DI Final / Quiz 4

Question 1

What type of contrast material do you use for myelograms?

Answer 1

Non-ionic

Question 2

What type of contrast material is safer? Which is used more commonly?

Answer 2

Non-ionic

Ionic; barium (cheaper)

Question 3

Which phase of the EU is used to assess the functional renal parenchyma?

Answer 3

Nephrogram (1st)

Question 4

Which phase of the EU is used to asses the pelvic recesses, renal pelves and ureters?

Answer 4

Pyelogram (2nd)

Question 5

T/F Renal lymphoma is normally bilateral.

Answer 5

True

Question 6

Which kidney is usually visible?

Answer 6

Left (more caudal and ventral than the right)

Question 7

What vertebrae is used to provide a relative measurement of the length of the kidney?

Answer 7

L2
(Dog 2.5-3.5x
Cat 2.4-3.0x)

Question 8

What does a constant or increasing nephrogram opacity without collection system visualization indicate when doing a renal contrast study?

Answer 8

Contrast medium induced renal failure (Give IVF)

Question 9

T/F The location of renal/urinary calculi can be determined on the lateral view.

Answer 9

False. Need 2 views (at least).

Question 10

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?

Answer 10

Summation

Question 11

Phosphate and oxalate calculi are radioopaque. Which cystic calculi are non-radiopaque?

Answer 11

Cystine and Urate

Can’t C U

Question 12

T/F Glucose fermentation in the bladder results in a radioopaque fluid accumulation. This indicates diabetes.

Answer 12

False. Abnormal gas formation occurs.

Question 13

T/F Survey radiographs should be done within 48 hours of a contrast study.

Answer 13

False. Should be done just before the contrast is administered.

Question 14

T/F Non-ionic contrast material is less hyper-osmolar than ionic.

Answer 14

True.

They have an osmolality 5-8 times lower than ionic. This makes them safer.

Question 15

What does a filling defect that is seen centrally in the bladder in all views indicate?

Answer 15

A free object (stone, clot)

Question 16

What does a filling defect that is seen in the periphery of the bladder in at least 1 view indicate?

Answer 16

A wall lesion, something adherent to the wall (could be a stone), or air bubbles if using double contrast

Question 17

In a dog, when is the earliest that fetal mineralization can be detected on an x-ray? In US?

Answer 17

42 days

33-39 days

Question 18

In a cat, when is the earliest that fetal mineralization can be detected on an x-ray?

Answer 18

35 days

Question 19

When can a fetal heart beat be detected using US?

Answer 19

23-25 days

Question 20

How fast should the fetal heart rate be compared to the mother’s?

Answer 20

1.5 - 2 times

Question 21

What part of the male urethra is the most narrow?

Answer 21

Prostatic

Question 22

Where are the earliest and often most severe signs of cystitis seen?

Answer 22

Cranioventral aspect, apex (thickened, irregular wall)

Question 23

What type of shadowing do you expect to see with multiple, separate uroliths?

Answer 23

Dirty

Question 24

What type of shadowing do you expect to see with a single, large urolith?

Answer 24

Clean +/- edge

Question 25

Where is the pylorus of the dog positioned? What about in the cat?

Answer 25

Dog-Right. | Cat-Central.

Question 26

What radiographic technique (mAs/kVp) do you use for examining the stomach?

Answer 26

High mAs, low kVp

Question 27

Why is some medication radioopaque in the stomach?

Answer 27

Calcium

Question 28

Where in the stomach is gas seen on a right lateral?

Answer 28

Fundus

Question 29

Where in the stomach is gas seen on a left lateral?

Answer 29

Pylorus

Question 30

Where in the stomach is gas seen on a DV?

Answer 30

Fundus

Question 31

Where in the stomach is gas seen on a VD?

Answer 31

Pylorus (but if there is a lot of gas, it will be in the body of the stomach as well)

Question 32

What is the best modality to assess gastric motility?

Answer 32

US

Question 33

With GDV, where is the pylorus located?

Answer 33

Craniodorsally and to the left. | Fundus shifts to the right (with the spleen in tow)

Question 34

What disease are gastric ulcers associated with?

Answer 34

Gastric carcinomas (neoplasia)

Question 35

What gastric tumor type is more common in the dog? In the cat?

Answer 35

Dog- Gastric carcinoma | Cat- Lymphoma

Question 36

Which modality is more sensitive for detecting gastric neoplasia?

Answer 36

US

Question 37

What are the top differentials for a palpable mid abdominal mass?

Answer 37

Lymph node mass, Splenic mass, Intestinal mass

Question 38

What structure is regurgitation usually associated with?

Answer 38

The esophagus

Question 39

What 2 bones are used to estimate the diameter of the small intestines in dogs?

Answer 39

(Height of ) L2 (2 x width of a ) Rib Cat: 2 x height of central part of L4, approx 12mm)

Question 40

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?

Answer 40

Best: US Alt: Contrast study

Question 41

T/F Asymmetric distribution of the intestines usually indicates pathology.

Answer 41

False, usually not significant.

Question 42

Where is a linear foreign body often lodged in a cat?

Answer 42

Base of the tongue

Question 43

What contrast medium is counter-indicated for an intestinal foreign body assessment? What is the alternative?

Answer 43

Barium (Risk of rupture, potential emergency surgery) Alternative: Iodine

Question 44

What are indications for a barium study?

Answer 44

Persistent vomiting with unknown cause Inconclusive radiographs Not having US available

Question 45

T/F Barium sediments in the GIT.

Answer 45

False

Question 46

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?

Answer 46

15min-> Duodenm 30min-> Jejunum filled 1-2hrs-> Stomach empty 6 hrs-> Jejunum empty

Question 47

What does a 'sting of pearls' on a feline barium study indicate?

Answer 47

Normal

Question 48

What is it called when the outline of the intestines during a barium study is poorly defined or rough-looking?

Answer 48

Fimbriation (or possibly pseudoulcers if they are smooth defects) Normal- not a sign of disease

Question 49

What does the term "ileus" mean?

Answer 49

Intestinal obstruction

Question 50

What type of ileus is caused by electrolyte imbalances, ischemia, peritonitis, and shock?

Answer 50

Paralytic

Question 51

What type of ileus is caused by foreign bodies, tumors, scarring, adhesions, hernias and volulus?

Answer 51

Mechanical

Question 52

Which type of ileus presents with 2 populations of bowel, normal and enlarged?

Answer 52

Mechanical

Question 53

Which type of ileus tends to cause a larger degree of enlargement?

Answer 53

Mechanical

Question 54

What disease is the "sentinel loop sign" associated with and what organ does it occur in?

Answer 54

``` Pancreatitis Duodenum (pushed toward the body wall) ```

Question 55

What type of ileus is often only associated with gas (rather than gas and fluid in the lumen)?

Answer 55

Paralytic

Question 56

What causes a gravel sign?

Answer 56

Collection of foreign material in the small intestines due to a CHRONIC PARTIAL OBSTRUCTION

Question 57

What type of intestinal pathology causes bunching, plication, and/or comma/crescent-shaped gas bubbles?

Answer 57

Linear foreign body

Question 58

Where is a linear foreign body often lodged in a dog?

Answer 58

The pylorus

Question 59

What type of intestinal pathology is associated with "thumb-printing"?

Answer 59

Infiltrative bowel disease-eccentric mural lesion, neoplasia

Question 60

What type of intestinal pathology is associated with an "apple core sign"?

Answer 60

Infiltrative bowel disease- a circumferential mural lesion, neoplasia

Question 61

What is your primary differential for a thickened intestinal wall with a loss of layers?

Answer 61

Neoplasia

Question 62

What is your anatomic landmark separating large from small intestines in a dog?

Answer 62

Cecum (often gas filled)

Question 63

T/F There is usually more feces in the colon than in the rectum.

Answer 63

True

Question 64

How would you distinguish whether a small radioopaque structure is in the ureter or in the large intestines (other than taking a different view)?

Answer 64

Compression (if in ureter, it will not move with the displaced colon)

Question 65

T/F Feces in a chronic impaction is often less radioopaque than normal.

Answer 65

False, more radioopaque

Question 66

What is usually the underlying cause for perineal hernias in a male dog?

Answer 66

Prostatomegaly

Question 67

What modality for evaluating abdominal structures is preferred in patients that are super skinny?

Answer 67

Ultrasound (also in young patients or those with large amounts of peritoneal fluid)

Question 68

What modality for evaluating abdominal structures is preferred in patients that are gassy?

Answer 68

Radiographs

Question 69

If you suspect abdominal disease, but no changes can be found in the US or rads, what do you do?

Answer 69

US guided biopsy

Question 70

How many liver lobes and liver processes do dogs and cats have?

Answer 70

6 lobes, 2 processes (papillary, caudate)

Question 71

Which lobe cannot be seen using rads in a dog?

Answer 71

Left lateral

Question 72

Which lobe cannot be seen using rads in a cat?

Answer 72

Right lateral

Question 73

T/F The presence of peritoneal fluid enhances liver visualization.

Answer 73

True

Question 74

What causes the ventral margin of the liver to be more prominently seen, i.e. delineated?

Answer 74

Falciform fat

Question 75

What three artifacts make it difficult to see the caudal aspect of the liver?

Answer 75

Summation, silhouetting, superimposition

Question 76

The gastric axis should be ___ with the ribs and ____ to the spine

Answer 76

Parallel to ribs | Perpendicular to spine

Question 77

T/F: The liver should be covered by the rib cage.

Answer 77

True

Question 78

What are some causes of cranial liver displacement?

Answer 78

Diaphragmatic hernia, microhepatia, pancreatic or splenic masses, pregnancy

Question 79

What are some causes of caudal liver displacement?

Answer 79

Hepatomegaly, inguinal/abdominal hernia

Question 80

What are you differentials for a triangular small liver?

Answer 80

Chronic hepatitis, cirrhosis

Question 81

What type of PSS do cats and small breed dogs get more often?

Answer 81

Extrahepatic

Question 82

What are 2 ways to diagnose PSS?

Answer 82

Transcolonic scintigraphy or portography of jejunal vein

Question 83

What modality is most appropriate for assessing the gallbladder?

Answer 83

US

Question 84

In what species can the normal spleen be seen on a lateral rad?

Answer 84

Dog

Question 85

What does a C-shaped, "lacy" looking spleen indicate?

Answer 85

Splenic torsion

Question 86

What will a doppler examination or a splenic torsion reveal?

Answer 86

Lack of blood flow

Question 87

What could a dark spot or spots in a spleen indicate?

Answer 87

Anaerobic bacterial infection

Question 88

What pathology in a different body system is often associated with prostatic neoplasia?

Answer 88

Spondylitis at L5-L7

Question 89

What is the darker triangular structure ventral to the bladder and prostate?

Answer 89

Fat

Question 90

What type of artifact, caused by the colon, can obscure the prostate?

Answer 90

Dirty shadowing

Question 91

What does gas opacity in fetal skulls indicate? Acute abortion Chronic abortion Viable fetuses

Answer 91

Chronic abortion

Question 92

T/F Brown fat provides the best contrast.

Answer 92

False, poor contrast

Question 93

What view can the feline pancreas sometimes be seen on?

Answer 93

VD

Question 94

What modality is most appropriate for diagnosing pancreatitis?

Answer 94

US

Question 95

What modality is most sensitive for detecting free abdominal gas?

Answer 95

US

Question 96

On a VD, where can free abdominal gas be seen?

Answer 96

Between the cranial margin of the liver and the caudal margin of the diaphragm

Question 97

What does mineralization of adrenal glands indicate in a dog? In a cat?

Answer 97

Dog-Neoplasia | Cat- Incidental

Question 98

Adrenal should be less than ___mm

Answer 98

7

Question 99

What does a hypoechoic adrenal gland indicate?

Answer 99

Pheochromocytoma

Question 100

What are your differentials for a hyperechoic kidney?

Answer 100

Nephritis, Dehydration, End stage kidney disease

Question 101

T/F PKD is inherited and irreversible.

Answer 101

True

Question 102

Which 2 views do you do to assess the lower urinary tract in a male?

Answer 102

2 lateral views, stretched/normal and flexed hips

Question 103

What patients is the use on non-ionic water soluble organic iodinated media indicated?

Answer 103

High risk

Question 104

What can be done to improve visibility of small lesions when doing a positive contrast study on the bladder?

Answer 104

Dilute contrast medium

Question 105

What can be done to decrease the risk of air emboli in negative contrast bladder studies?

Answer 105

Use carbon dioxide

Question 106

What radiographic study can be done to assess the urethra?

Answer 106

Urethrogram

Question 107

When can you stop taking hourly rads when doing a barium study?

Answer 107

When the barium reaches the colon

Question 108

Which type of ileus can be treated medically?

Answer 108

Paralytic / functional

Question 109

Which side of the abdomen is the ascending colon on?

Answer 109

Right

Question 110

What modalities can contrast material be used for?

Answer 110

Rads, US, CT and MRI

Question 111

What is negative contrast material used in rads and CT?

Answer 111

Gas (air or CO2)

Question 112

What category and agent of contrast material is used in MRI

Answer 112

Positive | Paramagnetic - Gadolinium (DTPA)

Question 113

How do you place your patient for negative contrast studies?

Answer 113

In left lateral recumbency