Kelsey Johnson Papers

Question 1

Which quantitative thyroid scintigraphy index is the most accurate for diagnosis of hyperthyroidism? Which correlates the best to serum T4? How are these indices affected by methimazole?

Answer 1

• Thyroid-salivary ratio is most accurate; if you can’t do this one because of poor salivary uptake or salivary inflammation, do thyroid-to-heart, it is the next best
• Percent thyroid uptake (TcTU) is most correlated to serum T4
• ALL indices (thyroid to salivary, thyroid to background, percent thyroid uptake) are increased in cats that have been treated with methimazole vs. cats that have not, however authors believe this is because the cats tx’d with methimazole have been hyperthyroid for longer by the time they get scintigraphy, and so have chronic changes to thyroids that cause increased uptake compared to non-methimazole cats that have had the disease for less time

Peterson VRU 2016

Question 2

In MRI of dogs with osseous-associated cervical spondylomyelopathy, which positioning resulted in the most spinal cord compression sites? Which positioning worsened compression compared to neutral?

Answer 2

Extension identified the most sites of spinal cord compression, including some not seen on neutral position - both dorsal and ventral compression.

Extension worsened compression compared to neutral. The effect of flexion on compression was variable - worse in some, better in others.

Provencher, VRU 2017

Question 3

Regarding imaging features of Great Danes with and without clinically evident cervical spondylomyelopathy: which group had spinal cord compression? Which group had spinal cord signal changes? What findings distinguished affected from unaffected dogs?

Answer 3

• Both groups had spinal cord compression (clinically affected and clinically normal dogs)
• Only the clinically affected group had spinal cord signal changes
• Distinguishing findings included more severe compression, more stenotic foramina, and the presence of spinal cord signal change

Martin-Vaquero, JAVMA 2014

Question 4

What 3 factors act in combination to explain pathophysiology of disk-associated cervical spondylomyelopathy?

Answer 4

Recall that disk-associated CSM has Dobermans as its poster child and has a predilection for the caudal cervical spine.

• Congenitally, relatively stenotic vertebral canals
• Caudal cervical spine more prone to torsional forces, which worsen disk degeneration more than compressive forces do
• Dogs with CSM have larger intervertebral disks than clinically normal dogs –> more disk available to protrude into vertebral canal

da Costa, VCNA 2010

Question 5

What are the major differences in signalment and morphology of disk-associated vs. osseous-associated cervical spondylomyelopathy?

Answer 5

Disk-associated: older, mean age 6.8 in Dobermans and 7.8 in other dogs; large breed dogs; spinal cord compression is mainly ventral secondary to disk protrusion or herniation, +/- vertebral canal stenosis or ligamentum flavum hypertrophy

Osseous-associated: younger, mean age 3.8 years; giant breed dogs; spinal cord compression mainly dorsal/dorsolateral secondary to proliferation of the vertebral arch, articular facets, and/or pedicles, +/- vertebral canal stenosis. Can also have synovial cysts from articular facets. Can also have disks.

da Costa, VCNA 2010

Question 6

What are the most common clinical signs and biochemical abnormalities in dogs presenting with paraneoplastic hypertrophic osteopathy? What findings make up the radiographic diagnosis of HO?

Answer 6

CS: leg swelling, lameness, lethargy
Biochem: anemia, neutrophilia, elevated ALP

Note that CS of HO frequently become apparent prior to the primary pathology.

Radiographic findings: symmetric periosteal new bone proliferation along the long bones of the appendicular skeleton

Withers, Vet Comp Onco 2015

Question 7

What are the reported neoplastic causes of paraneoplastic hypertrophic osteopathy, and of these, which is the most common? What are the other reported non-neoplastic causes?

Answer 7

Neoplastic - primary lung tumor (most common); also bladder and renal sarcoma or carcinoma

Others (acronym SCBIDER):

• Infectious or inflammatory lung disease
• Dirofilaria immitis
• Spirocerca lupi esophageal granuloma
• Bacterial endocarditis
• R to L shunt with a PDA (wat)
• Esophageal foreign body (and now gastric FB - the Doberman that ate plastic cups at Tufts)
• Congenital megaesophagus

Withers, Vet Comp Onco 2015

Question 8

What is the signalment most commonly associated with quadrigeminal cysts (rostral cerebellar diverticula)? Are RCD incidental?

Answer 8

Signalment: most commonly small-breed dogs, particularly brachycephalic; and often male

Can be incidental or associated with clinical signs. Clinical signs are more likely present if occipital compression is >14%. Over 50% of the patients in this article had RCD as incidental findings.

Matiasek, JVIM 2007

Question 9

Meningiomas and histiocytic sarcomas are typically of what localization in relation to the brain parenchyma and the meninges?

Answer 9

Intradural, extramedullary

Recall that histiocytic sarcomas can have dural tail signs.

Wada, VRU 2017

Question 10

In a study of 17 dogs, 11 with intracranial meningioma and 6 with intracranial histiocytic sarcoma, what were the signal characteristics of histiocytic sarcoma vs. meningioma on T1w, FLAIR, and DWI?

Answer 10

Histiocytic sarcoma was T1w-hypointense, FLAIR-hypointense, and DWI-hyperintense compared to meningioma.
HS also had worse peritumoral edema compared to meningiomas.

Wada, VRU 2017

Question 11

What distinguishing characteristic was identified for intracranial menigioma vs. histiocytic sarcoma, in a 2017 study evaluating MRI and diffusion characteristics of these two tumors?

Answer 11

ALL histiocytic sarcoma dogs had invasion of the sulci - appeared as contrast-enhancing tissue extending into and spreading apart the sulci; meningioma never had this.

Authors acknowledged 17 dogs was not enough to make that into a rule yet.

Wada, VRU 2017

Question 12

What is the expected difference in ADC values vs. fractional anisotropy values for tumor volume of intracranial meningioma vs. histiocytic sarcoma (which tumor has the higher value for each)? What about for peritumoral margins?

Answer 12

Tumor volume:

• ADC: histiocytic sarcoma lower, meningioma higher (reflects aggressive/malignant nature of HS: more aggressive = more cellular = less free water = lower ADC value)
• FA value: no statistically significant difference between FA values of meningioma and histiocytic sarcoma

Peritumoral margins:

• ADC: histiocytic sarcoma higher, meningioma lower
• FA value: histiocytic sarcoma margins lower than meningioma margins (reflects invasive HS vs. non-invasive mening: lower FA means tumor invasion disrupting normal architecture, facilitates free water –> HS is invasive and its margins are expected to have lower FA and higher ADC)

Wada, VRU 2017

Question 13

Generally, vasogenic edema has what signal on ADC? Cytotoxic edema?

Answer 13

Vasogenic = high ADC signal; increased extracellular water due to leakage of plasma from damaged capillaries
Cytotoxic = low ADC signal

Question 14

What are the sensitivities for MRI diagnosis of neoplastic, inflammatory, or vascular intradural spinal cord lesions? What was the overall MRI sensitivity for detection of intradural spinal cord lesions?

Answer 14

Neoplastic - 86%
Inflammatory - 64%
Vascular - 25%

Overall - 97%; specificity only 64% –> higher likelihood of false positives.

Masciarelli, VRU 2017

Question 15

What are the spinal predilection sites for meningioma, nephroblastoma, and nerve sheath tumors?

Answer 15

Meningioma: C1-C4
Nephroblastoma: T9-L3
Nerve sheath tumor: brachial or lumbosacral plexuses

Masciarelli, VRU 2017

Question 16

True or false: a short clinical course, but with progressive neurologic signs, has been reported in cases of vascular spinal cord disease.

Answer 16

True.

Masciarelli, VRU 2017

Question 17

What is the median ratio of left kidney length to L2 length on a VD radiograph for brachycephalic, mesaticephalic, and dolichocephalic dogs?

Answer 17

Squish-faced dogs have higher ratio than long-faced dogs (maybe squished L2 vertebrae are shorter than their kidneys - that’s from me, not from the paper)
Brachycephalic: 3.1
Mesaticephalic: 2.97 (almost exactly between 3.1 and 2.8)
Dolichocephalic: 2.8

Dogs <10 kg have a higher LK:L2 ratio than dogs >30 kg

Lobacz VRU 2012

Question 18

What radiographic characteristics have been reported for feline idiopathic pulmonary fibrosis?
What CT characteristics have been reported?

Answer 18

Radiographs: broncho-interstitial pattern, alveolar pattern, pulmonary masses, pulmonary bullae, pleural effusion, and cardiomegaly

“Purple cats breathe against pulmonary pathology”

CT: focally increased soft tissue attenuation, masses, ventral consolidation that doesn’t alter with recumbency

Radiographic characteristics are highly variable and can mimic other diseases such as pneumonia, asthma, pulmonary edema, or neoplasia

Evola VRU 2014

Question 19

T/F: Cervical extension can alter which spinal cord site is most severely compressed in up to 33% of patients.

Answer 19

True.

Provencher, VRU 2017

Question 20

Describe the CT characteristics of a ‘tree in bud’ pattern.

Answer 20

Nonenhancing nodules and branching V or Y lines; at least 5 mm away from pleura. Represents enlarged bronchial airways coursing perpendicular and parallel to CT plane section.

Tree in bud can be seen in non-clinical cats, and in cats with normal radiographs but with clinical signs. Sign of chronic inflammatory airway disease.

Hahn, VRU 2017

Question 21

Most common CT characteristics of idiopathic pulmonary fibrosis in Westies

Answer 21

Ground glass pattern - mild degree of severity
Focal reticular and mosaic ground-glass patterns - moderate severity

Thierry, VRU 2017

Question 22

What respiratory condition is associated with a tree-in-bud appearance on pulmonary CT in cats?

Answer 22

Chronic lower airway disease

Tree-in-bud can be seen in cats with clinical signs of airway disease, even if no abnormalities are identified on radiographs.

Hahn, VRU 2017

Question 23

What is the mean attenuation of presumed normal canine abdominal lymph nodes on CT, before and after contrast?

Answer 23

Before = 37 (20-50)
After = 109 (36-223)

Beukers VRU 2013

Question 24

Describe the location of the following canine abdominal lymph nodes:
Hepatic
Splenic
Gastric
Pancreaticoduodenal
Renal
Lumbar aortic
Medial iliac
Internal iliac and sacral

Answer 24

• Hepatic = either side of the portal vein, anywhere between liver and insertion of splenic vein
• Splenic = along the splenic vein, ~2 cm proximal to its insertion on the portal vein
• Gastric = always single; located in lesser curvature of stomach, closer to body than pylorus
• Pancreaticoduodenal = ventral to body of pancreas and/or duodenum, close to pylorus
• Renal = along the renal artery
• Lumbar aortic = long axis parallel to aorta/cava, usually dorsolateral to aorta or cava
• Medial iliac = at the level of or caudal to the trifurcation of the aorta
• Internal iliac and sacral = along the left and right sides of the median sacral artery; not distinguishable from each other

Beukers VRU 2013

Question 25

Gelified ethanol can be injected (with image guidance) into the intervertebral disk in humans as a minimally invasive treatment for disk protrusion. Why does it work (or what is the theory)?

Answer 25

Ethanol causes molecular splitting of the proteoglycans making up the nucleus pulposus –> reduction in nuclear volume and regression of the disk protrusion

Mackenzie VRU 2016

Question 26

Is injection of gelified ethanol into the lumbosacral nucleus pulposus well-tolerated in healthy dogs? What is the rate of leakage into the vertebral canal, and is this clinically significant?

Answer 26

No clinical signs noted for 1 year after injection, appears well-tolerated in healthy dogs.

Rate of leakage was 3/9 immediate, +1 more over the duration of the study, so 33% or a little higher. No adverse effects were noted, so it appears that leakage is subclinical for at least the first year.

Mackenzie VRU 2016

Question 27

What are some distinguishing clinical characteristics of patients with MRPLN masses secondary to inflammatory lymphadenitis vs. neoplasia? Distinguishing MRI characteristics?

Answer 27

Non-neoplastic lymphadenitis: Fever, leukocytosis, neutrophilia, neck pain/painful neck mass; usually younger (<6.5 years is 80% sensitive, 75% specific); moderate to marked perinodal contrast enhancement, presence of muscle enhancement

Neoplasia: older patient, nonpainful neck mass, larger neck mass

Johnson VRU 2016

Question 28

What is the cutoff value for US cross-sectional area of a parathyroid nodule, above which response to radiofrequency ablation of the nodule is less likely to be successful?

Answer 28

0.35 cm^2
Sensitivity of 78%, specificity of 86%
(Probably because the bigger the nodule, the more likely that it is incompletely ablated.)

Bucy VRU 2017

Question 29

Is thyroid size related to likelihood of treatment success with radiofrequency ablation of a parathyroid nodule? Degree of hypercalcemia or PTH elevation? Presence of hypothyroidism?

Answer 29

No. Parathyroid size, yes; thyroid size, no.
Biochemical values were not related to treatment success.
Presence of concurrent hypothyroidism was associated with treatment failure.

Bucy VRU 2017

Question 30

What is the effect of methimazole treatment on thyroid gland size, attenuation, and heterogeneity, in hyperthyroid cats evaluated with CT?

Answer 30

Size - UNCHANGED
Attenuation - decreased: 96 HU to 86 HU
Heterogeneity - decreased (they used standard deviation of attenuation in multiple ROIs to quantify it, but I’m not going to remember that number)

Bush VRU 2017

Question 31

What is the correlation between thyroid gland size pre-treatment, and the dose of methimazole needed to achieve euthyroidism?

Answer 31

Positive. Bigger gland = higher dose (to the surprise of no one).

Bush VRU 2017

Question 32

In hypercalcemic dogs undergoing cervical US, with no palpable neck mass or clinical signs of thyroid disease, what is the prevalence of incidentally identified thyroid nodules? Is sampling indicated?

Answer 32

15%; and yes, because nodules may be benign or malignant and there are no distinguishing features between them on US.

Pollard VRU 2015

Question 33

What are the differentials for a thyroid nodule identified on cervical ultrasound?

Answer 33

• Thyroid cyst
• Thyroid adenoma
• Thyroid adenocarcinoma
• Nodular hyperplasia

Pollard VRU 2015

Question 34

What is the overall prevalence of thyroid masses/nodules in dogs? What is the prevalence of incidentally discovered thyroid masses/nodules in dogs?

Answer 34

Overall prevalence = 2.1%
Incidentally discovered prevalence = 0.76%

Bertolini VRU 2017

Question 35

What percentage of thyroid nodules/masses are malignant, whether incidentally discovered or suspected based on clinical signs and history? Is sampling of a ‘thyroid incidentaloma’ indicated?

Answer 35

Incidentally discovered masses are 70% malignant

Non-incidentally + incidentally discovered masses are 82-90% malignant (Bertolini paper was 82%, older paper was 90%)

Sampling is ALWAYS indicated because of at least 70% likelihood of malignancy

Bertolini VRU 2017

Question 36

At doses of 10 mcg/kg IV, what effects does dexmedetomidine have on radiographic heart size and echocardiography parameters in dogs?

Answer 36

• Larger heart on rads (bigger VHS on lateral, cardiothoracic ratio on VD)
• Increased LVEDV and LVESV –> increased preload
• Decreased FS, CO
• Moderate to severe mitral and tricuspid regurgitation, +/- lesser aortic and pulmonic regurgitation

(Recall that the normal dose of dex is only 2 mcg/kg, maybe up to 4)

Wang VRU 2016

Question 37

At doses of 40 mcg/kg IM, what effects does dexmedetomidine have on radiographic heart size in cats?

Answer 37

• Mild increase in VHS measured on R lateral
• Mild increase in % thoracic width occupied by the heart on VD and DV

Zwicker VRU 2016

Question 38

What diagnoses can be evaluated using lung ultrasound in an ER setting in a dyspneic patient?

Answer 38

Presence/absence of peripheral pulmonary edema - does NOT distinguish between causes of peripheral pulmonary edema, e.g. NCPE, cardiogenic, ARDS, diffuse interstitial disease.

Ward JAVMA 2017

Question 39

What is the upper limit of normal for MPA:Ao ratio on echocardiography in dogs?

Answer 39

0.98 for echo

Granger VRU 2016

Question 40

What is the effect of respiratory phase on MPA:Ao as measured on CT (insp vs. exp)? Can the echocardiographic limit for MPA:Ao ratio be used on CT of the canine thorax? Does contrast administration alter MPA:Ao?

Answer 40

Expiratory scan = lower MPA:Ao ratio than inspiratory (I can’t really get my head around why this would happen pathophysiologically so just go with it)
No, the echo limit cannot be used on CT because it is too low. In this study, between various inspiratory/expiratory scans, the ratio was at least 1.1. A normal for CT MPA:Ao has not been established.
Contrast has no effect on MPA:Ao on CT.

Granger VRU 2016

Question 41

What are the differentials for focal contrast enhancement of the myocardium on CT?

Answer 41

• Neoplasia
• Revascularization of a myocardial infarct secondary to a thromboembolic event
• Inflammation

Stieger-Vanegas VRU 2016

Question 42

What are the 4 reported types of primary pulmonary artery neoplasia?

Answer 42

Hemangiosarcoma, hamartoma, leiomyosarcoma, and chondrosarcoma (what)

Stieger-Vanegas VRU 2016

Question 43

What is the difference between arteriovenous fistula, arteriovenous malformation, and hamartoma?

Answer 43

AVF = connection between a single artery and vein; most commonly acquired, secondary to blunt/penetrating trauma, surgical procedure, or catheterization
AVM = multiple aberrant shunting vessels that originate from >/=1 arteries and terminate in >/=1 veins; usually congenital
Hamartoma = nodular growth consisting of disorganized, excessive proliferation of nonneoplastic vascular tissue; many contain AVFs and AVMs

Shaikh VRU 2016

Question 44

How is percent thyroid uptake (TcTU) calculated on a scintigraphic image?

Answer 44

• Thyroid uptake is corrected for background, depth, and decay
  TcTU = net counts of all visible thyroid tissue / number of counts injected
  **TcTU requires that 99mTc was given IV

Peterson VRU 2016

Question 45

What percentage of hyperthyroid cats are likely to have unilateral disease, bilateral disease, or multifocal disease?

Answer 45

Unilateral - 42%
Bilateral - 56%
Multifocal - 2%

Peterson VRU 2016

Question 46

Do the intestinal layers as identified on US correspond to those identified on histology?

Answer 46

Yes. This was a worthless paper.

LeRoux VRU 2016

Question 47

What is the effect of a normal meal and a high-fat meal on echogenicity of the canine duodenal and jejunal mucosa, immediately post-prandial vs. at 1 hour later, in healthy dogs?

Answer 47

Normal meal: mucosal hyperechogenicity increased at 60 min
High-fat meal: mucosal hyperechogenicity of the DUOD increased immediately and at 60 min; jejunal mucosal hyperechogenicity increased at 60 min just like with normal meal
Hypothesis that the increased echogenicity at 60 min represents physiologic, post-prandial lacteal dilation; hyperechogenicity at immediate post in duodenum is likely due to admixture of substances at mucosal surfaces, b/c lacteal dilation doesn’t happen that fast
Take home message: intestinal echogenicity can be increased after a meal in healthy dogs, regardless of meal fat content

Gaschen VRU 2016

Question 48

What structures are hyperintense vs. hypointense in the distal limb of the horse using 18F-FDG PET?

Answer 48

Hypointense - medulla of bone (P1-P3)
Mild hyperintensity - tendons
Moderate hyperintensity - the rest of the soft tissues
Greatest hyperintensity - coronary band

Spriet VRU 2016

Question 49

What is the range of risk of iatrogenic hypothyroidism after I131 treatment in cats?

Answer 49

• 7-30% of cats can become biochemically hypothyroid
• Wallack’s ACVR abstract in 2010: 18%

Bettencourt VRU 2016

Question 50

Which quantitative scintigraphic measurement is most closely correlated to serum radioactivity in thyroid scintigraphy with 99mTc?

Answer 50

Thyroid to heart background ratio

Bettencourt VRU 2016

Question 51

What is the definition of craniomandibular osteopathy? What is a distinguishing feature between CMO and calvarial hyperostosis syndrome?

Answer 51

• CMO = bilateral, irregular, non-neoplastic osseous proliferative disease of YOUNG DOGS, usually affecting multiple bones of the cranium, +/- the metaphyses of long bones
• CMO differs from calvarial hyperostosis syndrome because CMO involes the mandible, and hyperostosis syndrome does not

Matiasovic VRU 2016

Question 52

What are the predilection sites for CMO? Predisposed breeds? MRI appearance?

Answer 52

• Sites: frontal, parietal and occipital bones; tympanic bullae, mandibular rami, TMJs
• Breeds: Westies, Cairn terriers, Scotties
• Bone lesions are T2w-hyperintense, T1w-hypointense, with intense and homogeneous contrast enhancement of the lesion and surrounding soft tissue

Matiasovic VRU 2016

Question 53

What is calvarial hyperostosis syndrome?

Answer 53

Similar to CMO, characterized by osteoproliferative lesions of the flat bones of the skull; but does NOT affect the mandible

Only described in bullmastiffs and one Springer

Matiasovic VRU 2016

Question 54

What is the rate of recurrence of hypercalcemia after radiofrequency ablation of the parathyroid in dogs with primary hyperparathyroidism?

Answer 54

Between 2 and 28%, depending on the study

Bucy VRU 2017

Question 55

How does methimazole interfere with thyroid hormone synthesis?

Answer 55

Methimazole blocks ORGANIFICATION of iodide, and COUPLING of iodotyrosines –> inhibits production of thyroid hormone (recall organification = incorporation of I into tyrosine)

Does NOT directly block iodide uptake by the thyroid gland

Fischetti VRU 2005

Question 56

Why might 99mTcO4 uptake increase in cats made hypothyroid by methimazole therapy?

Answer 56

When cats become hypothyroid, TSH will increase; TSH supports all thyroid gland functions, including iodide trapping, and increased iodide trapping = increased 99mTcO4 uptake because they are treated the same by the thyroid.
Because 99mTcO4 isn’t actually iodine, methimazole doesn’t interfere with it (b/c methimazole blocks organification of iodide and coupling of iodotyrosyl groups)

Fischetti VRU 2005

Question 57

What is the normal thyroid:salivary ratio in euthyroid cats? Normal percent thyroid uptake in euthyroid cats?

Answer 57

T:S = 1.0; up to 1.5 has been reported in older euthyroid cats.
TcTU = 0.64-0.75%

Fischetti VRU 2005

Question 58

Does methimazole increase uptake of pertechnetate (99mTcO4) compared to pre-treatment uptake in hyperthyroid cats?

Answer 58

No. Methimazole treatment does not affect radionuclide uptake with pertechnetate in hyperthyroid cats. This is because (at least in this study) TSH suppression by elevated T4 was NOT relieved over the 30 days of methimazole therapy.

Fischetti VRU 2005

Question 59

T/F: A ‘good’ radiology report should have clinical history and the clinical question provided, and should include a prioritized differential list.

Answer 59

True.

Weissman VRU 2016

Question 60

In brief, how is indirect computed tomography lymphography performed for dogs with anal sac adenocarcinoma?

Answer 60

Peritumoral injection of contrast followed by serial caudal abdominal CT scans for iliosacral lymph node identification; 2 ml of 1:1 Isovue-300 and saline in a 4-quadrant technique. Put dogs in supported sternal recumbency. Identification of primary sentinel nodes in 1-20 min post-contrast.

Majeski VRU 2017

Question 61

In CT lymphography for canine mammary tumors, what factors are useful in distinguishing LN metastasis presence vs. absence?

Answer 61

Neoplastic invasion: Heterogeneous contrast enhancement of the sentinel LN, no contrast enhancement of the sentinel LN, HU <444 in the center of the LN

No invasion: Homogeneous contrast enhancement

Size, shape are LESS correlated with neoplastic invasion than the enhancement characteristics above.

Soultani VRU 2017

Question 62

What proton magnetic resonance spectroscopy findings have been associated with tick-borne encephalitis?

Answer 62

Reduced compared to normal dogs: N-acetyl aspartate, creatine

Increased: glutamine-glutamate complex (mainly from glutamate)

Unchanged: myoinositol, choline

Not found: lactate, lipids, taurine

Sievert VRU 2017

Question 63

What proton magnetic resonance spectroscopy findings have been associated with non-infectious meningoencephalitis?

Answer 63

LOW N-acetyl aspartate, creatine, glutamine-glutamate complex, myoinositol
HIGH choline

Sievert VRU 2017

Question 64

What are the findings associated with tick-borne encephalomyelitis on 3T MRI imaging?

Answer 64

• Bilaterally symmetric, grey matter lesions
• Hippocampus, thalamus, brainstem, basal nuclei of brain; ventral horn of spinal cord
• T2w-hyperintense, T1w-iso to hypointense
• No contrast enhancement, mass effect, or perilesional edema
• *MRI can be structurally normal.

Beckmann VRU 2016

Question 65

Is general anesthesia (vs. sedation) contraindicated for CT diagnosis of idiopathic pulmonary fibrosis in West Highland white terriers? What is the effect of anesthesia vs. sedation in this scenario?

Answer 65

Not contraindicated - can still provide a diagnostic scan. However, sedation vs. anesthesia provide non-systematically different (aka variable) results for identification and severity of findings consistent with IPF, e.g. ground glass opacity, consolidation, mosaic attenuation pattern.
* Note that ground glass has been reported in clinically normal Westies.

Roels VRU 2017

Question 66

What are the 3 main CT features of canine idiopathic pulmonary fibrosis in Westies?

Answer 66

Ground glass attenuation, mosaic attenuation, and bronchial wall thickening

Roels VRU 2017

Question 67

What are the differentials for a luminal mass within the canine bladder?

Answer 67

• Hematoma
• Foreign body
• Cystolith
• Laminated debris ball/laminated fibrinous ball
• Fungal ball

Yoon VRU 2017

Question 68

What patients are predisposed to develop fungal and/or fibrinous balls within the urinary bladder?

Answer 68

Immunocompromised patients - diabetes, neoplasia. Reported only in dogs so far.

Yoon VRU 2017

Question 69

What is the radiographic tracheal diameter:thoracic inlet ratio of: normal, non-brachycephalic dogs; non-brachycephalic, tracheal hypoplasia dogs; and English bulldogs with tracheal hypoplasia?

Answer 69

Normal, non-brachycephalic dogs: >0.2
Tracheal hypoplasia, non-brachycephalic dogs: <0.16
Tracheal hypoplasia, English bulldogs: <0.12

Kaye VRU 2015

Question 70

What is the extent of variation in % tracheal diameter on CT between inspiration and expiration in healthy dogs?

Answer 70

Up to 24%

Kaye VRU 2015

Question 71

What breeds have smaller cricoid cartilage cross-sectional areas on CT? Is this associated with brachycephalic airway syndrome?

Answer 71

Brachycephalic breeds
Not associated with clinical brachycephalic airway syndrome, can be seen in clinically normal dogs
Pugs and French bulldogs have vertically ovoid cricoids compared to Labs and JRTRs

Rutherford VRU 2017

Question 72

What neoplasms can have dural tail signs?

Answer 72

Meningioma, histiocytic sarcoma, inflammatory fibrosarcoma

Scarpante VRU 2016

Question 73

When imaging equine lumbosacral nerve roots (L6, S1, S2) with transrectal ultrasound, what are three anatomic markers and is size correlated with age or sex?

Answer 73

Anatomical markers include L7-S1 disk, intervertebral foramina, and the caudal gluteal artery

Size is quite variable in normal Warmbloods. Overall L6 is larger than S1 and S2, and S2 is smaller than L6 and S1. Comparison of right and left sides recommended, since they are normally bilaterally symmetric.

Espinosa VRU 2017

Question 74

What is the association between aberrant caudal nasal turbinates and age, sex, and clinical signs in English bulldogs? (Excluding grade 4 turbinates, which protrude into the nasopharynx.)

Answer 74

• There is no association between age, sex, and presence/absence of aberrant caudal turbinates
• 100% of healthy (not affected by BAS) English bulldogs had them –> effect of aberrant caudal nasal turbinates is subclinical, consider them to be incidental and breed-related up to grade 3 (grade 4 was not seen in any dog in this study)

Grosso VRU 2015

Question 75

What are the differences in tympanic bulla morphology between brachycephalic and non-brachycephalic dogs?

Answer 75

Brachycephalic dogs have thicker bulla walls and smaller total bullae volume, and greater prevalence of sub-clinical middle ear effusion, than non-brachycephalic dogs.

Salguero VRU 2016

Question 76

What is the relationship between soft palate thickness and the presence of material in the tympanic bulla?

Answer 76

Brachycephalic dogs with material in their bullae had thicker soft palates (~12 mm) than brachycephalic dogs without fluid in their bullae (~9mm)

Salguero VRU 2016

Question 77

Which are more common in brachycephalic breeds, vertebral segmentation defects or vertebral body formation defects? What is the most common site?

Answer 77

Vertebral body formation defects are more common; sites are T7, T8, T12.

Gutierrez-Quintana VRU 2014

Question 78

Can vertebral body malformations be the cause of neurologic signs, and which types are more likely to be associated with neurologic signs?

Answer 78

Yes - spinal cord compression
Ventral and ventro-lateral aplasia (creating dorsal and dorso-lateral hemivertebrae) are more commonly associated with clinical signs, at least in this study

Gutierrez-Quintana VRU 2014

Question 79

How is 99mTc-MDP ‘taken up’ into bone? Why does it end up in soft tissue?

Answer 79

• Taken up into bone via ‘chemisorption’ to exposed inorganic bone, particularly hydroxyapatite crystal
• Will also occur in areas of calcium phosphate, which is present in dystrophic and metastatic mineralization –> will get taken up in soft tissues if calcium phosphate is present

Ruff VRU 2016

Question 80

What is a pilomatricoma? What is its rate of metastasis and its predilection site for metastatic disease in dogs?

Answer 80

• Pilomatricoma = follicular tumor, comes from metrical cells of the hair bulb (whatever those are)
• Metastasis in 1/3
• Predilection site is BONE - very different from other species

Ruff VRU 2016

Question 81

What is the effect on laparoscopic-assisted gastropexy on GI transit time in normal dogs? On GI transit time in dogs with GDV?

Answer 81

Difficult question over at least 2 different studies. Short version, normal dogs have no altered GITT in at least 2 studies, GDV dogs have prolonged GITT in 1 study.

Balsa JVIM 2017

Question 82

What is a noninvasive imaging method of measuring lung area changes during respiration in normal dogs?

Answer 82

Fluoro of the thorax - can measure max inspiratory and expiratory lung volume (by drawing ROI around lung margins, excluding mediastinal structures) and calculate % change. Mean is 20.8%. There are body weight correction factors.

Chan JVIM 2017

Question 83

Which joints of the equine carpus bear the majority of stress during locomotion?

Answer 83

Antebrachiocarpal and middle carpal, particularly the dorsal and medial aspects.
Carpometacarpal remains mostly stable under both axial and torsional loading.

Suarez Sanchez-Andrade VRU 2018

Question 84

What imaging method is most sensitive for detection of articular cartilage defects in the equine carpus?

Answer 84

CT-arthrography - 70%
MR-arthrography - 53%
Plain MR - 33%
Plain CT - 18%
Weirdly, there was no statistically significant difference between these.

Suarez Sanchez-Andrade VRU 2018

Question 85

Describe the appearance of feline restrictive orbital myofibroblastic sarcoma (FROMS) on MRI.

Answer 85

• Thickening of retrobulbar tissues w/ effacement to loss of retrobulbar fat
• No abnormal T1 or T2 signal intensity, but heterogeneous on STIR
• Marked contrast enhancement
  Fat-suppressed images are suggested.

Thomasy Vet Ophth 2013

Question 86

What is the recommended treatment for feline restrictive orbital myofibroblastic sarcoma?

Answer 86

Aggressive and early therapy with surgical excision

Thomasy Vet Ophth 2013

Question 87

What are the normal protein and cell counts for CSF?

Answer 87

Total protein <25 mg/dl

Total nucleated cell count <5 cells/ul

Question 88

Name 3 types of canine eosinophilic meningoencephalitis, and some of their underlying causes.

Answer 88

• Infectious: Neospora, Toxoplasma, Angiostrongylus, Cryptococcus/Prototheca, distemper, rabies
• Non-infectious: trauma, infarct, shunt placement, paraneoplastic
• Unknown origin: origin…unknown

Cardy JSAP 2018

Question 89

What signalment is associated with canine eosinophilic meningoencephalitis of unknown origin (eosinophilic MUO)?

Answer 89

Young, male, large breed dogs

Cardy JSAP 2018

Question 90

What are the MRI findings of canine eosinophilic meningoencephalitis of unknown origin (eosinophilic MUO)?

Answer 90

Bilaterally symmetric T2/FLAIR hyper, T1 hypo affecting cerebrocortical grey matter; also diffuse meningeal enhancement.
Contrast to NLE, NME, GME, where lesions are more likely bilateral and asymmetric.

Cardy JSAP 2018

Question 91

Name two types of reactions to the presence of textile foreign bodies in the abdomen (e.g. in the GI tract).

Answer 91

• Aseptic fibrous response - adhesions, encapsulation, usually few/vague clinical signs
• Exudative reaction - abscess, fistulation, sepsis; more severe clinical course up to and including perforation

Anson VRU 2018

Question 92

Define dorsal border lesion vs. dorsal abrasion of the DDFT in equine foot MRI.

Answer 92

• Dorsal border lesion: rectangular/geometric area of increased signal in dorsal half of the tendon, +/- tendon thickening
• Dorsal abrasion: disruption of dorsal contour of DDFT, without signal change or thickening of tendon

Busoni VRU 2005

Question 93

What are the enhancement characteristics of polypoid vs. non-polypoid cystic mucosal hyperplasia in dog gallbladders, using contrast-enhanced US?

Answer 93

Polypoid cystic mucosal hyperplasia - polypoid lesions enhance, wall enhances normally
Non-polypoid cystic mucosal hyperplasia - wall enhances normally

Bargellini VRU 2018

Question 94

On small animal radiographs, bowel diameter of ______x the height of L5 has a 50%-66% probability of mechanical obstruction. Bowel diameter of ______x the height of L5 has a 80% probability of mechanical obstruction.

Answer 94

1. 73x = 50%
2. 95x = 80%

Drost VRU 2016

Question 95

A recent study compared diagnosis of small intestinal mechanical obstruction using radiographs vs. abdominal CT. What were the sensitivity and specificity for each modality?

Answer 95

Radiographs - sens 79%, spec 69% (you picked up 8/10 cases, and 3/10 were incorrectly identified)
CT - sens 95%, spec 80% (you picked up 95/100 cases, and incorrectly identified 20/100)

Drost VRU 2016

Question 96

In comparing radiographs to CT for ability to DIAGNOSE small intestinal obstruction, which modality was more sensitive and specific (though not statistically significantly so)? In comparing rads to CT for ability to recommend SURGERY for small intestinal obstruction, which was more sensitive and specific (though not statistical

Answer 96

Diagnosis - CT was more sensitive and more specific than rads
Send to surgery - rads were more specific than CT
(Neither difference was statistically significant)

Drost VRU 2016

Question 97

On CT, an intestinal diameter:L5 ratio of 2.1 corresponds to what sensitivity and specificity for mechanical obstruction?

Answer 97

79% sensitive, 72% specific

Drost VRU 2016

Question 98

MRI of the canine cruciate ligaments may be useful to determine partial versus complete fiber loss in what population of patients?

Answer 98

Dogs with clinically stable stifles - MRI sensitive and specific for determining partial vs. complete fiber loss
In dogs with clinically unstable stifles, MRI was very sensitive but poorly specific, and called a lot of complete ruptures that were in fact partials.

Fazio VRU 2018

Question 99

Is contrast-enhanced ultrasound of the equine limb with perfluorobutane/decafluorbutane safe?

Answer 99

Yes - no adverse effects
Should use intra-arterial injection, produces much better contrast and image quality

Seiler VRU 2016

Question 100

What are the low and high doses for IV and intra-arterial contrast injection, per horse? (US contrast)

Answer 100

IV - 5 and 10 ml
IA - 0.5 and 1 ml

Seiler VRU 2016

Question 101

How is the intravertebral sagittal ratio calculated in horses?

Answer 101

Vertebral canal height divided by vertebral body height

DeRouen VRU 2016

Question 102

What is the association between anomalous C6 vertebrae and presence of radiographic signs of OA in equine cervical spines?

Answer 102

None
However, anomalous C6 is associated with increased frequency of cervical pain?
Is NOT associated with neurologic signs
(This study was crap, I can’t believe I wasted a penguin on it.)

DeRouen VRU 2016

Question 103

What shape and density changes occur in the mandibular condyle and TMJ space on CT of young vs. mature horses on temporomandibular CT? (Young being <1 year, mature being >1 year)

Answer 103

• Shape: condyle becomes more flattened and less globoid, with decreased height:width ratio
• Attenuation: condyle increases in attenuation with age; focal hypodensities consistent with cysts present in >50% of asymptomatic horses >1 YO
• TMJ disk: hyperdense in many horses >10 YO

Carmalt VRU 2016

Question 104

What are the broad differentials for ureteral rupture in the horse?

Answer 104

Congenital defect (wat), ureterolithiasis, infection, neoplasia, or trauma

Beccati VRU 2016

Question 105

What are the CT characteristics of equine melanoma of the head? Most common locations affected?

Answer 105

• Most common locations: parotid salivary gland, guttural pouches, larynx and pharynx, and near the hyoid apparatus
• Hyperattenuating to muscle, mean 115 HU; occasional mineralization; moderately, homogeneously contrast-enhancing
• Multiples per horse! Up to 60 in 1 case

Dixon VRU 2016

Question 106

What are the differentials for a soft tissue mass that is hyperattenuating to muscle on CT of the equine head?

Answer 106

MOOO! Melanoma, osteoma, ossifying fibroma, osteosarcoma
Ethmoidal hematoma less likely because those live in the ethmoids, not in the soft tissues

Dixon VRU 2016

Question 107

Why is CT the optimal modality for selecting stent size in cases of tracheal collapse, compared to fluoroscopy or radiographs? Should tracheal height or width be used?

Answer 107

• Radiographs and fluoro underestimate tracheal size compared to CT –> smaller stent selected –> greater risk of stent migration (statistically significant difference in tracheal diameter with CT vs fluoro)
• CT has lowest inter/intra-observer variability in tracheal measurement
• Use height, is less variable than width

Williams VRU 2016

Question 108

Can malignant and nonmalignant hepatic or splenic masses be distinguished based on CT features pre- and post-contrast, using dual-phase CT?

Answer 108

No, there is a lot of overlap.

Jones VRU 2016

Question 109

What are the two underlying anatomical causes leading to intranasal airway obstruction in brachycephalic dogs?

Answer 109

1) Aberrant configurations of the nasal conchae (rostral aberrant turbinates and caudal aberrant turbinates), especially the ventral and middle conchae, that can almost entirely obstruct the airways;
2) failure of growth termination of the turbinates either in combination with, or possibly because of, an extremely undersized nasal cavity –> leads to relative conchal hypertrophy –> subsequent intranasal mucosal contact.

Oechtering Vet Surg 2016

Question 110

What is the mean T2 relaxation time of normal canine articular cartilage?

Answer 110

56 +/- 8 msec

Ruoff VRU 2016

Question 111

Which is preferred for evaluation of articular cartilage defects, 1.5T or 3T MRI?

Answer 111

3T MRI
98% of articular cartilage defects were correctly identified, with size ranging from 0.5 to 3 mm depth. (Slice thickness was 2 mm in this study.)
Note that this study had a scan time of 240 min…so perhaps not ideal in a clinical setting.

Ruoff VRU 2016

Question 112

Are CT and arthroscopy often, sometimes, or rarely in agreement regarding the presence of subchondral bone defects in the medial humeral condyle, in dogs with elbow disease?

Answer 112

Sometimes. No significant agreement was found between CT and arthroscopy for the presence of a subchondral bone defect on the MHC.

Coppetiers VRU 2016

Question 113

Are CT and arthroscopy often, sometimes, or rarely in agreement regarding the presence of fragmentation of the medial coronoid process?

Answer 113

Often. Significant agreement was found between CT and arthroscopy for presence of fragmentation of the medial coronoid process.

Coppetiers VRU 2016

Question 114

What are some differentials for organisms causing infectious pneumonia in companion rats?

Answer 114

Mycoplasma pulmonis, Pneumocystis carinii, Strep pneumoniae, Corynebacterium kutscheri…

Fouriez-Lablee VRU 2017

Question 115

What are some differentials for primary pulmonary neoplasia in companion rats? Metastatic?

Answer 115

Most common: alveolar adenoma; carcinoma from type II pneumocytes
Less common: spontaneous hemangiosarcoma, rhabdomyosarcoma

Metastatic: mammary carcinoma, lymphoma, histiocytic sarcoma, mesothelioma

Fouriez-Lablee VRU 2017

Question 116

What is the anatomic organization of the rat lung?

Answer 116

Right: cranial, middle, caudal, and accessory lobes
Left: single lobe

Fouriez-Lablee VRU 2017

Question 117

T/F: Radiographic pulmonary patterns differ between rats with infectious pneumonia and rats with pulmonary neoplasia (primary or metastatic).

Answer 117

False - there is overlap. For example, nodular lesions and lobar consolidation can represent pulmonary abscesses and lobar necrosis.

Fouriez-Lablee VRU 2017

Question 118

What distinguishing feature is more likely to be associated with pulmonary neoplasia (primary or metastatic) than with infectious pneumonia on thoracic radiographs of companion rats?

Answer 118

Cranial mediastinal mass/mass effect = more likely neoplasia

Fouriez-Lablee VRU 2017

Question 119

Urethrovaginal fistula is a rare complication of vaginal foreign bodies. What is the imaging modality of choice for diagnosis of urethrovaginal fistula?

Answer 119

CT with retrograde vaginourethrogram

Agut VRU 2016

Question 120

What are the differentials for punctate hyperechoic foci within the liver on US? (Very hyperechoic, not just hyperechoic portal markings)

Answer 120

• Mineralization: should not be mobile
• Portal gas: e.g. secondary to severe, raging ulcerative colitis or GDV
• Pneumobilia: Idk what causes this but probably anaerobic or emphysematous cholecystitis

Cartwright VRU 2016

Question 121

What are the potential origins of portal vein gas?

Answer 121

• Severe, raging enterocolitis
• GDV
• Blunt force trauma
• Iatrogenic from endoscopy and/or hepatic biopsy
• Hypertrophic pyloric stenosis (wat - maybe some weird duodenal reflux)
• Abdominal abscessation
• *Portal gas is no longer itself an indication for surgery unless an appropriate underlying cause is identified.

Cartwright VRU 2016

Question 122

What are the signal characteristics of canine spinal lymphoma on MRI?

Answer 122

T2w iso- to hyperintense
STIR hyperintense
T1w iso to hypointense
Moderately to strongly contrast-enhancing

Allett VRU 2016

Question 123

Which of the following are associated with intervertebral disk protrusion vs. extrusion?

• Midline instead of lateralized disk herniation
• Partial instead of complete disk degeneration
• Presence of single instead of multiple herniations
• Dispersed disk material beyond the borders of the disk space

Answer 123

PROTRUSION: disk material on midline instead of lateralized; partial instead of complete disk degeneration

EXTRUSION: single site instead of multiple; disk material dispersed beyond the borders of the disk space

De Decker VRU 2016

Question 124

Which of the following radiographic findings are, or are not, associated with canine influenza virus infection?

• Lymphadenopathy
• Cranial mediastinal widening
• Pleural effusion
• Unstructured interstitial pattern
• Alveolar pattern
• Bronchial pattern
• Structured interstitial pattern
• Multiple lung lobes affected

Answer 124

NOT associated with influenza virus: cranial mediastinal widening, thoracic lymphadenopathy, bronchial pattern, structured interstitial pattern

ASSOCIATED: unstructured interstitial pattern, alveolar pattern, pleural effusion (rare), multiple lung lobes affected

Secrest VRU 2016

Question 125

What is the radiographic distribution of interstitial to alveolar infiltrates in canine influenza virus infection?

Answer 125

Most commonly, cranioventral; can be diffuse or caudodorsal, however this is thought to represent an earlier timepoint in disease course, and infiltrates would become cranioventral over following few days

Secrest VRU 2016

Question 126

What are the possible effects of medroxyprogesterone acetate administration in dogs?

Answer 126

• Contraception (rarely used for this clinically): similar to endogenous progesterone, inhibits myometrial contractility and causes endometrial proliferation
• Weight gain
• Adrenocortical depression
• Diabetes
• Mammary tumors
• Endometrial hyperplasia
• Pyometra
• Diffuse endometrial mineralization (in this case report)

Jeong VRU 2016

Question 127

What is the gastric emptying half-time of solid food mixed with barium in dogs imaged without sedation or restraint? When does contrast first appear in the duodenum?

Answer 127

Gastric emptying half-time = 60-120 min
Duodenal contrast first appears at 30 min

Wrigglesworth VRU 2016

Question 128

Describe the appearance of feline tooth resorption on CT.

Answer 128

Irregular, hypoattenuating defects associated with the external surfaces of the tooth, most commonly at the root or cementoenamel junction. Mandibular PM3 most commonly affected.

Lang VRU 2016

Question 129

What HU correspond to hyperinflated, normoaerated, poorly aerated, and nonaerated pulmonary parenchyma in cats and dogs under inhalant anesthesia?

Answer 129

Hyperinflated: -1000 to -901
Normoaerated: - 501 to -900
Poorly aerated: -101 to -500
Nonaerated: -100 to +100

Guarracino VRU 2016

Question 130

What is the optimal positive airway pressure level to apply during breath-hold for evaluation of the pulmonary parenchyma with thoracic CT?

Answer 130

airway pressure level to apply during breath-hold for evaluation of the pulmonary parenchyma with thoracic CT?
10-12 cm H2O
Best value to minimize atelectasis without causing hyperinflation

Guarracino VRU 2016

Question 131

What are the theoretical cardiovascular effects of application of positive airway pressure? Have these been proven clinically relevant for healthy patients?

Answer 131

• Increased right atrial pressure
• Decreased venous return
• Decreased stroke volume and cardiac output
• Decreased arterial blood pressure

Not documented to be clinically relevant in stable patients, but could potentially be a problem in unstable patients.

Guarracino VRU 2016

Question 132

A repeatable pattern of subchondral bone resorption has been observed radiographically and with CT of equine stifles with osteoarthritis. Where is this resorption located?

Answer 132

• Medial tibial plateau, cranial and/or caudal aspects
• Medial aspect of the lateral femoral condyle, in the caudal portion of the intercondylar fossa

De Lasalle VRU 2016

Question 133

What is the most common location for osteophytes affecting the equine stifle?

Answer 133

Medial femorotibial joint - osteophytes can make their own sort of Morgan line associated with the insertion of the medial femorotibial joint capsule cranially on the medial femoral condyle

De Lasalle VRU 2016

Question 134

What is an example of homologous variation in vertebrae?

Answer 134

Variation within vertebral bodies without change in total vertebral number or identity; for example, transposition of the caudal portion of ventral process of C6 onto C7 in horses

Veraa VRU 2016

Question 135

What is an example of homeotic variation in vertebrae?

Answer 135

Change in numbers of one section of vertebrae without a change in the total number; for example, a transitional C7 with hypoplastic ribs, but there is still a proper T1 with normal ribs.

Veraa VRU 2016

Question 136

Which consistently provides better evaluation of articular cartilage thickness in the equine metacarpophalangeal joint, CT-arthrography or MR-arthrography?

Answer 136

Neither, there was no modality that provided consistent assessment of articular cartilage thickness.

Porter VRU 2016

Question 137

Regarding image management:

• What does .jpeg stand for?
• Is .jpeg a ‘lossy’ method of image compression?
• What is one of the major determinants of the degree to which compression degrades image quality?

Answer 137

• Joint Photographic Experts Group
• .jpeg compression is lossy, which means it is irreversible. The opposite would be ‘lossless’, or reversible compression.
• one of the major determinants of the degree to which compression degrades image quality is the COMPRESSION RATIO

Noel VRU 2016

Question 138

What is the effect on sensitivity and specificity of recently qualified radiologists, compared to radiologists with many years of post-residency experience?

Answer 138

Recently qualified radiologists tend to have higher sensitivity and lower specificity.

Noel VRU 2016

Question 139

What is/are the recommended diagnostic modalities for evaluating traumatic abomasitis in the cow?

Answer 139

Radiographs AND ultrasound - because US is limited by ingesta, gas, and other organs, so radiographs are needed to identify any radiopaque foreign material and increase the suspicion for foreign bodies, which have been reported (in this paper) to cause traumatic abomasitis and colic.

Constant VRU 2016

Question 140

What is the appearance of gallbladder wall edema on contrast-enhanced ultrasound?

Answer 140

Double-rim sign, just like in conventional US.

Bargellini VRU 2018

Question 141

What is the difference between polypoid cystic mucosal hyperplasia and non-polypoid cystic mucosal hyperplasia, in CEUS of the canine gallbladder?

Answer 141

CEUS will enhance the polyps of the polypoid version, will not enhance the other version because…it doesn’t have polyps…
Both will have wall enhancement, no difference there

Bargellini VRU 2018

Question 142

What is the approximate distribution of unilateral, bilateral, and multifocal disease in thyroid lobes for cats undergoing 99mTcO4 thyroid scintigraphy?

Answer 142

1/3 unilateral, 2/3 bilateral, 4% multifocal

Peterson VRU 2014

Question 143

Which is more sensitive for detection of feline hyperthyroidism, thyroid to salivary ratio or thyroid to background ratio? What about total T4 levels?

Answer 143

Both ratios are very sensitive, but thyroid to salivary ratio is more sensitive (98% compared to 96%). TT4 least sensitive at 90%.
Note that this has no relation to specificity.

Peterson VRU 2014

Question 144

What is the effect of methimazole administration on thyroid:salivary ratio in hyperthyroid cats?

Answer 144

No effect, doesn’t change it.

Peterson VRU 2014

Question 145

T/F: Quantitatively, thyroid scintigraphy does not change after methimazole therapy in hyperthyroid cats.

Answer 145

True.

Fischetti VRU 2005

Question 146

Name 5 general categories of differentials for young dogs (14 mo or less) with progressive brainstem or cerebral signs.

Answer 146

Inflammatory/infectious, degenerative, malformation, neoplasia, meningioangiomatosis.

Bishop JVIM 2004

Question 147

Describe the MR features of meningioangiomatosis.

Answer 147

T2w hyper, T1w iso- to hypo, strongly contrast enhancing, located peripherally and extending into parenchyma. +/- subarachnoid space narrowing. Does NOT have a mass effect. Is a weird benign hamartoma-y thing.

Bishop JVIM 2004

Question 148

In contrast-enhanced ultrasonography, what is the difference between peak intensity and mean intensity?

Answer 148

Peak intensity = maximum contrast enhancement
Mean intensity = mean pixel intensity over 60 sec

Rademacher VRU 2016

Question 149

What is the effect of pancreatitis on mean and peak pixel intensity on contrast-enhanced US evaluation of the canine pancreas?

Answer 149

Dogs with pancreatitis have increased mean and peak pixel intensity of their pancreas compared to the pancreas of normal dogs.
These values decreased at a 10-15 day recheck.

Rademacher VRU 2016

Question 150

Does ultrasound guidance improve operator total success rate in injection of the canine lumbosacral space, compared to landmark-guided blind injection?

Answer 150

Yes. To the surprise of no one.

Etienne VRU 2016

Question 151

What disease categories are most common causes of neurologic disease in small ruminants? (E.g. neoplastic, vascular)

Answer 151

Toxic-metabolic and infectious.

Ertelt VRU 2016

Question 152

What is the MRI appearance of polioencephalomalacia in small ruminants?

Answer 152

Bilaterally symmetric grey matter lesions of the forebrain: T2w-hyper, T1w-hypo, moderately contrast-enhancing

Ertelt VRU 2016

Question 153

What is the MRI appearance of enterotoxemia in the brain of small ruminants?

Answer 153

Bilaterally symmetric thalamic lesions: T2w/FLAIR-hyperintense, T1w-HYPERintense, non-contrast enhancing (which is weird, it seems like polioencephalomalacia would be not-enhancing and enterotoxemia would be enhancing, but it’s the other way around)

Ertelt VRU 2016

Question 154

What is the MRI appearance of listeriosis in the brain of small ruminants?

Answer 154

Brainstem lesions, variable distribution, asymmetric: T2w/FLAIR-hyperintense, T1w-isointense, +/- contrast enhancement.
(Mainly remember it’s brainstem and asymmetric.)

Ertelt VRU 2016

Question 155

What are the clinical characteristics common to both ischemic myelopathy and acute noncompressive nucleus pulposus extrusion in dogs?

Answer 155

Both are characterized by hyperacute onset of non-deteriorating, often markedly lateralizing paresis or plegia

Fenn VRU 2016

Question 156

What is the difference in origin of spinal cord injury between fibrocartilaginous embolism (FCE) and acute noncompressive nucleus pulposus extrusion (ANNPE?)

Answer 156

• FCE causes primarily ISCHEMIC injury
• ANNPE causes primarily CONTUSIVE injury, due to explosive extrusion of nucleus pulposus; followed by variable secondary injury and edema

Fenn VRU 2016

Question 157

What are 4 MRI criteria for making a diagnosis of ANNPE?

Answer 157

1) Focal area of intramedullary T2w-hyperintensity overlying a disk space
2) Reduction in volume of T2w-hyperintense nucleus pulposus signal
3) Mild narrowing of the associated disk space
4) Extradural material, or change in signal intensity, with minimal or no evidence of compression at this level

Fenn VRU 2016

Question 158

What are 3 MRI criteria for making a diagnosis of ischemic myelopathy (aka presumed FCE)?

Answer 158

1) Focal, well-demarcated intramedullary T2w-hyperintensity
2) Affects grey matter
3) Does NOT have the criteria of ANNPE (i.e. it’s not over a disk space and there is no associated disk space narrowing or loss of nucleus pulposus signal)

Fenn VRU 2016

Question 159

In a study comparing interobserver agreement, lesions that were overlying a vertebral body and were not lateralized were more likely to have what agreed-upon presumptive diagnosis?

Answer 159

Ischemic myelopathy/FCE

Fenn VRU 2016

Question 160

In a study comparing interobserver agreement, lesions that were overlying a disk space, were lateralized, with reduced nucleus pulposus volume of that disk space, +/- extradural material or signal change, were more likely to have what agreed-upon presumptive diagnosis?

Answer 160

ANNPE

Fenn VRU 2016

Question 161

In evaluating transverse MRI images of the spinal cord in dogs with presumed ANNPE, what percent of cross-sectional area of lesion compared to total cord (e.g. lesion represents 30% of total cord) is 92% predictive of unsuccessful outcome?

Answer 161

90%

De Risio JAVMA 2009

Question 162

Why do central tarsal bone fractures in horses tend to be nondisplaced or minimally displaced?

Answer 162

Due to support from the intertarsal ligaments

Knuchell VRU 2016

Question 163

What is the common fracture configuration and orientation of central tarsal bone fractures in racehorses?

Answer 163

Slab fracture in the dorsal plane (best seen on lateromedial radiographs)

Knuchell VRU 2016

Question 164

What is the common configuration and orientation of central tarsal bone fractures in non-racehorses?

Answer 164

Slab fracture, dorsomedial to plantarolateral, non-displaced
Need PLDMO views, often multiple at slightly different angles of obliquity, to see fx

Knuchell VRU 2016

Question 165

What are three common thoracic lesions in horses with lymphoma?

Answer 165

• Pleural effusion
• Cranial mediastinal lymphadenopathy
• Lung parenchymal changes

Janvier VRU 2016

Question 166

What sonographically identifiable abdominal lesions can be seen in equine lymphoma?

Answer 166

• Hepatomegaly, splenomegaly
• Diffuse hyper/hypoechogenicity of liver and/or spleen
• Nodular change
• Masses, less commonly
• Lymphadenopathy
• Peritoneal effusion
  (So not unlike small animals.)

Janvier VRU 2016

Question 167

What distinguishing characteristic can be identified on CT in cases of adenosquamous carcinoma, to differentiate it from fungal or other neoplastic causes of rhinosinusitis?

Answer 167

Adenosquamous carcinoma is more aggressive and more severe; characterized (in the 1 existing case report) by extensive osteolysis extending well beyond the sinonasal region to affect the calvaria, occipital condyles, and atlas.

Chow VRU 2016

Question 168

What are the MRI signal characteristics of trigeminal neuritis in horses?

Answer 168

Moderate to marked nerve enlargement, T1w/T2w iso- to hypointense to grey matter, peripherally contrast enhancing; possible widening of the foramina secondary to pressure atrophy

Beltran VRU 2016

Question 169

What are two possible differentials for unilateral trigeminal nerve enlargement identified on CT or MRI of the equine head?

Answer 169

• Peripheral nerve sheath tumor
• Trigeminal neuritis

Beltran VRU 2016

Question 170

What is the most common primary hepatic tumor in dogs?

Answer 170

Hepatocellular carcinoma, makes up 50% of all primary hepatic tumors.

Constant VRU 2016

Question 171

What is gadoxetate disodium, how is it excreted, and what is it used for?

Answer 171

• Paramagnetic contrast agent for MRI
• 50% hepatobiliary and 50% renal excretion in humans
• Used for liver-specific contrast MRI of the liver

Constant VRU 2016

Question 172

What contrast enhancement is expected for lesion vs. normal liver parenchyma in gadoxetate disodium-enhanced MRI of canine hepatocellular carcinoma? Why?

Answer 172

Hepatocellular carcinoma is expected to be LESS enhancing than normal liver parenchyma
This is because HCC hepatocytes have retained, but impaired, functional capacity –> are not able to take up and excrete contrast agent as readily as the surrounding normal parenchyma, so are less enhancing by comparison.

Constant VRU 2016

Question 173

Is the cranioventral recess of the equine coxofemoral joint a normal structure? How is it formed?

Answer 173

Not normal.
Theorized that it forms as a pathologic response to severe effusion and/or joint capsule stretching during excessive femoral head excursion in horses with coxofemoral luxation or subluxation.

Whitcomb VRU 2016

Question 174

What are the two possible approaches for US-guided injection of the coxofemoral joint in horses?

Answer 174

Dorsal or cranioventral; the latter is preferred when a cranioventral recess of the coxofemoral joint is present.

Whibcomb VRU 2016

Question 175

What CT feature of feline nasopharyngeal polyps may help distinguish them from a collection of exudate or a neoplastic mass?

Answer 175

Consistent ring enhancement - masses are more likely to enhance heterogeneously
This paper demonstrated that, to the surprise of no one, the ring enhancement of polyps is correlated with the degree of peripheral inflammation present, and is negatively correlated with the degree of peripheral edema present. Because inflammation is more enhancing than edema.

Lamb VRU 2016

Question 176

What is truncation or Gibbs artifact?

Answer 176

A line of abnormal signal intensity that occurs parallel to an interface between tissues of markedly different signal intensity. Occurs in ALL MR sequences, is a result of Fourier transform. Produces T2w-hyperintense lines and T1w-hypointense lines.

Gregori VRU 2016

Question 177

How can truncation artifact be minimized? Name 3 ways.

Answer 177

• Increasing spatial resolution (decreasing pixel size)
• Applying pre-reconstruction filters (e.g. Hamming or Tukey)
• Post-processing optimization (e.g. Total Variation method)

Gregori VRU 2016

Question 178

What is the appearance of truncation artifact in sagittal vs. transverse T2w images of the canine spinal cord?

Answer 178

• Sagittal: hyperintense line overlying the cord, parallel to the long axis of the cord; wider at lower resolution, becomes multiple smaller bands at higher resolution
• Transverse: multiple concentric zones of alternating signal intensity

Gregori VRU 2016

Question 179

In dynamic sonography of the equine distal limb, what is an indication of palmar/plantar annular ligament desmitis?

Answer 179

Restricted gliding motion between the palmar/plantar annular ligament and the SDFT.

DiGiovanni VRU 2016

Question 180

Is optic nerve sheath diameter as determined by transpalpebral ultrasound correlated with age and weight in horses?

Answer 180

No correlation with age and weight.
Foals were all <5 mm, adults were all <6.5 mm; these could be used as cutoffs if a relationship between ONSD and ICP is ever proven in horses.

Cooley VRU 2016

Question 181

Name four conditions that can present with swelling of the mandible in goats.

Answer 181

• Primary dental disease (abscesses)
• Actinomycosis (lumpy jaw)
• Fibrous osteodystrophy secondary to hyperparathyroidism
• Neoplasia: osteosarcoma, osteoma, ossifying fibroma, non-ossifying fibroma, adenocarcinoma, or multinucleated giant cell tumor

Dixon VRU 2016

Question 182

What are the CT characteristics of multinucleated giant cell tumor in a goat?

Answer 182

Aggressive, monostotic, multiloculated, extensive, with deformation of the affected bone and surrounding structures (mandible, in the 1 reported case). Contrast was not given so don’t know how it enhances.

Dixon VRU 2016

Question 183

What are the contrast enhancement characteristics of the spleen on CEUS in dogs?

Answer 183

Progressive enhancement, sometimes heterogeneous, to homogeneous peak enhancement; then progressive and homogeneous washout.

Rossi VRU 2016

Question 184

What is the effect of dexmedetomidine on CEUS of the spleen in dogs? Butorphanol?

Answer 184

Dex - Delayed enhancement with diminished intensity: prolonged arrival time, time to peak; decreased AUC and peak intensity.
Butorphanol - no effect

Rossi VRU 2016

Question 185

What MRI findings are more likely to be associated with intervertebral disk protrusion vs. extrusion?

Answer 185

• Protrusion: longer duration of clinical signs, midline instead of lateralized herniation, and partial instead of complete disk degeneration
• Extrusion: single herniation site, disk material dispersed beyond the borders of the disk space

Gomes VRU 2016

Question 186

What is the difference between pachymeninges and leptomeninges?

Answer 186

Recall that meninges are dura - arachnoid - pia
Pachymeninges = dura mater
Leptomeninges = arachnoid and pia

Question 187

In a study evaluating dogs with inflammatory brain disease, did dynamic subtraction imaging improve visualization of meningeal enhancement?

Answer 187

No. Dynamic subtraction did improve visualization of contrast-enhancing intra-axial lesions.

Dirrig VRU 2016

Question 188

Why does US contrast enhancement differ between the gallbladder vs. the liver and bile ducts?

Answer 188

Because GB is supplied solely by the cystic artery, has different blood supply than liver and bile ducts.

Bargellini VRU 2016

Question 189

What additional evaluation is preferred to further evaluate gallbladder wall necrosis or rupture suspected on ultrasound, in order to confirm or rule out the need for emergent surgical intervention?

Answer 189

Contrast-enhanced ultrasound provides better sensitivity and specificity than conventional US.

Bargellini VRU 2016

Question 190

Why is it advisable to use specifically medium-size (~8g) solid food boluses when evaluating swallowing with video fluoroscopy?

Answer 190

To minimize variation in swallowing parameters caused by variation in bolus size. Large (12g) boluses are associated with earlier UES opening and later maximum pharyngeal contraction compared to medium boluses.

Cheney VRU 2016

Question 191

Name 3 dog breeds predisposed to supracollicular fluid accumulations (previously called quadrigeminal cysts).

Answer 191

Shih Tzu, Chihuahua, Maltese

Bertolini VRU 2016

Question 192

Name the intensities of the following stages of hemorrhage on T1w and T2w images:

• Hyperacute, < 24 hrs
• Acute, 1-3 days
• Early subacute, 1-7 days
• Late subacute, 7-14 days
• Chronic, >15 days

Answer 192

• Hyperacute = iso/hyper (I Bleed)
• Acute = iso/hypo (I Die)
• Early subacute = hyper/hypo (Bleed Die)
• Late subacute = hyper/hyper (Bleed Bleed)
• Chronic = hypo/hypo (Die Die)

Thomas VRU 2016

Question 193

How long can magnetic susceptibility artifact persist after arthroscopy in horses? What is its suspected origin?

Answer 193

Up to 12 weeks demonstrated so far (their study didn’t run longer than that). Theorized to result from either hemorrhage or small surgical metallic debris.

Thomas VRU 2016

Question 194

Which approach is easier to perform and more accurate for CT-guided injection of the lumbosacral epidural space, translaminar or transforaminal?

Answer 194

Translaminar. Incorrect needle position may result in subarachnoid contamination and vertebral venous plexus puncture.

Liotta VRU 2016

Question 195

In ultrasound-guided injection of the collateral ligaments of the equine distal interphalangeal joint, what are the periligamentous structures that are most commonly inadvertently also injected?

Answer 195

Distal interphalangeal joint and common digital extensor tendon.

Lewis VRU 2016

Question 196

Which modality is best for detection of defects in the cruciate ligaments, proximal tibia, and ligament entheses of the equine stifle? Which for detecting articular cartilage damage on the medial femoral condyle?

Answer 196

CT-arthrography is better than rads or US. MRI is not an option because you can’t MR the stifle.
No modality is good at detecting articular cartilage; requires arthroscopy.

Nelson VRU 2016

Question 197

Why is axial skeletal lymphoma often not visible on radiographs, and only identified on MRI?

Answer 197

Because axial skeletal lymphoma is often not primarily lytic - does not cause the 30-50% loss of mineral density required for radiographic visualization. Is very visible on STIR sequences because the medullary fat is replaced by malignant cellular infiltrate.

Kornder VRU 2016

Question 198

What condition should be distinguished from diskospondylitis in young dogs?

Answer 198

Physitis of the caudal vertebral physis: lysis is initially restricted to the caudal vertebral physis, leading to collapse of the vertebral body and spondylosis of the caudal aspect of the vertebral body. Disko has symmetric osteolysis of the endplates with spondylosis deformans of the cranial and caudal disk spaces.

Ruoff VCNA 2017

Question 199

What are the two most common sites for dysphagia in dogs?

Answer 199

• Esophagus: esophageal motility disorders (45% of dysphagic dogs)
• Abnormalities of the lower esophageal sphincter/hiatus (45% of dysphagic dogs)
• Note that in this study, 38% of dogs had concurrent abnormalities in multiple anatomic locations, so could also have pharyngeal or cricopharyngeal problem

Pollard VRU 2017

Question 200

If a videofluoroscopic swallowing study is normal in a dysphagic dog, what are two differentials that cannot be ruled out on the basis of a normal study?

Answer 200

Gastroesophageal reflux or sliding hiatal hernia, as these are transient events that may not have been seen during the study period

Pollard VRU 2017

Question 201

What does an elevated pharyngeal constriction ratio indicate, and with which anatomic origins is it associated in dysphagic dogs?

Answer 201

Elevated pharyngeal constriction ratio = decreased ability of pharynx to adequately propel a bolus through the upper esophageal sphincter
Associated w/ dysphagia of pharyngeal (normal UES opening) or cricopharyngeal (abnormal UES opening) origin

Pollard VRU 2017

Question 202

What is the MR appearance of leukoaraiosis?

Answer 202

T2w/FLAIR-hyperintense, T1w-isointense pre- and post-contrast, contiguous with lateral ventricles with variable periventricular extension into white matter
Also hyperintense on ADC, low FA on DTI (humans only)
Often accompanied by brain atrophy and thinning of interthalamic adhesion

Scarpante VRU 2017

Question 203

What is osmotic demyelination syndrome?

Answer 203

Result of hyponatremia + aggressive correction of hyponatremia: leads to myelinolysis and T2w hyperintensities of periventricular white matter, particularly affecting the pons

Scarpante VRU 2017

Question 204

Name three findings associated with the presence of pulmonary hypertension on radiographs.

Answer 204

• Right ventricular enlargement
• Main pulmonary artery enlargement
• Caudal lobar artery enlargement

Adams VRU 2017

Question 205

Are thoracic radiographs able to differentiate severity of pulmonary hypertension?

Answer 205

No, no correlation between radiographic findings and severity of pulmonary hypertension. Echocardiography should remain the gold standard for PHT evaluation, though radiographs can provide useful additional information.

Adams VRU 2017

Question 206

Are lymph nodes with hyperechoic perinodal fat more likely to be reactive, neoplastic, or inflammatory?

Answer 206

Hyperechoic perinodal fat = unlikely to be reactive (which in this study meant hyperplastic); equally likely to still be benign (inflammatory, aka lymphadenitis) or malignant (neoplasia), therefore sampling may be indicated

Dave VRU 2017

Question 207

Should sagittal STIR sequences replace sagittal T2w sequences in evaluation of the canine spine for intervertebral disk herniation?

Answer 207

No, there was no statistically significant difference in sensitivity between T2w and STIR sequences in identifying the exact disk space, or localizing the region of disk spaces, of intervertebral disk herniation

Housley VRU 2017

Question 208

What are the differentials for a broad-based, focal, ventrally convex soft tissue opacity associated with the dorsal tracheal wall on thoracic radiographs of a dog?

Answer 208

• Hematoma
• Abscess
• Migrated or broken extraluminal tracheal ring prosthesis (correlate with history)
• Dorsal tracheal membrane neoplasia
• Esophageal stricture or adhesion or mass
• Unlikely to be redundant tracheal membrane when focal

Paradise 2017 VRU

Question 209

What is the normal range for bronchoarterial ratios in healthy dogs?

Answer 209

0.8 - 2.0

Coia VRU 2017

Question 210

Name 5 differentials for heterogeneously hyperattenuating pulmonary nodules with ground glass opacity on canine thoracic CT.

Answer 210

• Angiostrongylus vasorum infection
• Eosinophilic bronchopneumopathy
• Pulmonary lymphoma
• Granulomatous disease
• Histiocytic sarcoma

Coia VRU 2017

Question 211

What are the thoracic CT findings typically associated with Angiostrongylus vasorum infection in dogs?

Answer 211

• Peripheral distribution of increased lung attenuation with diffuse, poorly organized, and multifocal nodules of ground glass opacity
• Tracheobronchial lymphadenopathy

Coia VRU 2017

Question 212

With which 4 neoplasms is pleural metastasis associated?

Answer 212

• Transitional cell carcinoma
• Mammary carcinoma
• Prostatic carcinoma
• Epithelial neoplasms (e.g. squam)
  In theory can be any carcinoma, but these are the top 4

Watton VRU 2017

Question 213

What CT characteristics differ between malignant pleural effusion vs. pleuritis?

Answer 213

More associated with malignancy:

• Presence of pleural thickening (65% malignant, but seen in 35% of pleuritis cases)
• Worse pleural thickening (3 mm vs. 0 mm median)
• Thickening of the parietal pleura only (best discriminator)

More associated with pleuritis:
- Mediastinal LN enlargement

Watton VRU 2017

Question 214

What are the thoracic CT findings associated with the acute phase of leptospirosis in dogs?

Answer 214

• Short-lived peribronchovascular thickening and bronchiolectasis (resolves within 3-7 days)
• Areas of consolidation and consolidated nodules –> rapidly morph into ground glass lesions of similar distribution
• Ground glass nodules

Gendron VRU 2017

Question 215

What are the two most common organs affected at ultrasound in patients with leptospirosis? Name two atypical findings that have occurred in patients with leptospirosis in that one paper, that they said were ‘caused by’ leptospirosis in a completely unfounded claim.

Answer 215

• Kidneys (100%) and liver (83%)
• Gallbladder mucocele and small intestinal intussusception (wat)

Sonet VRU 2017

Question 216

Screening thoracic radiographs are worthwhile in what populations of canine and feline patients?

Answer 216

• Cats in general
• Geriatric patients in general
• Cats with anemia or low-normal PCV
• Dogs with elevated lactate

Summary: cats, anemic cats, hyperlactatemic dogs, old cats and dogs
Keyserling VRU 2017

Question 217

In a study evaluating use of computational fluid dynamics for assessing airflow resistance in brachycephalic dogs, what region of the nasal passages exhibited the largest airflow resistance?

Answer 217

The rostral third of the nasal passages exhibited larger airflow resistance than the middle or caudal thirds. (This actually makes sense if you picture where the turbinates are densest on CT.)

Hostnik VRU 2017

Question 218

What is the relationship between tympanic bulla morphology and presence of middle ear effusion in brachycephalic dogs?

Answer 218

There isn’t one. No significant relationship between tympanic bulla morphology and presence of middle ear effusion could be identified.

Mielke VRU 2017

Question 219

In brief, describe the technique for CT-lymphangiography with aqueous contrast in evaluating tumors of the head in dogs.

Answer 219

• Position in sternal, caution with ET tube ties and padding to ensure no blocking of lymphatic flow
• Inject 1 ml of contrast in 4 quadrants around the tumor
• Serial CT scans 1 min apart until sentinel node identified; usually identified within 3 minutes

Grimes VRU 2017

Question 220

What location was most affected by lumbosacral stenosis in a study evaluating lumbar and lumbosacral CT in Labradors?

Answer 220

Cranial L6
(Study evaluated vertebral canal at endplates of L5-6, L6-7, and L7-S1)

Mukherjee VRU 2017

Question 221

What is the expected effect of age on interthalamic adhesion thickness, ratio of interthalamic adhesion to brain height, and ratio of (interthalamic adhesion to brain height) to (lateral ventricle to brain height)?

Answer 221

All three parameters are expected to decrease with age.

Noh VRU 2017

Question 222

Which MRI sequence is preferred for clearest depiction of normal canine femoral and sciatic nerves in a 3T magnet? Which sequence will reduce nerve visualization the most? Which imaging planes should be used?

Answer 222

• Clearest nerves: T1w, because of good visualization of peri-neural fat
• Reduced nerve visualization: anything fat-saturated, because the fat helps highlight the nerves
• Sciatic and femoral nerves can be seen in dorsal and transverse planes. Sagittal was not useful.

Sievert VRU 2017

Question 223

What is palatal instability in horses?

Answer 223

‘Billowing’ of rostral and caudal soft palate around the edges of the epiglottis, without displacement of the soft palate over the epiglottis. Can be precursor to DDSP.

Barakzai Eq Vet Educ 2012

Question 224

Which phase of respiration is affected by dorsal displacement of the soft palate in horses?

Answer 224

Expiration - soft palate billows up and blocks a good portion of airflow –> inc airway resistance –> impaired performance

Barakzai Eq Vet Educ 2012

Question 225

In ultrasound evaluation of the equine larynx, what structure can be assessed and its depth (from the skin surface) measured and correlated with likelihood of the horse having DDSP?

Answer 225

Basihyoid bone, where it meets the lingual process; depth from skin surface correlated with likelihood of DDSP. Bigger measurement = less likely DDSP, smaller measurement = more likely.

Chalmers VRU 2009

Question 226

What are the three sites of insertion for congenital extrahepatic portosystemic shunts originating from the left gastric vein in dogs?

Answer 226

1) Left gastrophrenic - to L phrenic vein
2) Left gastrocaval - to post-hepatic caudal vena cava (post-hepatic = after the liver, from a blood flow perspective)
3) Left gastroazygos - to azygos vein

White JSAP 2013

Question 227

What is the definition of ground glass opacity on CT?

Answer 227

Hazy increase in lung opacity without obscuring vessels or bronchi, is secondary to partial replacement of alveolar gas with fluid or cells - or secondary to thickening of the interstitium with fluid or cells.

Schiborra JSAP 2017

Question 228

Describe the signalment associated with open-mouth jaw locking in cats. Name 3 possible predisposing factors.

Answer 228

• 1-10 YO, any breed but brachycephalics overrepresented
• Trauma, TMJ dysplasia, mandibular symphyseal laxity

Nutt JFMS 2017

Question 229

Hyperechoic mucosal striations are associated with what histopathologic finding and clinical syndrome?

Answer 229

Lacteal dilation on histopath; protein-losing enteropathy clinically - hypoalbuminemic, sometimes panhypoproteinemic, hypocalcemic and hypomagnesemic

Sutherland-Smith VRU 2007

Question 230

T/F: Hyperechoic mucosal striations can distinguish between primary inflammatory disease, primary lymphangiectasia, and villus histiocytic sarcoma.

Answer 230

False - all three of these can have hyperechoic mucosal striations, and can look the same.

Sutherland-Smith VRU 2007

Question 231

T/F: Intestinal wall thickness on US can be used to distinguish between food-responsive IBD, idiopathic IBD, and protein-losing enteropathy.

Answer 231

False. There was no significant difference in wall thickness between these two groups. Wall thickness was neither sensitive nor specific for presence, type, or severity of disease.

Gaschen VRU 2008

Question 232

A normal, hypoechoic jejunal mucosa in dogs with signs of chronic enteropathy (>3 wks increased frequency, decreased consistency, and decreased volume of defecation) is suggestive of what subtype of inflammatory disorder?

Answer 232

Food-responsive (aka food allergy) enteropathy; this is in contrast to protein-losing enteropathy, which more often has hyperechoic striations; or idiopathic, which did not have specific US findings. Hyperechoic mucosal speckles are nonspecific inflammatory change.

Gaschen VRU 2008

Question 233

Name some differentials for thoracic CT findings of moderate to marked bronchial wall thickening, alveolar to ground glass multifocally, and mild to moderate bronchiectasis in dogs with a history of chronic cough.

Answer 233

• Crenosoma vulpis
• Angiostrongylosis
• Eosinophilic bronchopneumopathy
• Chronic bronchitis
• Infectious bronchopneumonia of any kind
• • Not the same as for Pneumocystis or HW (remember HW should have vascular changes)

Mortier VRU 2018

Question 234

Briefly describe the thoracic CT features of Pneumocystis carinii, Dirofilaria, Crenosoma vulpis, and Spirocerca lupi infections in dogs.

Answer 234

• Pneumocystis: Diffuse or multifocal ground glass pattern, variable bronchial dilation, parenchymal bands, possible pulmonary hypertension.
• HW: Multifocal interstitial ground glass opacity, tortuous and blunted pulmonary arteries (w/ filling defects from PTE), hypoventilation and bronchial collapse in multiple lung lobes.
• Crenosoma: Multifocal ground glass pattern, marked bronchial thickening, moderate bronchiectasis, sometimes parenchymal bands.
• Spirocerca: Esophageal nodules.

Question 235

Describe the thoracic CT findings of feline heartworm disease.

Answer 235

Multifocal interstitial ground glass opacity, tortuous and blunted pulmonary arteries, multiple arterial filling defects if angiography, bronchial collapse with resulting hypoventilation of lung regions.

Panopoulos VRU 2017

Question 236

At what age does the thymus start to regress? Are the neoplastic cells responsible for a thymoma the thymic epithelial cells or the immune cells?

Answer 236

5 months
Epithelial cells, even though lots of immune cells are there

Patterson JAAHA 2014

Question 237

Describe the thoracic US features of cranial mediastinal thymoma vs. lymphoma.

Answer 237

• Thymoma - often cystic, often heterogeneous echogenicity
• Lymphoma - often homogeneously hypoechoic, but can be heterogeneous, no cysts
  => Lack of cysts + homogeneous = more likely lymphoma; cysts + heterogeneous = more likely thymoma

Patterson JAAHA 2014

Question 238

What is the normal adrenal gland size in both chronically sick (with non-adrenal illness) and healthy cats, as measured on US?

Answer 238

Cranial pole - 3.0-4.8 mm
Caudal pole - 3.0-4.5 mm
No statistically significant difference in size btwn the two groups.

Combes JFMS 2013

Question 239

In cats with unilateral adrenal masses, what may be histologically (but not sonographically) identified in the contralateral adrenal gland?

Answer 239

Contralateral gland is usually sonographically normal, but cat adrenal carcinomas can be bilateral with histologic infiltration of the sonographically normal gland with carcinoma.

Combes JFMS 2013

Question 240

T/F: Benign and malignant adrenal masses can cause hyperaldosteronism in cats.

Answer 240

True.

Combes JFMS 2013

Question 241

Name 5 conditions with which vertebral venous system anomalies have been associated in dogs.

Answer 241

1) Arteriovenous malformation
2) Occlusion (e.g. due to presence of large intra-abdominal masses, or pregnancy)
3) Thrombosis or agenesis of other vessels such as the vena cava or jugular veins
4) Herniated disks
5) Connective tissue disorder (Marfan’s syndrome)

Vernon VRU 2017

Question 242

What is subclavian steal syndrome?

Answer 242

Retrograde flow within a vertebral artery as a result of stenosis or occlusion of the subclavian artery. Mostly asymptomatic but can be associated with ipsilateral thoracic limb paresthesia or claudication.

Vernon VRU 2017

Question 243

What is an unusual neoplastic differential for multifocal, intra-axial and/or intramedullary lesions that are hyperintense on T1w images of the canine brain and spine?

Answer 243

Oligodendroglioma
Not typically T1w-hyperintense, but can be

Schkeeper VRU 2017

Question 244

What are the primary sonographic features of insulinoma in ferrets?

Answer 244

Multifocal (contrast to dogs and cats), hypoechoic, can be homogeneous or heterogeneous

Wu VRU 2017

Question 245

Describe the typical signalment and presenting complaint of ferrets with insulinoma. What is the incidence of ferret insulinoma?

Answer 245

• average 5 YO (range 2-7 YO)
• no sex predilection
• signs of hypoglycemia (ptyalism, pawing at face)
• incidence 22%: most common ferret neoplasm; adrenocortical and lymphoma are next most common

Wu VRU 2017

Question 246

Name a recently developed radiographic method of assessing humeroulnar congruity in normal dog elbows.

Answer 246

Measuring radius of curvature of the humeral trochlea and ulnar trochlear notch. This paper was a methods description study that didn’t describe the method.

Alves-Pimenta VRU 2017

Question 247

What are the thoracic CT findings more prevalent in aged dogs than in young dogs?

Answer 247

• Heterotopic bone and partial lung collapse (aka atelectasis)
• Fibrosis, emphysema, ground glass or reticular pattern, or pleural/bronchial/septal thickening were NOT age-related and should not be considered incidental in dogs w/ respiratory signs.

Hornby VRU 2017

Question 248

T/F: Fractal analysis of canine pulmonary vasculature based on thoracic CT is able to diagnose pulmonary thromboembolism.

Answer 248

False.
Fractal analysis able to distinguish healthy dogs from sick dogs, but not able to distinguish sick dogs with PTE from sick dogs without.

Muller VRU 2017

Question 249

Name the modality options for injecting the distal DDFT in standing horses. Which is preferred?

Answer 249

• US-guided: difficult, can’t be done to distal tendon b/c probe can’t reach
• Bursoscopic or CT-guided: both require general anesthesia; bursoscopic requires lesions in dorsal part of tendon, in navicular bursa
• Rad-guided, transcuneal: limited access to only a part of the tendon
• Open MRI-guided, standing: Preferred b/c no general anesthesia, can reach all of needed structures; however no papers yet on injection of lesions, only this proof-of-concept paper using normal cadaver limbs

Groom VRU 2017

Question 250

Describe the MRI findings of idiopathic oculomotor neuropathy in dogs.

Answer 250

• Variable on T2w, FLAIR, and T1w
• Majority are contrast-enhancing, focal or diffuse
• Majority have some enlargement, of variable degree
  Clinical signs are always unilateral. CSF is mostly normal. Good prognosis, can improve w/ or w/o meds, and do not deteriorate.

Tetas Pont VRU 2017

Question 251

What cranial nerves can be affected in middle cranial fossa syndrome, also known as cavernous sinus syndrome?

Answer 251

3, 4, 5, and 6
Oculomotor, trochlear, abducens, and the 3 branches of the trigeminal

Tetas Pont VRU 2017

Question 252

Describe the ultrasonographic appearance of intrasynovial hair shafts. What is the clinical relevance of this finding?

Answer 252

Hair shafts appear as small, thin, linear hyperechogenicities WITHOUT distal acoustic shadowing.
In cases with history of trauma and apparent inflammation of the synovial structure, finding of hair shafts indicates need for arthroscopic debridement as opposed to needle lavage.

Partlow VRU 2017

Question 253

What are the differential diagnoses for a geographic, osteolytic lesion with cortical destruction, in the region of the interosseous ligament of the radius and ulna?

Answer 253

• Bone cyst
• Primary bone tumor (weird)
• Metastatic disease
• Fungal disease
• RUIN lesion (necrosis thought to be result of ischemia of interosseous ligament attachment sites)

Schmid VRU 2016

Question 254

What are the cutoffs compatible with dementia based on interthalamic adhesion thickness and ratio of interthalamic adhesion thickness:brain height, on CT or MRI of canine brains? Which parameter is preferred for use?

Answer 254

Interthalamic adhesion thickness: <4.7 mm associated with dementia
Interthalamic adhesion thickness:brain height: <13.6%
Interthalamic adhesion thickness:brain height is preferred because it does not vary as much with age, brain height, body weight, etc.

Noh VRU 2017

Question 255

What 2 anatomic structures are most affected in medial humeral epicondylitis in cats? What 2 structures are not affected by MHE? What is the recommended treatment, surgical or medical?

Answer 255

• Primarily humeral head of the flexor carpi ulnaris
• Ulnar nerve, flattened and impinged by bony proliferation
• Medial coronoid and medial collateral ligament are NOT affected.
• Surgical management: debridement of proliferation, tendon, release of ulnar nerve

Streubel Vet Surg 2015

Question 256

What is the utility of pulmonary trunk:aorta ratio on CT of the canine thorax?

Answer 256

• Can be used to distinguish patients with moderate to severe pulmonary hypertension
• Cannot distinguish between mild PHT, and no PHT
• Ratio of 1.4 is proposed

Sutherland-Smith VRU 2018

Question 257

Name 4 conditions with which sliding hiatal hernia is associated.

Answer 257

• Brachycephalic obstructive airway syndrome
• Chronic diaphragmatic hernia
• Tetanus
• Laryngeal paralysis

Broux Vet Surg 2017

Question 258

What are the predominant clinical features of focal lipogranulomatous lymphangitis in dogs?

Answer 258

• Chronic diarrhea +/- vomiting
• Minimal biochemical abnormalities
• Ultrasonographic evidence of thickened ileal or proximal colonic wall: mainly muscularis and serosa
  Sx biopsies recommended, endoscopic were mainly nondiagnostic.

Lecoindre JSAP 2016

Question 259

What are the top three differentials for canine tonsillar neoplasia? Name 3 benign differentials.

Answer 259

1) Squamous cell carcinoma *can be bilateral
2) Melanoma
3) Lymphoma

Benign - tonsillar polyp, hyperplasia, or tonsillitis

Thierry VRU 2018

Question 260

What CT features clearly differentiate benign from malignant tonsillar disease in canines?

Answer 260

Trick question, there aren’t any. Both benign and malignant overlap in heterogeneity, size, contrast enhancement. Policy should be that if you have an enlarged MRPLN of uncertain etiology, you should sample the tonsils even if they look normal.

Thierry VRU 2018

Question 261

Which dog breeds are more likely to have sliding hiatal hernias?

Answer 261

French bulldogs - suspected breed predisposition
Any brachycephalic presenting for BOAS with GI signs (regurgitation, vomiting)

Reeve JSAP 2017

Question 262

Name 5 differentials for a well-circumscribed intramedullary lucency with surrounding sclerosis in the long bone of a horse.

Answer 262

• Aneurysmal bone cyst
• Intraosseous ganglion
• Non-ossifying fibroma
• Fibrous dysplasia
• Bone infarction

Stocker EVJ 2017

Question 263

Cats with _______ are 21x more likely to have positive bile culture results compared to cats with _____.

Answer 263

Cats with 1 or more findings of GB disease (sludge, wall thickening, cholelithiasis, mucosal hyperplasia, wall edema) were 21x more likely to have (+) culture results compared to cats with normal GB US.
If normal GB US, 96% probability that bile culture will be negative.

Policelli Smith JVIM 2017

Question 264

What MRI technique has been used to evaluate the vascular anatomy of a PDA in dogs?

Answer 264

Black blood imaging clearly depicted the course of the PDA from the pulmonary artery to the aorta in 3 dogs.

Lee VRU 2017

Question 265

What is the difference between ‘torsion’ and ‘volvulus’?

Answer 265

Torsion = twisting of an intestinal segment around its axis - colonic torsion often not associated with acute abdomen
Volvulus = rotation of a segment of bowel around its mesenteric axis - colonic volvulus generally associated with acute abdomen

Plavec Vet Surg 2017

Question 266

What is the most sensitive modality for detection of small volume pneumothorax in the horse?

Answer 266

2-D and M-mode ultrasound is most sensitive compared to radiographs (80-84% compared to 48%)

Partlow VRU 2017

Question 267

What are ‘rice bodies’, where are they found, and with what diagnosis are they associated?

Answer 267

Rice bodies = fusiform, slightly hyperechoic to muscle structures made up of fibrin, collagen, and RBCs; found in bursae of horses (and also humans), associated with chronic bursitis.

Hohu VRU 2018

Question 268

Describe a protocol for positive contrast colonography (radiographs, not fluoro).

Answer 268

• 60% w/v barium suspension, diluted 1:1 with water, administered as enema at dose of 3 ml/kg
• Can also do up to 10 ml/kg, diluted to 20%

Gremillion VRU 2018

Question 269

What are most common presenting complaints in patients with colonic torsion?

Answer 269

Vomiting (most common), mild abdominal pain
* Severe pain or hypovolemic shock are uncommon with colonic torsion

Gremillion VRU 2018

Question 270

What are the most common radiographic signs associated with colonic torsion?

Answer 270

Cecal displacement to the L, descending colonic displacement to the R, colonic narrowing/segmental colon

Gremillion VRU 2018

Question 271

What is a CT MIP?

Answer 271

MIP = maximum intensity projection; this is a CT post-processing technique that uses only the highest attenuating voxels projected along a line through the dataset to generate a two-dimensional image.
Can be used to increase confidence in defining small structures like pulmonary nodules, ectopic urters.

Secrest VRU 2017

Question 272

Describe the CT characteristics of lipomas vs. infiltrative lipomas.

Answer 272

Lipoma = rounded, well-defined, mostly homogeneously fat-attenuating with sometimes hyperattenuating components
Infiltrative lipoma = irregular, margins range from good to poor definition, mostly homogeneous, tendency towards linear hyperattenuating components

**Note that both can be associated with regional lymphadenopathy, if less commonly than liposarcs. LNs do not a diagnosis of aggressive disease make, even with lipomas.

Spoldi VRU 2017

Question 273

Describe the CT characteristics of liposarcomas.

Answer 273

Often rounded to ovoid, margins range from good to poor definition, heterogeneous with hyperattenuating, often nodular or conglomerate components
In contrast to lipomas/infiltrative lipomas, liposarcs can have other features of aggressive dz: mineralization, regional osteolysis

Spoldi VRU 2017

Question 274

Describe the biologic behavior of liposarcoma.

Answer 274

Locally invasive, low metastatic rate, high recurrence rate

Spoldi VRU 2017

Question 275

Describe in brief 3 theories as to how syringohydromyelia develops in COMS patients.

Answer 275

1) Waterhammer effect - change in intracranial pressure during systole drives either CSF or a pressure wave into the central canal, causing progressive expansion
2) Slosh effect - with distention of epidural veins during cough/sneeze, CSF flows more freely in the syrinx than in the subarachnoid space –> pressure waves cause CSF to slosh and fissure surrounding parenchyma
3) Ball valve effect - herniated cerebellar vermis at the foramen magnum contributes to progressive fluid accumulation within the spinal cord

Dewey Compendium 2004

Question 276

Name some causes of prehepatic portal hypertension.

Answer 276

Congenital atresia
PV fibrosis, thrombosis, or neoplasia
Extraluminal obstruction (mass, LN, abscess)
Hepatic arteriovenous fistula (b/c arterial blood overfills the PV)
Flukes - Schistosoma or Heterobilharzia
Complication of congenital PSS attenuation

Buob JVIM 2011

Question 277

Name some causes of posthepatic portal hypertension.

Answer 277

Right heart failure (tamponade, pericardial effusion, pulmonary hypertension)
Budd-Chiari syndrome
Intraluminal or extraluminal fibrosis/thrombosis/neoplasia of the posthepatic CVC

Buob JVIM 2011

Question 278

What is Budd-Chiari syndrome? (Not to be confused with Chiari malformation.)

Answer 278

Budd-Chiari syndrome = obstruction of hepatic venous outflow in the caudal vena cava or larger extrahepatic veins; obstruction is most commonly due to intraluminal obstruction by tumor, thrombosis, or congenital fibrous webs; or to extraluminal compression by tumor.

Buob JVIM 2011

Question 279

What is the effect of ascites on prognosis in dogs with chronic hepatitis?

Answer 279

Worsens it. Ascites is negative prognostic indicator.

Buob JVIM 2011

Question 280

In experimental models of canine portal hypertension, how long does it take for acquired shunts to form?

Answer 280

5-14 weeks

Buob JVIM 2011

Question 281

Which type of portal hypertension CANNOT be the cause of acquired shunts? (i.e. prehepatic, intrahepatic, presinusoidal, etc.)

Answer 281

Post-hepatic - b/c the obstruction is after the PV and CVC have met, so it doesn’t matter if there’s a shunt between the PV and CVC, and there is no pressure gradient to form one because the PV and CVC are suffering the same hypertension due to whatever is obstructing the posthepatic CVC

Buob JVIM 2011

Question 282

Where do acquired shunts tend to form in dogs - from what vein to what anastomosis to what vein?

Answer 282

From splenic vein –> anastomose with embryonic connections to the gonadal veins –> empty into left renal vein

Buob JVIM 2011

Question 283

Where do acquired shunts tend to form in cats?

Answer 283

Left gastric –> phrenicoabdominal vein
Left colic –> left gonadal vein

Buob JVIM 2011

Question 284

Name 2 factors that distinguish between single extrahepatic shunts and multiple acquired shunts based on ultrasound findings.

Answer 284

Acquired shunts are greater in number (>2) and smaller in size (<0.4 cm).

Buob JVIM 2011

Question 285

The presence of both multifocal renal cysts and bile duct abnormalities (e.g. dilation, ectasia, calcification) may be seen with what condition?

Answer 285

Caroli’s disease

Heather Spain, 2017

Question 286

T/F: Portal hypertension can be associated with gastric ulcers.

Answer 286

True.

Buob JVIM 2011

Question 287

Is the insertion of the lateral patellar ligament in a horse stifle expected to be homogeneous with regular fiber pattern?

Answer 287

No; expected to be inhomogeneous with irregular fiber pattern, or with gaps in the fiber pattern. This is important to remember in order to avoid false positive diagnosis of LPL damage.

Gottlieb EVJ 2016

Question 288

Of injuries to the three patellar ligaments in the equine stifle, one is associated with trauma, and one is not. Which is which?

Answer 288

Middle patellar ligament injuries are mostly atraumatic (no inciting traumatic event known). Lateral patellar ligament injuries are most commonly traumatic (e.g. kicked, ran into something, etc).

Gottlieb EVJ 2016

Question 289

Between radiographs and ultrasound of the equine stifle, which is more sensitive vs more specific for detection of OCD lesions?

Answer 289

Rads: lower sensitivity, higher specificity (80 vs 100)
US: higher sensitivity, lower specificity (100 vs 60-80)

Beccati VRU 2013

Question 290

Name two distinguishing CT characteristics of lipomas/infiltrative lipomas vs. liposarcomas.

Answer 290

• Liposarcomas contrast-enhance, while lipomas/infiltrative lipomas do not.
• Liposarcomas tend to be soft tissue-attenuating (HU>0) with some fat foci, while lipomas/infiltrative lipomas are fat-attenuating (HU<0).

Fuerst VRU 2017

Question 291

In measuring the area of the L7-S1 intervertebral foramen on MRI of dogs with degenerative lumbosacral stenosis, what patient position, location of measurement, and slice orientation provides measurement of the minimum foraminal diameter?

Answer 291

• Hyperextended spine position (as opposed to neutral)
• ‘Middle zone’ of nerve, defined as the area of nerve passing under the pars interarticularis and pedicle
• Parasagittal oblique, defined as perpendicular to the nerve root exiting the spinal cord, as opposed to parallel to the long axis of the spine

Zindl VRU 2017

Question 292

True or false: Intervertebral foramen diameter, and therefore potential nerve claudication at the foramen, is dynamic and influenced by position in dogs with degenerative lumbosacral stenosis.

Answer 292

True.

Zindl VRU 2017

Question 293

What is the lower limit of normal for interspinous space measurement on a lateral radiograph in horses? (I.e. how small is it before it is abnormal)

Answer 293

4 mm

Djernaes VRU 2017

Question 294

Name one patient factor, one CT scanning factor, and one contrast medium factor that affect contrast enhancement in CT angiography.

Answer 294

• Patient factors: body weight (patient size), cardiac output
• CT scanning factors: scan delay, table direction, scan duration
• Contrast factors: iodine volume, duration/rate of injection, saline flush

Lee VRU 2017

Question 295

T/F: Arterial enhancement on CT angiography is directly proportional to the flux of iodine that enters the circulatory system in mg I/sec.

Answer 295

True. The mg I/sec is calculated from the injection rate, in ml/sec; and the concentration, in mg I/ml.

Lee VRU 2017

Question 296

A 3-kg dog requires a three-phase liver angiogram. Due to small patient size, a 24g IV catheter is placed. Will a contrast injection rate of 1.5 ml/sec provide adequate enhancement of and distinction between arterial, portal and delayed phases?

Answer 296

Yes. Injection rate is decreased because the volume injected in a 3 kg dog is so small, that if you used the standard 3 ml/sec your phases would pass by before the CT could scan it. 3 ml/sec is the standard because this faster injection rate has been shown to provide wider enhancement between arterial and venous phases.

Lee VRU 2017

Question 297

What is traction bronchiectasis?

Answer 297

Irreversible dilation of the bronchioles that occurs secondary to pulmonary fibrosis. Is a result of traction from the surrounding fibrous tissue that dilates the bronchial lumen without other signs of bronchial disease.

Fitzgerald VRU 2017

Question 298

What is the Macklin effect?

Answer 298

(Burt Macklin, FBI.)
Macklin effect = air leaking through sites of alveolar rupture, tracking along the interstitium of the bronchovascular bundle and accumulating in the mediastinum. Means pneumomediastinum as a result of primary lung disease.

Fitzgerald VRU 2017

Question 299

What is the modality of choice for highest sensitivity and specificity in identifying canine tarsal fractures?

Answer 299

CT is most sensitive.
However, the second part is a trick, because radiographs and CT are approximately equally specific.
Greatest difference in sensitivity between rads and CT was for evaluation of 4th tarsal bone - rads could potentially underestimate 4th tarsal fx occurrence.

Butler VRU 2018

Question 300

Which is more sensitive in identifying canine tarsal fractures on radiographs, two orthogonal views or a 10 view study including oblique and stressed views?

Answer 300

Neither, they were equally sensitive.

Butler VRU 2018

Question 301

Name three diagnostic utilities for 18F-FDG PET or PET/CT.

Answer 301

• Cancer staging
• FUO hunt
• Extent of disseminated fungal disease
• Assessment of perfusion
• Localization of inflammation

Grobman VRU 2018

Question 302

Caudal articular process dysplasia in dogs is associated with what signalment and clinical signs?

Answer 302

• Pugs, French bulldogs, and English bulldogs; no age or sex predilection
• Pugs 97% affected! And almost all APLASIA, as opposed to hypoplasia
• Clinical signs part is a trick question: dysplasia is present in clinically normal and neurologic dogs

Bertram VRU 2018

Question 303

Describe the prevalence of caudal articular process dysplasia, and aplasia vs. hypoplasia, in French bulldogs, English bulldogs, and Pugs.

Answer 303

• Frenchies: 70% dysplastic; 1/3 aplasia, 2/3 hypoplasia
• EBLs: 84% dysplastic, 1/4 aplasia, 3/4 hypoplasia
• Pugs: 97% dysplastic, 99% aplasia, 1% hypoplasia

Bertram VRU 2018

Question 304

What is elastography?

Answer 304

Sonographic method that evaluates tissue elasticity by comparing local tissue displacement before and after application of a compressive force. Compares the radiofrequency signal before and after mild tissue compression to reflect the hardness of a lesion.

Seiler VRU 2018

Question 305

Can benign and malignant lymph nodes be differentiated using elastography?

Answer 305

Sort of. LN hardness was statistically significantly different between benign (softer) and malignant (harder), however there was overlap between the two groups, so elasticity cannot be used as a sole criterion. Recommended to use in conjunction with standard greyscale US findings (size, echogenicity, hilus, etc).

Seiler VRU 2018

Question 306

Name the HU ranges for pure fluids (water, bile, urine, intestinal fluid), unclotted extravascular blood, and clotted blood.

Answer 306

Pure fluids: 0-15 HU
Extravascular unclotted blood: 30-45 HU
Clotted blood: 45-75 HU

Specchi VRU 2017

Question 307

Define ‘sentinel clot sign’.

Answer 307

The highest-attenuating hematoma adjacent to a bleeding organ in patients with a hemoabdomen. Median attenuation in this study was 56, compared to median attenuation of the hemoabdomen of 34.

Specchi VRU 2017

Question 308

Is a sentinel clot expected to enhance with contrast administration?

Answer 308

In general, no, because it is a clot and therefore avascular. Exception is when there is serpiginous or amorphous, strong enhancement within the sentinel clot, representing active bleeding into the clot from the organ of origin.

Specchi VRU 2017

Question 309

What is the approximate prevalence of canine ovarian tumors, their signalment or other predilections, and general prognosis?

Answer 309

• Low prevalence, 1.2%
• Sex predilection for…female
• Usually unilateral, and more often left-sided (weird)
• Good prognosis if complete excision, poor if metastasis

Rowan VRU 2017

Question 310

Which is more sensitive for evaluation of metastatic lymphadenopathy in dogs with anal sac carcinoma: US, or contrast-enhanced CT?

Answer 310

• Trick question, US and CT+c are about equally sensitive. CT is able to detect many more normal iliosacral LNs, detection rate of abnormal iliosacral LNs was about equal between the two modalities.
• CT is indicated to evaluate specifically sacral LNs (better at these than US, b/c they are intrapelvic) and for surgical planning

Pollard VCO 2017

Question 311

What is the difference between primary and secondary peristalsis, according to Watrous and Suter?

Answer 311

Primary = triggered by oropharyngeal reflex/swallowing phase
Secondary = triggered mechanically by esophageal luminal distention or tactile stimulation

Watrous VRU 1979

Question 312

For dual-phase CT of the gastrointestinal tract, what timing is likely to present good mucosal enhancement of the small intestines vs. of the stomach and pyloric region?

Answer 312

Small intestines: 30 sec delay is best; PV enhancement >/= 43 HU
Stomach and pyloric region: ‘late’ enhancement, aka 60 sec or more

Fitzgerald VRU 2017

Question 313

An 11-year-old Warmblood gelding, 2/5 lame on the LF, undergoes standing MRI of the fetlock. There is focal STIR-hyperintensity with PD/T1w/T2*GRE hypointensity adjacent to the sagittal groove of P1, and MCP degenerative joint disease. What common injuries affect this area (sagittal groove of P1), and what is the prognosis for return to function?

Answer 313

• Common injuries: osseous cyst-like lesions, subchondral bone loss, incomplete mid-sagittal fractures
• Prognosis: poor, 30% return to performance level when concurrent sagittal groove injury and OA. Theory that presence of OA indicates a worse prognosis than same injury without OA.

Gold VRU 2017

Question 314

What are the MRI characteristics of a periradicular lipoma? By comparison, what are the MRI characteristics of a myelolipoma?

Answer 314

• Periradicular lipoma = around/along nerve roots, T2w/T1w-hyperintense, STIR-hypointense, non/minimally contrast-enhancing
• Myelolipoma = also T2w/T1w-hyperintense and STIR-hypointense, but more heterogeneous, due to the hematopoietic components of a myelolipoma instead of pure fat
  Both can be intraspinal, but rare.

Wahle VRU 2017

Question 315

What is the incidence and signalment associated with atresia ani in dogs? What are the 4 types of atresia ani?

Answer 315

• Incidence: rare; 0.007% (<0.01%)
• Signalment: females > males, more common in Finnish spitz, toy poodles, min Schnauzers, Boston terrier, GShP, Chow; age usually <24 weeks but can be >1 YO
• 4 types: type I - congenital anal stenosis; II - imperforate anus; III - imperforate anus + rectum ends as blind pouch; and IV - distal rectum and anus develop normally but are discontinuous with the proximal rectum, which is atretic

Vianna JAAHA 2005

Question 316

With what other comorbidities is atresia ani associated? What specific imaging test (special procedure) is indicated to identify one of these comorbidities?

Answer 316

Other congenital defects: rectovaginal fistula in particular, also more standard things like cleft palate, hypospadias
Special procedure is retrograde positive contrast vaginography, to see whether there is communication with the rectum

Ellison JAVMA 2012

Question 317

Which sub-phase(s) of oropharyngeal swallowing deficits is/are commonly associated with aspiration?

Answer 317

Pharyngeal and cricopharyngeal.

• Oral dysphagia = almost no aspiration
• Pharyngeal dysphagia = more aspiration
• Cricopharyngeal dysphagia = more aspiration

Suter VRU 1980

Question 318

Cricopharyngeal dysphagia is often associated with dysfunction of what other component of the swallowing reflex system?

Answer 318

Esophageal dysfunction: poor proximal esophageal motility, proximal esophageal dilation, lack of primary peristalsis –> secondary peristalsis is predominant mode of bolus transport to stomach
Can also have mixed dysphagias of cricopharyngeal + pharyngeal or whatever, but that is less common than having cricopharyngeal + esophageal deficits

Watrous VRU 1983

Question 319

What is the most common cause of pneumonia in foals?

Answer 319

Rhodococcus equi

Heidmann Clin Tech Eq Pract 2006

Question 320

What are lesions associated with R equi infection in susceptible foals?

Answer 320

• Pneumonia is most common
• Other lesions include: vertebral osteomyelitis, other osteomyelitis, physitis, uveitis, enteritis/colitis…
  Hematogeneous spread presumed

Giguere EVJ 1994

Question 321

What lung patterns are expected on radiographs acquired within 12-24 hours of birth in normal foals, septicemic foals, immature foals, and foals with respiratory distress syndrome?

Answer 321

Normal foals - normal lungs, no pattern
Immature or septicemic - diffuse interstitial
RDS foals - alveolar **differentiate from bronchopneumonia

Lamb VRU 1990

Question 322

Name two differentials for the causative organism in lung abscesses in foals <6 months of age.

Answer 322

Rhodococcus equi
Strep zooepidemicus
*Equal prevalence in this study - one was not more likely than the other. Other studies say R equi is most common cause of foal pneumonia.

Lavoie EVJ 1994

Question 323

What radiographic findings are significantly associated with outcome in foals with rhodococcal pneumonia?

Answer 323

• Severity of alveolar pattern
• # cavitary lesions

Giguere VRU 2012

Question 324

What alternative diagnostic imaging test is recommended for field evaluation of suspected pneumonia in foals, if radiographs are not available?

Answer 324

Thoracic ultrasound. Can see consolidation, abscesses, pleural thickening, pleural fluid. Limited by lack of depth, but R equi pneumonia is usually diffuse enough that there are plenty of lesions in the periphery of the lung.

Ramirez VRU 2004

Question 325

Name 2 underlying etiologies for spontaneous, secondary pneumothorax in cats.

Answer 325

• Small airway disease (chronic lower airway disease, asthma)
• Heartworm or lungworm infection
  Recall that secondary spontaneous pneumo = due to parenchymal lung disease. Primary spontaneous = no underlying lung disease, and has not been reported in cats.

White JAVMA 2003

Question 326

What is the overall recommended management strategy for canine vs. feline spontaneous pneumothorax?

Answer 326

Canine - surgical, directed at underlying cause (bulla, migrating FB, neoplasia, etc) often with lobectomy of the affected lung lobe
Cats - conservative, underlying cause seems to be most commonly diffuse lung parenchymal disease (inflammatory airway disease) with fewer cases d/t ruptured neoplasia [do still go to sx if conservative tx not working]

Mooney JFMS 2012

Question 327

List some differentials for an older dog with acquired esophageal dilation.

Answer 327

• Motility disorder causing megaesophagus (thymoma, hypothyroidism, Addison’s, myasthenia, lead, neuropathy/myositis, botulism, tetanus)
• Distal esophageal obstruction (stricture, FB, neoplasia, granuloma [spirocerca])
  Types of neoplasia: SCC, leiomyoma (good survival time), leiomyosarcoma, lymphoma, carcinoma, OSA or fibrosarc from spirocerca

Robin JAVMA 2018, Okanishi JSAP 2015

Question 328

Describe a minimally invasive interventional radiology treatment option for distal esophageal leiomyoma in a dog.

Answer 328

Palliative stenting - turned out radial compression of stent for a few months was enough to alleviate clinical signs even after the stent migrated, was removed, and never replaced

Robin JAVMA 2018

Question 329

What is Barrett’s esophagus? What is its clinical relevance?

Answer 329

• Barrett’s esophagus = human term, but happens in dogs: replacement of the squamous epithelium of the esophagus with glandular epithelium that more resembles intestine
• Occurs secondary to chronic reflux/regurg
• Clinically relevant because is considered ‘premalignant’, due to stepwise progression from metaplasia, to dysplasia, to neoplasia –> leads to adenocarcinoma or adenosquamous carcinoma

Okanishi JSAP 2015

Question 330

How is Spirocerca lupi infection diagnosed?

Answer 330

Finding eggs in feces, or gastroesophageal endoscopy

Kirberger VRU 2015

Question 331

What is the classic triad of CT/rad findings for spirocercosis in endemic (tropical) areas?

Answer 331

• Aortic aneurysm
• Caudal thoracic spondylitis
• Caudal mediastinal mass (the esophageal sarcoma)

Kirberger VRU 2015

Question 332

Name the differentiating factors between neoplastic and non-neoplastic Spirocerca nodules in esophageal CT in dogs.

Answer 332

between neoplastic and non-neoplastic Spirocerca nodules in esophageal CT in dogs.
Neoplastic: irregular, have mineralization, poor perfusion, and reduced contrast enhancement
Non-neoplastic: smoother, never have mineralization, more hypoattenuating with necrotic pockets pre-contrast, enhance well (around the necrotic pockets)
Both are hypoattenuating precontrast (30 vs 40 HU, malignant vs non)

Kirberger VRU 2015

Question 333

What contrast medium would you choose for an upper GI in a red-eared slider turtle and why?

Answer 333

Gastrografin, aka diatrizoate, chosen over barium sulfate because it can be administered faster and has faster transit time –> faster results available. Both have minimal hemodynamic effects. Gastrografin does dilute out a little in distal SI and colon.

Long VRU 2010

Question 334

What is the difference in total intestinal transit time of barium sulfate vs. ionic iodinated contrast in tortoises/turtles? (Ballpark only.)

Answer 334

BaSO4: 144-166 hours
Diatrizoate: 17-24 hours

This question is just to illustrate why diatrizoate would be a much better choice than barium for upper GI in a reptile.

Numbers from Seth’s book.

Question 335

What are the 3 most common diagnoses for dysphagic cats undergoing fluoro studies?

Answer 335

Hiatal hernia, esophageal stricture, and esophageal dysmotility. Most cats have multiple.
Oropharyngeal or cricopharyngeal causes of dysmotility were not identified in any cat.

Levine VRU 2014

Question 336

Does sternal vs lateral recumbency affect swallowing parameters in dogs?

Answer 336

Yes. Sternal has faster transit times and more swallows associated with primary and secondary peristalsis.

Bonadio JVIM 2009

Question 337

What is recommended first-line procedure after barium aspiration in humans and dogs, to reduce severity of inflammation afterwards?

Answer 337

Bronchoscopy with suction to remove as much barium as possible.
BAL contraindicated, b/c it just washes barium further into lungs without removing it.
Lobectomy can be considered based on severity and volume of barium

Meola JVECC 2008

Question 338

What is the normal diameter of ferret small intestine?

Answer 338

5-7 mm

Schwarz VRU 2003

Question 339

What is the normal gastric emptying time for barium sulfate in cats? Normal small intestinal transit time?

Answer 339

They are the same: 30-60 min.

Morgan VRU 1981

Question 340

Name 6 differentials for causes of arterial thromboembolism in cats.

Answer 340

1) Secondary to HCM
2) Tumor emboli from primary pulmonary carcinoma
3) General anesthesia
4) Progestagens (wat)
5) Hyperthyroidism
6) Hypercortisolism

van Stee Can Vet J 2014

Question 341

What is a recently reported potential cause for dorsal displacement of the soft palate in the horse?

Answer 341

Unilateral malformation of the hyoid apparatus - could have been congenital vs. traumatic

Dixon VRU 2017

Question 342

Name three factors that suggest additional imaging (e.g. CT-myelography or MRI) will be required after CT with contrast of the spine in a T3-L3 myelopathy patient.

Answer 342

• Increasing patient age
• It’s not a Dachshund (if it is, it almost never needs more imaging because it’s almost always a disk)
• A surgical lesion was not identified on the CT

Emery VRU 2018

Question 343

What common condition of prairie dog dentistry often presents as respiratory distress?

Answer 343

Incisor pseudo-odontomas: benign proliferative growth of the incisor tooth roots, which are elodont (constantly growing) teeth –> if affecting maxillary incisors, proliferation eventually impinges on the nasal cavity –> respiratory distress (turns out they are obligate nasal breathers). If mandibular, facial deformity but otherwise no effect.

Pelizzone VRU 2017

Question 344

What is the basis of left lateral recumbency in a patient undergoing double contrast cystography?

Answer 344

Left lateral recumbency = right atrium UP and pulmonary trunk DOWN, keeps air bubbles from entering into the pulmonary arterial circulation which causes an air trap –> cyanosis, syncope, death

Zontine VRU 1970

Question 345

What is neuronal heterotopia?

Answer 345

CNS malformation with arrest of normal migration of neuronal progenitor cells from the germinal matrix into the outer layers of developing cerebrum; results in accumulations of histologically normal, but aberrantly located, grey matter throughout the brain.

ADJ VRU 2018

Question 346

What are the imaging features of neuronal heterotopia on MRI?

Answer 346

Isointense to normal grey matter on most/all sequences.

ADJ VRU 2018

Question 347

What is the typical signalment associated with pneumocystosis?

Answer 347

Miniature Dachshunds and Cavalier King Charles spaniels; presumed breed-related immunodeficiency. Other breeds can be affected d/t immunosuppression from co-infection. Classically ~1 YO, but range 6 months - 6 years of age

Weissenbacher-Lang JVDI 2018

Question 348

What is the typical clinical presentation of pneumocystosis?

Answer 348

Chronic respiratory signs, exercise intolerance, weight loss, partial or no response to usual treatments, usually not febrile unless pneumonia of other cause. Can have low or low-normal gamma globulins.

Weissenbacher-Lang JVDI 2018

Question 349

In a study using CT-lymphangiography to define sentinel nodes for a variety of neoplasms all over the body, what were the doses of contrast vs body weight that provided good opacification of the nodes? (canine)

Answer 349

Dogs <10 kg: 0.8 ml
Dogs 10-20 kg: 1.2 ml
Dogs >20 kg: 2 ml
These were the total volumes, 1/4 of each amount was injected in 4 quadrants around the tumor bed.

Rossi VRU 2018

Question 350

What is gliomatosis cerebri?

Answer 350

An extensive, aggressive growth pattern of various glioma types. Is not its own tumor type, because its histology is not unique.

Schweizer-Gorgas VRU 2018

Question 351

What is the MRI appearance of gliomatosis cerebri?

Answer 351

White and grey matter + 3 or more contiguous lobes affected + thalamic and caudal fossa involvement = gliomatosis cerebri. ‘Affected’ = looks like a glioma, being T2w/FLAIR-hyper, T1w-iso to hypo, variable but generally little contrast enhancement.

Schweizer-Gorgas VRU 2018

Question 352

In evaluating canine/feline abdominal radiographs of cases with signs of acute abdomen, is there increased accuracy or increased reader confidence associated with 3 views as opposed to 2 views in the study?

Answer 352

No. No statistically significant difference in diagnostic accuracy or reader confidence between 2-view and 3-view studies.

Mavromatis VRU 2018

Question 353

What sonographic ratios were recently validated for assessing degree of dehydration in dogs?

Answer 353

Diameter of CVC to aorta in transverse and longitudinal planes. This paper was stupid. If you do this ratio, do it intercostal to avoid compressing the vessels, and trans diameters are more repeatable than long.

Kwak VRU 2018

Question 354

Describe the normal characteristics of the feline pancreas on three-phase CT-angiography.

Answer 354

Hypo- to isoattenuating to liver and spleen in all phases, and homogeneously enhancing in all phases.

Secrest VRU 2018

Question 355

What are the normal times to peak arterial enhancement and to peak portal enhancement in cats undergoing dynamic CT-angiography, in a study evaluating the angiographic appearance of the normal feline pancreas?

Answer 355

Peak arterial: mean 9 sec, range 4-12 sec
Peak portal: mean 21 sec, range 16-32 sec

Secrest VRU 2018

Question 356

Describe a technique recently reported for diagnostic evaluation of bilateral congenital ureterovesicular junction stenosis in a ferret.

Answer 356

Negative contrast cystography (5 ml room air) + intravenous pyelography (850 mgI/kg), provided good opacification of kidneys and ureters and clear visualization of ureteral entrance into bladder.

Vilalta VRU 2017

Question 357

What is the difference between ectopic spleen, accessory spleen, and splenosis?

Answer 357

Ectopic spleen = normal splenic tissue in an abnormal location; includes both accessory spleen or splenosis
Accessory = congenital extra splenic tissue, usually located in the gastrosplenic ligament
Splenosis = secondary to splenic rupture, splenectomy, trauma (splenic tissue grafts itself onto other tissue and stays there)
**Histopath diagnosis, no distinguishing features

Kutara VRU 2017

Question 358

What is the difference in blood supply for accessory spleen vs. splenosis?

Answer 358

Accessory spleen - supply from branches of splenic artery and hilus
Splenosis - vasculature parasitized from surrounding tissue
Suggested that this is why ectopic spleen that is heterogeneously CT-contrast-enhancing is more likely splenosis, because of heterogeneous blood delivery via surrounding tissue

Kutarau VRU 2017

Question 359

What rare embryonic remnant neoplasm might be associated with a mass that is located on midline, well-demarcated, T2w-hyper/T1w-iso to hypo, mildly heterogeneous and mildly contrast-enhancing, with a “honeycomb” appearance +/- GRE voids (of hemorrhage)?

Answer 359

Chordoma, uncommon neoplastic lesion derived from embryonic remnants of the notochord (and the one with ‘physaliferous’ cells)
Treat w/ sx + RT, no data on outcomes in animals

Brocal VRU 2017

Question 360

What is a rare differential for a cat with multifocal neuro signs, signs of systemic disease (CBC/chem abnx), and bilaterally symmetric T2w/FLAIR hyperintensities that are non-contrast enhancing on brain MRI?

Answer 360

Feline systemic reactive angioendotheliomatosis: intravascular proliferative disorder that causes multisystemic vasculopathy, and is idiopathic and fatal. Other ddxs could be infx/infl encephalitis, intravascular lymphoma, post-ictal change.

Schkeeper VRU 2017

Question 361

In a 2017 JVIM study of risk factors for acute ascending/descending myelomalacia in dogs with IVDD, what 4 factors were associated with development of myelomalacia?

Answer 361

• T2 length ratio >4.5 (ratio of length of T2w hyperintensity to length of L2 body): 15x more likely to develop MM
• <24 hours to become non-ambulatory: 3x
• <5 YO: 3x
• Paraplegia w/ no deep pain: 4x

Balducci JVIM 2017

Question 362

What is the preferred location and technique for image-guided collection of CSF in the rabbit?

Answer 362

• Cerebellomedullary cistern (cisterna magna)
• US-guided

Anselmi VRU 2018

Question 363

Why is CEUS preferred over standard color or power Doppler for evaluation of renal blood flow (e.g. in post-renal transplant patients)?

Answer 363

CWD and PWD can underestimate flow from small vessels, low-volume flow, or flow from unfavorable angles. CEUS is better at this and allows ‘capillary level perfusion’ quantification.

Greenbarg JFMS 2018

Question 364

What changes to CEUS parameters were reported in a case of feline renal transplant allograft rejection?

Answer 364

Increased mean time to peak cortical echogenicity, slower wash-in and slower wash-out rates

Greenbarg JFMS 2018

Question 365

What is a hamartoma?

Answer 365

Excessive, unorganized growth of normal cells and associated tissues intrinsic to the organ in which they occur (so sounds like cancer) but, because they have minimal growth in the mature animal, are NOT considered neoplastic. Are considered a congenital malformation.

Taylor-Brown VRU 2018

Question 366

When are hamartomas more commonly diagnosed?

Answer 366

Juvenile patients, before the onset of skeletal maturity.

Taylor-Brown VRU 2018

Question 367

What clinical effects can be associated with vascular hamartomas?

Answer 367

Clinical signs are based on location and may include mass effect, spontaneous hemorrhage, or adherence to adjacent tissues

Taylor-Brown VRU 2018

Question 368

What is an osteochondroma?

Answer 368

Abnormal cartilaginous growth that is replaced with bone via endochondral ossification. Can affect soft tissues (esophagus, trachea) or skeletal structures (axial or appendicular).

Caporn JSAP 1996

Question 369

What is the name of the condition in which an animal is affected by multiple osteochondromas?

Answer 369

Osteochondromatosis, OR multiple cartilaginous exostoses

Caporn JSAP 1996

Question 370

What are the imaging findings associated with pulmonary pythiosis in dogs?

Answer 370

• Tracheobronchial lymphadenopathy
• Bronchopneumopathy: bronchial thickening, peribronchial interstitial infiltrates; the one case had a pulmonary mass with displacement and involvement of trachea and a principal bronchus

Kepler VRU 2017

Question 371

What is the pressure-volume index with respect to the brain and spinal cord?

Answer 371

PVI = the volume of fluid that, when injected intrathecally (aka into the subarachnoid space) would increase ICP by a factor of 10. Higher PVI = more compliance, can inject larger volume without much increase in ICP.

Arany-Toth VRU 2012

Question 372

What are the general doses of iodinated, non-ionic contrast for myelography in dogs 5 kg, 15 kg, or 30 kg?

Answer 372

5 kg or less: 0.35 ml/kg
15 kg: 0.22 ml/kg
30 kg or more: 0.19 ml/kg or slightly less

Arany-Toth VRU 2012

Question 373

What signalment is associated with congenital corpus callosal abnormalities in dogs?

Answer 373

• Staffordshire bull terriers and miniature Schnauzers
• Young: 3-19 months reported
  Interestingly, they can live years with supportive care (externally managed water supplementation)

Goncalves JVIM 2014

Question 374

What clinical signs are associated with corpus callosal abnormalities in dogs?

Answer 374

• Can be neurologically normal (weird) but can also have ataxia, proprioceptive deficits, circling, tremors, seizures
• Main sign is adipsia/hypodipsia
• +/- ichthyosis, hyperkeratosis of footpads
• Hypernatremic on bloodwork

Goncalves JVIM 2014

Question 375

Miniature horses, Shetland ponies, and falabella ponies are predisposed to what orthopedic condition, which rarely occurs in full-size horses?

Answer 375

Primary shoulder osteoarthritis; suspected due to dysplasia of the scapulohumeral joint. In full-size horses shoulder OA occurs secondary to trauma, OCD, septic arthritis, or bone cyst.

Clegg Vet Rec 2001 (also in Parth Aust Vet J 2008)

Question 376

What condition causes stertorous respiration, pharyngeal swelling, and sometimes nasal return of milk, coughing during suckling, or aspiration pneumonia in foals?

Answer 376

Guttural pouch tympany. Etiology unknown, fix with chronic Foley catheterization of the nasopharyngeal ostium, or laser ablation of the nasopharyngeal ostium.

Greet EVJ 2015

Question 377

What MR features suggest high grade for astrocytoma?

Answer 377

Intratumoral hemorrhage
Degree of contrast enhancement (signals disruption of BBB)

Wisner VRU 2011

Question 378

Most common sites for astrocytoma and oligodendroglioma

Answer 378

Both have predilection for frontal, piriform, and temporal lobes

Astrocytomas can also be in the diencephalon

Wisner VRU 2011

Question 379

Choroid plexus tumors

Answer 379

6 yo, Golden retrievers
50% arise from 4th ventricle and apertures
Papillomas and carcinomas
Variable T1w appearance, T2w hyperintense, strongly and uniformly contrast enhancing