High Yield Trivia Flashcards
1
Q
Pulmonary interstitial emphysema (PIE) - put the __________ side down
A
Bad
2
Q
Bronchial Foreign Body —put the ________ side down (if it stays that way, it’s positive)
A
Lucency
3
Q
Papillomatosis has a small (2% ) risk of squamous cell CA
A
.
4
Q
only variant that goes between the esophagus and the trachea. This is associated with trachea stenosis.
A
Pulmonary sling
5
Q
Thymic rebound—
A
seen after stress (chemotherapy). Can be PET-Avid
6
Q
most common mediastinal mass in child (over 10)
A
Lymphoma
7
Q
Anterior mediastinal mass with calcification
A
either treated lymphoma or thymic lesion (lymphoma doesn’t calcify unless treated)
8
Q
Most common posterior mediastinal mass in child under 2
A
Neuroblastoma (primary thoracic does better than abd)
9
Q
Hypertrophic pyloric stenosis—age?
A
3 weeks to 3 months (NOT at birth, NOT after 3 months)
10
Q
Criteria for HPS
A
4mm and 14mm (4mm single Wall, 14mm length)
11
Q
Annular pancreas presentation in child, adult
A
Children: duodenal obstruction
Adult: pancreatitis
12
Q
Most common cause of bowel obstruction in child over 4
A
Appendicitis
13
Q
Intussusception—age
A
3 months to 3 years is ok, earlier or younger think lead point
14
Q
Gastroschisis is always on the ____side
A
ALWAYS on the Right side
15
Q
Which has associated anomalies: omphalocele or gastroschisis?
A
Omphalocele has associated anomalies. Gastroschisis does not.
16
Q
Physiologic gut hernia normal at 6-8 weeks
A
.
17
Q
______ is elevated with hepatoblastoma
A
AFP
18
Q
_______ is elevated with hemangioendothelioma
A
Endothelial growth factor
19
Q
Most common cause of pancreatitis in a kid
A
Trauma (seatbelt)
20
Q
Weigert Meyer rule
A
Duplicated ureter on top inserts inferior and medial
21
Q
Most common tumor of the fetus or infant
A
Sacrococcygeal teratoma
22
Q
Most common cause of idiopathic scrotal edema
A
HSP
23
Q
Most common cause of acute scrotal pain age 7-14
A
Torsion of testicular appendages
24
Q
Etiology for testicular torsion
A
Bell Clapper Deformity
25
SCFE is a Salter Harris Type _____
Type 1
26
Physiologic Periostitis of the Newborn—age?
NOT NEWBORN! Doesn’t occur in newborn. Seen around 3 months.
27
Acetabular Angle should be ______, and Alpha Angle should be _______
Acetabular <30,
| Alpha >60
28
Most common benign mucosal lesion of the esophagus
Papilloma
29
Esophageal webs have increased risk for ____
Cancer and Plummer-Vinson Stndrome (anemia + web)
30
Dysphasia Lusoria —cause?
Compression by a right subclavian artery (most patients with aberrant rights don’t have symptoms)
31
Achalasia has increased risk of ____
Squamous cell cancer (20 years later)
32
Most common mesenchymal tumor of GI tract
GIST
33
Most common location for GIST
Stomach
34
Krukenberg tumor (what is it)
Stomach (GI) met to the ovary
35
Menetrier’s— involves the ____ and spares the _____
Involves the FUNDUS
| Spares the ANTRUM
36
Most common location for sarcoid (in the GI tract)
Stomach
37
Gastric remnants have an increased risk of cancer years after Billroth
.
38
Most common internal hernia
Left sided paraduodenal
39
Most common site of peritoneal carcinomatosis
Retrovesical space
40
Injury to bare area of the liver can cause _____
Retroperitoneal bleed
41
Primary Sclerosing Cholangitis associated with _________
Ulcerative Colitis
42
Extrahepatic ducts are normal with ________
Primary Biliary Cirrhosis
43
__________ are positive with primary biliary cirrhosis
Anti-mitochondrial Antibodies
44
Mirizzi Syndrome—(what is it)
Stone in the cystic duct obstructs CBD
45
Mirizzi has a 5x increased risk of ______
GB cancer (5x increased risk)
46
Dorsal pancreatic agenesis—associated with ________
Diabetes and polysplenia
47
Hereditary and Tropical Pancreatitis—age of onset, increased risk of _____
Early age of onset,
| Increased risk of cancer
48
Felty’s Syndrome—features?
Big spleen,
RA,
Neutropenia
49
Splenic Artery Aneurysm—more common in _______; more likely to rupture in _________
more common in WOMEN.
| more likely to rupture in PREGNANT WOMEN.
50
Most common islet cell tumor
Insulinoma
51
Most common islet cell tumor with MEN (not overall most common!)
Gastrinoma
52
Ulcerative colitis has increased risk of ______
Colon cancer (if it involves colon past the splenic flexure). UC involving just rectum does not increase cancer risk.
53
Calcifications in a renal CA—associated with _______
Improved survival
54
RCC bone mets appearance
“Always” lytic
55
Increased risk of _______ with dialysis
Malignancy
56
Horseshoe kidneys more susceptible to ________
Trauma
57
Most common location for TCC
Bladder
58
Second most common location for TCC
Upper urinary tract
59
Which is more commonly multifocal: bladder TCC or upper tract TCC?
Upper tract TCC more commonly multifocal. (Upper tract 12%; bladder 4%)
60
Weigert Meyer Rule
Upper pole inserts medial and inferior
61
Ectopic ureters—associated with _____
Incontinence in women (NOT men)
62
Leukoplakia vs Malakoplakia: which is pre-malignant?
Leukoplakia is pre-malignant. (Malakoplakia is not)
63
Extraperitoneal bladder rupture is ____ common, and managed _______
Extraperitoneal bladder rupture is MORE common and managed MEDICALLY
64
Intraperitoneal bladder rupture is ______ common and managed _______
Intraperitoneal bladder rupture is LESS common and managed SURGICALLY
65
Only stones not seen on CT
Indinavir stones
66
Stones not seen on plain films
Uric acid stones
67
Endometrial tissue in a rudimentary horn (even one that does not communicate) increases risk of ______
Miscarriage
68
Arcuate Uterus (does OR does not?) have increased risk of infertility
Does NOT (it’s a normal variant )
69
Fibroids with higher T2 signal respond _______ to UAE
Better
70
_______ Fibroid Degeneration is most common subtype
Hyaline Fibroid Degeneration
71
Adenomyosis — favors _____, spares _______
Favors POSTERIOR WALL,
| Spares CERVIX
72
Hereditary non-polyposis colon cancer (NHPCC)—30-50x increased risk of _______
Endometrial cancer
73
Tamoxifen— increases risk of ______
Endometrial cancer and endometrial polyps
74
Cervical cancer —
treatment for types
WITH parametrial involvement (2B) or WITHOUT (2A)
WITH (2B)—chemo/radiation.
| WITHOUT (2A)—Surgery
75
Vaginal cancer in adults is usually ____
Squamous cell
76
Vaginal Rhabdomyosarcoma—age?
Children/teens
77
Ovaries on PET (premenopausal vs post-menopause)
Premenopausal ovaries can be hot (depending on phase of cycle). Post menopause should never be hot.
78
Transformation subtypes: endometrioma=________;
| Dermoid=_____________
Endometrioma =Clear cell;
| Dermoid = squamous
79
Postpartum fever can from ____
Ovarian vein thrombophlebitis
80
Fractured penis—what is it really
Rupture of corpus cavernosum and surrounding tunica albuginea
81
Prostate Cancer most commonly in _____ zone. -ADC _______
Most commonly PERIPHERAL ZONE. -ADC DARK
82
BPH nodules—location
Central zone (prostate cancer in peripheral zone)
83
Most common association with prostatic utricle
Hypospadias
84
Seminal vesicle cysts—associated with _____
Renal agenesis and ectopic ureters
85
Cryptorchidism—increases risk of _____
Cancer (in BOTH testicles); not reduced by orchiopexy
86
Immunosuppressed patients can get ____________, hiding behind the blood-testes barrier
Testicular lymphoma
87
Most common cause of correctable infertility in men
Varicocele
88
Undescended testicles are more common in _________
Premature kids
89
Membranes disrupted before 10 weeks, increased risk of ________
Amniotic bands
90
Earliest visualization of embryo is the “_______ Sign “
“Double Bleb Sign “
91
Hematoma greater than _______ the circumference of the chorion has increased risk of ______
Hematoma greater than *2/3* the circumference of the chorion has increased risk of ABORTION (2x increased risk)
92
Biparietal Diameter—how measured
Recorded at level of thalamus,
| From outer edge of near skull to the inner table of the far skull
93
Abdominal Circumference—does not include ______
Subcutaneous soft tissues
94
Abdominal Circumference—where measured?
Recorded at level of the junction of the umbilical vein and left portal vein
95
Parameter classically involved with asymmetric IUGR
Abdominal Circumference
96
Femur Length (does OR does not?) include the epiphysis
does NOT include the epiphysis
97
Umbilical Artery Systolic/Diastolic Ratio — should not exceed _____ at 34 weeks
3
| Makes you think pre-eclampsia and IUGR
98
Placenta previa mimic
Full bladder
99
Nuchal ligament — measured at what age? and should be what size?
Measured between 9-12 weeks.
Should be < 3mm
(greater than 3mm associated with downs)
100
Lemon sign (repro) will disappear after ________
24 weeks
101
Most common cause of non-communicating hydrocephalus in a neonate
Aqueductal Stenosis
102
______ valve is the most anterior
Tricuspid
103
________ valve is the most superior
Pulmonic
104
There are ___(number)___ lung segments on the right, and _____ on the left.
10 on the right,
| 8 on the left
105
If it goes ______, it’s in the posterior mediastinum.
Above the clavicles
| cervicothoracic sign
106
Azygos lobe has _____ layers of pleura
4 layers
107
Most common pulmonary vein variant
Separate vein draining the right middle lobe
108
Most common cause of pneumonia in AIDS patient
Strep pneumonia
109
Most common opportunistic infection in AIDS
PCP
110
Immune status of patient with aspergilloma
Normal immune patient
111
Immune status of patient with Invasive Aspergillosis?
Immune compromised patient
112
Fleischner Society Recommendations do NOT apply to patients with ___________
Known cancers
113
Most suspicious pattern (chest)
Eccentric calcifications in a solitary pulmonary nodule pattern
114
Most suspicious morphology you can have (chest)
A part solid nodule with a ground glass component
115
Lung CA most commonly presents as _____
Solitary nodule
116
Stage 3B lung CA is (resectable or unresectable?)
unresectable
(Contralateral nodal involvement; ipsilateral or contralateral scalene or supraclavicular nodal involvement,
Tumor in different lobes.)
117
Most common cause of unilateral lymphangetic carcinomatosis
Bronchogenic carcinoma lung cancer invading the lymphatics
118
There is a _____(time)___ latency between initial exposure and development of lung cancer or _______. (My note: I’m assuming asbestos or inhaled toxin/irritant?)
20 year latency.
| Pleural Mesothelioma
119
Earliest and most common finding with asbestos exposure
Pleural effusion
120
Silo Filler’s Disease : agent, pathology pattern
Nitrogen dioxide,
| Pulmonary edema pattern
121
First finding of UIP on CXR
Reticular pattern in the posterior costophrenic angle
122
Most common recurrent primary disease after lung transplant
Sarcoidosis
123
Pleural plaque of asbestosis typically spares ______
Costophrenic angles
124
Most common manifestation of mets to the pleura
Pleural effusion
125
There is an Association with mature teratomas and ______.
Klinefelter Syndrome
126
Injury close to the carina is going to cause ________, rather than _______
Will cause PNEUMOMEDIASTINUM.
| Rather than Pneumothorax.
127
MRI is ___(superior or inferior )__ for assessing superior sulcus tumors because _________.
MRI is SUPERIOR.
| Because you need to look at BRACHIAL PLEXUS.
128
Most common benign esophageal tumor. (And where most common location?)
Leiomyoma.
| Most common in distal 1/3.
129
Esophageal Leiomyomatosis May be associated with _______
Alport’s Syndrome
130
Bronchial/tracheal injury must be evaluated with _______
Bronchoscopy
131
“If you say COP also say _____.”
Eosinophilic Pneumonia
132
“If you say BAC also say ______”
Lymphoma
133
Bronchial atresia is classically in the ______
LUL
134
Are they simple?:
- Pericardial cysts
- Bronchogenic cysts
Pericardial cysts MUST be simple.
| Bronchogenic cysts don’t have to be simple.
135
Post treatment, PAP follows rule of ______.
Rule of 1/3s:
1/3 gets better,
1/3 doesn’t,
1/3 progresses to fibrosis.
136
Dysphagia Lusoria presents later in life as ________ develops
Atherosclerosis
137
Carcinoid is _____ on PET
COLD
138
Wegener’s is now called ________ (bc Wegener was a Nazi.)
Granulomatosis with Polyangiitis
139
The right atrium is defined by the ____
IVC
140
The right ventricle is defined by the _________
Moderator band
141
The _____ papillary muscles insert on the septum.
Tricuspid. (Mitral ones do NOT.)
142
PET appearance of lipomatous hypertrophy of the intra-atrial septum
Can be PET Avid
143
LAD gives off _______
Diagonals
144
RCA gives off ____
Acute marginals
145
LCX gives off_____
obtuse marginals
146
RCA perfuses ___ and ____
SA and AV nodes (most of the time)
147
Dominance is decided by which vessel _____ (cardiac Section).
It’s the ___(Right or Left)___ 85% of time.
Dominance is decided by which vessel lives off the posterior descending.
It’s the RIGHT 85%.
148
Treatment for LCA from Right Coronary Cusp
ALWAYS gets repaired
149
Treatment for RCA from Left Coronary Cusp
Repaired if symptoms
150
Most common location of myocardial bridging
Mid portion of the LAD
151
Coronary Artery Aneurysm:
Most common cause in
Adult?
Child?
```
Adult = Atherosclerosis
Child = Kawasaki
```
152
Left Sided SVC empties into ______
The coronary sinus
153
Most common cause of mitral stenosis
Rheumatic heart disease
154
Most common cause of tricuspid atresia
Pulmonary Arterial Hypertension
155
“Double most common vascular ring is _____”
The double aortic arch
156
Most common congenital heart disease
VSD
157
Most common ASD
Secundum
158
Infracardiac TAPVR classically shown with _______ in a newborn
Pulmonary edema in a newborn
159
Prognosis :
“L” Transposition type?
“D” Transposition type?
“L” Transposition is congenitally corrected (they are “L”ucky).
“D” Transposition type is Doomed.
160
Truncus is associated with _____
CATCH-22 (DiGeorge)
161
Rib notching from coarctations spares the _________
1st and 2nd ribs
162
Prognosis for recovering function: infarct with 50% involvement?
Unlikely to recover function
163
Microvascular Obstruction ___(is OR is not?)___ seen in chronic infarct
is NOT
164
Most common cause of restricted cardiomyopathy
Amyloid
165
Primary amyloid can be seen in multiple myeloma
.
166
Most common neoplasm to involve the cardiac valves
Fibroelastoma
167
Congenital absence of the pericardium (most commonly):
- Complete or partial?
- when partial, describe which part
- PARTIAL most common
- involves pericardium over LEFT atrium and adjacent pulmonary artery. (The LEFT atrial appendage is the most at risk to become strangulated.)
168
Glenn Shunt: describe
SVC to pulmonary artery (vein to artery)
169
Blalock-Taussig Shunt: describe
Subclavian Artery to Pulmonary Artery (Artery-Artery)
170
Ross Procedure: describe
Replaces aortic valve with pulmonic, and pulmonic with a graft (done for kids)
171
Aliasing is common with Cardiac MRI. Fix it by: ?
1) opening your FOV,
2) oversampling the frequency encoding direction, OR
3) switching phase and frequency encoding directions.
172
Giant Coronary Artery Aneurysms (>8mm): prognosis
Don’t regress.
| Associated with MIs.
173
Wet Beriberi
Thiamine deficiency.
| Can cause Dilated cardiomyopathy.
174
Most common primary cardiac tumor in children
Rhabdomyoma
175
Second most common primary cardiac tumor in children
Fibroma
176
Most common complication of MI
Myocardial remodeling
177
Unroofed coronary sinus is associated with _____
Persistent left SVC
178
Most common source of cardiac mets
Lung cancer (lymphoma #2)
179
A-Fib is most commonly associated with _____
Left atrial enlargement
180
Most common cause of tricuspid insufficiency
RVH (usually from pulmonary hypertension/ cor pulmonale)
181
Artery of Adamkiewicz:
- comes off on __(Right or left?)__
- between ______
Comes off on LEFT side (70%)
| between T8-L1 (90%).
182
Arch of Riolan: parts?
Middle colic branch of the SMA with the left colic of the IMA
183
Most common hepatic vascular variant (and description)
Right hepatic artery replaced off the SMA.
Proper right hepatic artery is ANTERIOR the RIGHT portal vein.
Replaced right hepatic artery is POSTERIOR to the MAIN portal vein.
184
Most common hepatic venous variant
Accessory right inferior hepatic vein
185
First branch off popliteal
Anterior tibialis
186
Common Femoral Artery: begins at the level of _____
Inguinal ligament
187
Superficial Femoral Artery: begins once the _____
Begins once the CFA (common fem art) gives off the profunda femurs
188
Popliteal Artery: terminates as the ____ and ______
Anterior tibial Artery And
| Tibioperoneal Trunk
189
Popliteal Artery: begins as the ____
SFA exits the adductor canal
190
Axillary Artery: begins at the ____
First rib
191
Brachial Artery: begins as it crosses ______
Teres major
192
Brachial Artery: bifurcates to the ____ and ______
Ulnar and radial artery
193
Intraosseous Branch: typically arises from the _______
Ulnar artery
194
Superficial arch: from the ____.
| Deep Arch: from the ______.
Superficial Arch: from the Ulna.
| Deep Arch: from the Radius.
195
The “coronary vein” is the _____
Left gastric
196
Enlarged splenorenal shunts are associated with _______
Hepatic encephalopathy
197
Aortic Dissection and Intramural Hematoma are both caused by ______
Hypertension (70%)
198
Penetrating ulcer is from ______
| Vascular section
Atherosclerosis
199
Strongest predictor of progression of dissection in intramural hematoma
Maximum aortic diameter >5cm
200
Leriche Syndrome triad
Claudication,
Absent/Decreased femoral pulses,
Impotence
201
Most common associated defect with aortic coarctation
Bicuspid aorta (80%)
202
Most common subtype of thoracic outlet syndrome
Neurogenic compression
203
Splenic Artery Aneurysm:
- more common in which population?
- more likely to rupture in which population?
- more common in pregnancy.
| - more likely to rupture in pregnancy.
204
Median Arcuate Compression: worse with ______
Expiration
205
Colonic Angiodysplasia: associated with ____\
Aortic stenosis
206
Popliteal Aneurysm stats:
- % of patients with PA who have AAA?
- % of patients with AAA who have PA?
- % of PAs that are bilateral ?
- 30-50% have AAA
- 10% of AAA patients have PA
- 50-70% of PAs are bilateral
207
Popliteal Entrapment: cause (anatomical)
Medial deviation of the popliteal artery by the medial head of the gastrocnemius
208
Type ____ Takayasu is the most common
Type 3 (arch + abdominal aorta)
209
Most common vasculitis in a kid
HSP (Henoch-Schonlein Purpura)
210
Tardus parvus infers stenosis ____(direction)_____ to that vessel
Proximal
211
ICA Peak Systolic Velocity:
| 3 categories/cut-offs
<125: No Significant Stenosis
(<50%)
125-230: stenosis (“Moderate”)
>230: >70% Stenosis (“Severe”)
212
18G needle will accept _____ inch guidewire
19G needle will accept _____ inch guidewire
18G=0.038 inch
19G=0.035 inch
Note: 0.038, 0.035, 0.018 wires are INCHES!!
213
3 French = _____
1 mm
214
French size is the __(inside OR outside?)__ of a catheter,
| And the __(inside OR outside?)__ of a sheath
French:
OUTSIDE of a catheter,
INSIDE of a sheath
215
End Hole Only Catheters = ____
Hand Injection Only
216
Side Hole + End Hole =______
Power Injection OK, Coils NOT OK
217
Double flush technique is for....?
For neuro IR —no bubbles ever
218
“Significant lesion” means....? (IR)
A systolic pressure gradient >10mmHg at rest
219
Don’t stick a drain in....? (3 things. IR.)
Tumors,
Acute hematoma ,
Those associated with acute bowel rupture and Peritonitis
220
Renal Artery Stenting for renal failure: tends to not work if _____
Cr >3
221
Persistent sciatic artery is prone to _______
Aneurysm
222
Even if the cholecystostomy tube instantly resolves all symptoms, you need to leave the tube in for ________ , otherwise you are going to get _____
MUST leave tube in 2-6 weeks (until the tract matures).
Or you’ll get a bile leak.
223
MELD scores greater than 24 are at risk of _______
Early death with TIPS
224
Target gradient post tips (for esophageal bleeding) is _____
Between 9 and 11
225
Absolute contraindications for TIPS
Heart failure,
| Severe hepatic failure
226
Most common side effect of BRTO (IR)
Gross hematuria
227
Sensitivity (required rate to detect):
- GI Bleed Scan?
- Angiography?
GI Bleed Scan: 0.1 mL/min
| Angiography: 1.0 mL/min
228
For GI Bleed: after performing an embolization of the GDA (for duodenal ulcer), you need to do a run of the _____ to look at the_______
SMA
| inferior pancreaticoduodenal
229
Most common cause of lower GI bleed
Diverticulosis
230
TACE vs systemic chemo, which is better for survival length?
TACE will prolong survival better than systemic chemo
231
TACE: contraindication (sometimes)
Portal Vein Thrombosis (sometimes considered contraindication) due to risk of infracting liver
232
Go _____ the rib for Thora
Above
233
Left Bundle Branch Block needs _____ before a thoracic angiogram
A pacer
234
Never inject contrast through a _______ for a thoracic angiogram
Swan ganz catheter
235
You treat pulmonary AVMs at _____ (size)
3mm
236
Hemoptysis: do you typically see active extravasation with the active bleed?
No. Active extravasation is NOT typically seen with the active bleed
237
UAE— Gonadotropin-releasing medications (often prescribed for fibroids) should be stopped for _____prior to the case
3 months
238
The general rule for transgluteal is to avoid ________ and _______ by access through __________. (IR)
Avoid the sciatic nerves and gluteal arteries .
| Access through the sarcospinous ligament medially (close to the sacrum, inferior to the piriformis)
239
When to pull an abscess catheter
As a general rule,
- when the patient is better (no fever, wbc normal), and
- output is <20cc over 24 hours.
240
The the thyroid biopsy is non-diagnostic, you have to wait _______ before you re-biopsy.
3 months
241
Approach for percutaneous nephrostomy
Posterior lateral approach
242
You can typically pull a sheath with an ACT <150-180.
.
243
Artery calcifications (common in diabetics) make compression difficult, and can lead to a false elevation of ________. (IR)
The ABI
244
Most common type of endoleaks
Type 2
245
Types of endoleaks that are high pressure and need fixing stat
Type 1 and Type 3
246
```
Circumaortic Left renal vein:
Anterior one is ___(location)__.
Posterior one is _______.
Filter should be _______.
(IR)
```
Anterior one is SUPERIOR.
Posterior one is INFERIOR.
Filter should be BELOW THE LOWEST ONE.
247
Risk of _____ is increased with IVC filters. (IR)
DVT
248
What do you do with a Filter with clot > 1cm^3?
Filter stays in
249
What do you do: Budd Chiari with fulminant liver failure
Needs a TIPS
250
What do you do: Pseudoaneurysm of the pancreaticoduodenal artery
“ sandwich technique”— distal and proximal segments of the artery feeding off the artery must be embolized
251
Median arcuate ligament syndrome: first line therapy
Surgical release of the ligament
252
Massive hemoptysis: likely source
Bronchial artery. Particles bigger than 325 micrometers
253
Acalculus cholecystitis: treatment (IR)
Percutaneous cholecystostomy
254
Hepatic Encephalopathy after TIPS: treatment (IR; 2 options)
You can either
1) one place a new covered stent constricted in the middle by a loop of suture – deployed in the pre-existing TIPS,
2) place 2 new stents – parallel to each other (one covered self expandable, one uncovered balloon expandable)
255
Treatment for Recurrent variceal bleeding after placement of a constricted stent
Balloon dilation of the constricted stent
256
Appendiceal Abscess: treatment
Drain placement
| (just remember: a drain should be used for a mature/walled off abscess and no frank peritoneal symptoms.)
257
Inadvertent catheterization of the colon (after trying to place a drain in an abscess)—what to do?
Wait 4 weeks for tract to mature—verify by over-the-wire tractogram—then remove the tube.
258
DVT with severe symptoms and no response to systemic anticoagulation—what to do?
Catheter Directed Thrombolysis
259
Geiger Mueller: max dose it can handle
100 mR/h
260
# Define “major spill”:
- Tc-99m
- Tl-201
- In-111
- Ga-67
- I-131
- Tc-99m >100 mCi
- Tl-201 > 100 mCi
- In-111 >10 mCi
- Ga-67 >10 mCi
- I-131 > 1 mCi
261
Annual dose limit to the public
100 mrem
262
Not greater than _____ per hour in an “unrestricted area”
Not greater than 2 mrem/hr
263
Total body dose per year
5 rem
264
Total equivalent organ dose (including skin) per year
50 rem
265
Total equivalent extremity dose per year
50 rem (500 mSv)
266
Total dose to embryo/fetus over entire 9 months
0.5 rem
267
NRC allows no more than ____ of Mo per 1 mCi Tc, at the time of administration
0.15 micro Ci
| NOTE: micro!
268
Chemical purity (Al in Tc) is done with ______
pH paper
269
Allowable amount of Al in Tc is ______
<10 micro g
270
Radiochemical purity (looking for free Tc) is done with _______
Thin layer chromatography
271
Free Tc occurs from _____
Lack of stannous ions or accidental air injection (which oxidizes)
272
Prostate cancer bone mets are uncommon with a PSA less than ____
10 mg/ml
273
Flair phenomenon occurs ______ after therapy (time frame)
2 weeks-3 months
274
________ Study is more sensitive for lytic mets (NM)
Skeletal Survey
275
AVN: hot or cold?
- early
- middle
- late
- early: COLD
- Middle: HOT (repairing)
- Late: COLD
276
Particle size for VQ Scan
10-100 micrometers
277
Xenon is done ______ during the VQ Scan
First
278
Classic thyroid uptake blocker
Amiodarone
279
Hashimotos increases risk of ______
Lymphoma
280
Hot nodule on Tc shouldn’t be considered benign until ________
you show that it’s also hot on I-123. (Concept of the discordant nodule)
281
History of methimazole treatment (even years prior) makes I-131 treatment _________
More difficult
282
Methimazole side effect
Neutropenia
283
Thyroid uptake Blocker of choice in pregnancy
PTU
284
Sestamibi in the parathyroid depends on ____ and ____
Blood flow and mitochondria
285
PET imaging post therapy, when to do it:
- After chemotherapy
- after radiation
And why wait?
After chemo: 2-3 weeks.
After radiation: 8-12 weeks.
This avoids stunning—false negatives, and inflammatory induced false positives.
286
Most commonly used agent for somatostatin receptor imaging.
And “the classic use is for _____”
In-111 Pentetreotide
Classic use is for CARCINOID TUMORS
287
Meningiomas: take up octreotide?
Yes. Meningiomas take up octreotide.
288
Prior to MIBG, you should block the thyroid with ______ or _______
Lugols Iodine or Perchlorate
289
Left bundle branch block: can cause a false ______ defect in the ________
False POSITIVE
| In the VENTRICULAR SEPTUM (spares the apex)
290
Pulmonary uptake of Thallium is an indication of ______
LV dysfunction
291
MIBG mechanism
Analog of Norepinephrine—actively transported and stored in neurosecretory granules
292
MDP mechanism
Phosphate analog —works via chemisorption
293
Sulfur Colloid mechanism
Particles phagocytized by RES
294
The order of tumor prevalence in NF-2
Same as the mnemonic MSME:
Schwannoma >meningioma>ependymoma
295
Etiology of Sturge Weber
Maldeveloped draining veins
296
All phakomatosis (NF-1, etc) EXCEPT ________ are autosomal _______.
All phakomatosis
(NF-1, NF-2, TS, VHL)
EXCEPT STURGE WEBER are autosomal DOMINANT.
(So family screening is a good idea)
297
Most common primary brain tumor in adult
Astrocytoma
298
“Calcifies 90% of the time” (Neuro, tumors)
Oligodendroglioma
299
Restricted diffusion in ventricle: differential
Watch out for Choroid Plexus Xanthogranuloma (NOT a brain tumor, a benign normal variant.)
300
Pituitary : T1 big and bright
Pituitary Apoplexy
301
Pituitary: normal T1 bright
Posterior part (because of storage of vasopressin, and other storage proteins)
(My note: I’m not sure this makes sense. Grammar equivocal. Adjust as needed)
302
Pituitary: T2 Bright
Rathke cleft Cyst
303
Pituitary: calcified
Craniopharyngioma
304
CP Angle: invades internal auditory canal
Schwannoma
305
CP Angle: invades both internal auditory canals
Schwannoma with NF2
306
CP Angle: restricts on diffusion
Epidermoid
307
Peds, neuro: arising from vermis
Medulloblastoma
308
Peds, neuro: 4th ventricle “toothpaste” out of 4th ventricle
Ependymoma
309
Adult myelination pattern
T1 at 1 year, T2 at 2 years
310
Myelinated at birth
Brainstorm and posterior limb of the internal capsule
311
NOT in the cavernous sinus
CN2, CNV3 (typo?)
312
Persistent trigeminal Artery (vertebral to carotid) increases the risk of ______
Aneurysm
313
Subfalcine herniation can lead to _____
ACA infarct
314
ADEM lesions __(will always OR will not?)__ involve the calloso-septal interface.
Will NOT
315
Marchiafava-Bignami progresses from ____ to _____ to ______.
BODY to GENU to SPLENIUM
316
Post Radiation changes start _____ (time)
After 2 months (latent period)
317
_____is first with Alzheimer Dimentia
Hippocampus atrophy
318
Most common TORCH
CMV
319
Toxo abscess __(does OR does not?)__ restrict diffusion
Does NOT
320
Small cortical tumors can be occult without ______
IV contrast
321
JPA and Ganglioglioma (can OR do OR do not?) enhance and are (high OR low?) grade.
CAN
| LOW
322
Most common fracture (neuro)
Nasal bone
323
Most common fracture pattern (neuro).
What does it involve?
Zygomaticomaxillary Complex Fracture (Tripod).
Involves the zygoma, inferior orbit, and lateral orbit
324
Supplemental oxygen can mimic ______ on FLAIR
SAH
325
Most common location for hypertensive hemorrhage
Putamen
326
Restricted diffusion without bright signal on FLAIR should make you think ______
Hyperacute (<6 hours) stroke
327
Enhancement of a stroke: Rule of ___ (and describe)
Rule of 3s:
Starts at 3 days,
Peaks at 3 weeks,
Gone at 3 months
328
Most common systemic vasculitis to involve the CNS
PAN
329
Most common type of craniosynostosis
Scaphocephaly
330
Piriform aperture stenosis is associated with ________
Hypothalamic pituitary adrenal axis issues
331
Most common primary petrous apex lesion
Cholesterol granuloma
332
Large vestibular aqueduct Syndrome has absence of the bony modiolus in _____ % of cases
90%
333
Octreotide Scan will be ______ for esthesioneuroblastoma
Positive
334
Main vascular supply to the posterior nose
Sphenopalatine artery (terminal internal maxillary artery)
335
Warthins tumors (do OR do not?) take up pertechnetate
DO
336
Sjorgens gets salivary gland ______
Lymphoma
337
Most common intra-ocular lesion in an adult
Melanoma
338
Enhancement of nerve roots for 6 weeks after spine surgery: _________.
for 6 weeks: NORMAL.
| After that, arachnoiditis.
339
Most important factor for outcome in a traumatic cord injury
Hemorrhage in the cord
340
Currarino Triad
Anterior Sacral Meningocele,
Anorectal malformation,
Sarcococcygeal osseous defect
341
Most common type of Spinal AVF
Type 1 (Dural AVF)
“By far more common”
342
Herpes spares _______. (neuro)
What doesn’t spare it?
Basal ganglia
MCA infarcts do not.
343
First sign of a SNAC or SLAC wrist
Arthritis at the radioscaphoid compartment
344
SLAC wrist has a ______ deformity
DISI
345
The pull of the _______ tendon is the cause of the ___(direction)___ dislocation in the Bennett Fracture
Abductor pollucis longus tendon
Dorsolateral
346
Carpal tunnel syndrome has an associated with ____
Dialysis
347
Degree of femoral head displacement predicts risk of ____
AVN
348
What part of the scaphoid is at risk of AVN with fracture ?
Proximal pole
349
Most common cause of sacral insufficiency fracture
Osteoporosis in old lady
350
Patella dislocation is nearly always which direction?
Lateral
351
Tibial plateau fracture is way more common which direction?
Laterally
352
SONK favors the __(direction?)__ knee
MEDIAL knee (area of max weight bearing)
353
________ excludes Ank Spon
Normal SI joints
354
Looser Zones are a type of _____
Insufficiency fracture
355
T score of ______ marks osteoporosis
-2.5
356
First extensor compartment
DeQuervains
357
First and second extensor compartments
Intersection Syndrome
358
6th extensor compartment
Early RA
359
Flexor pollicis _____ goes through the carpal tunnel.
| Flexor pollicis ______ does not.
LONGUS goes through.
BREVIS does not.
360
Do pisiform recess and radiocarpal joint normally communicate?
Yes.
361
The periosteum is intact in which of the following?:
- Perthes
- ALPSA
- True Bankart
Periosteum intact in Perthes and ALPSA.
Disrupted in true Bankart.
362
Buford complex: describe
Absent anterior/superior labrum,
| Along with thickened middle glenohumeral ligament
363
Which side of medial meniscus is thicker?
Posterior
364
Most commonly torn ankle ligament
Anterior talofibular ligament
365
TB in the spine: effect on disc space
Spares the disc space
| so can brucellosis
366
Scoliosis curvature points __(away from or toward?)__ the osteoid osteoma
AWAY FROM
367
The only benign skeletal tumor associated with radiation
Osteochondroma
368
Mixed Connective Tissue Disease requires ________ for diagnosis
Serology (ribonucleoprotein)
369
Medullary Bone Infarct will have ____ in the middle
Fat
370
Bucks Handle Meniscal tears are what direction/orientation?
Longitudinal
371
Physical exam test for ACL
Anterior Drawer Sign
372
Physical exam test for PCL
Posterior drawer sign
373
Physical exam test for MCL
“McMurray”
| My note: I don’t know what this is & assumed physical exam finding from context. Correct if needed
374
No _____ on mag views. (mammo)
Grid
375
BR-3 : % chance of cancer
Less than 2%
376
BR-5: % chance of cancer (mammo)
>95%
377
Nipple enhancement on post contrast MRI
Can be NORMAL! Don’t call it Paget’s!
378
Quadrant with highest density of breast tissue (and therefore the most breast cancers)
Upper outer
379
Majority of blood (60%) is via _____(vessel)
| Mammo
Internal mammary
380
Majority of lymph (97%) goes to the ________
| Mammo
Axilla
381
The sternalis muscle can only be seen on ____ view
CC View
382
Most common location for ectopic breast tissue
Axilla
383
Best phase in cycle to have a mammogram (and MRI)
Follicular phase (day 7-14)
384
Breast tenderness is max around day ________
Day 27-30
| My note: written by a dude, for dudes without ladies. Otherwise would know the girls hurt right before period.
385
Most comprehensive risk model (mammo)
But it does not include _______.
Tyrer Cuzick
Doesn’t include BREAST DENSITY.
386
If you had more than _____ Gy of chest radiation as a child, you can get a screening MRI
20Gy
387
BRCA ___ is seen (more than the other type) with male breast cancer
BRCA 2
388
BRCA 1 and 2: age of demographic
BRCA 1: more in younger patients
BRCA 2: more post menopausal
389
BRCA ____ is more often a triple negative CA
BRCA 1
390
Use the __(Angle)__ for kyphosis, pectus excavatum, and the avoid a pacemaker/line. (Mammo )
LMO
391
Use the __(angle)__ to help catch milk of calcium layering. (mammo)
ML
392
Which morphology for calcification has highest suspicion for malignancy? (Mammo)
Fine pleomorphic
393
Are intramammary lymph nodes in the fibroglandular tissue?
No!
394
Surgical scars getting denser: diagnosis
| Mammo
Think recurrent cancer.
Surgical scars should get lighter.
395
Can you have isolated intracapsular rupture?
| Mammo
Yes! You CAN!
396
Can you have isolated extracapsular rupture?
| Mammo
NO! You CAN NOT!
| It’s always with intra.
397
If you see silicone in a lymph node, you need to recommend ________ to evaluate for _______.
MRI
to evaluate for INTRACAPSULAR RUPTURE
398
Number one risk factor for implant rupture (mammo)
Age of implant
399
Tamoxifen causes a ______ in parenchyma uptake, then _______. (mammo)
DECREASE in parenchyma uptake,
then REBOUND.
400
T2 Bright Things: usually benign or malignant?
Except________
(Mammo)
Usually BENIGN .
Don’t forget COLLOID CANCER is T2 bright.
401
Tibial pseudoarthroses
NF-1
