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Huda Facts > NERRS Facts > Flashcards

NERRS Facts Flashcards

1
Q

DICER 1

A

Multilocular cystic nephroma and pleuropulmonary blastoma. The way to remember the Multilocular cystic nephroma association with DICER 1 = Michael Jackson tumor, DICE are black and white just like MJ.

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2
Q

Mesoblastic nephroma treatment?

A

Excision.

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3
Q

Multilocular cystic nephroma treatment?

A

Excision bc cannot distinguish from cystic Wilms

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4
Q

Most commonly benign bone lesion in kids?

A

NOF

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5
Q

MRI signal of fibrous dysplasia

A

Low T1 and low 2

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6
Q

SH 1 and 2

A

Treated conservatively

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7
Q

SH 3 and 4

A

Treated surgically

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8
Q

Apophysis

A

Tendon insertion site

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9
Q

Differential for synovitis in kid

A

septic, inflammatory, and LYME

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10
Q

Where does lyme most affect kids joints?

A

knee

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11
Q

Key features of lyme

A

myositis, lymphadenopathy adjacent

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12
Q

Four vessel sign

A

Double aortic arch (axial view)

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13
Q

What does PVA stand for?

A

poly-vinyl alcohol (particles)

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14
Q

Why would you have a bronchial artery embo in a kid?

A

CF or TB

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15
Q

What is the problem of using glue in bronchial artery embo?

A

Shunting or non-target embo

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16
Q

In bronchial artery embo, how big particles?

A

At least 350 to avoid non-target/necrosis

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17
Q

Lateral marginal vein of Servelle

A

KTS

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18
Q

Sciatic vein

A

KTS

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19
Q

Pulmonary AVM

A

Not true AVM; misnomer. Really AVF without intervening parenchyma.

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20
Q

Developing focal asymmetry

A

PASH

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21
Q

PASH

A

BR 2

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22
Q

Before ML for milk of mag

A

Wait for a few min in compression to allow layering

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23
Q

When does lactating adenoma present?

A

3rd trimester or during breast feeding; MUST be evaluated to distinguish from aggressive cancer during pregnancy

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24
Q

Lactating adenoma

A

Increased vascularity distinguishes from galacocele; not always going to see a fat fluid level in galactocele

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25
Q

Grouped calcs

A

5 within 1 cm sq

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26
Q

Peanut M&M

A

Circumscribed breast cancer: papillary, mucinous, medullary

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27
Q

Capsule or no capsule for fibroadenolipoma (hamartoma)?

A

Capsule

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28
Q

“cut sausage appearance”

A

Breast hamartoma

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29
Q

Cancer detection rate FFDM v. BTS?

A

4/1000 v. 6/1000

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30
Q

Order of suspicion: asymmetry, global asymmetry, focal asymmetry, developing asymmetry

A

In that order

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31
Q

First follow-up for asymmetry?

A

rolled or true lateral

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32
Q

If the global asymmetry is new (developing)?

A

Must biopsy

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33
Q

BR 3 on baseline

A

Fibroadenoma, focal asymmetry without ultrasound correlate, grouped calcs.

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34
Q

First post-contrast phase on breast MRI occurs when?

A

1m 30s

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35
Q

No shape or margin descriptors for what on MRI?

A

Focus (too small)

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36
Q

What does clustered ring descriptor of non-mass like enhancement on MRI represent?

A

Periductal stroma

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37
Q

Cornybacterium in breast culture

A

Granulomatous mastitis

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38
Q

Nodular lactational hyperlasia

A

AKA lactating adenoma

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39
Q

If a cyst yields bloody aspirate during aspiration (typically using 18 G needle) make sure to leave a clip in case a follow-up biopsy is necessary

A

And send bloody fluid to pathology (brown fluid just discard)

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40
Q

Type 3 os naviculare

A

just very large navicular - all continuous bone

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41
Q

Type 2 os naviculare

A

type that is most painful

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42
Q

Pitt’s Pit

A

MUST HAVE SCLEROTIC BORDER

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43
Q

Soleal line

A

tug line related to gastroc

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44
Q

Defect in type 1 collagen

A

OI

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45
Q

Type of OI is mild

A

Type 1 - no real symptoms

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46
Q

Type of OI that is lethal

A

2

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47
Q

Type of OI with normal sclera

A

type 4 (apparently the ABR loves this fact for the test)

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48
Q

Type of OI with tibial bowing

A

3

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49
Q

Marble bone disease

A

Osteopetrosis

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50
Q

Macrodystrophia Lipomatosa

A

Associated with NF1, Proteus Syndrome, and KTS (localized gigantism usually unilateral in hands/feet)

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51
Q

Bipartite patella type III (most common type ~75%)

A

supralateral. symptomatic in 2-5% of the population

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52
Q

Male:Female prevalence for bipartite patella

A

nine to one

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53
Q

Type I bipartite patella

A

Inferior

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54
Q

type II bipartite patella

A

lateral

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55
Q

Bone disease that presents in a sclerotomal distribution

A

Malorheostosis (although it can be painful, it is usually asymptomatic)

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56
Q

Bone lesion in TS

A

Sclerotic bone lesions (look like bone islands)

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57
Q

Genetic inheritance of TS

A

AD

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58
Q

Genetic inheritance of Marfan

A

AD

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59
Q

Gene involved in Marfan

A

Fibrillin 1

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60
Q

Optic lens dislocation

A

Marfan

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61
Q

Steinberg Sign

A

Thumb past the palm

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62
Q

Talar beaking associated with?

A

Tarsal coalition - both subtalar and talocalcaneal

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63
Q

C sign of tarsal coalition

A

What you are seeing is the increased size of the sustanaculum tali

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64
Q

Most specific sign for osteomyelitis on MRI?

A

Low T1

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65
Q

New bone surrounding a sequestrum

A

involucrum

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66
Q

Digital nerve calcifications and acroosteolysis

A

Leprosy

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67
Q

In adults most common cause of osteomyelitis AND septic joint

A

SA

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68
Q

Phemister triad

A

periarticular osteopenia, marginal erosions, and delayed loss of joints space (TB and mycobacteria in fishmongerers)

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69
Q

After discovery of an osteosarcoma on X-ray what are the 3 best next steps?

A

bone scan, chest ct, and referral to orthopedic oncologist - DO NOT BIOPSY WITHOUT FIRST CONSULTING WITH AN ORTHOPOD AS THE BIOPSY TRACT CAN COMPLICATE THE SURGICAL APPROACH

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70
Q

Looks normal on X-ray (shoulder dislocation)

A

grade 1

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71
Q

CC distance is increased

A

grade 3 AC separation

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72
Q

Massive rotator cuff tear

A

> 5 cm in dimension or 2 or more cuffs

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73
Q

Bucket handle SLAP

A

Type III

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74
Q

SLAP into the biceps tendon

A

IV

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75
Q

Galeazzi fracture

A

Ulnar head displaced DORSALLY

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76
Q

Monteggia fracture

A

Radial head displaces proximally

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77
Q

what percentage of FD are mono-ostotic?

A

80.0%

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78
Q

Denosumab used for?

A

GCT

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79
Q

Can GCT be multifocal?

A

yes

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80
Q

BPOP

A

Nora’s Lesion

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81
Q

Solid and uninterrupted periosteal reaction

A

These are features of benign periosteal reaction

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82
Q

Can PET differentiate benign and malignant soft tissue masses?

A

NO! FDG accumulation is non-specific

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83
Q

Are there calcifications on PVNS?

A

NO!

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84
Q

Volar or Dorsal - Giant cell tumor of the tendon sheath of the hand?

A

Volar

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85
Q

What is the most common soft tissue mass?

A

Ganglion cyst

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86
Q

Name 2 cystic soft tissue tumors that are malignant?

A

Myxoid liposarcoma. Synovial sarcoma.

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87
Q

Mid third capsular ligament avulsion

A

Segond

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88
Q

Arcuate sign

A

Posterolateral corner injury

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89
Q

Rodent facies

A

Thalassemia (along with hair on end)

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90
Q

What is the inheritance pattern of thallasemia?

A

AR

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91
Q

Small or large joints in hemophilia?

A

Large (knee most common)

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92
Q

On MRI don’t confuse PVNS with?

A

hemophilia (especially in the knee)

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93
Q

Crescent sign is on?

A

radiograph (AVN)

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94
Q

double line sign is on?

A

MRI (AVN)

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95
Q

Red marrow can be distinguished from tumor using?

A

In and out of phase imaging (red marrow should drop out because it retains some degree of intracellular fat; whereas tumor would not drop out)

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96
Q

AVN usually occurs in?

A

Non-hematopoetic marrow. In other words, it occurs in yellow marrow.

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97
Q

treatment for angiodysplasia

A

endoscopy NOT coiling

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98
Q

absolute contraindication to TACE for HCC?

A

Decompensated liver failure, because you are going to further decrease liver function

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99
Q

Inject thrombin into pseudo aneurysm if less than:

A

1 cm

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100
Q

Amplatzer plug in splenic artery for trauma where?

A

between dorsal pancreatic and pancreatic magna arteries

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101
Q

Are stents placed in the SVC for benign strictures?

A

No! Just angioplasty. The reason is that they may embolize into the heart.

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102
Q

The purpose of lipiodol on TACE is to visualize the injection.

A

Poppy seed oil

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103
Q

Lobar chemoembo is avoided in patients with:

A

Cr greater than 2, ECOG greater than 2, biliary sphincter compromise, and portal vein occlusion

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104
Q

Thermal ablation of HCC is ideal for:

A

Less than 3 cm and far from vessel

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105
Q

what is the problem with ablating HCC near a blood vessel?

A

heat sink

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106
Q

what chemotherapeutic agent do you use for TACE in the setting of metastatic colorectal cancer?

A

irinotecan

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107
Q

Which type of thermal ablation uses grounding pads?

A

Radiofrequency

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108
Q

Which type of thermal ablation does not use grounding pads?

A

Microwave (faster technique)

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109
Q

Why is cryoablation not used in the liver?

A

Increased risk of bleeding

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110
Q

Typical bug for PID

A

polymicrobial (not ecoli)

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111
Q

Risk factor for PID

A

IUD

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112
Q

Most common part of the fallopian tube for ectopic?

A

ampulla (not isthmus)

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113
Q

Abdominal measurements in utero are:

A
  1. at the level of the PV and umbilical vein confluence / stomach. 2. outer skin to outer skin
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114
Q

Femur length in 2nd trimester

A

Exclude the epiphysis

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115
Q

What percent of pregnancies are ectopic?

A

2%

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116
Q

Three high risk factors for ectopic pregnancy?

A

previous ectopic, previous fallopian tube surgery, assisted reproductive technology

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117
Q

Largest cause of error of image interpretation

A

Missed finding. Second is satisfaction of search

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118
Q

With hydrancephaly what structures are preserved?

A

Midline structures such as falx and thalami

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119
Q

Alobar holopro is associated with?

A

Trisomy 13

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120
Q

What else to look for with Chiari II?

A

club feet!

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121
Q

what is rocker bottom feet associated with? (AKA hindfoot valgus)

A

myelomeningocele

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122
Q

Where does the umbilical cord insert with omphalocele?

A

centrally

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123
Q

Where does the umbilical cord insert in gastrochisis?

A

Eccentrically to the RIGHT

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124
Q

What does gastrochisis include?

A

Only small bowel (no colon, no liver, no stomach)

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125
Q

FNH is a:

A

hamartoma

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126
Q

Hepatic adenoma type that bleeds

A

inflammatory

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127
Q

Hepatic adenoma that has increased risk of malignant transformation?

A

beta catenin

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128
Q

Keyhole bladder on ultrasound

A

Posterior urethral valves

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129
Q

Biliary cystadenoma is now called (updated nomenclature):

A

Mucinous cystic neoplasm of the liver

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130
Q

Fat containing fibroid

A

lipoleiomyoma

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131
Q

Ductal plate malformation

A

Carolis

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132
Q

Caroli’s treatment

A

Partial hepatectomy or transplant

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133
Q

Caoli’s premalignant or not

A

yes, can turn into cholangiocarcinoma

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134
Q

Cervical fibroids are:

A

usually refractory to UAE

135
Q

Appropriateness criteria female infertility and recurrent pregnancy loss

A

saline infused hysterosonography

136
Q

Appropriateness criteria for female infertility and no history of recurrent pregnancy loss

A

HSG

137
Q

External genitalia with Kuster Hauser Syndrome?

A

Normal

138
Q

Ovaries in Kuster Hauser?

A

Normal

139
Q

Nabothian cysts are related to:

A

chronic healed cervicitis

140
Q

Adenoma malignum of the cervix

A

Variant of mucinous adenocarcinoma; watery vaginal discharge; related to Peutz-Jegher; looks like very big, very aggressive Nabothian cysts

141
Q

Incidence of ectopic in the setting of IVF?

A

1 out of 100

142
Q

Sector transducer

A

Phase array (used for intercostal)

143
Q

Primary cysts of the spleen are AKA

A

epidermoid cysts (I don’t understand this, but it was emphasized in the review course)

144
Q

Echogenic lesions in the spleen that are enlarging

A

Must be biopsied even though likely hemangioma (worst case scenario they are littoral cell angioma)

145
Q

SANT

A

Splenic mass with blooming on GRE

146
Q

Splenic angiosarcoma

A

Exploding spleen (rupture)

147
Q

Graded compression technique for appendicitis ultrasound in normal size patient

A

high resolution linear probe (not a sector probe)

148
Q

Graded compression technique for appendicitis in larger patient

A

curvilinear probe (not a sector probe)

149
Q

IPMNs are

A

pre-malignant

150
Q

Next step after cystic pancreatic lesion seen on ultrasound?

A

MRCP

151
Q

Follow-up for testicular and tunica albuginea cyst

A

None. Both are benign.

152
Q

What does loss of diastolic flow in renal transplant indicate after recent transplantation?

A

renal vein thrombus

153
Q

What does loss of diastolic flow in renal transplant indicate after remote transplantation?

A

chronic rejection

154
Q

Ureteral jets are harder or easier to see with hematuria?

A

Easier to see bc red blood cells are echogenic.

155
Q

Lung uptake in MIBG study can be:

A

normal

156
Q

PET avid brown fat is most common in

A

kids

157
Q

Distinguish increased soft tissue radiotracer uptake from exercise v. eating just before PET scan.

A

With exercise you should see the liver. With eating you shouldn’t

158
Q

Four causes of hepatic uptake on MDP bone scan

A

Amyloid, aluminum contamination, metastatic disease, severe hepatic disfunction

159
Q

Sudek Dystrophy

A

Reflex sympathetic dystrophy

160
Q

Time to imaging after injecting I123 or I131 in thyroid

A

6-24 hours

161
Q

Time to imaging after injecting Tc99m in thyroid

A

Only 30 minutes so greater amount of bkgd. this is a good way to know that you are NOT looking at an iodine study.

162
Q

When do you give I 131 for Hasimotos?

A

Never. Not treated with I 131. No type of thyroiditis is treated with radio-iodine.

163
Q

Should you stop levothyroxine before scintigraphy for a lingual thyroid?

A

No. When kids with lingual tonsil come off synthroid they suffer neuronal loss.

164
Q

How long do you wait after injection for a SC liver-spleen study?

A

Only about 20-30 minutes. The reticuloendothelial system is quick to take up the SC.

165
Q

Dose for gastric emptying study?

A

1 mCi Tc 99m SC

166
Q

n-MYC gene amplicfication

A

BAD prognostic factor in neuroblastoma

167
Q

notch-3

A

CADASIL

168
Q

small bowel bleeds can be distinguished from colonic bleeds on NM

A

Cross the midline and have ‘snake like movements’

169
Q

Edge packing in gamma camera

A

When a cracked crystal shows up much thicker as a defect

170
Q

Measles in gamma camera

A

hygroscopic NaI crystals absorb water and turn yellow

171
Q

What accounts for a very thin line or channel of increased or decreased uptake - very thin - in gamma camera scintigraphy

A

septae messed up

172
Q

Photopenic femoral head ddx

A

joint effusion, perthes, cyst, coins in pocket

173
Q

Heart uptake on MDP bone scan

A

Amyloid

174
Q

Four tracers with cardiac uptake

A

Tl, MIBI, FDG, MIBG

175
Q

Don’t miss cause of hydronephrosis in the teenage male?

A

Obstruction 2/2 retroperitoneal seminoma mets

176
Q

Perfusion only in NM PE study when?

A

pregnancy to reduce dose

177
Q

Set up in the room for Xe ventillation scan

A

Negative pressure ventilation with exhaust fan at the level of the floor bc Xe is heavier than air

178
Q

Biologic half life of MAA particles in VQ scan

A

A few hours. then they dissolve

179
Q

Velcro type crackles on auscultation

A

IPF/UIP

180
Q

Connective tissue disease most likely to have pulmonary fibrosis

A

scleroderma. not RA.

181
Q

UIP is

A

idiopathic most of the time

182
Q

NSIP is

A

rarely idiopathic. usually occurs in the setting of connective tissue or collagen vascular disease

183
Q

Compared to adults, pediatric acute blunt injury to the abdomen is more likely to be:

A

treated conservatively

184
Q

In KTS, is there always limb overgrowth?

A

No, sometimes there can be limb undergrowth

185
Q

Is KTS hereditary?

A

No, no germ line mutation

186
Q

Limbus vertebrae are usually:

A

asymptomatic

187
Q

Limbus vertebrae occurs because of

A

herniation of disc material during adolescence before the ring apophysis fuses

188
Q

Birt hogg Dube is

A

AD

189
Q

Skin lesions in Birt Hogg Dube

A

Folliculomas

190
Q

Isolated 5th metacarpal shortening

A

Either in familial diabetes type I or just in the normal population

191
Q

4th metacarpal shortening with or without 5th metacarpal shortening

A

pseudo-hypopara, pseudo-pseudo-hypopara, post-traumatic, basal-cell-nevus (gorlin)

192
Q

GG nodules > 6 mm follow up (Fleishner 2017)

A

f/u 6-12 months

193
Q

Solid nodules 6-8mm (Fleishner 2017)

A

f/u in 12 months and if no change then in another 12 months

194
Q

(Fleishner 2017) 15 mm GG opacity

A

f/u in 6 months

195
Q

LUNG-RADS 15 mm GG opacity

A

f/u in 12 months (called category 2 - probably benign)

196
Q

LUNG-RADS 6 mm solid nodule

A

f/u in 6 months (category 3)

197
Q

Treatment options for chondroblastoma

A

RF ablation, curettage, resection

198
Q

Dose for LUNG RADS screening CT

A

Less than or equal to 3.0 mGy CTDI vol

199
Q

SIR Guidelines: risk for PICC

A

Low risk procedure (INR can be a high at 2)

200
Q

SIR Guidelines: risk for TCVL

A

medium (INR needs to be lower than 1.5 but you don’t have to hold ASA)

201
Q

Both lower lobes collapse:

A

posteriorly and medially

202
Q

Infrahilar window

A

On the lateral xr bounded anteriorly the by right middle lobe bronchus and posteriorly by the left main stem bronchus

203
Q

Common paraneoplastic syndromes associated with thymoma

A

MG, pure red cell aplasia, hypogammaglobulinemia. Most common is MG.

204
Q

How often do contrast extravasations happen

A

<1% of all IV contrast injections

205
Q

Air bronchograms through a mass

A

lymphoma

206
Q

Doege Potter Syndrome

A

Hypoglycemia associated with fibrous tumor of the pleura

207
Q

Most common primary pleural tumor

A

Mesothelioma (not fibrous tumor of the pleura)

208
Q

Glucothorax

A

Central line placement complicated by venous bleed and hemothorax

209
Q

Shrinking lung syndrome

A

SLE

210
Q

Reverse halo sign

A

Not only COP but also pulmonary infarct after PE

211
Q

Pruning of the pulmonary arteries

A

Chronic PE

212
Q

Fat emboli and amniotic fluid emboli

A

Are not seen on PE study

213
Q

Septic emboli

A

Are typically not seen as filling defects on a PE study

214
Q

Where does the left superior intercostal vein (aortic nipple) drain?

A

hemiazygous - classic spot for misplaced CVC

215
Q

Pulmonary laceration appears as:

A

Holes in the lung - not linear. The example provided looked like several contiguous cysts.

216
Q

According to the North American consensus guidelines, pediatric nuclear medicine doses are based on

A

body weight only, not surface area

217
Q

PAPVR loads which ventricle?

A

Right ventricle (similar appearance to an atrial defect)

218
Q

Left atrial enlargement with increased pulmonary vascularity

A

VSD

219
Q

Conoventricular VSD

A

The type seen in TOF

220
Q

PDA causes enlarged or small aorta

A

enlarged as well as enlarged left heart

221
Q

Very large central PAs that taper quickly on CXR

A

Eisenmengers. This is different than the ‘pruning’ which is seen in chronic PE.

222
Q

the descending interlobar artery should be

A

smaller in caliber than the trachea

223
Q

which type of TAPVR is most common to present with obstruction?

A

Type 3 - infra cardiac. The intracardiac variant is also commonly obstructed.

224
Q

Smooth septal ventricular surface

A

morphologic left ventricle

225
Q

Is cor triatriatum left or right sided

A

left

226
Q

What does CADRADs categorize?

A

coronary artery stenosis

227
Q

Which level CAD RADS do you stent

A

CAD RAD 4

228
Q

What are the criteria for CAD RADS 4

A

severe 70-99% stenosis of the RCA or LCX; > 50% stenosis for LAD; 3 vessel disease

229
Q

Most common vasculopathy associated with spontaneous coronary artery dissection?

A

FMD

230
Q

Most common cause of coronary artery aneurysm in the world/USA?

A

world = Kawasakis; US = atherosclerosis

231
Q

paradoxical septal motion

A

LBBB (note: this is different than the septal bounce seen in constrictive pericarditis)

232
Q

In addition to LAD apical infarction, what are another two entities that common present with left ventricular apical thrombus?

A

Llofler’s endocarditis and Non-compaction

233
Q

Order of cardiac chambers that are affected by tamponade?

A

RA, RV, LA, LV (note that the RV is compromised before the LA)

234
Q

treatment for pericardial cyst?

A

nothing unless symptomatic

235
Q

most common primary pericardial mass?

A

mesothelioma

236
Q

Snoopy sign

A

Cardiac torsion in the setting of congenital absence of the pericardium. In this case the pericardium is only partially absent and the heart herniates through the defect before torsing.

237
Q

Right sinus of vasalva aneurysm would rupture into?

A

right ventricle

238
Q

non-coronary sinus aneurysm would rupture into?

A

right atrium

239
Q

the left coronary sinus aneurysm would rupture into the pericardium and cause?

A

tamponade

240
Q

Claw sign and spider web sign both help to identify the:

A

false lumen in an aortic dissection

241
Q

Type 4 and 5 endoleaks are:

A

diagnosis of exclusion

242
Q

Marginal vein of Servelle

A

KTS

243
Q

Costoclavicular space is bound by

A

the 1st rib, clavicle, subclavius muscle, and anterior scalene - spot for Paget Schrodetter

244
Q

Vein of Sappey

A

Collateral supplying the caudate lobe in SVC obstruction. This causes the hot caudate sign on SC studies and sometimes CTA.

245
Q

Bifid uvula and sinus of valsalva dilation

A

Loeys Dietz

246
Q

Difference between Loeys Dietz and Marfan

A

Marfan does not present with aneurysms outside the aorta; LD has aneurysms everywhere. A diagnosis of LD requires head to toe CT angiography.

247
Q

When is follow-up after finding aortic root aneurysm?

A

6 month, NOT 1 year follow-up

248
Q

Wilkie’s Disease

A

SMA syndrome

249
Q

Most common place to tear esophagus in BLUNT trauma

A

thoracic inlet, upper esophagus

250
Q

Most common place to tear the esophagus in general?

A

GE junction

251
Q

Menetrier’s

A

Mucus secreting disease of the stomach

252
Q

Epiphrenic diverticula are

A

congenital

253
Q

Duodenal bulb is

A

intraperitoneal

254
Q

2nd segment of the duodenum onward is:

A

retroperitoneal

255
Q

Water lilly sign

A

Eccinococcal cyst

256
Q

Giant cavernous hemangioma in the liver is defined as

A

greater than 10 cm

257
Q

What is the standard of care for a peripheral liver mass like cholangio?

A

resection

258
Q

In the setting of choledochal cysts, what is the biggest risk factor for cancer

A

abnormally high pancreatic and CBD junction - predisposes to reflux

259
Q

Common mix up for choledocholithiasis on MRCP

A

flow void. Stones are eccentric. Flow voids fill the center of the CBD lumen.

260
Q

Magnesium ammonium phosphate

A

struvite (type of stone seen in infection)

261
Q

calcium phosphate

A

most dense urinary stone

262
Q

calcium oxalate

A

most common urinary stone

263
Q

uric acid stones are usually

A

less than 500 HU

264
Q

less than what HU is amenable to extracorporeal lithotripsy

A

< 1000 HU

265
Q

Forniceal rupture

A

requires antibiotics

266
Q

pyelonephritis is more common in men or women?

A

women

267
Q

Best prognosis RCC type

A

chromophobe

268
Q

Erdheim Chester

A

Hot femur on bone scan and perinephric soft tissue

269
Q

Involving collecting system renal laceration

A

Grade IV

270
Q

If the patient is stable, unto what grade can you manage renal lacerations conservatively?

A

Up to and including grade IV

271
Q

Intraperitoneal bladder rupture

A

requires surgery

272
Q

Boundary of the anterior and poterior urethra

A

Inferior edge of the urogenital diaphgram (this was a recent ABR question)

273
Q

Which glomerulonephritis has the highest risk for renal vein thrombosis

A

membranous

274
Q

necrotizing fasciitis bug in the rest of the body except the scrotum

A

Group A strep

275
Q

Fournier’s gangrene microbe

A

e coli

276
Q

How many veins drain the adrenals?

A

Only 1 each side

277
Q

Which are more common adrenal cyst or pseudocyst?

A

pseudocyst.

278
Q

Greater than what size is a risk factor for adrenal myelolipoma?

A

5 cm

279
Q

Adrenal Cortical Carcinoma

A

Li Fraumeni Syndrome

280
Q

Adrenal hemangioma

A

Looks exactly like hepatic hemangioma - peripheral nodular discontinuous enhancement

281
Q

Calcified targetoid mass in the spleen

A

brucellosis

282
Q

Skull base chordoma v. chondrosarcoma - which has worse prognosis

A

chordoma

283
Q

Compared to facial nerve schwnoma a facial nerve hemangioma is:

A

more symptomatic. you can distinguish these in the otic capsule (and particularly in the geniculate ganglion) by the presence of calcifications in hemangioma and not in schwanoma

284
Q

Endolymphatic sac tumor:

A

Blooming artifact on GRE

285
Q

SDHx mutations

A

Glomus tympanicum

286
Q

Soft tissue mass within the crura of the stapes

A

Persistent stapedial artery

287
Q

Lack of T1 shortening excludes melanoma met?

A

No, bc can have amelanotic variants that are dark on T1 weighted sequences

288
Q

Bony destruction with JNA?

A

No, because slow growing. you should have smooth expansion of the various foramen exiting the PPF.

289
Q

Most common variant of rhabdomyosarcoma occurring in the head and neck

A

embyronal

290
Q

Most common type of cancer to arise in a thyroglossal duct cyst?

A

papillary (not squamous)

291
Q

Intact v interrupted spinolaminar line

A

Intact with spondylolysis. Interrupted with facet degeneration.

292
Q

Spinal astrocytomas are:

A

eccentric in the cord, as opposed to centrally distributed ependymomas

293
Q

Cold abscesses

A

in the psoas adjacent to TB spondylodiscitis - named because not painful and no actual bacteria within, only granulation tissue

294
Q

Scheuermann Disease

A

painful scoliosis

295
Q

Associated with balloon cells

A

Focal cortical dysplasia in the brain

296
Q

Anti-Hu antibodies

A

paraneoplastic limbic encephalitis from SMALL cell lung cancer

297
Q

Which has better prognosis: paraneoplastic or non-paraneoplastic limbic encephalitis

A

Non

298
Q

Which type of craniopharyngioma is found in adults

A

papillary - calcifications are rare

299
Q

scalpel sign

A

dorsal thoracic arachnoid web (this is different than arachnoid cyst which can also occur in the spine)

300
Q

another way to fix gibbs artifact

A

smoothing filters (other options would be to increase the grid or to use a saturation band)

301
Q

T2 central dot sign

A

Neurofibroma. Schwanomas would not have the T2 central dot sign.

302
Q

Treatment for dural venous thrombosis causing intracerebral hemorrhage

A

anticoagulation (EVEN if there is intracerebral hemorrhage)

303
Q

Venetian blind artifact

A

slabs on coronal TOF MRA - modifying the flip angle through the acquisition

304
Q

Treatment for intractable seizures 2/2 Rasmussen’s encephalitis

A

hemispherectomy

305
Q

Palmar Pits

A

Gorlin Syndrome (also odontogenic keratocysts and dural calcifications)

306
Q

Does hemangioblastoma have a capsule?

A

No, you have to remove the whole thing or it will recur

307
Q

What percent of hemangioblastomas occur with VHL?

A

10%. The vast majority are not associated.

308
Q

Most common primary cerebellar tumor in the adult?

A

Hemangioblastoma

309
Q

Most common presenting symptom of spinal cord herniation through the dura

A

Hemi-cord syndrome AKA Brown Sequard

310
Q

Postganglionic thoracic nerve root avulsions are important because

A

they have capacity to regenerate, whereas preganglionic do not

311
Q

Treatment for choroidal fissure / neurepithelial cyst

A

No treatment needed

312
Q

Important thing to include in dictation on dermoid cyst at the floor of the mouth

A

relation to mylohyoid muscle

313
Q

Most common location for dermoid in the head

A

orbit (2nd is floor of mouth)

314
Q

Ranula is

A

mucocele of the sublingual duct

315
Q

Hard palate is part of the

A

oral cavity

316
Q

Soft palate is part of the

A

oropharynx

317
Q

The vast majority of tumors of the post-styloid parapharyngeal space

A

are neurogenic including not only CN 9-12 but also the sympathetic ganglionic chain

318
Q

The vast majority of tumors of the pre-styloid parapharyngel space

A

are of salivary gland origin

319
Q

Most Ludwig angina come from

A

odontogenic source

320
Q

Cowden’s

A

skin tags

321
Q

Septo-optic dysplasia

A

Schizoenchepahlic cleft

322
Q

Rosai-Dorfman

A

Multiple dural based masses - (sinus histiocytosis with massive lymphadenopathy)

323
Q

Most common locations for anterior circulation intracranial aneurysm

A
  1. ACOMM, 2. PCOMM, 3. MCA bifurcation/trifurcation
324
Q

Most common forms of CJD

A

sporadic (not variant)

325
Q

Ecchordosis physaliphora

A

Benign, clivus based, in the differential for chordoma

326
Q

Suprasellar meningiomas are

A

off center and narrow the the ICAs

327
Q

pituitary adenomas

A

do not narrow the ICA (as opposed to meningiomas)

328
Q

Bony destruction and deforming the globe from intraorbital extraconal mass centered in the lacrimal gland

A

Adenoid cystic

329
Q

Most common site in the orbit to be affected by orbital pseudotumor

A

Inferior rectus

330
Q

Coca cola bottle

A

Thyroid orbitopathy

331
Q

According to TIRADS the most suspicious features of thyroid nodule

A

punctate echogenic foci, “very hypoechoic,” extra-thyroidal extension, and taller than wide on transverse view

332
Q

What is markedly hypoechoic in the thyroid

A

darker than the strap muscles

333
Q

Focal masses of the periorbital fat

A

Schwannoma and cavernous hemangioma

334
Q

Flow voids in orbital mass

A

within one year of life think capillary hemangioma; at 10 years old then think rhabdomyosarcoma

Huda Facts (5 decks)

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