Exam 2 Imaging

Question 1

CT good for?

Answer 1

Bone
Angio for diagnostic vascular study
Soft tissue (better w/ contrast but MRI better for fine distinction)

Question 2

MRI good for?

Answer 2

Soft tissue

Question 3

CT Contrast indicated when? (3)

Answer 3

All angiography (vessels)
Chest
All liver, pancreas, kidney, bladder

Question 4

CT Contrast NOT indicated when?

Answer 4

Renal stones
Spine
Extremities
High-res chest (interstitial lung, pulm fib)
General brain
General sinus, orbit, maxillofacial
Pt in renal fail

Question 5

Scout Film is?

Answer 5

CT image taken before contrast given

Always look at Scout

Question 6

How to read an emergency CT: Blood Can Be Very Bad

Answer 6

Blood
Cisterns (CSF collections around brain)
Brain
Vetricles
Bone

Question 7

Blood on CT?

Answer 7

hyperdense (bright white)

Question 8

Cisterns on CT: Look for?

Circummesencephalic?

Suprasellar?

Quadrigeminal?

Sylvian?

Answer 8

blood, effacement and asymmetry

Circum: Ring around midbrain. 1st effaced w/ ICP

Sup: (Star shaped) Circle of Willis. Freq aneurysm

Quad: W-shaped at top of midbrain. Effaced by rostrocaudal herniation

Syl: b/w temporal/frontal lobes. Site of hemorr

Question 9

Brain on CT: Look for? (5)

Answer 9

Asymm
Gray-white differentiation
Shift
Hyperdense (blood, calcif, IV contrast)
Hypodense (air/gas, fat, ischemia, tumor)

Question 10

Ventricles on CT: Look for? (2)

Answer 10

Dilation (hydrocephalus, temp horns 1st)

Compression/shift

Question 11

Bone on CT: Look for? (2)

Answer 11

Compare sides for asymm

Basliar fxr = blood in mastoid cells

Question 12

Epidural Hematoma on CT?

Subdural?

Intraparenchymal/Intravent?

Answer 12

Has smooth, rounded border

Less defined border

Middle of brain

Question 13

MRI indicated when? (5)

Answer 13

R/O subdural hematoma
R/O cerebral CA
Normal pressure hydrocephalus
Frontal lobe atrophy
Prior strokes

Question 14

Imaging for cough?

Answer 14

CXR 1st

CT after elimination of common causes

Question 15

Imaging for dyspnea?

Answer 15

CXR 1st

Then urgent CT if red flags for PE

Question 16

Imaging for chest pain?

Answer 16

CXR

Question 17

Questions to ask about suspected coronary artery synd? (3)

Answer 17

1) Is event happening now?
2) Is chest pain 2° to narrowing?
3) How likely is event in future?

Question 18

US study of choice for? (4)

Answer 18

RUQ pain
Acute pancreatitis (to r/o gallstones)
Gallbladder/biliary tree
NEW ONSET RENAL FAILURE

Question 19

Imaging of choice for Abd Pain “Plus”?

Answer 19

CT

Question 20

Study of choice for hematuria?

Answer 20

CT w/ or w/o contrast

Question 21

SOC for acute flank plain?

Answer 21

CT w/o contrast

Question 22

CXR signs of CHF? (3)

Answer 22

Kerley B lines
Peribronch cuffing
Fluid-filled fissure