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SOFT B > FINAL Summer 2014 > Flashcards

FINAL Summer 2014 Flashcards

1
Q

Signs of paranasal sinusitus on upright Water’s or upright coronal CT are:

a) opacification with air fluid level
b) hyperacration
c) mixed opacification and air density
d) Rounded, well defined, soft tissue density

A

a) opacification with air fluid level

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2
Q

The most common neoplasm to produce paraneoplastic syndrome such as HPT, Cushing’s syndrome or acromegaly and produce mediastinal widening?

a) squamous cell
b) small cell
c) large cell
d) carcinoid

A

b) Small cell

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3
Q

On this view the right ventricle is non-border forming:

a) PA
b) Lateral
c) LAO
d) RAO

A

a) PA

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4
Q

Small bowel obstruction (mechanical ileus) produces _________ on the palin film upright radiograph? put air up the butt

a) Multiple water filled loops of bowel
b) Distended gas filed loops/air-fluid levels
c) Distended gas filled loops/no air fluid levels
d) fluid/fluid levels due to fat and fluid separation

A

b) Distended gas filled loops/air-fluid levels

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5
Q

All of the following are causes of large bowel obstruction (mechanical ileus)? which is most common

a) intussusception, adhesions
b) colon cancer, diverticulitis
c) ovarian mets, vulvulus
d) bowel hernia, distended bladder

A

b) colon cancer, diverticulitis

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6
Q

Lymphangitic carcinomatosis/pulmonary lymphatic mets, causes reduced - lymph absorption edema is most commonly related to primaries of the stomach, pancreas, prostate and breast and will show all of the following findings except:

a) kerly lines
b) Hilar LAN
c) Reticulonodular pattern
d) 3-5mm nodules

A

d)3-5mm nodules

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7
Q

Descending order of incidence for aortic aneurysm location is: Most common to least common:

a) aortic arch, thoracic, ascending, abdominal
b) thoracic, ascending, abdominal, arch
c) ascending, arch, thoracic, abdominal
d) abdominal, arch, thoracic, ascending

A

d) abdominal, arch, thoracic, ascending

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8
Q

Marfans syndrome would cause a ________ aneurysm?

a) Stanford A
b) Stanford B

A

a) Stanford A

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9
Q

A common posterior mediastinal mass:

a) Bronchogenic cyst
b) IVF schwanoma
c) aortic aneurysm
d) esophageal achalasia

A

b) IVF schwanoma

SLANT- Spine (tumor, infection), Lymphoma, Aneurysm (descending aorta), Neurogenic turmors (nerve root, schwanoma, sympathetic chain), TB-abcess, potts, cold abcess in psoas.

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10
Q

Healed end stage (not active-not bleeding) secondary/post primary TB usually produxes radographic upper lung

a) air space sonsolidation, cavitation
b) fibrotic nodules, conglomerulate masses
c) nodular densities, multiple calcific nodules
d) fibrosis, cicatrix atalectasis

A

d) fibrosis, cicatrix atalectasis

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11
Q

Probably the most common potentially life-threatening disorder encountered in patients presenting with back pain:

a) Infectious diskitis
b) Multiple myeloma
c) emphysematous cholecystitis
d) abdominal aortic aneurysm

A

d) abdominal aortic aneurysm

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12
Q

Which of the following are characteristic findings of acquired valvular heart disease (usually mitral and aortic) which means typically causes valvular stenosis? Pick all correct choices

a) alterations in the caridac size
b) valvular calcifications may be present
c) Alterations in pulmonary vascularity
d) alterations in size and shape of specific cardiac chambers

A

a) alterations in the caridac size
b) valvular calcifications may be present
c) Alterations in pulmonary vascularity
d) alterations in size and shape of specific cardiac chambers

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13
Q

True of both Hodgkin’s lymphoma? and non Hodgkin’s lymphoma?:

a) Anterior mediastinal mass
b) Pleural effusion
c) Interstitial lung pattern
d) bimodal age distribution

A

a) Anterior mediastinal mass

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14
Q

Pancoast tumor is a(n) __________ usually:

a) bronchogenic carcinoma
b) carcinosarcoma
c) alveolar cell carcinoma
d) bronchial adenoma

A

a)bronchogenic carcinoma

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15
Q

Aortic coarctation? classic radiographic finding:

a) bilateral rib notching
b) unilateral rib notching
c) Rt ventricle enlargent
d) compression of the trachea

A

a) bilateral rib notching

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16
Q

Upright abdominal or lumbar spine plain film would not be helpful in the evaluation of

a) free peritoneal air
b) acute pancreatitis
c) abnormal calcifications
d) gas and fluid patterns

A

b) acute pancreatitis

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17
Q

The presence of pulmonary hematogenous mets:

a) Indicates slow primary growth
b) May have no signs and symptoms at discovery
c) Indicates the primary lesion is a carcinoma
d) indicates the primary lesion is a adenoma

A

b) May have no signs and symptoms at discovery

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18
Q

A patient with multiple small cavitating pulmonary nodules without air fluid levels ,nasopharygeal mass with diffuculty nose breathing and renal disease is likly suffering from:

a) Carters syndrome
b) Wegeners disorder
c) Erasmus syndrome
d) Langerhans histocytosis/eosinophilic granuloma

A

b) Wegeners disorder

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19
Q

WHere in the body are air fluid levels normal? Pick 2

a) maxiallry sinus
b) proximal large bowel
c) Lung
d) Gastric fundus

A

b) proximal large bowl

d) Gastric fundus

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20
Q

A patient with an acute abdomen showing distended loops of small bowel 5dm in diameter has a(an) ________ small bowel pattern

a) Normal
b) abnormal

A

b) abnormal

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21
Q

Which of the following causes pulmonary edema related to pulmonary venous hypertension Pick all that apply

a) Mitral stenosis
b) pulmonary fibrosis
c) Congestive heart failure
d) ammonia gas inhalation

A

c) congestive heart failure

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22
Q

Periostitis - diffuse synovitis and digital clubbing may be a clinical indication of:

a) atelectasis
b) previous pulmonary infarction
c) Pleuritis
d) Pulmonary neoplasm

A

d) pulmonary neoplasm

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23
Q

Westermarks sign and hamptons hump are radiographic features of:

a) pneumothorax
b) myocardial infarction
c) pulmonary embolism/infarction
d) pneumococcal pneumonia

A

c) pulmonary embolism/infarction

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24
Q

The pancoast syndrome consist of:

a) localized emphysema, epical pulmonary mass, rib pain
b) arm pain, cervical spine pain, hilar pulmonary mass, horners syndrome
c) Bloody sputum, apical pulmonary mass, arm pain, vertebral destruction
d) Oculoosympathetic interference, arm pain, neck pain, apical pulmonary mass

A

d) Oculoosympathetic interference, arm pain, neck pain, apical pulmonary mass

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25
Q

The end stage findings of empyema (infections, massive pleural effusion) may result in:

a) Plerual plaque calcification
b) herniation of ipsilateral lung tissue
c) Tracheal deviation to contralateral side
d) Expanded rib cage on ipsilateral side

A

a) Plerual plaque calcification

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26
Q

Eisenmenger physiology results in:

a) Cardiac arrest
b) Great exercise for the right ventricle
c) Left atrial enlargement
d) Increased pulmonary gaseous transmission

A

a) Cardiac arrest

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27
Q

Chiropractic clinicians should be aware that many intrinsic organ diseases refer pain. Abdominal visceral disease may refer pain to the musculoskeletal system. Kidneys and ureters may refer pain to the _________ (where patients with kidneys stones

a) lumbar spine, pelvis
b) groin, flank
c) lower thoracic spine
d) sacral region

A

b) groin, flank

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28
Q

Costophrenic angle blunting may indicate pleural scar, low flat diaphragm or

a) free pleural effusion
b) atelectasis of a lower lobe
c) Basal sub-segmental infiltrate
d) subpulmonic pleural effusion

A

a) free pleural effusion

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29
Q

Next to lymph nodes and ectopic thyroid, this might be a third common cause for middle mediastinal masses.

a) trachea
b) esophagus
c) aorta
d) azygos vein enlargement

A

b) esophagus

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30
Q

Best cardiac examination for chamber wall thickness and volume?

a) echocardography
b) Retrograde aortography
c) coronary arteriography
d) Thallium scan

A

a) echocardiography

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31
Q

300 ml or greater pleural effusion volume is required to be visible on

a) upright PA projection
b) the lateral
c) a lateral view
d) a cross table lateral projection

A

a) upright PA projection

32
Q

All of the following would be considered true statements regarding pulmonary mets except:

a) May have no known primary
b) May have no symptoms at discovery
c) pleural effusion commonly accompanies
d) Lymph more common than hematogenous

A

d) Lymph more common than hematogenous

33
Q

Hilar mediastinal lymphadenopathy is most often due to _______ in patients less than 40 yoa.

a) lung cancer spread
b) Histoplasmosis
c) Coccidioidomycosis
d) Sarcoidosis

A

a) lung cancer spread

34
Q

Which of the following is not a finding of pneumothorax:

a) peripheral hyperluccency/ pleural space air
b) Mediastinal shift to the affected side
c) Visceral pleural line
d) Tracheal deviation to unaffected side

A

b) Mediastinal shift to the affected side

35
Q

Which of the following is associated with pulmonic stenosis. ASD and right ventricle hypertrophy (The naming usually tells you what is wrong: except the fallot defects)

a) Tetralogy of Fallot
b) Trilogy of Fallot
c) Transposition of great vessels
d) Tricuspid atresia
e) Ebsteins anomaly with cyanosis

A

b) Trilogy of Fallot

36
Q

ASD with mitral stenosis would be expected to produce ______ which will eventually produce ______? pick two ( hint Draw a diagnosis, put in the defects and see what happens and stenosis impedes flow)

a) Left atrial enlargement
b) Fallot physiology
c) Eisenmenger’s
d) High volume left to right shunting

A

c) Eisenmenger’s

d) High volume left to right shunting

37
Q

Which of the following would not have an ASD?

a) Trilogy of Fallot
b) Treneus arteriosus (truncus?)
c) Tricuspid atresia
d) Pentalogy of Fallot
e) Ebstein’s anomaly with cyanosis

A

b) Treneus arteriosus (truncus?)

38
Q

On a recumbent AP chest film, upper and lower lung blood vessels of equal size may indicate pulmonary blood pressure alterations ( the only reason there is a 1:2 ratio in a standing upright AP is that the gravity is pulling the blood down and causing for more vasculature at the base of the lung)

a) true
b) false

A

b) false

39
Q

Which one of the following is non-cyanotic?

a) VSD & eisenmenger
b) trilogy of fallot
c) ebstein’s & ASD
d) Lutembacker’s syndrome
e) pentalogy of fallot

A

d) Lutembacker’s syndrome

40
Q

Which condition would not be a precursor for left ventricle failure

a) emphysema
b) Aortic stenosis
c) Mitral regurgitation
d) Coronary artery disease

A

a) emphysema

41
Q

Which type of aortic dissection is the most common and has the worst prognosis using the DeBakery classification? (BB review pages)

a) Type II
b) Type I
c) Type III
d) Type IV

A

b) Type I

42
Q

Using the same responses as question 42, which dissection in the Stanford system would have better prognosis?

a) Type II
b) Type I
c) Type III
d) Type IV

A

c) Type III

43
Q

What is a classic sign of pulmonary arterial hypertension?

a) Small hilar areas
b) pulmonary edema
c) constriction of upper lobe blood vessels
d) Large pulmonary artery

A

d) Large pulmonary artery

44
Q

A common finding of mitral stenosis and congestive heart failure: hint think about what these are doing that is the same.

a) Right atrial enlargement
b) Right lung base airbronchogram sign
c) Phantom tumor
d) Pulmonary venous hypertension (PVH)
e) Left ventricular enlargment

A

d) Pulmonary venous hypertension (PVH)

45
Q

A patient with multiple posterior mediastinal masses and enlarged IVF’s may have:

a) myathenia gravis
b) neurofibromatosis
c) Multiple sclerosis
d) muscular dystrophy

A

b) neurofibromatosis

46
Q

Chamber enlargement at the right ventricle, would be expected with which of the following: pick the sign choice reflecting the correct answers..remember put in the defect and follow the blood flow.

1) Ebstein’s anomaly
2) Aortic coarctation
3) Pulmonic stenosis
4) ASD
5) Ventricular Septal Defect

a) 123
b) 234
c) 124
d) 345
e) 134

A

d) 345

47
Q

Which primary malignancy is responsible for 3-5mm metastatic nodules?

a) osteosarcoma
b) colon cancer
c) seminoma
d) Breast cancer

A

c) seminoma

48
Q

Pulmonary vasculature obstruction disease secondary to chronic increased pulmonary blood flow can convert a left to right to a right to left shunt.

a) true
b) false

A

a) true

49
Q

With regard to lung tumor staging, all of the following combinations of TNM are stage IIIA or B cancers except?

a) T1 N0 M0
b) T2 N2 M0
c) T4 N2 M0
d) T3 N3 M0

A

a) T1 N0 M0

50
Q

WHich of the following combinations would involve only ipsilateral lymph node groups on CT examinations?

a) T1 N0 M0
b) T2 N1 M0
c) T1 N2 M0
d) T3 N3 M0

A

b) T2 N1 M0

51
Q

Berqvist’s triad ? is associated with __________ and _______: pick 3

a) rib fractures
b) traumatic hernia of the left hemidiaphragm
c) spine &/or pelvic fracture
d) Traumatic hernia of the right hemidiaphragm

A

a) rib fractures
b) traumatic hernia of the left hemidiaphragm
c) spine &/or pelvic fracture

52
Q

isenmenger’s physiology with VSD would have cyanosis: Hint put in the defect and follow the blood flow

a) In the lower extremity
b) In the upper extremity
c) In the upper and lower extremity
d) In the peripheral extremities only

A

c) In the upper and lower extremity

53
Q

Carcinoid tumor of the lung is a _________?

a) bronchiolar carcinoma
b) bronchial adenoma
c) carcinosarcoma
d) bronchogenic carcinoma

A

b) bronchial adenoma

54
Q

Which of the following would not be a cause of left ventricular enlargement?

a) Mitral stenosis
b) Systemic hypertension
c) Large VSD
d) Aortic coarctation

A

a) Mitral stenosis

55
Q

Echinococcosis (hydatid disease) is a pulmonary infection:

a) Causing a “water-lilly sign” and bone disease
b) Caused by a parasite found in South Asia
c) That occurs in newborns with inactivated surfactant
d) complicating comatose or quadriplegic patients

A

a) Causing a “water-lilly sign” and bone disease

56
Q

Which of the following would be causes of proximal aortic enlargement? pick all correct choices.

a) Coarctation
b) ASD
c) Mitral Stenosis
d) PDA

A

a) Coarctation

57
Q

Which cause of atypical pleural effusion is usually right sided and interfissure major and minor?

a) empyema
b) congestive heart failure
c) pulmonary infarction
d) SLE
e) pleural mets

A

b) congestive heart failure

58
Q

All of the following must be considered in the differential diagnosis of the thymoma except:

a) teratoma
b) substernal thyroid
c) lymphoma
d) pericardial cyst

A

d) pericardial cyst

59
Q

The “extra pleural sign” (remember what this tells us) helps to differentiate lung lesions from all of the following except:

a) Free pleural effusion
b) rib mets or fractures
c) mediastinal lesions
d) Intercostal lesions

A

a) free pleural effusion

60
Q

Adynamic or paralytic/non-obstructive ileum may be caused by:

a) Diverticulitis
b) Spinal trauma
c) Tumor
d) volvulus

A

b) spinal trauma

61
Q

Gallstone mechanical ileus is caused by:

a) a stone filled, spastic gallbladder
b) a gallstone in the small bowel.
c) a gallstone lodged at the biliary duct
d) A gallstone lodged in the pancreatic duct

A

b) a gallstone in the small bowel.

62
Q

Diagnostic abdominal ultrasound is the most cost effective imaging for which two:

a) gallbladder
b) small bowel
c) stomach
d) aorta

A

a) gallbladder

d) aorta

63
Q

Smooth muscle leiomyoma is a common finding in the female patient in this area:

a) uterine
b) spleen
c) hepatic
d) adrenals

A

a) uterine

64
Q

The most common reasons for mediastinal lymph node calcification include:

a) bronchogenic carcinoma and lymphoma
b) Fungal infections and pneumoconiosis
c) mets chondrosarcoma and neurofibroma
d) sarcoidosis and metastatic osteosarcoma

A

b) Fungal infections and pneumoconiosis

65
Q

Small cell carcinoma may create a radiographic appearance of:

a) Pulmonary nodules
b) large pulmonary artery
c) Hilar enlargement
d) Apical mass

A

c) hilar enlargement

66
Q

Interstitial pulmonary edema and normal Hilar size and normal upright vascular relationship suggest:

a) pulmonary venous hypertension
b) ebsteins anomaly
c) pulmonic stenosis
d) increased capillary permeability

A

d) increased capillary permeability

67
Q

AAA should be suspected on a lateral lumbar xray any time the calcified vessel wall diameter measures:

a) >2cm
b) >3cm
c) >5cm
d) >3.8cm

A

d) >3.8cm

68
Q

Periostititis, synovitis and digital clubbing:

a) is associated with atelectasis
b) is an indication of pleural effusion
c) related to previous pulmonary tuberculosis
d) a paraneoplastic syndrome relate to bronchogenic cancer

A

d) a paraneoplastic syndrome relate to bronchogenic cancer

69
Q

With skeletal metastasis, which should be remembered relative to bronchogenic carcinoma? pick 2

a) commonly causes mixed mets
b) May spread beyond axial skeleton
c) causes osteolytic mets
d) typically spreads only to the rib cage

A

b) May spread beyond axial skeleton

c) causes osteolytic mets

70
Q

The potential seriousness of abdominal aortic aneurysm (AAA) is directly related to lumen diameter. The rule is in clinical practice, AAA measuring

A

d) 5

71
Q

Multiple cm pulmonary nodules can be seen with all except:

a) mets
b) sarcoidosis
c) Rheumatoid lung
d) Pulmonary infarction

A

d) pulmonary infarction

72
Q

Teratoma

A. Non-obstructive/paralytic ileus

b. high diabetes association
c. hemoptysis common
d. Mediastinum near origin of great vessels
e. bronchiolar carcinoma
ab. caplans syndrome
ac. LAN & lung disease

A

d. Mediastinum near origin of great vessels

73
Q

Coal workers pneumoconiosis

A. Non-obstructive/paralytic ileus

b. high diabetes association
c. hemoptysis common
d. Mediastinum near origin of great vessels
e. bronchiolar carcinoma
ab. caplans syndrome
ac. LAN & lung disease

A

ab. caplans syndrome

74
Q

Acute traumatic spine compression fracture

A. Non-obstructive/paralytic ileus

b. high diabetes association
c. hemoptysis common
d. Mediastinum near origin of great vessels
e. bronchiolar carcinoma
ab. caplans syndrome
ac. LAN & lung disease

A

c. Hemoptysis common

75
Q

sarcoidosis

A. Non-obstructive/paralytic ileus

b. high diabetes association
c. hemoptysis common
d. Mediastinum near origin of great vessels
e. bronchiolar carcinoma
ab. caplans syndrome
ac. LAN & lung disease

A

ac. LAN & lung disease

76
Q

Vas deferens calcifications

A. Non-obstructive/paralytic ileus

b. high diabetes association
c. hemoptysis common
d. Mediastinum near origin of great vessels
e. bronchiolar carcinoma
ab. caplans syndrome
ac. LAN & lung disease

A

b. High diabetes association

77
Q

The pressure on the wall of a AAA is important. How many times greater is the pressure on the wall of a 6cm AAA compared to a 4cm AAA? This is a worthwhile exercise if you’ve never done it

a) 1.5
b) 3.0
c) 4.0
d) 5.0

A

d) 5.0

SOFT B (10 decks)

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