Gamesmanship Flashcards

1
Q

Mammo:

The calcifications don’t change configuration on CC and MLO views. This is the so called “tattoo sign “ for DERMAL calcifications. Next step: tangential view to prove it.

A

.

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2
Q

Mammo:

Remember that secretory calcifications occur after menopause. Don’t call them secretory in a premenopausal patient (no matter how much they look like them).

A

.

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3
Q

Mammo:

If they show you a ML view for calcifications. Think hard about milk of calcium - is it tea cupping?

A

.

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4
Q

Mammo:

If a test writer wants you to say DCIS, they can prompt it 3 ways:

1) suspicious calcifications (fine linear branching or fine pleomorphic),
2) non mass like enhancement on MRI,
3) multiple intraductal masses on galactography.

A

.

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5
Q

Mammo:

Skin thickening and trabecular thickening should get progressively better with time. It should start out worst, then better, then better. If it gets worse—this recurrent disease.

A

.

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6
Q

Mammo:

Gynecomastia looks like a cancer on ultrasound. This is why a male breast cancer workup (palpable finding) always begins with a mammogram.

A

.

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7
Q

Nukes:

Distinguishing
Tc-99 DTPA vs Xe-133.

DTPA can be done in multiple projections. DTPA tends to clump in the central airways.

A

.

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8
Q

IR:

Sneaky things related to TIPS.

1) CO2 run during hepatic vein wedge—blowing liver dome off bc injection pressure too strong. Anytime see CO2 run over liver, think of this.
2) TIPS placed into hepatic artery (not portal vein). Pay attention to anatomy!
3) Could say portal systemic gradient was normal (3-6). Remember—TIPS treats portal hypertension. Don’t do TIPS on someone without portal HTN!

A

.

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9
Q

IR:

Self Expandable: anywhere you might get external compression.
Balloon Expandable: if you need more precise placement

May Thurner Syndrome—Self
SFA—Self
Focal Atherosclerosis Stenosis in distal aorta—balloon
Renal Ostium Stenosis—balloon

A

.

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10
Q

Vascular:

Thoracic Angiogram: If you see an angiogram through the great vessels and aorta, think about TOS, Takayasu, and Giant Cell. The locations are classic, and helpful.
Takayasu—young (probably Asian female),
Giant Cell-old person.
AGE TRUMPS LOCATION!
If they show you TOS, they’ll show arms up and down—dead give away.
If trauma, don’t forget to check great vessels (not just aorta)

A

.

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11
Q

Vascular:

Aortic Dissection on Angiogram:
Can show as opacification of abdominal aortic branch vessels during aortography (cath in aortic true lumen) w/branch vessels (celiac axis, sup. mesenteric a., and renal arteries) arising out of nowhere. They appear to be floating, w/little or no antegrade opacification of aortic true lumen.

“Floating Viscera Sign”

A

.

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12
Q

Vascular:

Collateral Filling:
If you inject SMA and the celiac branches fill—infers a tight stenosis at celiac origin.

If you inject celiac and the SMA branches fill—infers tight stenosis at the SMA origin.

A

.

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13
Q

Vascular:

Hand Angiograms:
Pathology: it’s going to be either Buergers or Hypothenar Hammer Syndrome (HHS).

Ask yourself: is ulnar artery involved?
If yes, go with HHS.
If the ulnar nerve (typo?) looks ok, but the fingers are out, go w/Buergers.
Careful: fingers can be out w/HHS too (distal emboli).
Pseudo-aneurysm off ulnar artery: slam dunk HHS.

A

.

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14
Q

Vascular:
Renal Artery Angiogram:

Ostial narrowing—think atherosclerosis; treat with balloon + stent

Beading mid vessel—think FMD; treat with balloon only

A

.

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15
Q

Vascular:

Kidney Angiogram

First question should always be
“Is there an RCC or AML?”

Second question should be
“Is there PAN/Speed kidney/A bunch of little aneurysms?”

A

.

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16
Q

Vascular:

Kawasaki:
Two classic ways to show this:

1) CT with a coronary artery aneurysm (obvious one),
2) calcified coronary artery aneurysm shown on CXR (old oral boards favorite)

A

.

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17
Q

Cardiac:

Signs of left atrial enlargement:

1) Double density—superimposed over contour of the right heart
2) Splaying of the carina—Angle over 90*
3) Posterior placement of the heart—seen on lateral CXR

A

.

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18
Q

Upper or Lower Lobe Predominant?

Most inhaled stuff (not asbestosis!)—coal workers, silicosis. Includes progressive massive fibrosis.

A

Upper

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19
Q

Upper or Lower Lobe Predominant?

CF

A

Upper

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20
Q

Upper or Lower Lobe Predominant?

RB-ILD

A

Upper

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21
Q

Upper or Lower Lobe Predominant?

Centrilobular Emphysema

A

Upper

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22
Q

Upper or Lower Lobe Predominant?

Ankylosing Spondylitis

A

Upper

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23
Q

Upper or Lower Lobe Predominant?

Asbestosis

A

Lower

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24
Q

Upper or Lower Lobe Predominant?

Primary Ciliary Dyskinesia

A

Lower

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25
Q

Upper or Lower Lobe Predominant?

Most Interstitial lung diseases (UIP, NSIP, DIP)

A

Lower

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26
Q

Upper or Lower Lobe Predominant?

Panlobular Emphysema (Alpha 1)

A

Lower

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27
Q

Upper or Lower Lobe Predominant?

Rheumatoid Lung

A

Lower

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28
Q

Upper or Lower Lobe Predominant?

Scleroderma

A

Lower

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29
Q

Obtuse margin with lung. Is it mediastinal or pulmonary origin?

A

Mediastinal

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30
Q

Acute margin with lung. Is it mediastinal or pulmonary origin?

A

Pulmonary

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31
Q

Ground glass nodule on PET:

HOT GGO = _______

A

Infection

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32
Q

Ground glass nodule on PET:

COLD GGO = _______

A

Cancer (BAC)

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33
Q

Collapse—
Always be on the lookout for collapse. Anytime see anything that could be, at least entertain idea.
-post intubation
-placement of central line
-ICU patient w/no other details (mucous plugging)
-outpatient w/no other history (cancer)

A

.

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34
Q

Pulmonary edema—
After chest tube placement: re-expansion edema

After crack or heroin: drug induced edema

After head injury: neurogenic edema

After lung transplant: reperfusion edema related to ischemia/reperfusion (peak day 4)

A

.

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35
Q

Collagen vascular tricks:

RA in shoulders on frontal CXR

A

Lower lobe UIP pattern

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36
Q

Collagen vascular tricks:

Ankylosing Spondylitis on lateral CXR

A

Upper lobe fibrobullous disease

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37
Q

Collagen vascular tricks:

Dilated esophagus on CT

A

Scleroderma with NSIP lungs

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38
Q

“Frozen hemithorax”—lack of contralateral mediastinal shift in association with massive pleural effusion . Diagnosis?

A

Mesothelioma.

It’s due to encasement of the lung (and fissures) by cancer

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39
Q

Infections in AIDS by CD4:

> 200

A

Bacterial infections,

TB

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40
Q

Infections in AIDS by CD4:

<200

A

PCP,

Atypical Mycobacterial

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41
Q

Infections in AIDS by CD4:

<100

A

CMV,
Disseminated Fungal,
Mycobacterial

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42
Q

AIDS:

Lung cysts = (diagnosis?)

A

LIP

LIP is AIDS defining in a pediatric patient

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43
Q

AIDS:

Lung cysts + ground glass + pneumothorax = (diagnosis?)

A

PCP

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44
Q

AIDS:

hypervascular nodes = (diagnosis?)

A

Castleman’s or Kaposi

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45
Q

AIDS:

Most common airspace opacity

A

Strep pneumonia

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46
Q

AIDS:

CT with ground glass = (diagnosis?)

A

PCP

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47
Q

AIDS:

Flame-shaped perihilar opacity = (diagnosis?)

A

Kaposi sarcoma

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48
Q

AIDS:

Persistent opacities= (diagnosis?)

A

Lymphoma

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49
Q

If they show you a varicocele, regardless of side (right being more suspicious than left), if it’s a next step question, look for the ____

A

Abdominal cancer

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50
Q

If “hyperemesis” is in question stem (repro), think ______

A

Things that give you elevated B-hCG—like moles and multiple pregnancy (twins)

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51
Q

If it’s a GYN case and has “history of abdominal surgery”, keep in mind _______

A

Peritoneal inclusion cysts (from adhesions)

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52
Q

Met to vagina in anterior wall upper 1/3 is “always” (90%) from _______

A

Upper genital tract

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53
Q

Met to vagina in posterior wall lower 1/3 is “always” (90%) from _______

A

GI tract

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54
Q

Fluid in endometrial canal in post menopausal woman should make you think ______

A

Cervix is obstructed (cancer, or more commonly stenosis)

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55
Q

Repro: combo of ovarian mass and thickened endometrium should make you think _____

A

Granulosa Cell Tumor

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56
Q

IUGR: Symmetrical

-baby or placenta issue?

A

Baby problem (placenta is fine)

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57
Q

IUGR: Symmetrical

-head spared or not?

A

head NOT spared

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58
Q

IUGR: Symmetrical

-when first apparent?

A

Early, including first trimester

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59
Q

IUGR: Symmetrical

-causes?

A

TORCHS,
Fetal EtOH,
Chromosomal abnormalities

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60
Q

IUGR: Asymmetrical

-baby or placenta issue?

A

Placenta problem

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61
Q

IUGR: Asymmetrical

-head spared or not?

A

Head spared

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62
Q

IUGR: Asymmetrical

-when first apparent?

A

Normal until third trimester

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63
Q

IUGR: Asymmetrical

-causes?

A

Maternal hypertension,
Severe malnutrition,
Ehler-Danlos

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64
Q

prostate CA v BPH:

______ is usually in the peripheral zone. When it is in central zone, T2 is “smudgy” or charcoal.

A

Prostate CA

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65
Q

prostate CA v BPH:

_______ is usually in central zone. Have a sharp border. Can “draw a line around them with a pencil”

A

BPH nodules

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66
Q

Gartner duct cyst v Bartholin cyst

______ is above pubic symphysis.
_______ is below.

A

GARTNER DUCT CYST is above pubic symphysis.

BARTHOLIN is below it.

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67
Q

Bicornuate v septate uterus

Distinguish the two by:

A

Apex of the fundal contour

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68
Q

Bicornuate v septate uterus

Apex of fundus >5mm above tubal Ostia

A

Septate

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69
Q

Bicornuate v septate uterus

Apex of fundus <5mm above tubal Ostia

A

Bicornuate

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70
Q

Bicornuate v septate uterus

Which has established increased 1st trimester loss?

A

Septate

Bicornuates have a lot less problems. Maybe no increased risk, depending who you ask

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71
Q

IVPs (GU section):

Haven’t been used since 1970s, but few tricks. If have medial deviation of the ureters, think______

A

Retroperitoneal fibrosis

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72
Q

IVPs (GU section):

Haven’t been used since 1970s, but few tricks. If have lateral deviation of the ureters, think______

A

Psoas hypertrophy, or lymph nodes

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73
Q

RCC v oncocytoma:

___ is typically colder than surrounding renal parenchyma on PET

A

RCC

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74
Q

RCC v oncocytoma:

___ is typically hotter than surrounding renal parenchyma on PET

A

Oncocytoma

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75
Q

Oncocytoma: if they wanted to ask it, can be shown 3 ways:

  • CT solid mass with central scar
  • ultrasound “spokewheel” vascular pattern
  • PET CT it will be hotter than surrounding renal cortex
A

.

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76
Q

Renal cysts syndromes:

Cysts in liver, kidneys are BIG

Diagnosis?

A

ADPKD

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77
Q

Renal cysts syndromes:

Cysts in pancreas

Diagnosis?

A

VHL

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78
Q

Renal cysts syndromes:

kidneys are small

Diagnosis?

A

Acquired (uremic)

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79
Q

Renal cancer syndromes:

Subtype: Clear Cell

Syndrome/Association?

A

Von Hippel-Lindau

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80
Q

Renal cancer syndromes:

Subtype: papillary

Syndrome/Association?

A

Hereditary papillary renal carcinoma

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81
Q

Renal cancer syndromes:

Subtype: chromophobe

Syndrome/Association?

A

Birt Hogg Dube

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82
Q

Renal cancer syndromes:

Subtype: Medullary

Syndrome/Association?

A

Sickle cell trait

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83
Q

If you’re shown a unilateral renal agenesis case, remember association with _______ in men, and _______ in women

A

Men: absent vas deferens, and ipsilateral seminal vesicle Cyst

Women: mullarian anomalies (unicornuate uterus)

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84
Q

Showing persistent nephrograms —either by plain film or CT is the classic trick for ATN—usually contrast induced nephropathy.

A

.

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85
Q

CJD restricts diffusion (MRI).

A

.

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86
Q

Dilated esophagus on CT, ground glass in the lung bases (and maybe sub-pleural sparing). Diagnosis?

A

Scleroderma with NSIP

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87
Q

Benign Liver Masses

Hemangioma:
-ultrasound appearance?

A

Hyperechoic

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88
Q

Benign Liver Masses

Hemangioma:
-CT appearance?

A

Peripheral nodular discontinuous enhancement

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89
Q

Benign Liver Masses

Hemangioma:
-MR appearance?

A

T2 Bright

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90
Q

Benign Liver Masses

Rare in cirrhotics.

Which one?

A

Hemangioma

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91
Q

Benign Liver Masses

FNH:
-ultrasound appearance?

A

Spoke wheel

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92
Q

Benign Liver Masses

FNH:
-CT appearance?

A

Homogeneous arterial enhancement

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93
Q

Benign Liver Masses

FNH:
-MR appearance?

A

“Stealth Lesion —Iso on T1 and T2”

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94
Q

Benign Liver Masses

Central scar, Bright on delayed eovist (Gd-EOB-DTPA).

Which is it?

A

FNH

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95
Q

Benign Liver Masses

Hepatic adenoma :
-ultrasound appearance?

A

Variable

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96
Q

Benign Liver Masses

Hepatic adenoma :
-CT appearance?

A

Variable

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97
Q

Benign Liver Masses

Hepatic adenoma :
-MR appearance?

A

Fat containing on In/Out phase

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98
Q

Benign Liver Masses

OCP use, Glycogen storage Disease, can explode and bleed.

Which is it?

A

Hepatic adenoma

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99
Q

Benign Liver Masses

Hepatic angiomyolipoma :
-ultrasound appearance?

A

Hyperechoic

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100
Q

Benign Liver Masses

Hepatic angiomyolipoma :
-CT appearance?

A

Gross fat

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101
Q

Benign Liver Masses

Hepatic angiomyolipoma :
-MR appearance?

A

T1/T2 Bright

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102
Q

Benign Liver Masses

50% don’t have fat (unlike renal AML); tuberous sclerosis.

Which is it?

A

Hepatic angiomyolipoma

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103
Q

GI location:

H. pylori gastritis

A

Antrum (usually)

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104
Q

GI location:

Zollinger-Ellison

A

Jejunal ulcer is buzzword.

Duodenal bulb is actually the most common location for ZE ulcers

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105
Q

GI location:

Crohns

A

Antrum when in stomach (but uncommon in stomach)

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106
Q

GI location:

Menetrier’s

A

Fundus (classically spares antrum)

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107
Q

GI location:

Lymphoma

A

“Crosses the pylorus “

Classically describes as doing so, although in reality adenocarcinoma does it more

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108
Q

GI location:

Giardia

A

Duodenum

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109
Q

GI location:

Strongyloides

A

Duodenum

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110
Q

GI location:

TB

A

Terminal ileum

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111
Q

GI location:

Yersinia

A

Terminal ileum

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112
Q

Herpes esophagitis v CMV and AIDS:

Multiple small ulcers

A

Herpes esophagitis

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113
Q

Herpes esophagitis v CMV and AIDS:

Solitary large ulcer

A

CMV and AIDS

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114
Q

Esophageal cancer:

Black guy who smokes and drinks—mid esophagus.

Diagnosis?

A

Squamous cell

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115
Q

Esophageal cancer:

White guy with reflux (history of PPIs)—Lower esophagus.

Diagnosis?

A

Adenocarcinoma

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116
Q

Uphill v downhill varices:

Caused by portal hypertension

A

Uphill Varices

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117
Q

Uphill v downhill varices:

Confined to bottom half of esophagus

A

Uphill Varices

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118
Q

Uphill v downhill varices:

Caused by SVC obstruction (Catheter or tumor related)

A

Downhill Varices

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119
Q

Uphill v downhill varices:

Confined to top half of esophagus

A

Downhill Varices

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120
Q

Traction v Pulsion Diverticulum:

Triangular

A

Traction

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121
Q

Traction v Pulsion Diverticulum:

Will empty

A

Traction

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122
Q

Traction v Pulsion Diverticulum:

Round

A

Pulsion

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123
Q

Traction v Pulsion Diverticulum:

Will NOT empty (contain no muscle in their walls)

A

Pulsion

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124
Q

Esophageal hernias, Sliding v Rolling:

GE junction ABOVE diaphragm

A

Sliding

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125
Q

Esophageal hernias, Sliding v Rolling:

GE junction BELOW diaphragm

A

Rolling

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126
Q

Carney’s Triad, parts

A
  • Extra-Adrenal Pheochromocytoma
  • GIST
  • Pulmonary Chondroma (hamartoma)
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127
Q

Carney’s Complex, parts (vaguely)

A

-Cardiac Myxoma
(C is for Complex. Not Carney’s Triad!)

  • skin stuff
  • endocrine stuff
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128
Q

Benign v malignant ulcers (on barium):

Width>depth

A

Malignant

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129
Q

Benign v malignant ulcers (on barium):

Depth > width

A

Benign

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130
Q

Benign v malignant ulcers (on barium):

Located within lumen

A

Malignant

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131
Q

Benign v malignant ulcers (on barium):

Project behind expected lumen

A

Benign

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132
Q

Benign v malignant ulcers (on barium):

Nodular, irregular edges

A

Malignant

133
Q

Benign v malignant ulcers (on barium):

Sharp contour

A

Benign

134
Q

Benign v malignant ulcers (on barium):

Folds adjacent to ulcer

A

Malignant

135
Q

Benign v malignant ulcers (on barium):

Folds radiate to ulcer

A

Benign

136
Q

Benign v malignant ulcers (on barium):

Aunt Minnie: Carmen Meniscus Sign

A

Malignant

137
Q

Benign v malignant ulcers (on barium):

Aunt Minnie: Hampton’s Line

A

Benign

138
Q

Inguinal Hernia: direct v indirect

Less common

A

Direct

139
Q

Inguinal Hernia: direct v indirect

Medial to inferior Epigastric

A

Direct

140
Q

Inguinal Hernia: direct v indirect

Defect in Hesselbach Triangle

A

Direct

141
Q

Inguinal Hernia: direct v indirect

NOT covered by internal spermatic fascia

A

Direct

142
Q

Inguinal Hernia: direct v indirect

More common

A

Indirect

143
Q

Inguinal Hernia: direct v indirect

Lateral to inferior epigastric

A

Indirect

144
Q

Inguinal Hernia: direct v indirect

Failure of processus vaginalis to close

A

Indirect

145
Q

Inguinal Hernia: direct v indirect

Covered by internal spermatic fascia

A

Indirect

146
Q

Crohns v UC:

Slightly less common in USA

A

Crohns

147
Q

Crohns v UC:

Discontinuous “Skips”

A

Crohns

148
Q

Crohns v UC:

Terminal ileum—String Sign

A

Crohns

149
Q

Crohns v UC:

Ileocecal valve “stenosed”

A

Crohns

150
Q

Crohns v UC:

Mesenteric Fat Increased “creeping fat”

A

Crohns

151
Q

Crohns v UC:

Lymph nodes are usually enlarged

A

Crohns

152
Q

Crohns v UC:

Makes fistula

A

Crohns

153
Q

Crohns v UC:

Slightly more common in USA

A

UC

154
Q

Crohns v UC:

Continuous

A

UC

155
Q

Crohns v UC:

Rectum

A

UC

156
Q

Crohns v UC:

Ileocecal valve “Open”

A

UC

157
Q

Crohns v UC:

Perirectal fat Increased

A

UC

158
Q

Crohns v UC:

Lymph nodes NOT usually enlarged

A

UC

159
Q

Crohns v UC:

Doesn’t usually make fistula

A

UC

160
Q

Volvulus, sigmoid v cecal:

Old person (constipated)

A

Sigmoid

161
Q

Volvulus, sigmoid v cecal:

Young person (mass, prior surgery, 3rd trimester pregnancy)

A

Cecal

162
Q

Volvulus, sigmoid v cecal:

Points to the RUQ

A

Sigmoid

163
Q

Volvulus, sigmoid v cecal:

Points to the LUQ

A

Cecal

164
Q

Liver Nodules, Regenerative, Dysplastic, HCC:

Contains Iron

A

Regenerative

165
Q

Liver Nodules, Regenerative, Dysplastic, HCC:

T1 Dark, T2 Dark

A

Regenerative

166
Q

Liver Nodules, Regenerative, Dysplastic, HCC:

Does NOT enhance

A

Regenerative

167
Q

Liver Nodules, Regenerative, Dysplastic, HCC:

Contains Fat, glycoprotein

A

Dysplastic

168
Q

Liver Nodules, Regenerative, Dysplastic, HCC:

T1 bright, T2 dark

A

Dysplastic

169
Q

Liver Nodules, Regenerative, Dysplastic, HCC:

Usually does not enhance

A

Dysplastic

170
Q

Liver Nodules, Regenerative, Dysplastic, HCC:

T2 Bright

A

HCC

171
Q

Liver Nodules, Regenerative, Dysplastic, HCC:

Does enhance

A

HCC

172
Q

Central Scars, FNH v FL HCC

T2 Bright

A

FNH

173
Q

Central Scars, FNH v FL HCC

Enhances on delay

A

FNH

174
Q

Central Scars, FNH v FL HCC

Mass is sulfur colloid avid (sometimes)

A

FNH

175
Q

Central Scars, FNH v FL HCC

T2 Dark (usually)

A

FL HCC

176
Q

Central Scars, FNH v FL HCC

Does NOT enhance

A

FL HCC

177
Q

Central Scars, FNH v FL HCC

Mass is gallium avid

A

FL HCC

178
Q

Hepatic Adenoma v FNH:

Usually >8cm

A

Hepatic Adenoma

179
Q

Hepatic Adenoma v FNH:

No bile ducts

A

Hepatic adenoma

180
Q

Hepatic Adenoma v FNH:

No kupffer cells

A

Hepatic adenoma

181
Q

Hepatic Adenoma v FNH:

Sulfur colloid cold

A

Hepatic adenoma

182
Q

Hepatic Adenoma v FNH:

Usually < 8cm

A

FNH

183
Q

Hepatic Adenoma v FNH:

Normal bile ducts

A

FNH

184
Q

Hepatic Adenoma v FNH:

Normal kupffer cells

A

FNH

185
Q

Hepatic Adenoma v FNH:

Sulfur colloid hot (sometimes)

A

FNH

186
Q

HCC v FL HCC:

Cirrhosis

A

HCC

187
Q

HCC v FL HCC:

Older (50-60s)

A

HCC

188
Q

HCC v FL HCC:

Rarely calcifies

A

HCC

189
Q

HCC v FL HCC:

Elevated AFP

A

HCC

190
Q

HCC v FL HCC:

No cirrhosis

A

FL HCC

191
Q

HCC v FL HCC:

Younger (30s)

A

FL HCC

192
Q

HCC v FL HCC:

Calcifies sometimes

A

FL HCC

193
Q

HCC v FL HCC:

Normal AFP

A

FL HCC

194
Q

Hemochromatosis—primary v secondary:

Genetic—increased absorption

A

Primary

195
Q

Hemochromatosis—primary v secondary:

Liver, Pancreas

A

Primary

P for Pancreas and Primary

196
Q

Hemochromatosis—primary v secondary:

Heart, thyroid, pituitary

A

Primary

197
Q

Hemochromatosis—primary v secondary:

Acquired—chronic illness, and multiple transfusions

A

Secondary

198
Q

Hemochromatosis—primary v secondary:

Liver, Spleen

A

Secondary

S is for Spleen and Secondary

199
Q

Heterotaxia Syndromes:

Right-sided or left-sided?

Two fissures in left lung

A

Right

200
Q

Heterotaxia Syndromes:

Right-sided or left-sided?

Asplenia

A

Right

201
Q

Heterotaxia Syndromes:

Right-sided or left-sided?

Increased cardiac malformations

A

Right

202
Q

Heterotaxia Syndromes:

Right-sided or left-sided?

Reversed aorta/IVC

A

Right

203
Q

Heterotaxia Syndromes:

Right-sided or left-sided?

One fissure in right lung

A

Left

204
Q

Heterotaxia Syndromes:

Right-sided or left-sided?

Polysplenia

A

Left

205
Q

Heterotaxia Syndromes:

Right-sided or left-sided?

Less cardiac malformations

A

Left

206
Q

Heterotaxia Syndromes:

Right-sided or left-sided?

Azygous continuation of the IVC

A

Left

207
Q

Intralobular v Extralobular Sequestration:

No pleural covering

A

Intralobular

208
Q

Intralobular v Extralobular Sequestration:

More common

A

Intralobular

209
Q

Intralobular v Extralobular Sequestration:

Presents later with recurrent infection

A

Intralobular

210
Q

Intralobular v Extralobular Sequestration:

Has its own pleural covering

A

Extralobular

211
Q

Intralobular v Extralobular Sequestration:

Less common

A

Extralobular

212
Q

Intralobular v Extralobular Sequestration:

Presents early with other bad congenital things (heart etc)

A

Extralobular

213
Q

Location:

Intralobular sequestration

A

Left lower lobe

214
Q

Location:

Congenital lobar emphysema (CLE)

A

Left UPPER lobe

215
Q

Location:

CCAM

A

No lobar preference

216
Q

Baby liver, Age 0-3:

Diagnosis?

Endothelial growth factor elevated

A

Hemangioendothelioma

217
Q

Baby liver, Age 0-3:

Diagnosis?

High flow heart failure, big heart on CXR

A

Hemangioendothelioma

218
Q

Baby liver, Age 0-3:

Diagnosis?

AFP elevated

A

Hepatoblastoma

219
Q

Baby liver, Age 0-3:

Diagnosis?

Associated with Wilms

A

Hepatoblastoma

220
Q

Baby liver, Age 0-3:

Diagnosis?

Associated with prematurity

A

Hepatoblastoma

221
Q

Baby liver, Age 0-3:

Diagnosis?

Can cause precocious puberty

A

Hepatoblastoma

222
Q

Baby liver, Age 0-3:

Diagnosis?

AFP negative

A

Mesenchymal hamartoma

223
Q

Baby liver, Age 0-3:

Diagnosis?

“It’s really cystic.”

A

Mesenchymal hamartoma

224
Q

How often is it bilateral?

Blount’s Disease

A

“Often”—some sources say 50-60%

225
Q

How often is it bilateral?

SCFE

A

33% (1/3)

226
Q

How often is it bilateral?

Perthes

A

10%

227
Q

How often is it bilateral?

Wilms

A

5-10%

228
Q

How often is it bilateral?

DDH

A

20%

229
Q

Neuroblastoma:

  • age
  • calcifies how often
  • encase or invade vessels?
  • Well circumscribed?
  • mets to bone?
A
  • age: usually less than 2 (can occur in utero)
  • calcifies 90%
  • ENCASES vessels (no invasion)
  • NO. Poorly marginated.
  • yes, mets to bones
230
Q

Wilms:

  • age
  • calcifies how often
  • encase or invade vessels?
  • Well circumscribed?
  • mets to bone?
A
  • age: usually around 4 (NEVER BEFORE 2 mo)
  • calcifies rarely (<10%)
  • INVADES vessels (no encasing)
  • YES well circumscribed
  • no, doesn’t usually met to bone (unless clear cell Wilms variant)
231
Q

Neuroblastoma v Adrenal Hemorrhage:

Anechoic and avascular

A

Neuroblastoma

232
Q

Neuroblastoma v Adrenal Hemorrhage:

Low on T2

A

Neuroblastoma

233
Q

Neuroblastoma v Adrenal Hemorrhage:

Will grow on follow up

A

Neuroblastoma

234
Q

Neuroblastoma v Adrenal Hemorrhage:

Echogenic and vascular

A

Adrenal hemorrhage

235
Q

Neuroblastoma v Adrenal Hemorrhage:

High on T2

A

Adrenal hemorrhage

236
Q

Neuroblastoma v Adrenal Hemorrhage:

Should shrink on follow up

A

Adrenal hemorrhage

237
Q

Cardiac:

Cyanotic congenital heart diseases (6)

A

“Think the 6 Ts “

TOF
TAPVR
Transposition 
Truncus
Tricuspid atresia 

(That’s only 5, and I don’t know why)

238
Q

Which MRI sequence is best?

Cardiac Myxoma

A

Low T1, High T2

High myxoid content

239
Q

Which MRI sequence is best?

Acute vs Chronic MI

A

Look at T2–Bright on Acute, Dark on chronic (fibrous scar)

240
Q

Which MRI sequence is best?

Arrhythmogenic Right Ventricular Dysplasia (ARVD)

A

T1 Bright

241
Q

Which MRI sequence is best?

Microvascular Obstruction

A

First pass perfusion (25 sec post Gad)

242
Q

Which MRI sequence is best?

Infarct

A

Delayed Enhancement (10-12 min post Gad)

243
Q

Constrictive v restrictive Cardiomyopathy:

Pericardium is usually thickened in which?

A

Constrictive

244
Q

Constrictive v restrictive Cardiomyopathy:

Diastolic septal bounce is seen in which?

A

Constrictive (sigmoidization of the septum)

245
Q

True v False Ventricular Aneurysm:

Mouth is wider than body

A

True

246
Q

True v False Ventricular Aneurysm:

Myocardium intact

A

True

247
Q

True v False Ventricular Aneurysm:

Anterior-lateral wall

A

True

248
Q

True v False Ventricular Aneurysm:

Mouth is narrower than body

A

False

249
Q

True v False Ventricular Aneurysm:

Myocardium is NOT intact

A

False

Pericardial adhesions contain rupture

250
Q

True v False Ventricular Aneurysm:

Posterior-lateral wall

A

False

251
Q

True v False Ventricular Aneurysm:

Higher risk of rupture

A

False

252
Q

Stunned v hibernating myocardium v infarct/scar:

Wall motion normal or abnormal for each?

A

Abnormal wall motion for all

253
Q

Stunned v hibernating myocardium v infarct/scar:

Perfusion normal or abnormal for each?

A

Stunned: normal perfusion (thallium or sestamibi)

Hibernating: abnormal fixed perfusion

Infarct/scar: abnormal fixed perfusion

254
Q

hibernating myocardium v infarct/scar:

Will it redistribute with delayed thallium? (decide for each)

Will it take up FDG? (For each)

A

Hibernating:
-WILL redistribute
w/delayed thallium
-WILL take up FDG

Infarct/Scar:

  • will NOT redistribute
  • will NOT take up FDG
255
Q

Stunned v hibernating myocardium v infarct/scar:

What is each associated with?

A

Stunned: Acute MI

Hibernating: chronic high grade CAD

Infarct/Scar: chronic prior MI

256
Q

Left Atrial Myxoma v Clot:

Which will enhance?

A

Myxoma

257
Q

Vegetations v Fibroelastoma:

How do you tell difference?

A

Look for valvular damage (seen with vegetations).

Contrast enhancement is NOT reliable bc how small these things are.

258
Q

Internal v External Carotid

For each:
-resistance

A

Internal: Low resistance

External: high resistance

259
Q

Aortic coarctation :

Infantile—pre-ductal

  • can have pulmonary edema.
  • Usually long segment.
  • blood supply to descending aorta via PDA

Adult—ductal

  • not symptomatic until later childhood
  • often differential arm-leg pressure
  • usually short segment
A

.

260
Q

Internal v External Carotid

For each:
-systolic velocity

A

Internal: low systolic velocity

External: high systolic velocity

261
Q

Internal v External Carotid

For each:
-diastolic velocity

A

Internal : does not return to baseline

External: approaches zero baseline

262
Q

Internal v External Carotid

For each:
-color flow

A

Internal: continuous color flow is seen throughout the cardiac cycle

External: color flow is intermittent during cardiac cycle

263
Q

HIV Encephalitis v PML:

Which is symmetric, T2 bright, T1 normal?

A

HIV Encephalitis

264
Q

HIV Encephalitis v PML:

Which is asymmetric, T2 bright, T1 dark?

A

PML

265
Q

Choose HIV Encephalitis, PML, CMV, Toxo, or Cryptococcus

Symmetric, T2 bright

A

HIV Encephalitis

266
Q

Choose HIV Encephalitis, PML, CMV, Toxo, or Cryptococcus

Asymmetric T2 bright, T1 dark

A

PML

267
Q

Choose HIV Encephalitis, PML, CMV, Toxo, or Cryptococcus

Periventricular, T2 bright, Ependymal enhancement

A

CMV

268
Q

Choose HIV Encephalitis, PML, CMV, Toxo, or Cryptococcus

Ring enhancement, thallium cold

A

Toxo

269
Q

Choose HIV Encephalitis, PML, CMV, Toxo, or Cryptococcus

Dilated perivascular spaces , basilar meningitis

A

Cryptococcus

270
Q

Toxo v lymphoma:

For each:

  • ring enhancing?
  • hemorrhage after treatment common?
  • thallium cold/hot?
  • PET cold/hot?
  • MR perfusion ?
A

Toxo:

  • ring enhancing
  • hemorrhage after treat MORE common
  • Thallium COLD
  • PET COLD
  • MR perfusion: DECREASED CBV

Lymphoma:

  • ring enhancing
  • hemorrhage LESS common
  • Thallium HOT
  • PET HOT
  • MR perfusion: Increased (or decreased) CBV
271
Q

LeFort unique components:

LeFort 1?
LeFort 2?
LeFort 3?

A

LeFort 1—lateral nasal aperture

LeFort 2—inferior orbital rim, orbital floor

LeFort 3–zygomatic arch, lateral orbital rim/wall

272
Q

Temporal bone fractures: longitudinal v transverse

For each:
-which axis of T-bone?

A

Longitudinal: long axis of t-bone

Transverse: short axis

273
Q

Temporal bone fractures: longitudinal v transverse

For each:
-more or less common?

A

Longitudinal: More

Transverse: less

274
Q

Temporal bone fractures: longitudinal v transverse

For each:
-ossicular dislocation or vascular injury?

A

Longitudinal: More ossicular dislocation

Transverse: more vascular injury (carotid/jugular)

275
Q

Temporal bone fractures: longitudinal v transverse

For each:
-less or more facial nerve damage?

A

Longitudinal: LESS facial nerves damage (20%)

Transverse: MORE facial nerve damage (>30%)

276
Q

Temporal bone fractures: longitudinal v transverse

For each:
-type of hearing loss

A

Longitudinal: CONDUCTIVE

Tranverse: SENSORINEURAL

277
Q

Open lip schizencephaly: cleft lined by grey matter (malformation)

Porencephalic cyst: Hole from prior ischemia

A

.

278
Q

Vocal cord paralysis v cancer:

  • Affected side dilated w/Vocal cord paralysis
  • opposite side dilated w/Cancer
A

.

279
Q

Syndromes w/tumors (neuro)—

Name associated tumors:

NF-1

A

Optic nerve gliomas

280
Q

Syndromes w/tumors (neuro)—

Name associated tumors:

NF-2

A

MSME:
Multiple Schwannomas
Meningiomas
Ependymomas

281
Q

Syndromes w/tumors (neuro)—

Name associated tumors:

VHL

A

Hemangioblastoma (brain and retina)

282
Q

Syndromes w/tumors (neuro)—

Name associated tumors:

TS

A

Subependymal Giant Cell Astrocytomas,

Cortical tubers

283
Q

Syndromes w/tumors (neuro)—

Name associated tumors:

Nevoid Basal Cell Syndrome (Gorlin)

A

Medulloblastomas

284
Q

Syndromes w/tumors (neuro)—

Name associated tumors:

Turcot

A

GBM,
Medulloblastoma

(Note: nevoid basal cell Syndrome also has medulloblastoma)

285
Q

Syndromes w/tumors (neuro)—

Name associated tumors:

Cowdens

A

Lhemitte-Dulcos (dysplastic cerebellar gangliocytoma)

286
Q

Meningioma v Schwannoma:

For each:
-enhance homogenous or not?

A

Meningioma: enhance homogenously

Schwannoma: LESS homogenous

287
Q

Meningioma v Schwannoma:

For each:
-invade IAC?

A

Meningioma: do NOT usually invade IAC

Schwannoma: INVADE IAC

288
Q

Meningioma v Schwannoma:

Which calcifies more often?

A

Meningioma: calcify MORE often

289
Q

Meningioma v Schwannoma:

Which IAC can have “trumpeted” appearance?

A

Schwannoma

290
Q

Where is blood coming from? Match blood location to aneurysm location

ACOM

A

Interhemispheric fissure

291
Q

Where is blood coming from? Match blood location to aneurysm location

PCOM

A

Ipsilateral basal cistern

292
Q

Where is blood coming from? Match blood location to aneurysm location

MCA Trifurcation

A

Sylvian fissure

293
Q

Where is blood coming from? Match blood location to aneurysm location

Basilar tip

A

Interpeduncular cistern OR intraventricular

294
Q

Where is blood coming from? Match blood location to aneurysm location

PICA

A

Posterior fossa OR intraventricular

295
Q

Skull hole contents:

Foramen ovale

A

CN V3

Accessory meningeal artery

296
Q

Skull hole contents:

Foramen rotundum

A

CN V2

“R2V2”

297
Q

Skull hole contents:

Superior orbital fissure

A

CN 3
CN 4
CN V1
CN 6

298
Q

Skull hole contents:

Inferior orbital fissure

A

CN V2

299
Q

Skull hole contents:

Foramen spinosum

A

Middle meningeal artery

300
Q

Skull hole contents:

Jugular foramen

A

Jugular vein,
CN 9
CN 10
CN 11

301
Q

Skull hole contents:

Hypoglossal Canal

A

CN 12

302
Q

Skull hole contents:

Optic canal

A

CN 2

Ophthalmic Artery

303
Q

Forearm Fractures:

Fracture of the radial head + Anterior dislocation of the distal radial ulnar joint

A

Essex-lopresti

304
Q

Forearm fractures:

Radial shaft fracture with anterior dislocation of the ulna at the DRUJ

A

Galeazzi fracture (MUGR)

305
Q

Forearm fracture:

Fracture of proximal ulna, with anterior dislocation of the radial head

A

Monteggia Fracture (MU GR)

306
Q

Femoral neck stress fractures:

  • medial side:
    • stress fracture,
    • compressive side,
    • does well
  • lateral side:
    • bisphosphonate
    • tensile side
    • does terrible
A

.

307
Q

Bankart spectrum shoulders:

Which has disrupted periosteum?

A

True Bankart

308
Q

Avulsions—what attaches to…

Iliac crest

A

Abdominal muscles

309
Q

Avulsions—what attaches to…

ASIS

A

Sartorius

ASIS….Sartorius

310
Q

Avulsions—what attaches to…

AIIS

A

Rectus femoris

311
Q

Avulsions—what attaches to…

Greater trochanter

A

Gluteal muscles

312
Q

Avulsions—what attaches to…

Lesser trochanter

A

Illiopsoas

313
Q

Avulsions—what attaches to…

Ischial tuberosity

A

Hamstrings

314
Q

Avulsions—what attaches to…

Symphysis

A

ADDuctor group

315
Q

Pincer v Cam Impingement :

For each:
-age, gender

A

Pincer: middle-age women

Cam: young men

316
Q

Pincer v Cam Impingement :

Which is:

Over coverage of femoral head by acetabulum

A

Pincer

317
Q

Pincer v Cam Impingement :

Which is:

“Cross over sign”

A

Pincer

318
Q

Pincer v Cam Impingement :

Which is:

Bony protrusion on antero-superior femoral head-neck junction

A

Cam

319
Q

Pincer v Cam Impingement :

Which is:

Pistol grip deformity (appearance of the femur)

A

Cam

320
Q

Osteochondroses:

Kohlers:

  • location
  • age, gender
  • treatment
A
  • tarsal navicular
  • male 4-6
  • treatment NOT surgical
321
Q

Osteochondroses:

Freiberg Infarction:

  • location
  • age, gender
  • can lead to _____
A
  • Second metatarsal head
  • adolescent girls
  • can lead to secondary OA
322
Q

Osteochondroses:

Severs:

  • location
  • some say this is ______
A
  • calcaneal apophysis

- some say it’s a normal growing pain

323
Q

Osteochondroses:

Panners :

  • location
  • age
  • does not have ______
A
  • capitellum
  • kid 5-10 “thrower “
  • does not have loose bodies
324
Q

Osteochondroses:

Perthes:

  • location
  • age, race
A
  • femoral Head

- white kid, 4-8

325
Q

Osteochondroses:

Kienbock:

  • location
  • age
  • associated with….
A
  • carpal lunate
  • person 20-40 years
  • associated with negative ulnar variance
326
Q

Finger tip tumors:

T1 dark,

  • T2 BRIGHT*,
  • ENHANCES AVIDLY*

Diagnosis?

A

Glomus

327
Q

Finger tip tumors:

T1 dark,
T2 Dark,
Variable enhancement,
BLOOM ON GRADIENT

Diagnosis?

A

Giant cell tumor tendon

328
Q

Finger tip tumors:

T1 dark,
T2 dark,
NO BLOOMING

Diagnosis?

A

Fibroma