File 16 Flashcards
Pericardial effusion what is the next step modality?
A) Echocardiography
B) CT
C) MRI
A) Echocardiography
Notes:
- Echocardiography is the method of choice to confirm the diagnosis, estimate the volume of fluid and most importantly assess the hemodynamic impact of the effusion.
A 32-year-old patient, medically free with lower limb claudication and
decrease pulses on the lower limb, there is figure 3 sign and inferior rib
notching what is the diagnosis:
A) Cortication of the aorta
B) Aortic dissection
A) Cortication of the aorta
Patient with shortness of breath on x-ray there is double atrial sign and calcification over the heart chambers, on the right there is a double cardiac sign, with calcification of cardiac shadow, which of the following is the diagnosis: (They mentioned history of rheumatic fever)
A) Mitral stenosis
B) Aortic stenosis
C) Aortic Regurge
D) Tricuspid stenosis
A) Mitral stenosis
Patient with x-ray shows right heart apex and right sided aortic arch left sided gastric bubble what is the diagnosis?
A) Situs inversus
B) Dextrocardia
C) Situs solitus
B) Dextrocardia
Patient with dysphagia and posterior indentation on the esophagus what
is the cause?
A) Aberrant subclavian artery
B) Pulmonary sling
C) Dilated left atrium
D) Dilated right atrium
A) Aberrant subclavian artery
Patient with elevated left hemi diaphragm on chest X-ray and on
fluoroscopy there is paradoxical movement of the diaphragm what is the
diagnosis?
A. Cerebrovascular disease
B. Inferior mediastinal tumor
C. Pancoast tumor
D. Mass in the left lower lobe
C. Pancoast tumor
Female not smoker with right bronchus mass?
A) Carcinoid
B) Small cell cancer
C) Bronchogenic cyst
D) Adenocarcinoma
D) Adenocarcinoma
Patient has anterior mediastinal mass on CT and renal dysfunction. They want to do a Chest MRI for further evaluation. What is the appropriate thing to do?
A) Repeat CT
B) Do it if GFR >30
C) Do it then immediate hemodialysis
B) Do it if GFR >30
Patient with trauma there is shortness of breath and hyperresonance on examination patient cannot stand because of fracture what can you see on supine x ray?
A) Deepened left CP angle
B) Left pleural cap
C) Increase heart angle
A) Deepened left CP angle
Patient with MVA present with chest trauma x-ray shows rib fracture
and air space opacities after two days follow-up x-ray shows improved
opacities with large cyst with air fluid level. What is the diagnosis?
A) Pulmonary laceration
B) Bronchopulmonary fistula
C) Abscess
D) Atypical infection
A) Pulmonary laceration
Regions of pulmonary contusion with added blebs (pneumatoceles)
with air-fluid levels.
Unilateral lung findings of septal thickness and polygonal shape with budding?
A) Lymphangiomatosis carcinomatosis
B) Idiopathic lung fibrosis
A) Lymphangiomatosis carcinomatosis
Patient with tumor extending around the arch of aorta and pulmonary
vessels without invasion what do you suspect his symptom?
A) Hoarseness of voice
B) Dysphagia
C) Swelling in face and neck
A) Hoarseness of voice
Notes:
- Due to recurrent laryngeal nerve injury.
- The rest of the options mainly involve the upper.
Elderly patient with cough and fever x ray shows right middle zone
opacity on lateral x ray it appears to be at the apical segment of the right
lower lobe with oblique fissure is displaced away from the opacity with
pleural effusion what is the causative organism?
A) Klebsiella pneumoniae
B) Streptococcal pneumonia
C) Legionella
D) Hemophilus influenzae
A) Klebsiella pneumoniae
Patient with SOB and lower limb edema, what is the earliest sign to suggest pulmonary edema?
A) Measure of upper pulmonary vein is larger than lower
B) Perihilar airspace opacities
C) Fine lines
A) Measure of upper pulmonary vein is larger than lower
Answer: A
Notes:
- Aka cephalization.
- 1s → UPV > LPV.
- 2ɴᴅ → Fine lines aka Kerley B lines.
- 3ʀᴅ → Perihilar airspace opacities.
Patient with tail of pancreas traumatic injury which of the following is
the most appropriate next step?
A) US to assess the pancreatic duct integrity
B) ERCP
C) Laparotomy
D) Supportive management
B) ERCP
Answer: B
Notes:
- Suspected pancreatic injury → ERCP or MRCP → assess pancreatic duct patency.
Hepatoduodenal ligament suspend which part of the duodenum?
A) I
B) II
C) III
D) IV
A) I
Cystic artery is a branch of:
A) Hepatic artery
B) Celiac artery
A) Hepatic artery
Answer: A
Notes:
- Hepatic artery proper → Right hepatic artery → Cystic artery, ant & post. segmental artery of
liver, right artery of caudate lobe.
Patient with lung CA he did CT, and it shows well-defined adrenal lesion HU is 17 absolute washouts is 55% what is the next step?
A) Do MRI
B) Nothing it is adenoma
C) Nothing it is metastasis
A) Do MRI
After colonoscopy the patient has abdominal pain what to do?
A) Water soluble oral contrast
B) Double contrast barium
C) Single contrast barium
A) Water soluble oral contrast
To rule out perforation.
What is the lesser sac boundaries?
A) Lesser omentum, splenorenal ligament, and gastrosplenic ligament.
B) Lesser omentum, umbilical ligament, and duodenum
C) Lesser omentum, duodenum, and triangular ligament
A) Lesser omentum, splenorenal ligament, and gastrosplenic ligament.
- Anterior
o lesser omentum
o visceral peritoneum along posterior stomach
o gastrocolic omentum (between greater curvature of stomach and transverse colon) - Left lateral
o gastrosplenic and splenorenal ligaments
Early sign for Crohn’s disease?
A) Prominent vasa recta
B) Mural stratification
A) Prominent vasa recta
√ Asymmetric bowel wall thickening.
- Comb sign → engorgement of the vasa recta.
Synovial plicae:
A) Moderate intensity in high resolution
B) High in T2, low in T1
C) At the junctional zone
B) High in T2, low in T1
Synovial remnants → ↓ PD/T2.
A picture of hysterosalpingogram (it shows multiple small filling defects at the uterus cavity the contrast is spelled in the peritoneal cavity bilaterally). What is the diagnosis?
A) Intrauterine polyposis
B) Underfilled uterus
C) Intrauterine synechiae
D) Abscess/PID
C) Intrauterine synechiae
You did US for a patient, and it shows 3 cm echogenic renal mass what is the next step?
A) CT without contrast
B) CT with contrast
C) Non enhanced MRI
D) Enhanced MRI
B) CT with contrast
Female patient with left renal colic and hematuria; culture is negative for urine and blood on CT there is perinephric edema and fat stranding what is the diagnosis?
A) Pyelonephritis
B) Nutcracker syndrome
C) RCC
B) Nutcracker syndrome
