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PCM 3 > Midterm > Flashcards

Midterm Flashcards

1
Q

When do you use contrast for a head CT?

A

Suspicion of tumor, infection, vascular abnormality

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2
Q

What modalities do NOT use radiation?

A

US

MRI

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3
Q

What is the best modality to examine skull fractures?

A

Non-contrast CT

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4
Q

What does MRI show in M.S.?

A

Periventricular plaques

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6
Q

Who is at risk for getting nephrogenic systemic fibrosis?

When does it occur?

A

Dialysis pts with GFR < 30mL

2 days - 18mo post-exposure

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7
Q

What imaging to use for skull fracture?

A

CT

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8
Q

What syndrome is associated with hoarseness and compression of the left RLN?

A

Ortner’s –> Mitral Stenosis

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9
Q

What is a diastolic decrescendo murmur in the 3rd ICS LSB?

A

AR

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10
Q

What is unequal size of pupils called?

A

Anisocoria

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11
Q

How far away should a patent hold a chart (NOT the snellen chart) when doing an eye exam?

A

6 feet

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12
Q

HSV1 causes brain infections where?

A

Inferior and medial temporal lobes

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13
Q

Gradient across valve in AS is significant if greater than what?

Obstruction leads to what?

A

50

Pressure overload, LVH

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15
Q

Which visual field must be tested separately?

A

Nasal field

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16
Q

If you have trouble seeing far away, what kind of vision abnormality do you have?

A

Myopia

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17
Q

If you have a pt with M.S., a tumor, or a CVA, what imaging modality do you want to use?

A

MRI w/contrast

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18
Q

What are the diastolic murmurs?

A

AR, PR
MS, TS
Atrial myxoma

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19
Q

What tumor is benign and derived from Rathke’s pouch?

Also most common supratentorial tumor?

A

Craniopharyngioma

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20
Q

What imaging assesses hemodynamics via soundwaves?

A

Doppler

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21
Q

Chronic cause of AR?

A

Syphilis, ankylosing spondylitis

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22
Q

T2 weighted image: describe the TR and TE

What appears bright white on image?

A

Long TR and TE

Compartments filled with H2O

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27
Q

What is a duplex a combination of?

A

Traditional and doppler US

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28
Q

What imaging to diagnose an uncal herniation?

A

MRI

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29
Q

Concussion mainly results in damage to what?

A

White matter tracts

Diffuse axonal injury

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30
Q

Pulmonic valve listening post?

A

Left 2nd ICS at SB

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31
Q

What are the contraindications for mydriatic drops?

A

Head injury and coma

Narrow-angle glaucoma

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33
Q

MRI precautions?

A

Cardiovascular device
Unstable pt
Claustrophobic and agitated
Fatties

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34
Q

What is the normal AoV area?

AS how big?

A

4cm

Less than 1 cm

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35
Q

What do you always order before getting an Xray?

A

bhCG

Bitch might be preggo

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36
Q

What causes a blowing systolic murmur LSB that increases with inspiration?

What is the sign called?

A

TR

Carvallo’s

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37
Q

Where is a catheter placed for a cardiac catheter?

Is contrast used?

A

Femoral or radial a.

Yea

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38
Q

What bacteria causes conjuctivitis?

A

S. aureus (most common adults)
M. Catarrhalis (most common kids)
S. pneumo
H. Flu

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38
Q

What is a fluorescein stain used for?

Performed when?

A

ID epithelial defect

AFTER complete screening exam

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40
Q

Aortic valve listening post?

A

R 2nd ICS at SB

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41
Q

What shows a systolic murmur that is harsh, 2nd ICS RSB and radiates into suprastneral notch?

A

AS

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42
Q

If you have a pt with an AAA, embolism, lung nodule, hemorrhage, tumor or ischemia, what imaging modality do you want to use?

A

CT

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43
Q

Can contrast cross the BBB?

A

Nah

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44
Q

Xanthelasma are what?

Indicates what?

A

Cholesterol deposits

Hyperlipidemia

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45
Q

What imaging to diagnose a cingulate herniation?

A

CT

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47
Q

What is assoc. with PHTN, inferior MI or RV infarction?

See what?

A

TR

Big v wave

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48
Q

Mitral valve listening post?

A

L 5th ICS at Mid clavicular line

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49
Q

What are the types of valvular heart disease?

A

Degenerative (senile calcification)
Myxomatous degeneration (MVP)
Congenital (BAV)
RVD

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50
Q

What are the structures that you can see in a fundoscopic exam of the eye in the posterior chamber?

A

Optic disc - nasal and inferior
Arterioles: 2 laterally, 2 nasally
Macula is temporal

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51
Q

What can mimic MS?

A

Austin Flint murmur

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52
Q

What do the following indicate?

Low voltage, electrical altérants on EKG
Increased JVP
Muffled heart sounds
Decreased BP on inspiration?

A

Cardiac tamponade

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53
Q

Esotropia?

A

Medial drift of eyes

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53
Q

How do you view the palpebral conjuctiva?

A

Evert the eye lid

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54
Q

Where do you see an oligodendroglioma?

A

Frontal lobes

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55
Q

What is the normal reflection of light off the retina called?

A

Red reflex

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57
Q

LP is contraindicated in what kind of head trauma?

A

Subdural hematoma

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58
Q

What causes a blowing systolic murmur that radiates into the left axilla?

May have a systolic click

A

MR

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59
Q

In AS without tx, die when once you develop syncope?

Onset of HF?

A

3 yrs

2 yrs

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60
Q

Do males or females have a higher post-concussion symptom score 3 months post-injury?

A

Females

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64
Q

What requires venous access, saline, concerted effort to capture results, and a TTE?

A

Bubble study

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65
Q

What causes a rumbling diastolic murmur that is low pitched, best heard at the apex? May see a malar flush.

Use diaphragm or bell?

A

MS

Bell

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66
Q

Overgrowth of cornea due to excess sun exposure?

A

Pterygium

68
Q

Why give contrast?

A

Increases differences in density between anatomic structures

69
Q

When examining the optic disc how should you rotate the lens disc if the pt is myopic?

Hyperopic?

A

Counterclockwise to (-) diopters

Clockwise to (+) diopters

70
Q

When do you refer a pt to a vascular specialist with an AAA?

A

If aneurysm is > 4cm

71
Q

What is a chalazion?

Associated with what?

To treat, when do you give antibiotics?

A

Meibomian tear gland obstructed

Blepharitis and Rosales

NEVER

73
Q

What virus most often causes conjuctivitis?

A

Adenovirus

74
Q

Acute cause of MR?

A 
Ruptured chordal tendineae, papillary muscle
Ischemic papillary m
CAD/MI
IE
Valve perforation
75
Q

Pros of US?

Cons?

A

No radiation, cheap

Bowel gas and lung tissue hinder image

76
Q

What bacteria are most common in bacterial abscessses in non-immunocompromised pts?

What imaging should you use?

A

Strep
Staph

MRI (DWI)

77
Q

Without treatment in AS, what is the prognosis?

A

Poor

78
Q

What is used to visualize the LA to assess for thrombus formation?

A

TEE

79
Q

What is used for R->L shunts in A or V, PFO, AV shunts in pulmonary vasculature?

A

Bubble study

80
Q

What occurs with nephrogenic systemic fibrosis?

What is spared?

A

Advanced renal failure
Thickening of hardening of skin

HEAD

81
Q

Stroke or CVA of what artery has Motor effects only?

A

Lenticulo-striate artery

84
Q

What tumor crosses both hemispheres in a butterfly pattern?

A

Glioblastoma

86
Q

What imaging modalities use ionizing radiation?

A

XR
CT
Fluoroscopy
Angiography

87
Q

What does a narrow pulse pressure with delayed pulses and decreased SV indicate?

A

AS

88
Q

What causes a murmur in the 2nd-3rd ICS, LSB that radiates towards left shoulder and increases on inspiration?

Can cause what?

A

PS

Angina and syncope

89
Q

What are the systolic murmurs?

A

MR (MVP), TR
AS, PS
VSD
Shunts

90
Q

What does MRI give the greatest detail of?

Contraindication?

A

Soft tissue

Metal in the body

91
Q

Most common to least common adult tumors?

A 
Metastasis 
Glioblastoma
Meningioma
Schwannoma
Oligodendroglioma
Pituitary adenoma

MGM Studios

92
Q

What imaging to see SAH, ICH, and general acute head trauma?

A

CT

93
Q

Xray pros?

Cons?

A

Cheap, fast, everywhere

2D, radiation, poor detail of soft tissue

95
Q

The opening between the eyelids is called what?

A

Palpebral fissure

96
Q

What causes a diastolic, blowing murmur 2nd SB (Graham Steele)?

Due to what?

A

PR

PHTN

97
Q

What causes lateral drift of the eyes?

A

Exotropia

97
Q

MRI pro

Con?

A

Safe, no radiation, precise detail soft tissue

Expensive, cant be fat, takes a long time, not widely available

98
Q

What is assoc with MS, TR, and RHD?

See what pathophys?

A

TS

Big a wave in JVP ascites

99
Q

how can damage from a concussion be visualized?

A

3D diffusion tensor

100
Q

Who is at higher risk for 2nd impact syndrome?

Mortality rate?
Morbidity?

A

Young athletes (under 20)

50 %
100%

101
Q

A FAST exam is a type of what?

A

US

103
Q

What are the most likely carcinogenesis of ionizing radiation?

A 
Leukemia
Thyroid
Breast
Lung
Skin
104
Q

What is it called when a murmur radiates to the apex like MR?

A

Gallavardin phenomenon

105
Q

What are the common reactions to contrast?

A

Hypersensitivity
Chemotoxic ie N/V (very common)
Vasovagal ie bradycardia

105
Q

Toxo, CNS lymphoma, Cryptococcus, JC virus with CD4 count of what?

CMV with what count?

A

Under 200

Under 50

107
Q

Acute cause of AR?

A

IE, dissection, BAV

108
Q

S4 heard best heard with what? Describe

Due to what?

What else?

A

Bell, dull low pitch

Stiff low compliant ventricle

Atrial gallop

109
Q

What is used to evaluate the structural integrity of the heart?

Describe the procedure

A

TEE

Invasive

110
Q

PE of AR shows what?

A

Wide pulse pressure

112
Q

T1 weighted image: describe TR and TE

What kind of tissues appear bright?

A

Short TR and TE

High fat content tissues

114
Q

What are causes of provoked DVT?

Unprovoked?

A

Trauma, surgery

Oral BCP, cancer

115
Q

What is the initial test of choice for cardiac tamponade due to pericarditis?

A

TTE

116
Q

Tricuspid valve listening post?

A

L 4th ICS at SB

117
Q

What causes brain abscesses in ketoacidotic diabetic, and neutropenic pts?

A

Mucor

Rhizopus

118
Q

What kind of contrast is given in GI?

A

Barium and gastrograffin

118
Q

What is one of the most frequently reported behavior sequelae of concussions?

A

Major depression

120
Q

What are the 4 views of a FAST?

A

Pericardial
Perihepatic
Perisplenic
Peripelvic

121
Q

Pt with reptile skin has what?

A

Nephrogenic systemic fibrosis

121
Q

Where is a meningioma located?

Arises from what?

A

Parasagittally

Arachnoid cells

122
Q

What causes a diastolic murmur at LSB, increases with inspiration and decreases with expiration?

A

TS

123
Q

What kind of contrast is given in IV?

A

Iodine-based

123
Q

What does a duplex evaluate?

A

Blood flow via US

123
Q

What imaging used to see brain neoplasms?

A

MRI

123
Q

What is the stepwise progression of return to play for concussions?

A
  1. Cognitive and physical rest until asymptomatic
  2. Light aerobic exercise
  3. Sport aerobic exercise
  4. Noncontact drills, light resistance training
  5. Full contact if cleared medically
  6. GAME TIME
124
Q

What tumor arises from the posterior fossa, is GFAP +, benign with a good prognosis?

A

Pilocytic astrocytoma

124
Q

Common sites of injury for concussion?

A

Frontal and temporal poles

125
Q

What is involved in axonal injury at the cellular level for concussions?

A

JNKs

126
Q

Most common childhood brain tumors to least?

A

Pilocytic astrocytoma
Medulloblastoma
Ependymoma
Craniopharyngioma

127
Q

What distinguishes allergic conjuctivitis from viral?

A

B/L redness, watery discharge and ITCHING

127
Q

How does fluoroscopy work?

A

Uses continually emitted X-rays and allows for real-time visualization

127
Q

What symptoms seen in MR?

A

Orthopnea, PND, RHF/LHF

128
Q

What are the benefits of coronary angiography?

What are the risks?

A

Diagnostic w/immediate intervention, life saving

Anything else

129
Q

Occlusion to what causes lateral pontine syndrome?

What nuclei are fucked?

A

AICA

Vestibular, facial, cochlear

129
Q

What are the 4 major routes of an embolism?

A

Venous - PE
Arterial - systemic E
Portal vein - hepatic E
Paradoxical E

130
Q

Occlusion to what causes medial medullary syndrome with ipsilateral hypoglossal, LCST, and ML dysfunction?

A

Anterior spinal artery

130
Q

Where do you find a Schwannoma?

A

Cerebellopontine angle

130
Q

What tumor has perivascular rosettes and causes hydrocephalus with a poor prognosis?

A

Ependymoma

131
Q

What kind of contrast is given in MRI?

A

Gadolinium

132
Q

What is a FAST CXR used for?

A

To detect hemoperitoneum and pericardial effusion

133
Q

What is a real time assessment of intracardiac blood flow?

A

Bubble study

134
Q

When does an immediate CT scan warrant use in concussion?

A

Loss of consciousness > 60 sec
Post-concussive seizure
Major neurologic defect (especially motor)
Sig. lethargy or rapidly progressive worsening of symptoms

134
Q

Chronic cause of MR?

A

MVP - most common

MAC

135
Q

S3 best heard with bell or diaphragm? Describe

Mnemonic?

A

Bell, dull and low pitch

Kent-Tuck-y

136
Q

What organism causes a hordeolum?

What gland causes an internal hordeolum?

How to treat?

A

S. aureus

Meibomian gland

Warm compress

136
Q

What kind of cells cause demyelination in M.S.?

Associated with what halpotype?

A

Leukocytes activated by TH17

HLA-DL2

136
Q

What tool to evaluate concussions is the cheapest and probably most widely used?

A

SCAT2

136
Q

When does MS occur most often?

Symptoms?

A

4th decade

DOE, cough, orthopnea, PND, PE, hemoptysis, AFib

137
Q

Diplopia in 1 eye, with the other closed suggests a problem with what?

A

Cornea or lens

137
Q

CT pros?

Cons?

A

Everywhere, painless

Contrast, radiation, dx limited

137
Q

What does the following indicate?

W/in 24-48 hours there is INC serum Cr, DEC GFR with oliguria

A

Contrast induced nephropathy

137
Q

What medication can cause lactic acidosis and is contraindicated when imaging with contrast?

A

Metformin

137
Q

What is the persistence of concussion-induced symptomatologie for greater than 3 months post injury?

A

Postconcussion syndrome

137
Q

Triad of sx in AS?

Occurs when?

A

SAD - syncope (HF), angina, exertional dyspnea

6th decade

PCM 3 (1 decks)

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