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AA ST2 > Get through question reviews > Flashcards

Get through question reviews Flashcards

1
Q

most commoin cardiac mass

A

thrombus

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2
Q

how to distinguish thrombus on MR

A

no enhancement of contrast and adjacent wall poor motion

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3
Q

most common bengin primary tumour cardiac for adults

A

myxoma

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4
Q

where are myxomas typically found

A

left atria, inter atrial septum near fossa ovalis.

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5
Q

MRI myxoma volaues

A

T1 akin to myocardium.
t2 hyperintense

can get calc and hemosiderin deposition

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6
Q

caridac lipomas usually found where?

A

right atrium

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7
Q

histological difference of LHIS (septal lipoma) vs actual lipoma

A

lipoma has a capsule on histopathology

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8
Q

which is the tumour of the cardiac valves?V

A

papillary fibroelastoma

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9
Q

malignant cardiac masses - common type is

A

sarcoma

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10
Q

features of malignant cardiac tumours

A

more than one chamber
necrosis
invasion of pericardium and epicardial fat

extension
pericardial effusion
mets

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11
Q

cardiac angiosarcomas typically affect where

A

right atrium

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12
Q

appearance of angiosarcoma on the MRI

A

cauliflwoer like

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13
Q

Aortic aneurysm sizes

A

Ascending >4
descedning >3.5

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14
Q

GCA produces stenoses that are

A

long and smooth

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15
Q

Infections that can cause aortitis

A

Staph A
Salmonella
Pneumoccus
Ecoli

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16
Q

2 types of Takayasou

A

Pre-pulseless (fveres)

Pulseless (ischaemic)

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17
Q

Oesophagus - shaggy borders

A

infection with haemorrhage
think candida

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18
Q

Short pedicles
reduced interpeduncular distance
champagne glass pelvis
bullet shaped vcertebra

A

Achonddraplasia

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19
Q

inferior vertebral beaking

A

Hurlers / Hunters syndromes

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20
Q

Which MRI sequence is useful for haemorrhage

A

Gradient Echo

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21
Q

What are implications of brain - infarcted core

A

not salvageable

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22
Q

what are the implications of brain for penumbra

A

tissue at risk - that could be saved

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23
Q

lentiform nucleus contains

A

putamen and globus pallidus

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24
Q

MRI - thrombus best seen on

A

Gradient recall echo

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25
Q

MRI - stroke best seen on

A

DWI

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26
Q

Subacute stroke - cellular response

A

cytotoxic

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27
Q

acute stroke - cells become

A

vasogenic

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28
Q

Post stroke mass effect peaks at

A

3-4 days

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29
Q

Cortical laimnar necrosis happens due to

A

lipid laden macrophages

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30
Q

high attenuating sub arachnoid space

ddx

A

bleed
meningitis
letomeningeal mets

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31
Q

Sub arachnoid on MRI

A

hyperintense FLAIR

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32
Q

MRI appearnce of superficial siderosis

A

dark sulci on T2

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33
Q

Perimesencephalic subarachnoid haemorrhage found where

A

anterior to the brainstem

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34
Q

cingulate gyrus found where

A

above the corpus callosum

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35
Q

central sulcus seperates

A

motor (frontal)

sensory (parietal)

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36
Q

if T1 is elongated due to pathology it will be

A

T1 black

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37
Q

what things are T1 bright

A

fat
melanin
proteinacious fluid
methamglobin
Contrast
ions

flow voids

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38
Q

What is the pattern of true restricted diffusion

A

Bright on DWI

dark on ADC

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39
Q

Causes of restriction by category

A

Neoplasm
Inflammation
Infection
Vascular
Toxins
Metabolic
Congenital
Treatment
seizure
Trauma

VITAMIN C

Vascular
infection
Trauma
Autoimmune
Medications
inflammation
neoplasm
Congenital

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40
Q

SWI is also called

A

GRE

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41
Q

if bright on SWI what are the ddx

A

hypertensive microangiopathy
cerebral amyloid angiopathies
vasculopath
haemorrhagic mets
fat emobolism

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42
Q

location of HoCM

A

asymmetric septum in heartat 15mm ort thickert

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43
Q

Appearance of an endometrioma

A

thick walled cyst / fluid ;level / cysts

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44
Q

what imaging MRI sequences are needed for macroadenoma

A

pre and post contrast

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45
Q

most likely brian tumour to haemorrhage is

A

glioblastoma

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46
Q

How to differentiate ABC from a siomple bone cyst

A

ABC have a periosteal reactoin

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47
Q

fallen fragment sign of

A

simple bone cyst

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48
Q

Menetriers get what in stomach

A

thickening of the rugal folds

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49
Q

which patient groud gets amyloid arthropathy

A

renal dialysis

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50
Q

demyelinating feature

A

Long T2 but no mass effects

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51
Q

Virchow robins found where

A

lower 3rd of the basal ganglia

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52
Q

what are the different types of MS

A

relapse remitting

primary progressive
progressive

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53
Q

How to discern McDonalds criteria for time

A

give GAd

acute enhacne non acute don;t

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54
Q

best examination for SUFE

A

MRI

but can see them on frog leg

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55
Q

Gastric ulcer - malignant features

A

irregular
nodular
rolled edges
super flat

Hampton’s (Harmless = benign) and Carman (Carcinoma = malignant)

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56
Q

what is in the prostate central zone fro young men vs old

A

young is mostly the central gland

old men the transitional gets huge and comes in

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57
Q

id have seminal vesicle hypoplasia / cysts

what is assocaited

A

ipsilateral renal agenesis
ADPKD

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58
Q

Prostate
midline cystic structure is going to be a

A

Urticle cyst

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59
Q

urticle cysts are ax with

A

hypospadias

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60
Q

Prostatitis affects which zone

A

peripheral zone,

low T2 and restriction on DWI

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61
Q

If the prostate cancer is localised in the prostate it will be a Gleeson

A

T2

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62
Q

peripheral zone is what signal

cancer will therefore be

A

normal is bright

cancer is dark

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63
Q

Porstate cancer with contrast

A

early enhancement

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64
Q

PIRADS scoring uses what parameters

A

T2wi, DWI/ADC, dynamic contrast

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65
Q

MS in the eye mostly affects where

A

retrobulbar intraorbital

high T2 signal

chronic will atrophy

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66
Q

skene glands are found where

A

para urethral

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67
Q

bartholin glands are found where

A

vulva, lubricating fluid

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68
Q

Gartner cysts are found where

A

under the bladder, anterolateral

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69
Q

list the vagina lymph drainage

A

deep third - external iliacs

middle third - internal iliacs

superficial third of vagina - inguinal

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70
Q

MS brain atrophy hits the

A

corpus callosum

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71
Q

what are the features of cardiac amyloid ?

A

Left ventricle
delayed enhancement to the subendocardial layer

granular echngenic myocardium

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72
Q

what is common channel syndrome in the pancreas

A

reflux between the CBD and duct of Wisreng

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73
Q

Pancreas phase imaging is

A

late arterial

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74
Q

pre contrast T1 imaging is useful for what

A

r/v of the parenchymal bulk

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75
Q

T1 post contrast is useful for what in pancreas imaging

A

unform enhancement

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76
Q

MRI subtraction is useful in pacnreas for

A

pancreatic necrosis

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77
Q

Appearance of chronic pancreatitis is

A

atrophied gland
calc
dilated / beaded duct

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78
Q

lipase hypersecretion syndrome get what

A

sub cut fat necrosis
bone infarcts
eosinophilic

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79
Q

pancreas - bunch of grapes

A

serous cystadenoma

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80
Q

serous cystadenoma has what appearance

A

central enhancing scar
grapes
stellate calc

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81
Q

mucinous cystic

pancreas

A

capsule
some peripheral calc
found in body / tail

elevatedCEA and CA19-9

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82
Q

IPMN can be found where

A

main duct or side branch

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83
Q

IPMN sizes

A

> 5mm

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84
Q

IPMN - bad / ,malignant features

A

cyst > 3cm
mural nodule
dilated MPD 5 - 9 mm
lymphadenopathy
high Ca 19-9

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85
Q

What are the normal measurements of a pylorus

A

muscle < 3mm x17mm.
transverse less than 13mm

volume less than 1.5mcc

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86
Q

Cholecystitis wall thickening - what size

A

3mm

if distended will be >4cm
hyperaemic wall

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87
Q

GB adneomyomatosis - what is it

A

cholestrol in rekitansky-ascoff sinuses
comet tail
bubbly T2 high signal

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88
Q

GB polyp

6 ‘s’

A

Size - > 1cm
single - single bad
sessile - bad, stalk good
stones - inflammation, bad
Primary sclerosing cholangitis
sixty - age

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89
Q

MRCP acquisiation uses what

A

high T2wi for fluid.

fast spin echo

contrast can be used - Esocist for T1 brightness

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90
Q

most common neoplasm of the cardiac valves

A

fibroelastomas

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91
Q

What is wermer syndrome also known as

A

MEN 1

this of course is autosomal dominant

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92
Q

What is involved in Men 3A

A

Medullary Thyroid carcinoma

phaeo

ganglioneuromatosis

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93
Q

Men 1 what is inovled

A

Pituitary adeno

parathyroid adeno

pancreatic islet cell

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94
Q

Osteoid osteoma >2cm is called

A

osteoblastoma

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95
Q

how does CT blood change over time?

A

dense for a week then reduces

2 weeks isodense to brain

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96
Q

Anaemia value of what can cause acute bleed to appear as brain isodense

A

<100

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97
Q

Most child intussecption is located

A

ileocolic

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98
Q

What is cronkhite - canada syndrome

A

GI polyps in stomach
hair loss
nail dystrophy

diarrhoea

cystic dilatation

inflamed lamina propria

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99
Q

What is eye of the tiger sign?

A

low signal intensity of flobus palladus on T2, around a hyperdense area

PANC2

haemachromatosi

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100
Q

caudate atrophy - disease is

A

huntingdons

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101
Q

MELAs will have what appearance

A

multiple focal white matter signal changes
posterior parietal

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102
Q

CADASIL will have what appearance

A

extensive white matter signal changes

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103
Q

Claw of normal renal tissue around mass

A

Wilms

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104
Q

Wilms, how does it behave arund vessels

A

Vessels are displaced / vasc invasion

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105
Q

What are the types of endoleak

A

T1 - outside the graft
T2 - reversal of flow from eg lumbar
T3 - leaking graft defect
T4 - porous graft, nor around anymore

T5 - unknown

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106
Q

The isoenzyme NSE is asosciated with

A

Small cell lung cancer

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107
Q

What is the difference between modic type 1 and modic tpye 2 and type 3

A

Modic Type 1 - Low T1, high T2, fibrovascular invasion of tissues. OEDEMA

Modic Type 2 - fatty replcaement of red marrow. (bright T1/T2),

Modic tpye 3 - sclerosis

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108
Q

What is an andersons lesion in spine

A

disc involve in spondyloarthritis ank spond

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109
Q

Normal atlanto axial distance

A

<5mm

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110
Q

lateral mass displacement by age

A

can be 6mm up to 7 years old

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111
Q

what are the grades of ureteric reflux

A

1 - 5

1 - to distal ureters
2 - up to collecting system
3 - + mild dilatation
4 - Clubbed dilatation of calices
5 - severe tortuous urter

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112
Q

which grades of urteric reflux need surgery

A

4 and 5

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113
Q

What is the debakley criteria and what are the categories

A

1 - superior and inferior
2 - superior only
III a - proximal descending
III b - all the way down descending

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114
Q

foraminal impingement will affect which spinal nerve

A

exiting

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115
Q

neuronal impingment will affect wich spinal nerve

A

traversing

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116
Q

Diastematomyelia

A

saggital splitting of the spinal cord and rejoin s

women more than men

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117
Q

diplomelia

A

splitting of cord and doesn’t rejoin

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118
Q

doliocephaly

A

dolio means long

Saggital suture closes early

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119
Q

Scaphocephaly

A

another term for doliocephaly

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120
Q

Brachycephaly

A

bicoronal suture early fusio n

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121
Q

Anterior plagiocephaly

A

unicoronal suture fusion

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122
Q

Turricephaly

A

bilateral lamboid

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123
Q

Posterior plagiocephaly

A

UNilateral lambdoid

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124
Q

Trigonocephaly

A

metopic suture of forehead closes

get triangle shape

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125
Q

oxocephaly / turricephaly

A

sagittal and coronal

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126
Q

differentials for plulsatile portal vein wave form

A

right heart failure
tricuspid regurg

cirrhosis
fistula

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127
Q

how to classify portal hypertension

A

pre - sinusoidal

sinusoidal

post sinussoidal

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128
Q

max portal vein diameter

A

13mm

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129
Q

recanulized paraumbilical vein is diagnostic of

A

portal hypertension

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130
Q

TIPS surveillance schedule is

A

1 month, every 3 months for a year and then every 6 - 12 months.

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131
Q

what will flow in the portal veins be like post TIPS

A

retrograde in the veins distal to the tips as will come back to find the TIPS entry point.

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132
Q

TIPS indi cations

A

acute variceal bleed or recurrent
refractory ascites
hepatic hydrothorax - refractory
portal hypertensive gastropathy
hepatorenal syndrome
lower GI varices
bad compression of portal veins
moderate buddchiari of moderate level disease

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133
Q

TIPS

absolute contraindications

A

severe chronic liver disease - wont cope with new nutrient delivery

severe encephalopathy - can worsen

severe right heart failure - will worsen

uncontrolled sepsis

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134
Q

TACE indications

A

unresectable HCC - palliative or bridge to tx

hepatic mets

intrahepatic cholangiocarcinoma

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135
Q

TACE - absolute contraindications

A

extensive tumour in liver

extra hepatic disease burden

enephalopathy

allergy to contrast

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136
Q

post embolisation syndrome lasts

A

3 days

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137
Q

Uterine fobroid embolization blood flow is assesed on

A

3D contrast enhanced MRA

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138
Q

how will endometritis appear on MRI

A

uterine enlargement

T1 bright intracavitatory haematoma

gas assocaited with endometritis.

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139
Q

Aortic aneurysm - measurements that need to be given are

A

proximal landing zone
aneurysm sac
distal landing zone
vascular access

Diameters
- size at the inferior renal artery
- aortic neck 15mm distal to renal artery
- bifurcation
- largest sac size
- sizxe of iliac arteries

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140
Q

unfavourable aneurysm CT findings

A

length >32mm
diameter <7
angulation >60

sac
- residual lumen <18mm
- distal aorta diameter <20mm
- extension, involvement of common iliac arteries

iliofemoral vessels
- common iliac artery diameter >25mm
- landing zone length <10mm
- external iliac artery diameter <6mm

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141
Q

malignant breast calc patterns

A

pleomorphic

clustered

linear/ductal distribution

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142
Q

benign breast calcificaitons

A

coarse popcorn
eggshell
tramline
broken needle
lead pipe
puncate stellate

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143
Q

how can you distinguish between metastatic and osteoporotic compression fractures

A

DWI - adc will be different

convex posterior margin for mets

signal abnormal in pedicsl - mets

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144
Q

main finding of pyklnodysostosis

A

cortical thickening with narrowed medullary cavity

shortstature
frontal bossing
hypoplasia nails
wormian bones

stubby hands
obtuse mandible
bad clavicles

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145
Q

how does radio frequency abblation work

A

cell death at 49 degrees
immediate death 60, chars at 105.

denatures proteins

tip should be at the deep margin of the tumour

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146
Q

what is the heat sink phenomenona

A

reduced tissue temperatures due to blood vessels carrying heat away

explains weird margins and poor ouitcome in large tissues

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147
Q

how to reduce heat sink effect

A

reduce blood flow to the tumour in some way.

balloon occlusion
embolise
pringle maneouvre

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148
Q

calcaenous - ant eaters nose

A

calcaneonaviluclar coalition

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149
Q

C spine in foot on lateral

A

talocalcaneal coalitions

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150
Q

does melanoma have drop mets

A

NO

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151
Q

what tumours do have drop mets

A

medulooblastoma
PNET
Ependyomoma
Pineocytoma

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152
Q

deaf
blue eyes
bad teeth

A

osteogensis imperfefta

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153
Q

causes of pneumotosis

A

primary

secondary
- obstruction
- COPD / Asthma
- iswchaemic bowel/ infarct
- corhns / UC
- nec enterocolitis
- steroids / chemo
- collagen vascular disease like scleroderma
- SLE . Dermatomyositis

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154
Q

unilateral delayed nephrogram differential

A

acute ureteral obstruction
renal artery stenosis
renal vein thrombosis
acute pyelonephritis

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155
Q

bilateral peristent nephrogram

A

low bp
ATN
contrast nephropathy
acute urate nephropathy
proetinuria
bilateral obstructive uropathy

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156
Q

unilateral striated nephrogram

A

acute urinary obstruction
acute pyelo
renal infarct
renal vein thrombosis
renal contusion
acute radiation therapy

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157
Q

bilateral striated nephrograms

A

acute urinary obstruction
acute pyelo
ATN
low bp
ARPKD

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158
Q

kidneys - paintbrush like streaks

A

Tubular ectasia

159
Q

how does corticol necrosis happen ?

A

acute ischaemia from small vesel vasospasm or systemic hypotension

160
Q

papillary necrosis can cause which symptom

A

bleedy urine

161
Q

POSTCARD mnemonic for causes of papillary necorsis

A

Pyelo
Obstruction
Sickle cell
TB

Cirrhosis
Analgesia NSAIDS
Renal vein thrombosis
Diabetes mellitus

162
Q

signs of papillary necroiss

A

signet ring sign
ball on a tee sign
lobster claw sign

163
Q

primary vs secondary synovial osteochondromatosis

A

seocndary assocaited with articular surface disintegration due to loose intra-articular bodieswhich are calcified.

164
Q

synovial chondromatosis is also called what syndrome?

A

Reichel syndrome

165
Q

erlenmeyer flask deformity assocaited with

A

Gauchers, thalassaemia, osteopetrosis, and rickets

166
Q

desmoid tumours are assocaited with

A

Gardners syndrome

167
Q

pointed proximal 5th metacarpal base

A

Morquio

168
Q

anterior vertebral body beaking by location

A

inferior - Hurlers / Hunters

central - Morquio

rounded anterior beaking still inferior 0 achondroplasia

169
Q

klippel - Trenaunay triad

A

port wine naevus

overgrowth of distal digits

varicose veins on the lateral aspect of the limb

170
Q

TACE

abdolute contraindications

A

decomp liver failure - C
Jaundice
encephalopathic
refractory ascites

both lobe extensive tumour

reduced portal vein flow

renal insufficiency

171
Q

bladder TB cuases

A

thimble bladder

172
Q

discplacemetn of the 4th ventricle is typical of

A

brainstem glioma

173
Q

indications for TIPS

A

variceal bleeding
refractory ascietes
hepatorenal syndrome
budd chiari syndrome
hepatic veno occlusive diseease
hepatic hydrothorax
portal hypertensive gastropathy

174
Q

rectal cancer T staging

A

Tis - in situ
T1 - to submucosal
T2 - muscularis propria
T3 - mesorectum
a <5mm
b - 5- 10mm
c - >10mm
T4 - visceral peritoneum
b - other organs

175
Q

rectal cancer N staging

A

1c - tumour in regional. subserosa, mesentery.

N2a - four to six regional nodes

176
Q

what is Stills disease

A

polyarticular rheumatoid juvenile arthritis.

fever rash heptasospelnomegaly pericarditis

6 weeks or longer
some have rheumatoid factor

177
Q

Stills disease in the hands

A

periosteal reaction of the hands

boradened bones

cortical thickening

fevers + joint pain + salmon pink rash

178
Q

Lyme disease vs Stills in joints

A

Lyme disease is normally monoarticular

179
Q

do haemangioblastomas calcify

A

NO

180
Q

microadenoma mri appearance

A

low on T1 and non-enhancing post gadolinium

normal pituitary is iso anteriorly. Posterior is high T1 and low T2.

181
Q

“mulberry-like” cluster of hyalinized dilated thin-walled capillaries, with surrounding haemosiderin

A

cavernous malforations

182
Q

dilated capillaries and are interspersed with normal brain parenchyma with a thin endothelial lining but no vascular smooth muscle of elastic fibre lining.

A

capillary telangiectasia

183
Q

cavernous malforamtions and capillary telegievtasia are similar

distinguished by

A

telangiectiasia is interpseresed with normal brain parenchyma

184
Q

most common type of paeds brain tumour is

A

astrocytoma
or
medulloblastoma

185
Q

doppler criteria of renal artery stenosis

(post transplant)

A

v > 2m/s

velocity gradient over stenosis greater than 2:1

marked distal turbulence

186
Q

causes of increased bladder volume

A

enlarged prostate

strictures

amrions disease (obsdtructed bladder neck )

187
Q

4th ventricle

location of medulloblastoma and ependymoma

A

medulloblastoma from the roof

ependymoma from the floor

188
Q

features of inactive long standing crohns disease

A

submucosal fat deposition

pseudosacculation

fibro-fatty proliferation

fibrotic strictures

189
Q

haemangioblastoma vs pilocystic astrocytoma

A

haemangioblastoma in adults

jpa in kids - cyst wall enhances. some calc. v avid mural nodule enhancement.

190
Q

how to treat a pseudo aneurysm

A

mainly via US thrombin injection

but if greater than 3mm neck or the size is greater than 5cm needs operation

191
Q

How does the location of the 4th ventricle change in chiari I vs II

A

II it is displcaed caudally

192
Q

what are the Ax of Chiari II

A

Lumbar myelomeningocele
syringohydromyelia
dysgenesis of corpus callosum
obstructive hydrocephalus
absent septum pellucidem
excessive cortical gyrations

193
Q

Ax of chiari 1

A

basilar impresison
occipitalisation of the atlas
pltaybasia
Klipperp-Feil anomaly

194
Q

Which Crohns ulcers does MR enteroggraphy allow visualisation of

A

Deep
not apthous

195
Q

Indications of skeletal survey

A

MM
NAI
Eosinophilic grnulomatous
SKeletal dysplasia

196
Q

What is the imaging appearance of medulloblastoma

A

Midline
Non-calc
Solid/dense

obstruct 4th ventricloe
arise from 4th vetrricle roof

enhances with contrast

197
Q

How does a colloid cyst appears

A

attenuates on CT
high T1 from fat

flair postive

198
Q

what is the most common pure germ cell tumour

A

Seminoma

199
Q

What is the US appearance of teratomas

A

Well circumscribed complex mass

200
Q

Alobar holoprosencephaly

A

single frontal lobe , single ventricle

201
Q

lobar haloprosencephaly

A

there is division
but no septum pallucidem

202
Q

What is hamartoma of tuver cinerum

A

tuber cinerum is around the hypothalamus

get gelastic seizures

203
Q

Parahypothalamix hamartomas are found where

also called tuber cinereum hamartomas

A

floor of hypothalamus

204
Q

Most common soft tissue sdarcoma of later adulthood

A

Pleomorphic undifferentiated Sarcoma

205
Q

Common mets to small bowel is

A

melanoma

206
Q

Sertoli cell tumour is asscoaited with which systemic condition

A

Peutz-Jeghers

207
Q

Apperance of CJD on MRI

A

high singal in head of caudate and putamen

208
Q

Down get which ASD

A

ostium primum

209
Q

Radiation induced bone cancer is

A

Sarcoma then osteosarcoma (in terms of likelihood)

210
Q

Kidneys Brodel Bloodless line is found where

A

Posterolateral to the kidney

211
Q

Most common bilateral testicular tumour

A

lymphoma

212
Q

Peripheral neurofibromatosis is

A

NF1

213
Q

triad of NF1

A

cutaenous lesions
skeltal deformity
mental deficiency

214
Q

Which eye lesion is found in TS

A

optic nerve hamartoma

215
Q

features of benign thyomoma

A

Mild homogenous enhancement

216
Q

invasive thyomoma

A

heterogenous enhancement
egg shell calcification

217
Q

Best sign for perorated appendicixsits

A

focal absense of wall enhancement

218
Q

Erlenmeyer flask deformity is ax with what condition

A

LORA CHONG

leukameia
osteopetrosis
RA, rickets
achondroplasia

craniometaphyseal dysplasias
hypophosphatasia
niemann pick
gauchers disease

219
Q

fracture to hook of hamate can happen how

and cause what

A

in racket sports

causes compression of the nerve ulnar

do MRI

220
Q

tail gut cyst vs rectal duplication cyst

A

tail gut cyst - mucinous therefore high T1
rectal duplication cyst - high T2

221
Q

TS triad

A

mental retardation
adenoma sebaceum
epilepsy

ax with pckd1
get lots of amls
hamartomas in spleen

222
Q

cd4 levels and lung infections

A

500 + normal
200 - 500 - karposi, candidiasis
100 - 200: PCP, histoplasmosis, coccidioidomyocosis, pml
50 - 100: toxoplasma, cryptospiridiosis, cryptococcosis, cmv

<50: MAC

223
Q

weigert meyer rule

A

up obstructs - infero medial ectopic insertion with ureterocele
low flow - reflux due to horizontalinsertion

224
Q

posterior iliac horns think

A

nail patella syndrome

225
Q

fragmented/absent/hypoplastic patellae with a tendency for recurrent patellar dislocation
hypoplasia of the radial head and/or capitellum leading to subluxation or dislocation dorsally
bilateral posterior iliac horns (“Fong prongs”)
flared iliac crests with protuberant anterior iliac spines

A

nail patella syndrome

226
Q

paeds UTI imaging guidelines

A

3 categories based on age
<6 months - do a routine 6 week scan for a normal UTI. Do everything for atypical/recurrent.
6 months to 3 years - acute scan if atypical, 6 week if recurrent. DMSA for both.
3+ - Acute if atypical. 6 week us and dmsa if recurrnet.

227
Q

what proportion of bening mesothelioma becomes malignant?

A

8 - 30%

227
Q

benign mesothelioma is now called

A

solitaory fibroma

228
Q

imaging appearance of solitary fibroma

A

move on repsiration

T1 dark
T2 iso to bright if necrotic bits
big avid enhacnement with contrast

229
Q

imaging appearance of toxic colitis / toxic megacolon

A

typically transverse colon
pneumoeritoneum if perf

CT - loss of haustra markings, pleudopolyps / mucosal ilslands extend into the lumen due to ulceration of colonic wall. thumbprinting.

230
Q

list the schatzker classification for tibial fractures

A

1 - split
2 - split + depression
3 - central depression

4 - split fracture medial!
5 - bicondylar fracture
6 - dissociatin of metaphysis and diaphysis

231
Q

what is an Agger Nasi cells

A

anterior ethmoidal air cells. can cause sinusitis

232
Q

what is a haller cell

A

infraorbital ethmoid air cells

233
Q

what are the imaging features of constrictive pericarditis

A

will cause increased pressure in the IVC/svc and azygoes.

the interventricular septum will bow to the left due to increased right sided pressures.

234
Q

causes of constrictive pericarditis

A

post surgery

tb
coxsackie b
uraemia

235
Q

A hallmark finding of ascending cholangitis on ultrasound is

A

thickening of the walls of the bile ducts in the appropriate clinical setting

236
Q

acute choleCYSTITIS vs acute cholangitis

A

acute choleCYSTIitis - just the gallbladder

cholangitis is the biliary tree

237
Q

The development of acute calculous cholecystitis follows a sequence of events:

A

gallstone obstruction of the gallbladder neck or cystic duct

inflammation from chemical injury of the mucosa by bile salts

reactive production of mucus, leading to increased intraluminal pressure and distention

increased luminal distention restricting blood flow to the gallbladder wall (gallbladder hydrops)

increasing wall thickness from oedema and inflammatory changes

secondary bacterial infection in ~66% of patients

238
Q

The most sensitive US finding in acute cholecystitis is

A

the presence of cholelithiasis in combination with the sonographic Murphy sign

Both gallbladder wall thickening (>3 mm) and pericholecystic fluid are secondary findings.

239
Q

Heterotopic ossification refers to

A

the presence of bone in soft tissue where bone normally does not exist (extraskeletal bone).

Lesions range from small clinically insignificant foci of ossification to large deposits of bone that cause pain and restriction of function.

240
Q

dentigurous vs odontogenic kerato vs radicular

A

odontogenic - unilocular, has ax to Gorlin if multiple.
dentigurous - ax to the base of teeth
radicular - big expansile, no scalloping or septation

241
Q

adamantinoma

what and where are they found

A

often in the tibial diaphysis

soap bubble
no periosteal reaction

aggressive therefore surgically removed

242
Q

partly solid and ground glass pulomonary nodules are most likely to represent which type of cancer

A

adenocarcinoma

243
Q

uterus - submucosa vs subserosal

A

mucosa is on the inside

subserosa is outside

244
Q

types of lisfrance injury

A

divergent
homolateral

divergent - get medial dislocation of the 1st metatarsal joint
homolateral - either 2nd -5th is move lateral or 1st to 5th move latera.

245
Q

what is a tornwald cyst

A

midline
oropharynx cyst

get drip or halitosis

246
Q

what is cherubism

A

a bit like fibrous dysplasia get seling of the jaw and maxilla.

get exapnsile

247
Q

what is breast pappilloma

A

duct ectasia and a papilloma within it . benign hyperplastic epithelium.
most common cause of blood/serous discharge from nipple

248
Q

what is the normal enhancement of the prostate

A

transitional and central zone is lower than the peripheral zone.

hence in the peripheral zone get low T2 and restricting adenocarcinoma

249
Q

What is olliers disease

A

Multiple enchondromas.

Random mutation
There is an ax with gliomas and granulosa of ovary.

250
Q

enchondroma (also called chondromas) appearance

A

ring and arcs
hand and wrist most common.

narrow transition.
sharp edges.
expansile

251
Q

prostate T staging

A

T1 a and b - 5% over under. incidental
T2 - palpable. a - less than half.

T3 - outside prostate. b is into the seminal vesicles.

T4 - into adjancent tissue

252
Q

astrocytoma vs haemangioblastoma

A

kids vs adult
haemngioblastoma cyst wall DOESN’T enhance.
- astro can have
Haemangioblastoma - no calc.
- astro can have

253
Q

common compication post gastric banding

A

stomach stenosis

254
Q

most commmon cuase of pulmonary artery aneurysm

A

Behcets

255
Q

behcets vasculitis triad

A

ocular
oral ulcers
genital ulcers

256
Q

Wolman prognosis

A

die in 6months
lots of internal fat. Bilateral adrenal calcification possible

257
Q

Thymic epithelial tumours
(ie thyomoma, invasive thyomoma and thymic carcinoma)

A

cysts and calc are common in malingnant

A :medullary histology thymomas - round and smooth
B: Calc
C: carcinoma - invade mediastinal fat

258
Q

Thyomoma ax conditions

A

Myasthenia gravis
red cell aplasia
hypogammaglobulinaemia

SLE
RA
Graves
PA
Dpolymyo
cushings

259
Q

erlenmayer flask deformity ax with what conditions

A

Lysosomal storage disease
haemoglobinopathies

Ollier
achondroplasia
FD

260
Q

herpes simplex encephalitis affects where

A

limbic system, mid temporal lobes. asymmteric, insular cortices.

spares the basal ganglia - differentiation from middle cerebral artery infarction.

261
Q

what is blounts disease

A

from abnormal stress - calssic obese kids.
no pain
Tibia Vara (also called)

262
Q

Bladder cancer - at what stage to do radical cystectomy

A

invasive.

T1 or carcinoma in situ is resection WITH chemo.

only Ta can be trated by resection alone

MRI needed for differentiating T1 from T2

263
Q

osteosclerosis is ax with what hyperparathyroidism

A

Secondary

264
Q

mechanism of hyperparathyroidism

A

parathyroid hormone lead to increased osteoclastic activity.

bone resorption produces cortical thinning (subperiosteal resorption) and osteopenia.

265
Q

hyperparathyroidism sub perisosteal bone resoorption

classically affecting where>

A

radial aspects of the proximal and middle phalanges of 2nd and 3rd fingers

266
Q

rugger jersey spine, browns tumours

A

hyperparathyroidsm

267
Q

post lung transplant infections

A

intermediate period - candida, CMV, aspergillus

late - RSV, TB

268
Q

what is dandy wlaker malformation

A

vermis agenesis
4th ventricle dilatation
enlarged posterior fossa

269
Q

LAM affects who

A

young women (20-30s)

270
Q

LAM is ax with what

A

TS
chyloous effusion

271
Q

What are the CT features of LAM

A

diffuse thin walled cysts surrounded by normal lung

272
Q

Hand Schuller Christian is a type of

A

LCH

classicly kids.

triad of Diabetes inspidus, proptosis and lytic bone disease.

273
Q

Rathke on MRI

A

can be T1 bright if high protein content.
T2 mostly bright.
non enhancement as cust.

274
Q

pituitary adenoma imaging features

A

basically sio to brina unless have haemorrhage or cystic componenet

contrast moderate to bright enhancement

275
Q

US kidneys
lesion with central stellate appearance

A

Oncotycoma (seen in a third)
but look similar to RCC so taken out.

276
Q

Carmesistine and lung injury

A

Dose dependant

most other drugs aren’t dose dependnant

277
Q

RA lung disease is typically what pattern

A

UIP or NSIP
can be COP

reticulonodular

278
Q

How to grade liver trauma

A

1 - <1cm. <10%
2 - <10cm in diameter. 1-3cm in depth
3 - >3cm, >10cm in diamater. >50% surface area
4 - 25% - 75% lobe disruption, bleed to peritoneum
5 - major disruption, >75%

279
Q

bone changes in RA chest XR

A

reposroption of DISTAL clavicles
superior rib notching
rotator cuff tear

279
Q

most common tumour of the oseophagus

A

Leiomyosarcoma

280
Q

which stages of mesothelioma do you operate on

A

1 - 3

4 don’t

281
Q

Most common site of GI duplication cyst

A

Ileum

282
Q

what is transient synovitis of hips

A

common cause of hip pain in kids.
3-8 years old
1-3 days of hip pain

283
Q

What are the features of Wilsons on US

A

cirrhosis present age 10-13

therefore
ascites
varices

284
Q

extraintestinal features of IBD

A

Ank spond
single joint
clubbing
periostitis

285
Q

how to differentiate intramural haematoma vs mural thrombus

A

haematoma will be subintimal
dense on non contrast CT

mural thormbus is on top of the intima.

286
Q

osteoid osteoma on MRI

A

nidus will have a low T1
there will be oedema in the marrow adjacent

287
Q

How to reduce artefact in a hip prostheiss MRI

A

FSE over GE.
lower field strength
increase bandwith
thinner slices.
align prosthesis to magnetic field

288
Q

Disc calcification from
CPPD, haemachromatosi, high Vit D affect which bit

A

Annulus fibrosis

289
Q

describe the two types of gastric volvulus

A

Organo - axial.
- reversed greater and lesser curvatures
Mesentero - axial.
- antrum above the goj

290
Q

what is a brenner tumour

A

epithelial tumour of ovary
- normally women 50-70s.

benign

291
Q

imaging appearance of a brenner tumour

A

hypoechoic masses
half calcify in them

T2 dark as fibrous

292
Q

Write out the ovarian cancer/masses classifiers

A

functional vs endometrioma vs malignant

293
Q

types of ovarian malignant

A

ovarian epithelial

germ cell

sex cord

294
Q

which ovarian tumours are ax with endometrial hyperpalsia

A

endometrioid carcinoma
granulosa cell turnover (permenopaus)
- can secrete oestrogen
thecoma / fibrothecoma
- also oestrogen

295
Q

fibrothecoma on imaging

A

delayed enhancement.
t1 low
t2 - homogenous and lwo

296
Q

meigs syndrome from

A

Ovarian fibromas (benign)
but get the ascites and pleural effusion

297
Q

what is homocystinuria

A

metabolism disorder

eye lens - down and in (marfans up/out)
CNS - seizures, delay
Skeletal: scoliosis, pectus excavatum, long limbs, biconcave vertebrae.
Vascular: thromboembolism, annuloaortic ectasia

298
Q

what is sotos syndrome

A

large baby. big ehad.
big first year growth.

low intellect

299
Q

Lissencephaly appearance

A

smooth brain
no guri

300
Q

features of osteochondromas

A

cartilagenous cap (<2cm) covered by periosteum. away from the joint.

medullary cavity is continuous

  • form as kid. persist.
    can be part of multiple exostoses and trevor disease.
301
Q

pachygyria means

A

broad gyru

pachymeans fat or thick

302
Q

what are the causes of crazy paving?

A

Lipoid pnuemonia
proetinosis
COP
PCP
beonchialveolar carcinoma
sarcoid
NSIP
pulmonary haemorrhage

303
Q

PCOS how many cyst required

A

20cyst or >10ml.

304
Q

ovarian tumour with solid enhancing component what are the differentials

A

Sclerosing stromal tumour
sertoli-leydig
Struma ovarii
Cystadenofibroma

305
Q

what is the appearance of haemangiomas on different imaging

A

US - homogenous, hyperechoic, posterior enhancement
CT - blood pool. centripetal enhancement. Persist on delayed.

MRI - bright T2

306
Q

when is eovist used in Liver MRI

A

to discern FNH from Adenomas
- FNH, will take up and persist into delayed.

307
Q

when can steatosis be called on a CT

A

plain if liver is 10HU less than spleen.
with contrast about 25 less than spleent

normal liver is brighter than the spleen

308
Q

out of phase imaging is done on which sequence

A

GRe

309
Q

primary vs secondary haemachromatosis

A

primary - deposition

secondary - RES so spleen and marrow involved. haemosiderosis. frewuent transfusion.

310
Q

causes of a hyperintense liver

A

wilsons
iron
medications
glycogen

311
Q

why does FNH enhance with Eovist

A

it will on delayed as will uptake but can’t get rid of the contrast

Gad it will enhance with a central scar

312
Q

sulfur collid study used for

A

splenosis

313
Q

HIDA scan is used for

A

biliary tree

314
Q

what are the types of adeno

A

Inflammatory - common and bleedy
B Catenin - least common, glycogen storage disease. FAP
HNF Alpha - multiple, contraceptives

other

315
Q

causes of nephrocalcinosis

A

high calc - sarcoid, parathyroidism
renal acidosis
Medullary sponge kidney
papillary necrosis
Furosemide kids
Crohs
Osteoporis
drug induced

316
Q

C/I to liver biopsy

A

biliary duct dilataion
cholangitis
abnormal coagulation
thrombocytopenia
ascites
cysitc lesion

317
Q

resorbed calvicles think

A

hyperparathyrodism

but distal ones can be RA

318
Q

eccentric bone lesions

A

GCT
Chondroblastoma
ABC
NOF
Chondromyxoma

319
Q

central bone lesions

A

SBC, enchondroma, FD

320
Q

Mets to pericardium

A

lung
breast
lymph
melanoma

321
Q

Uterus on MRI by different layers

A

Endometrium is high

Myo - iso
junctional is LOW

322
Q

causes of posterior vertebral scalloping

A

achdronplaisa
mets
acromegaly
marfan

neurofibromatosis
ependymomomas
dural ectasia

323
Q

what are the signs of an open globe injury

A

contour change
loss of volume
flat tyre
air
fb

deep anterior chamber

324
Q

horseshoe kidney ax

A

Cardiovascular, skeletal, CNS, genitourinary,down, trisomy and turners

325
Q

congenital lobar emphysema preference for which lobes

A

LUL then RML then RUL

326
Q

ank spond fibrosis which lung zone

A

upper

327
Q

malignant GIST requires histopathologic analysis, but certain characteristics suggest malignancy 15:

A

exogastric growth

diameter >5 cm

central necrosis

extension to other organs

328
Q

optimal view of mitral in

A

2 chamber mid diastole

329
Q

prostate bone mets on MRI

A

low T2 and T1

330
Q

GPA diagnosis by 2 of the following 4

A

positive biopsy for granulomatous vasculitis

urinary sediment with red blood cells

abnormal chest radiograph

oral or nasal inflammation

331
Q

how do grade germinal matrix haemorrhage

A

1 - confined
2 - intraventricular extension
3 - big extension or dilated ventricle
4 - intraparenchymal extension

332
Q

Sonographic features favoring a benign nodule
thyroid

A

large cystic component

hyperechoic solid

comet tail artefact

spongiform appearance / sponge-like appearance 7,8

333
Q

Sonographic features favoring a malignant nodule

A

hypoechoic solid

presence of microcalcifications: almost always warrants biopsy

local invasion of surrounding structures

taller than it is wide

large size: the cutoff is often taken as 10 mm to warrant biopsy

suspicious neck lymph nodes suggesting metastatic disease

intranodular blood flow

334
Q

when to FNA a thyorid nodule

A

Solitary
- 1cm with micro calc
- 1.5cm with coarse calc or if solid.
- 2cm mixed solid cyst. mural componanet. grown in size.

multiple
- choose one based on above criteria

335
Q

thoracic duct starts where and moves to the left side where

A

starts T12 and moves to the left at T5

336
Q

rockwood ACJ disruption

A

1 - 6
1 - looks normal, ac sprain
2 - small elevation/widened. AC rupture. CC sprain. join rupture. deltoid min detached
3 - elevated, all ruptured / detached

337
Q

Hashimotos thyroiditis is what

A

autoimmune thyroiditis.
painless large thyroid. get hypothyroid as a result.

coarsened micronodular ghypoechoic on US

338
Q

classic featureless stomach is caused by

A

atrophic gastritis

339
Q

linitis plastica history would include

A

anaemia

340
Q

what vein thing can happen in graves

A

superior orbital vein can get enlarged due to poor outflow

341
Q

tracheomalcia can be a complciation of

A

polychondritis relapsing
COPD
intubation

342
Q

tracheomalcia is diangosed as

A

expiratory CT
collapse of 50%

343
Q

small bowle lymphoma can replicate crohns by

A

causing fistula.

crohns would be skip lesions though

344
Q

what is Potte puffy tumour

A

subperiosteal abscess of the frontal bone with frontal osteomyeltitis.

345
Q

Prostate Ca will do what on DWI

A

restrict

346
Q

prostate Ca - how to measure up the cancer

A

pirads 1-5

T2 DWI and kinetics
Peripheral
1: uniform high signal intensity (normal)

2: linear or wedge-shaped hypointensity or diffuse mild hypointensity, usually indistinct margin

3: heterogeneous signal intensity or non-circumscribed, rounded, moderate hypointensity; includes others that do not qualify as 2, 4, or 5

4: circumscribed, homogeneous, moderate hypointensity, and <1.5 cm in greatest dimension

5: same as 4 but ≥1.5 cm in greatest dimension or definite extraprostatic extension/invasive behavior

347
Q

causes of NAFL

A

DM
low thyroid
obese
high lipids
wilsons

348
Q

how does sagittal sinus thrombus cause small ventricles

A

cerebral oedema can compress the ventricles

349
Q

liver - anechoic lesion is a

A

cyst

350
Q

which hernia goes through hesselbachs triangle

A

direct

351
Q

Regeneration nodule vs dysplastic nodule

A

regenerative nodule has a lot of iron in it

dysplastic ones can have fat in them (t1 bright, often low T2)

352
Q

scirrhosis adenocarcinoma of stomach causes what appearance

A

small stomach

linitsplastica

353
Q

Menetriers triad

A

thickened stomach rugi
achloridia
low protein

354
Q

rhizo

meso

acro

A

femur / humerus

meso is the arm / leg

acro is hand/feet

355
Q

describe the adrenal washouts

A

review

356
Q

features suggestive of an adrenal carcinoma

A

large, calcification, necrotic centre

peripheral nodular enhancement

357
Q

osteosarcoma vs Ewings on location

A

Ewings appendicular but also CENTRAL axial

osteosarcoma diaphysis apendicular

358
Q

imaging appearance of scurvy

A

pelkin spurs around the metaphysisi
osteopenia
haemarthoris
cortical thinning

359
Q

cupping of metaphysis

A

rickets

360
Q

medullary spong kidney is ax with what

A

Ehlors - Danlos
PTH adenoma
carolis

361
Q

replaced right heaptic artery means what

A

the right haptic artery comes off the SMA

362
Q

Accessory hepatic artery means

A

comes from the SMA but with anormal right hepatic artery also

363
Q

replaced left hepatic artery comes from where

A

Left gastric

364
Q

where does the IMA terminate

A

superior rectal artery

365
Q

what is the pathway of winslow

A

anastomosis from the epigastric to external iliac

366
Q

draw out liver laceration

A

1 - 5(shattered)

367
Q

fat embolism timeframe

A

72 hours, gone by 2 weeks

368
Q

squaring of the patella think

A

Chronic haemarthrosis

369
Q

most common peritransplant fluid collections are

A

lymphoceles

370
Q

causes of lower zone fibrosis

A

Asbestos
aspiration
cryptogenic alveolitis
NF1, TS, RA, scleroderma, SLE, Drugs

371
Q

stages of neurocysticerosis

A

vesicular
colloidal - intense contrast
granular - oedema
calcified nodular

372
Q

DNETs are found in the

A

temporal bones

373
Q

PDOG -
ganglioglioma appearance

A

cyst with strong enhancing nodule
calcify in 50%

374
Q

DNET vs Astrocytoma

A

DNET as a rim on FLAIR
DNET T2 buibbly

375
Q

DNET cuase

A

seizures

376
Q

supernumaeray teeth, borad mandible,poorly developed calvicles

A

cleidocrnaial dysplasia

377
Q

cyst, mural nodule with a dural tail

A

PXA

378
Q

what do serous cystadenomas contain

A

Glycogen due to being lined by glycogen trich epithelium

379
Q

mx of serous cystadneomcarcinoma

A

benign, leave them alone

380
Q

mucinous cystadencarcinoma mx

A

surgery

381
Q

Solid pseduopapillary lesion of the pancreas mx

A

15% malignant so I think remove

382
Q

retinoblastoma on MRI

A

high T1 and low T2

383
Q

mcCune albright can get what endo diseases

A

prettyy much all of them –> raised

384
Q

Primary ciliary dyskinesia get bronchiectasiss where

A

lower lobes

385
Q

mortons neuroma is located where

A

between the 3rd and 4th metatarsals

386
Q

Melanoma on MRI

A

high T1 and low T2

387
Q

fetal MRI sequence to choose

A

only from the second trimester
indications: equivocal US
high risk pathology not seen on US

Single SHot Fast Spin Echo T2
T1
Steady state free precession for heart and blood vessels

388
Q

bone within a bone appearance

A

endosteal new bone formation

Pagets
sickle cell
thalassaemia gauchers
acromegaly
high vt D
scurvy rickets

389
Q

breast within a breast appearance

A

breast hamartoma

390
Q

investigate urethral diverticula how

A

double-balloon catheter urethrography (DBU)

or

MRI more common

391
Q
A

AA ST2 (14 decks)

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