structures is preferred in patients that are super skinny?
Ultrasound (also in young patients or those with large amounts of peritoneal fluid)
What modality for evaluating abdominal structures is preferred in patients that are gassy?
Radiographs
If you suspect abdominal disease, but no changes can be found in the US or rads, what do you do?
US guided biopsy
How many liver lobes and liver processes do dogs and cats have?
6 lobes, 2 processes (papillary, caudate)
Which lobe cannot be seen using rads in a dog?
Left lateral
Which lobe cannot be seen using rads in a cat?
Right lateral
T/F The presence of peritoneal fluid enhances liver visualization.
True
What causes the ventral margin of the liver to be more prominently seen, i.e. delineated?
Falciform fat
What three artifacts make it difficult to see the caudal aspect of the liver?
Summation, silhouetting, superimposition
The gastric axis should be ___ with the ribs and ____ to the spine
Parallel to ribs
Perpendicular to spine
T/F: The liver should be covered by the rib cage.
True
What are some causes of cranial liver displacement?
Diaphragmatic hernia, microhepatia, pancreatic or splenic masses, pregnancy
What are some causes of caudal liver displacement?
Hepatomegaly, inguinal/abdominal hernia
What are you differentials for a triangular small liver?
Chronic hepatitis, cirrhosis
What type of PSS do cats and small breed dogs get more often?
Extrahepatic
What are 2 ways to diagnose PSS?
Transcolonic scintigraphy or portography of jejunal vein
What modality is most appropriate for assessing the gallbladder?
US
In what species can the normal spleen be seen on a lateral rad?
Dog
What does a C-shaped, “lacy” looking spleen indicate?
Splenic torsion
What will a doppler examination or a splenic torsion reveal?
Lack of blood flow
What could a dark spot or spots in a spleen indicate?
Anaerobic bacterial infection
What pathology in a different body system is often associated with prostatic neoplasia?
Spondylitis at L5-L7
What is the darker triangular structure ventral to the bladder and prostate?
Fat
What type of artifact, caused by the colon, can obscure the prostate?
Dirty shadowing
What does gas opacity in fetal skulls indicate?
Acute abortion
Chronic abortion
Viable fetuses
Chronic abortion
T/F Brown fat provides the best contrast.
False, poor contrast
What view can the feline pancreas sometimes be seen on?
VD
What modality is most appropriate for diagnosing pancreatitis?
US
What modality is most sensitive for detecting free abdominal gas?
US
On a VD, where can free abdominal gas be seen?
Between the cranial margin of the liver and the caudal margin of the diaphragm
What does mineralization of adrenal glands indicate in a dog? In a cat?
Dog-Neoplasia
Cat- Incidental
Adrenal should be less than ___mm
7
What does a hypoechoic adrenal gland indicate?
Pheochromocytoma
What are your differentials for a hyperechoic kidney?
Nephritis, Dehydration, End stage kidney disease
T/F PKD is inherited and irreversible.
True
Which 2 views do you do to assess the lower urinary tract in a male?
2 lateral views, stretched/normal and flexed hips
What patients is the use on non-ionic water soluble organic iodinated media indicated?
High risk
What can be done to improve visibility of small lesions when doing a positive contrast study on the bladder?
Dilute contrast medium
What can be done to decrease the risk of air emboli in negative contrast bladder studies?
Use carbon dioxide
What radiographic study can be done to assess the urethra?
Urethrogram
When can you stop taking hourly rads when doing a barium study?
When the barium reaches the colon
Which type of ileus can be treated medically?
Paralytic / functional
Which side of the abdomen is the ascending colon on?
Right
What modalities can contrast material be used for?
Rads, US, CT and MRI
What is negative contrast material used in rads and CT?
Gas (air or CO2)
What category and agent of contrast material is used in MRI
Positive
Paramagnetic - Gadolinium (DTPA)
How do you place your patient for negative contrast studies?
In left lateral recumbency
