Pay It Forward Flashcards
1
Q
Most often injured artery especially at sites of fixation
A
Internal carotid
2
Q
Refers to increase in blood volume
A
Hyperemia
3
Q
Refers to increase in tissue fluid
A
Cerebral edema
4
Q
Often the only reliable evidence of the site of impact
A
Scalp soft-tissue swelling
5
Q
Most common manifestation of scalp injury
A
Subgaleal hematoma
6
Q
Most commonly caused by fracture of the thin medial orbital wall
A
Orbital emphysema
7
Q
Most common isolated maxillary fracture
A
Fracture of the maxillary alveolus
8
Q
Most common isolated sinus fracture
A
Anterolateral wall of the maxillary antrum
9
Q
Most common form of primary brainstem injury
A
Diffuse axonal injury (DAI)
10
Q
Most common skeletal injury in child abuse
A
Long bone fractures
11
Q
Most commonly recognized intracranial complication from child abuse
A
Subdural hematomas
12
Q
Most common intra-axial manifestation of head injury related to child abuse
A
Diffuse brain swelling
13
Q
Views requested in facial trauma
A
Cadwell, Waters, Cross table lateral and Submentovertex / Submental vertex view
14
Q
Most common type of fracture of orbits due to trauma
A
Blowout fracture
15
Q
Most common type of blow out fracture
A
Inferior blowout fracture
16
Q
Le fort fracture that is described as “floating palate”
A
Le Fort 1
17
Q
Le Fort fracture described as “pyramidal”
A
Le fort 2
18
Q
Le Fort fracture described as “craniofacial dysfunction”
A
Le Fort 3
19
Q
Le Fort fracture described as “dish face deformity”
A
Le Fort 2
20
Q
Simple mandibular fractures are most commonly found in the
A
Ramus and condyle
21
Q
This type of mandibular fracture exhibits cortical ring sign, which is a well coordinated density above the condylar neck on lateral view
A
Subcondylar fractures
22
Q
The most common site of isolated injury to the mandible
A
Mandibular angle
23
Q
Most malignant grade of astrocytoma
A
Grade IV
24
Q
Most malignant form of astrocytoma
A
Glioblastoma multiforme
25
Most common type of glioma
Glioblastoma multiforme
26
Most common hemorrhagic neoplasms in the brain
GBM, Metastasis, Oligodendroglioma
27
Ring enhancing lesions on contrast
"MAGIC-DR"
First three (3) are MOST COMMON
M - Metastasis
A - Abscess
G - Glioma
I - Infarct (Subacute phase)
C - Contusion
D - Demyelinating disease
R - Radiation Necrosis
28
Calcified Glial Tumors
"Old A.G.E"
Old = Oligodendroglioma
A = Astrocytoma
G = GBM
E = Ependymoma
29
Most common tumor seen in patients with chronic temporal lobe epilepsy
Ganglioglioma
30
Most common location of ganglioglioma
Temporal lobe
31
Known as the ghost tumor. This intra axial tumor is exquisitely sensitive to steroid and radiotherapy initially, only to rebound with a vengeance
Primary CNS lymphoma
32
This tumor is composed of small blue cells with a high nucleus to cytoplasm ratio packed tightly together in the perivascular spaces
Primary CNS lymphoma
33
Most common tumor associated with medically refractory partial complex seizures
Dysembryoplastic neuroepithelial tumor (DNET)
34
Most common site for intracranial neoplasms in the pediatric population
Posterior fossa, Cerebellum
35
Most common primary cerebellar neoplasm in the adult population
Hemangioblastoma
36
Most common pediatric CNS malignancy (High Grade, Grade IV)
Medulloblastoma
37
Most common pediatric posterior fossa tumor
Pilocytic astrocytoma
38
Most common site of metastasis of Medulloblastoma
Bone
39
Most common pediatric CNS tumor (Low Grade, Grade I)
Pilocytic Astrocytoma
40
Most common location of Pilocytic Astrocytoma
Cerebellum (60%)
41
Most common tumor seen in NF-1
Pilocytic Astrocytoma
42
Most common extra-axial neoplasm of adults
Meningioma
43
Most common location of meningioma
Parasagittal or convexity locations (50%)
44
Most common location of meningioma in children
Ventricles
45
Most common location of meningioma in the spine
Thoracic spine
46
MRI Imaging findings to determine extra-axial nature of a tumor
1. Prominent pial blood vessel flow voids (80%)
2. CSF clefts around the tumor margins
3. Broad dural base (KEY IMAGING FEATURE)
47
Most common primary vascular supply of meningioma
Middle Meningeal Artery, from the external carotid circulation
48
How many types of meningioma have been discovered by the WHO and how many are classified under each grade?
Total of 15 types
9 are Grade I
3 are Grade II
3 are Grade III
49
Most common form/transmission of metastasis of extra-axial tumors
Dural metastasis
Subdural lesions = hematogenous
Spinal lesions = via Batson's venous plexuses
50
This extra axial tumor was previously considered "angioblastic meningioma". Arises from modified pericapillary smooth muscle cells (pericytes of Zimmerman). Similar imaging to meningioma BUT has a narrow base attachment and is multilobulated (Instead of BROAD dural base and hemispheric)
Hemangiopericytoma
51
Ependymomas are most commonly found in
Fourth ventricle
52
Most common extra-axial mass in an adult
Meningioma
53
Most common primary tumors to spread to the ventricle where the choroid plexus is the most highly vascular part of the ventricular system
Lung carcinoma, RCC
54
An intraventricular tumor of neuroepithelial lineage arising from the septum pellucidum or the ventricular wall. Has numerous areas of cystic change giving the mass a "swiss cheese" morphology. Hyperintense on both t1 and t2
Central neurocytoma
55
An intraventricular tumor rising from the ependymal lining of the ventricular system in the sub ependymal layer. Hypointensity on t1 hyperintensity on t2
Subependymoma
56
An intraventricular tumor discovered in the region of the foramen of monro with strong association to tuberous sclerosis. Iso to slightly hyperintense on t1 and hyperintense on t2
Subependymal giant cell astrocytoma
57
Phenomenon associated with colloid cyst. Tilting of the head forward will reproduce acute severe headache
Brun phenomenon (Colloid cyst)
58
This lesion is not a true intraventricular neoplasm. Mimics a neoplasm. Characteristically occurs in the anterior superior portion of the third ventricle near the foramen of Monro. Presents with acute onset of severe headache
Colloid cyst
59
Most common type of neoplasms of the pineal gland
Giant cell tumors
60
Most common intracranial germ cell tumor
Germinoma
61
Most common sellar masses
Pituitary adenoma/s
62
Pituitary adenoma <10mm in size
Microadenoma
63
Pituitary adenoma
>10mm in size
Pituitary Macroadenoma
64
Most common of the secreting adenomas and presents with amenorrhea, galactorrhea, or impotence
Prolactinoma
65
Most common suprasellar mass in the pediatric population
Craniopharyngioma
66
TORCH Infections
T = Toxoplasmosis
O = Others ( Syphilis, Varicella)
R = Rubella
C = CMV
H = Herpes simplex, HIV
67
Most common cause of congenital CNS infection
Cytomegalovirus
68
Frontal sinusitis in children complicated by osteomyelitis with subperiosteal, epidural, and subdural abscesses
Pot puffy tumor
69
Congenital infection with primarily periventricular pattern of injury and dystrophic calcifications. Patients have hepatosplenomegaly, jaundice, chorioretinitis, deafness and cerebral involvement.
Cytomegalovirus
70
Congenital infection with scattered dystrophic calcifications in the white matter, basal ganglia and cortex. Necrotizing encephalitis of the fetal brain occurs. Patients present with microcephaly, chorioretinitis, and mental retardation.
Toxoplasmosis
71
Congenital infection associated with diffuse encephalitis with infarction presenting on cranial ultrasound as diffuse brain swelling and patchy areas of hypodensity in the white matter and cortex, with relative sparing of the basal ganglia, thalamus and posterior fossa structures. CSF analysis revealed pleocytosis (increased cell count), increased protein and decreased glucose.
Herpes simplex
72
Most common form of CNS tuberculosis
Tuberculous meningitis
73
Most common opportunistic FUNGAL CNS infections
- Cryptococcus
- Aspergillosis
- Candidiasis
- Mucormycosis
74
Most frequently reported CNS fungal infection
Cryptococcosis
75
Most common cause of sporadic encephalitis
Herpes simplex encephalitis
76
Most common opportunistic CNS infection
Toxoplasmosis
77
Most common fungal infection in hiv-positive patients
CNS cryptococcosis
78
Most common intracranial neoplasm in patients with AIDS
Primary CNS lymphoma
79
Region of the brain that is most severely involved in HIV encephalopathy
Centrum semiovale
80
Region of the brain that is spared in HIV encephalopathy
"No sHIVs (weapon) allowed in the grey courtroom"
Cortical gray matter
81
Region of the brain that is spared in herpes simplex encephalitis
Putamen
"Walang Herpes yung Puta"
"Yung Puta Walang Herpes"
Herpes simplex encephalitis spares Putamen
82
Most common manifestation of HIV infection of the brain on neuroimaging studies
Diffuse atrophy
83
This is the favored site of CNS toxoplasmosis
Basal ganglia
84
Difference between DEMYELINATION versus DYSMYELINATION
DEMYELINATION = Acquired, Adult, Affects normal myelin
DYSMYELINATION = Inherited, Pedia, Affects formation and maintenance of myelin
85
This refers to small infarcts (5-10mm) occurring within the basal ganglia typically over two-thirds of the putamina
Lacunae / Lacunar infarcts
86
Most common fatal encephalitis
Herpes encephalitis
87
Most common neurodegenerative disease
Alzheimer disease
88
Most common cause of dementia
Alzheimer disease
89
Most common of the leukodystrophies
Metachromatic leukodystrophy
90
This is also called subacute necrotizing encephalomyelopathy. Involves a mitochondrial enzyme defect. In contrast to Wernicke encephalopathy, there is sparing of the mammillary bodies
Leigh disease
91
This is also known as hepatolenticular degeneration. There is an inborn error of copper metabolism that is associated with hepatic cirrhosis and degenerative changes of the basal ganglia.
Wilson disease
92
Intracorneal deposit of copper is virtually diagnostic of the Wilson disease when present
Kayser-Fleischer ring
93
The most common basal ganglia disorder and one of the leading causes of neurologic disability in individuals older than age 60
Parkinson disease
94
This neurotransmitter is deficient in parkinson's disease due to dysfunction of the neuronal system specifically pars compacta of the substantia nigra
Dopamine
95
Postinfectious and postvaccinal encephalomyelitis. Typically occurs after a viral illness or vaccination.
Acute Disseminated Encephalomyelitis (ADEM)
96
Reactivated slowly progressive infection caused by the measles virus. Presents with patchy areas of periventricular demyelination as well as lesions of the basal ganglia.
Subacute Sclerosing Panencephalitis
97
Represents a reactivation of a latent JC polyomavirus. Seen in immunocompromised individuals and typically involves the deep cerebral white matter with subcortical U-fiber involvement but spares cortex and deep gray matter.
Progressive Multifocal Leukoencephalopathy (PML)
98
Presents as subacute encephalitis in immunocompromised patients. Characterized clinically by a progressive dementia without focal neurologic signs. Causes focal or diffuse white matter hyperintensities on T2WI.
HIV encephalopathy
99
Most common electrolyte abnormality associated with central pontine myelinolysis
Hyponatremia
100
Most common cause of Wernicke encephalopathy and Korsakoff syndrome
Thiamine (B1) deficiency secondary to poor oral intake in SEVERE CHRONIC ALCOHOLISM
101
Refers to a supraclinoid obliterative arteriopathy that occurs primarily in children and idiopathic in nature. Also known as "Puff of smoke"
Moyamoya disease
102
Clinical triad of Wernicke encephalopathy
1. Ocular movement abnormalities
2. Ataxia
3. Confusion
103
Persistent learning and memory deficits present in Wernicke encephalopathy
Wernicke-Korsakoff syndrome
104
What is the dysmyelinating disease with the following description:
- autosomal recessive pattern
- arylsulfatase deficiency
- infantile type (MC)
- 2 y/o, gait disorder, mental deterioration
- progressive with sparing of subcortical U-fibers
Metachromatic Leukodystrophy
105
This type of hydrocephalus occurs when there is obstruction within the ventricular system and prevent CSF from exiting the ventricles
Non-communicating hydrocephalus
106
This type of hydrocephalus has an obstruction that is beyond the ventricular system it is located instead within the subarachnoid space
Communicating hydrocephalus
107
Most sensitive indicator for hydrocephalus
Enlargement of the temporal horns
108
Most frequent causes of acute hydrocephalus
Subarachnoid hemorrhage and meningitis
109
Colloid cyst typically block CSF flow in what level / portion
3rd ventricle
110
Pineal tumors and tectal gliomas typically obstruct CSF flow at what level / portion
Aqueduct
111
Ependymoma and medulloblastomas typically interrupt CSF flow at the level of the
4th ventricle
112
Source of the majority of hemorrhages in premature infants
Germinal matrix
113
Most common clinical finding of ischemic perinatal stroke
Focal neonatal seizures
114
Most common cause for small amounts subarachnoid, subdural blood, or interventricular blood in the term newborn
Normal delivery / Traumatic normal delivery
115
Most severe form of holoprosencephaly
Alobar holoprosencephaly
116
Form of holoprosencephaly with an appearance of a horseshoe or cup-shaped interior rind of brain tissue, dominant single monoventricle that communicates with a posterior cyst. The corpus callosum interhemispheric fissure and falx cerebri or entirely absent.
Alobar holoprosencephaly
117
Most severe malformation resulting from an arrest of neuronal migration. Also known as "smooth brain"
Lissencephaly
"gLISSENingly smooth"
118
Most common chiari malformation
Chiari I (1)
119
Most rare chiari malformation
Chiari III (3)
"rar3st chiari malformation"
120
Most common of the phakomatoses
Neurofibromatosis Type 1 (Von Recklinghausen disease)
121
Chiari malformation associated with myelomeningocele/s
Chiari II (2)
"Dalawang Yelo”
Chiari II - myelomeningocele
122
Chiari malformation associated with encephaloceles
Chiari III (3)
"3nc3phaloc3l3s"
123
Chiari malformation associated with cerebellar hypoplasia
Chiari IV (4)
124
Chiari malformation associated with cerebellar agenesis with occipital lobe herniation
Chiari V (5)
125
Chiari malformation associated with normal posterior fossa
Chiari IV (4)
126
Most common neurologic symptom of tuberous sclerosis
Epilepsy
127
Most frequent brain lesions seen in tuberous sclerosis
Subependymal hamartomas
128
Most common pathology involved in the paranasal sinuses and nasal cavity
Sinusitis
129
Autosomal dominant disorder associated with retinal angiomas and cerebellar and spinal hemangioblastomas
Von Hippel-Lindau Syndrome (VHL)
130
A syndrome also known as Encephalotrigeminal angiomatosis, Associated with Port-wine nevus and Pial angiomatosis (gyral calcification, gyral atrophy and gliosis)
Sturge-Weber Syndrome
131
Most common sinus involved with mucus retention cyst
Maxillary sinus
132
Most common sinus involved with Mucocele
Frontal sinus
133
Most common disease involving the temporal bone
Cholesteatoma
134
Most common type of cholesteatoma, congenital or acquired?
Acquired (98%)
135
Most common site for formation of an acquired cholesteatoma
Superior portion of tympanic membrane (Pars flaccida = retracts easily)
136
Most common benign neoplasm arising of the minor salivary glands
Pleomorphic adenoma (Benign mixed-cell tumor)
137
Most common MINOR salivary gland malignancy
Adenoid cystic carcinoma
138
Most common malignancy of the aerodigestive tract
Squamous cell carcinoma
139
Most common variation in the vascular anatomy of the neck
Asymmetry of the internal jugular veins (RIGHT vein is LARGER)
140
Principal malignancy of the carotid space
Squamous cell nodal metastasis
141
Most common tumor of the parotid gland
Pleomorphic adenoma (Benign mixed cell tumors)
142
A mass in the carotid space will displace the parapharyngeal space in what direction?
Anteriorly
Mnemonic for Normal:
"a Carrot Must Pair Superficially on my P.A.L.M"
Carrot = Carotid space ( P = Posterior to PPS)
Must = "Must"icator space ( A = Anterior to PPS)
Pair = "Pair"otid space ( L = Lateral to PPS)
Superficially = Superficial mucosal space ( M = Medial to PPS)
143
This neck space serves as a potential conduit for the spread of tumor or infection from the pharynx to the mediastinum. A.k.a "Danger space"
Retropharyngeal space
144
These structures give rise to most pathologies in the prevertebral space
Cervical vertebral bodies
145
Most common tumor of the optic nerve and typically occurs during the first decade of life
Optic nerve glioma
146
This tumor arises from hemangioendothelial cells of the arachnoid layer of the optic nerve sheath. It assumes a circular configuration and grows into a linear fashion along the optic nerve. It demonstrates a tram track pattern of linear contrast enhancement. It may be extensively calcified.
Optic sheath meningioma
147
Most common cause of intraorbital mass lesion in the adult
Idiopathic inflammatory pseudotumor
148
The most frequent cause of unilateral or bilateral proptosis in adults
Thyroid ophthalmopathy (Graves disease)
149
Muscles involved in decreasing order of frequency in graves' disease
"IM SLow"
"I'M SLow"
Inferior rectus (most involved)
Medial rectus
Superior rectus
Lateral rectus (least involved)
150
Most common primary ocular malignancy in the pediatric age group and presents characteristically with leukocoria and a calcified ocular mass
Retinoblastoma
151
Most common neck malignancy in the pediatric age group
Lymphoma
152
Most common congenital neck lesion in children
Thyroglossal duct cyst
153
Most common midline neck mass
Thyroglossal duct cyst
154
Most branchial cleft cysts arise from which branchial cleft
Second branchial cleft (95%)
155
Classic symptoms of Myelopathy
"kapag Myelopathy, B.A.W.a.S"
"kapag Myelopathy, B.A.W.a.S"
- Bladder & Bowel Incontinence
- Ataxia
- Weakness
and
- Spasticity
156
Most common spinal causes of pain and neurologic deficit are
- Disc herniations
- Uncovertebral joint spurring
157
Most common spinal cord "inflammatory" disorder
Multiple sclerosis
158
Most common cause of intramedullary lesions
Multiple sclerosis
159
Currently the most common cause of arachnoiditis
Iatrogenic
160
Most common site of hematogenous infectious seeding in the spine
Vertebral body
161
Most common cause of spine infection in adults
Staphylococcus aureus
162
This is also known as tuberculosis of the spine. Associated with slow collapse of one or more vertebral bodies resulting in acute kyphosis or "gibbus" deformity. Cord compression may occur as a result of this gibbus deformity
Pott disease / Pott's disease
163
The term "cold abscess" describes large spinal abscesses without severe pain or frank pus is associated with what disease?
Pott disease / Pott's disease
164
Most common spinal cord tumor in adults
Ependymomas
165
Most common spinal cord tumor in children
Astrocytoma
166
Most common intradural tumor in the thoracic region and represents roughly 25% of all adult intraspinal tumors
Meningioma
167
Most common intraspinal mass. It is also the most common nerve sheath tumor
Schwannoma
168
Classic cause of spinal intradural extramedullary metastases
Subarachnoid seeding of primary CNS neoplasm
169
Spinal cord split into two hemicords by a sagittal bony or cartilaginous spur. Most occur in the lower thoracic region and are accompanied by vertebral segmentation abnormalities
Diastematomyelia
170
Most common site in the spine for root avulsion
Cervical spine
171
Most common cause of neuroforaminal stenosis
Degenerative disease of the facets with bony hypertrophy
172
Most common cause of central canal stenosis and lateral recess stenosis
Degenerative disease of the facets with bony hypertrophy
173
Most common modic type endplate changes
Modic type 2
- replacement of red marrow with fatty yellow marrow
- T1 High, T2 High
Other Modic Types:
Modic type 1
- marrow edema and inflammation
- response to degenerative disc disease
- can also be a sign of infection
- T1 Low, T1 High
Modic type 3
- Bony sclerosis
- T1 Low, T2 Low
174
Most common form of atelectasis
Obstructive or resorptive
175
Most common causes of endobronchial obstruction and secondary resorptive atelectasis
- bronchogenic carcinoma
- foreign bodies
- mucus plugs
- malpositioned endotracheal tube
176
Type of atelectasis associated with chronic tuberculosis
Cicatricial atelectasis
177
Type of atelectasis associated with surfactant deficiency
Adhesive atelectasis
178
The only DIRECT radiographic finding of lobar atelectasis
Displacement of an interlobar fissure
179
Type of atelectasis that is usually found along the inferior and posterior costal pleural surfaces adjacent to an area of pleural fibrosis or plaque formation. Identified also by a curvilinear bronchovascular tube or "comet tail" entering the anterior inferior margin of the mass
Round atelectasis
180
Atelectasis of this lobe produces the S sign of golden
Right upper lobe atelectasis
181
What sign will be produced when there is collapse of the right upper lobe superiorly and medially, superomedial displacement of the minor fissure and anteromedial displacement of the major fissure
S sign of Golden
182
What lobes are atelectatic when there is obstruction of the bronchus intermedius by a mucus plug or tumor
Combined right middle and right lower lobe atelectasis
183
Which lung lobe is commonly collapsed in patients with large hearts and in postoperative patients, particularly, who have had coronary bypass surgery
Left lower lobe atelectasis
184
Pulmonary edema and interstitial pneumonitis will present with this type of reticular pattern of opacities
Fine reticular "Ground glass pattern"
185
Pulmonary fibrosis will most commonly present with this type of reticular pattern of opacities
Medium reticular "Honeycombing"
186
Nodular opacities <2 mm
Miliary opacities
187
Nodular opacities 2-7mm
Micronodules
188
Nodular opacities 7-30mm
Nodules
189
Nodular opacities >30mm
Masses
190
Diseases that give rise to TRUE RETICULONODULAR opacities
- Silicosis
- Sarcoidosis
- Lymphangitic carcinomatosis
191
What type of kerley lines are obliquely oriented, course toward the hila, measure 2-6 cm long and with <1 mm thickness.
Kerley A lines
192
What type of Kerley lines are peripherally located, coarse, perpendicular to and contact the pleural surface, and measure about 1-2 cm.
Kerley B lines
193
Kerly lines that represent thickened peripheral subplural interlobular septa
Kerley B lines
194
Kerly lines that correspond to thickening of connective tissues sheets within the lung which contain lymphatic communications between the perivenous and bronchoarterial lymphatics
Kerley A lines
Ker-lymph-A-tics = kerly A lines
195
Most common cavitary pulmonary lesions
Lung abscess and necrotic neoplasm
196
A collection of gas <1 cm in size within the layers of the visceral pleura. It is usually found in the apical portion of the lung. Its rupture can lead to spontaneous pneumothorax
Blebs
197
Gas collection within the pulmonary parenchyma >1 cm in diameter and a thin wall of <1 mm thick. It represents a focal area of parenchymal destruction like emphysema and may contain fibrous strands, residual blood vessels, or alveolar septa.
Bullae
198
Thin-walled gas containing structures that represent distended airspaces distal to a check valve obstruction of a bronchus or bronchiole. It is most commonly secondary to staphylococcal pneumonia
Pneumatoceles
199
Any well-circumscribed intrapulmonary gas collection with a smooth thin wall >1 mm thick
Air cyst (Brant 5th ed)
200
This syndrome involves congenital absence of the pectoralis muscle which produce a unilateral pulmonary hyperlucency
Poland syndrome
P-oland syndrome
P-ectoralis muscle absence
P-ulmonary lucency (unilateral)
201
This syndrome is a condition that follows adenoviral infection during infancy. It is also known as unilateral hyperlucent lung. This will produce a TRUE unilateral hyperlucent lung.
Swyer-James syndrome
202
Diseases that may manifest as bilateral hyperlucent lungs
- Emphysema
- Asthma
- PS associated with TOF
- Obstruction of pulmo circulation (PAH, Chronic thromboembolic disease)
203
Most common finding of pneumomediastinum
Air outlining the left heart border
204
Air dissects between the pericardium above the central diaphragm below to allow visualization of central portion of the diaphragm
Continuous diaphragm sign
205
This sign indicates that a mass is superimposed on the hilum and normal hilar vessels can be seen through the density
Hilum overlay sign
206
This sign indicates enlargement of the intrahilar vascular structures. Vascular structures converge only as far as the lateral margin the increased higher density
Hilum/Hilar convergence sign
207
To differentiate pleural effusion from ascites on Axial CT
Pleural Effusion displaces Crus LATERALLY "PE.C.LAT"
Ascites displaces CRUS MEDIALLY (Opposite of Pleural effusion)
"A.C.MED)
208
Most common thoracic inlet mass seen in older patients
Tortuous arterial structures / Tortuous aorta
209
Enlargement of a thymus that is normal on gross and histologic examination. This occurs primarily in children as a rebound effect.
Thymic hyperplasia
210
This is a neuroendocrine tumor of the thymus. It is a rare malignant neoplasm believed to arise from the thymic cells of neural crest origin (APUD or Kulchitsky cells). Carcinoid tumor is the most common histologic type.
Thymic carcinoid
211
In lymphoma, this is the most frequent site of a localized nodal mass in which portion of the mediastinum particularly those of nodular sclerosing type
Anterior mediastinum
212
Most common subtypes of non-hodgkin's lymphoma
Lymphoblastic lymphoma and diffuse large b-cell lymphoma
213
This type of lymphoma most commonly involves the middle mediastinal and hilar lymph nodes
Non-hodgkin lymphoma
214
This type of lymphoma most commonly involves the anterior mediastinal and hilar nodal groups
Hodgkin lymphoma
H-odgkin = H-arap (Anterior and Hilar nodal groups)
215
This is the most common primary mediastinal neoplasm in adults
Lymphoma, either Hodgkin or Non-Hodgkin
216
Treatment for localized intrathoracic hodgkin disease
Radiation / Radiotherapy
217
Treatment for non-hodgkin's lymphoma and widespread hodgkin disease
Chemotherapy (Better response rates for Hodgkin than NHL)
"Radio Hud" Radiotherapy for Hodgkins
"Kimochi, Non-hentai!" Chemotherapy for Non-Hodgkins
218
Most common benign mediastinal germ cell neoplasm
Teratoma
219
Most common type of teratoma seen in the mediastinum
Cystic or mature teratoma
220
This neoplasm contains only elements derived from the ectodermal germinal cyst
Dermoid cyst
221
This type of teratoma commonly contains tissues of epidermal, dermal, and endodermal origins
Mature or Cystic teratoma
222
Most common malignant germ cell neoplasm
Seminoma
223
Most common source of metastases to the middle mediastinal nodes
Bronchogenic carcinoma
224
Bronchogenic carcinoma will metastasize specifically to which middle mediastinal nodes?
Paratracheal and aorticopulmonary nodes
225
Pericardial cysts most commonly arise from
Anterior cardiophrenic angle (right sided lesions twice as common as left cardiophrenic angle)
226
Neurogenic tumors arising from intercostal nerves
Neurofibroma, Schwannoma
227
Neurogenic tumors arising from the sympathetic ganglia
Ganglioneuroma, Ganglioneuroblastoma, Neuroblastoma
228
Neurogenic tumors arising from paraganglionic cells
Pheochromocytoma, Chemodectoma
229
Non-functioning paraganglioma
Chemodectomas
230
Functioning paraganglioma
Pheochromocytoma
231
Most common structure in a hiatal hernia sac
Stomach
Cardia in SLIDING HERNIA "Sliding Car"
Fundus in PARAESOPHAGEAL HERNIA "PARA is FUN to use (Counterstrike)"
232
Paraspinal masses produced by expansion of the vertebral body or posterior elements
Multiple myeloma, Aneurysmal bone cyst
233
Most common primary malignancies that metastasize to the thoracic spine
Bronchogenic, breast, or renal cell carcinoma
234
Most common posterior mediastinal mass in patients with neurofibromatosis
Meningocele
235
Most common cause of chronic sclerosing fibrosing mediastinitis
Granulomatous infection secondary to histoplasma capsulatum
Other less common causes include:
Tuberculous, Radiotherapy, Drugs
236
Most commonly affected structure in chronic sclerosing fibrosing mediastinitis
Superior vena cava (75% of symptomatic patients)
237
SVC syndrome manifests with...
Jugular venous distention, Cyanosis, Edema, Headache, Epistaxis
238
Most serious and potentially fatal manifestation of chronic sclerosing fibrosing mediastinitis
Obstruction of central pulmonary veins
239
Most common cause of mediastinal hemorrhage
Trauma
240
Most common source of pneumomediastinum
Air from the lungs
241
Pneumomediastinum - Extra-alveolar air collects within bronchovascular interstitium which dissects centrally to the hilum and mediastinum
Macklin effect
242
Substernal chest pain caused by intramediastinal extension of infections
Ludwig angina
243
Extrathoracic neoplasm with the highest incidence of intrathoracic nodal metastases
Malignant melanoma
244
Most common thoracic radiographic manifestation of lymphoma
Hilar and mediastinal lymph node enlargement
245
Most common form of pulmonary edema
Hydrostatic pulmonary edema (Normal capillary permeability)
246
PCWP range with findings of constriction of lower vessels and enlargement of upper lobe vessels
PCWP 12-18 mmHg (Mild elevation)
247
PCWP range with findings of interstitial edema, loss of vascular definition, peribronchial cuffing, and Kerley lines
PCWP 19-25 mmHg (Progressive elevation)
248
PCWP range with findings of alveolar filling with radiographic findings of bilateral airspace opacities in the perihilar and lower lung zones
PCWP above 25 mmHg
249
PCWP normal range
PCWP 8-12 mmHg
250
Most common finding in pulmonary embolism without infarction
Peripheral airspace opacities and linear atelectasis
251
Sign of pulmonary embolism - Regional oligemia (decreased pulmo blood flow) and has the highest positive predictive value / highest sensitivity
Westermark sign
252
Pulmonary embolism - peripheral wedge of airspace opacity and implies lung infarction
Hampton hump
253
Pulmonary embolism - sign of enlarged Pulmonary Artery
Fleischner sign
254
Hallmark of pulmonary embolism
Ventilation/perfusion mismatch (V/Q mismatch)
255
Traditionally considered to be the gold standard in the diagnosis of pulmonary embolism
Pulmonary angiography
256
Widely considered the first-line diagnostic modality for the evaluation of suspected pulmonary embolism
MDCT
257
Most common cause of pulmonary arterial hypertension
Increase in resistance to pulmonary blood flow
258
Identification of feeding and draining vessels emanating from the hilar aspect of a solitary pulmonary nodule is pathognomonic of this
Pulmonary Arteriovenous malformation (AVM)
259
Presence of halo of ground glass opacity encircling a solitary pulmonary nodule in an immunocompromised or neutropenic patient
Invasive pulmonary aspergillosis
260
A nodule or mass adjacent to an area of pleural thickening with a "comet tail" of bronchi and vessels entering the higher aspect of the mass and associated with lobar volume loss
Round atelectasis
261
The single most important factor in characterizing the lesion as benign or indeterminate
Internal density of a mass/nodule
262
Most common type of lung cancer, accounting for 1/3 of all bronchogenic carcinoma
Adenocarcinoma
263
Most common subtype of lung cancer in non-smokers
Adenocarcinoma
264
Most malignant neoplasms arising from bronchial neuroendocrine (Kulchitzky) cells and are alternatively referred to as Kulchitzky cell cancers or KCC-3
Small cell carcinoma
"Kulit-zky ng mga Maliit na bata" (Kulchitzky cells, Small Cell Carcinoma)
265
Bronchogenic carcinoma associated with cavitation of solitary malignant nodules
Squamous cell carcinoma
266
Bronchogenic carcinoma associated with air bronchograms or bubbly lucency within a nodular mass
Adenocarcinoma
267
Most common cause of SVC syndrome
Lung cancer
268
Most common primary tracheal malignancy
Squamous cell carcinoma
269
Majority of tracheal neoplasms arise from which portion of the trachea
Distal trachea, within 3 to 4 cm of the tracheal carina
270
Most common types of thyroid malignancy to invade the trachea
Papillary and follicular carcinoma
271
Most common pattern of pulmonary infection
Lobular or bronchopneumonia
272
Most common cause of multifocal patchy airspace opacities
Bronchopneumonia
273
Pulmonary infection represents radiographically as multifocal opacities that are roughly lobular in configuration which produce a "patchwork quilt" appearance because of the interspersion of normal and diseased lobules
Lobular or bronchopneumonia
274
Typical radiographic appearance for acute pneumococcal pneumonia
Lobar consolidation
275
In children, pneumococcal pneumonia present as a spherical opacity simulating a parenchymal mass
Round pneumonia
276
Most common type of pneumonia in hospitalized and debilitated patients
Staphylococcus aureus pneumonia
277
This type of pneumonia may develop following hematogenous spread to the lung in patients with endocarditis or indwelling catheters and in intravenous drug users
Staphylococcus aureus pneumonia
278
In this type of pneumonia, children may develop pneumatocele information
Staphylococcus aureus pneumonia
279
Used as an agent of bioterrorism in the united states. CT scan will show high attenuation lymphadenopathy and pleural effusion secondary to hemorrhage. Radiographic manifestations include:
- hemorrhagic lymphadenitis and mediastinitis
- hemorrhagic pleural effusions
Bacillus anthracis (Anthrax)
280
Pneumonia with bulging interlobular fissure. "Bulging fissure" sign. Incidence of effusion and empyema is higher
Klebsiella pneumoniae
281
Pneumonia with etiologic agent commonly found in air conditioning and humidifier systems. Produces airspace opacification that is initially peripherally located and sublobar
Legionnaires disease, L. Pneumophilia
282
Anaerobic gram positive filamentous bacterium. Part of normal flora of human oropharynx. Most commonly follows dental extractions manifesting as mandibular osteomyelitis or a soft tissue abscess.
Actinomyces israelii
283
Most common atypical pneumonia
Mycoplasma pneumonia
284
An important radiographic feature and indicates active and transmissible disease in tuberculosis
Cavitation
285
Tuberculous infiltrates can erode into a branch of pulmonary artery can produce aneurysm and cause hemoptysis
Rasmussen aneurysm
286
Consists of a calcified parenchymal nodule (Ghon complex) and nodal calcification
Ranke complex in Primary TB
287
Most common organism responsible for atypical mycobacterial infection
Mycobacterium avium-intracellulare (MAI) or M.kansasii
288
Most common cause of viral pneumonia in adults
Influenza
289
Most common method of pleuropulmonary involvement by amoebiasis
Direct intrathoracic extension from a hepatic abscess
290
Etiologic agent involved in most cases of human hydatid disease
Echinococcus granulosis
291
Definitive hosts for Echinococcosis / Hydatid cyst
Dogs
292
Intermediate hosts for Echinococcosis / Hydatid cyst
Sheep
293
Accidental hosts for Echinococcosis / Hydatid cyst
Humans
294
Most important parasitic infections of humans worldwide
Schistosomiasis
295
Most common complication of pneumonia and it is seen in 50% of patients
Parapneumonic effusion
296
Most common cause of pneumonia in immunocompromised hosts
Bacterial pneumonia
297
The most common non-tuberculous mycobacterial infection in patients with AIDS
Mycobacterium avium intracellulare (MAI)
298
Most common cause of fungal infection in the AIDS population
Cryptococcosis, C.neoformans
- a budding yeast commonly found in soil and bird droppings
299
Most serious consequence of cryptococcosis
Meningitis
300
The most common AIDS defining opportunistic infection. Most common in patient with AIDS usually those in the late stages of HIV infection with CD4 counts of < 200 cells/mm3
Pneumocystis jiroveci pneumonia (formerly Pneumocystis carinii pneumonia, PCP)
301
This obligate intracellular protozoan has cats as definitive hosts and spreads via ingestion of material contaminated by oocyst containing stool
Toxoplasma gondii, Toxoplasmosis
302
Most common pleural manifestation of rheumatoid disease and is found in 20% of patients
Pleuritis
303
Syndrome wherein nodules develop in the lungs of coal miners and silica or asbestos workers with rheumatoid arthritis as a hypersensitivity response to inhaled dust particles
Caplan syndrome
304
Sicca syndrome
Dry eyes (Xerophthalmia/Keratoconjunctivitis sicca)
Dry nose (Xerorhinia)
Dry mouth (Xerostomia)
305
Autoimmune disorder of middle-aged women and characterized by the Sicca syndrome
Sjogren syndrome
306
Most common pulmonary manifestation of Sjogren syndrome
Interstitial fibrosis
307
Most common of the idiopathic interstitial pneumonia
Usual interstitial pneumonia (UIP)
308
Type of interstitial pneumonia with a histologic feature of temporal heterogeneity, wherein different stages of the disease are seen simultaneously within the different portions of the lung.
Usual interstitial pneumonia (UIP)
309
Type of interstitial pneumonia also known as Hamman-Rich syndrome. It is an acute aggressive form of idiopathic interstitial pneumonitis and fibrosis. Histologic findings of diffuse alveolar damage with minimal mature collagen deposition which are diffuse and temporarily homogeneous. Manifests as ARDS with diffuse GGO and consolidation with air bronchograms.
Acute interstitial pneumonia
310
Chronic interstitial lung disease with pathology of smooth muscle proliferation in peribronchovascular and parenchymal interstitium.
Tuberous sclerosis (TS)
311
Classic triad of tuberous sclerosis (in Chronic interstitial lung disease)
"MR S.Ad Tubero"
1. Mental retardation
2. Seizures
3. Adenoma sebaceum
”MR S.Ad Tubero"
Mental Retardation, Seizures, ADenoma sebaceum, TUBEROus sclerosis
312
Chronic interstitial lung disease with pathology of smooth muscle proliferation within lymphatic channels
Lymphangioleiomyomatosis (LAM)
313
Chronic interstitial lung disease with development of chylothorax, chyloperitoneum or chylopericardium. May also produce chylous pleural effusions that are large and recurrent
Lymphangioleiomyomatosis (LAM)
314
Chronic interstitial lung disease that has a characteristic apple green color when stained with congo red under polarized light
Alveolar septal amyloidosis
315
Chronic interstitial lung disease with manifestations of cutaneous cafe au lait spots, cutaneous and subcutaneous neurofibromas, scalloping of the posterior aspect of vertebral bodies with kyphoscioliosis. "Ribbon rib" and rib notching may be seen as well.
Neurofibromatosis
316
Most common pleural manifestation of Asbestos inhalation
Parietal pleural plaques
317
Type of idiopathic eosinophilic lung disease disease also known as loffler syndrome. This is a transient pulmonary process characterized by pulmonary infiltration with eosinophilic exudates. Opacities have been described as "fleeting" because there is a tendency for rapid clearing and one area with new involvement in other areas.
Simple pulmonary eosinophilia
318
Drugs associated with pulmonary eosinophilia
"Nitro Pencil"
Nitrofurantoin and penicillin
Nitro-furantoin, Pencil-lin
319
Parasitic infections associated with pulmonary eosinophilia
"A Scar is Strong"
Ascaris lumbricoides, Strongyloides stercoralis
320
This type of idiopathic eosinophilic disease is a systemic disorder with a male predominance. Characterized by multiple organ damage from eosinophilic infiltration.
There is marked and prolonged blood eosinophilia. Associated with cardiac involvement causing CHF, Cardiomegaly, Pulmonary edema and Pleural effusions
Hypereosinophilic syndrome
321
Drug that cause diffuse alveolar damage
"Sabi ni mommy, nasa B.G.C. DAD MO"
B-leomycin
G-old
C-yclophosphamide
Diffuse Alveolar Damage
M-itomycin
O-piates
322
Drugs causing Usual Interstitial Pneumonia
"B.A.N.Me" (Banh mi)
B-leomycin
A-miodarone (If with pulmonary edema, this drug is likely the culprit)
N-itrofurantoin
Me-thotrexate
323
Lipoproteinaceous material surfactant deposits in abnormal amounts within air space of the lungs. Associated with acquired defect of alveolar macrophages that fail to phagocytose surfactant resulting in accumulation of surfactant within alveolar spaces. Alveoli filled with lipoproteinaceous material that stains deep pink with periodic acid-Schiff.
Pulmonary alveolar proteinosis (PAP)
PAP
P-hagocytose failure
P-rogressive dyspnea
P-ink (Deep) on P-eriodic acid-Schiff
P-eripheral nodules
P-eripheral airspace opacification that is bilateral and symmetric
324
Disorder characterized by deposition of minute calculi within the alveolar spaces. Produces a radiographic finding of confluent bilateral dense micronodular opacities (because of high interest of density) or "Black pleura sign"
Alveolar microlithiasis
Black pleura sign
= represent subpleural sparing of pulmonary calcification that occurs in the alveoli centrally. Seen as a strip of tangential peripheral lucency underlying the ribs as compared with adjacent diffusely dense calcified lung.
325
A congenital tracheal anomaly that is a true diverticula that represents herniation at the tracheal air column through a weakened posterior tracheal membrane
Tracheoceles / Paratracheal air cysts
326
Fixed deformity of the intrathoracic trachea in which the coronal diameter is diminished to less than two-thirds of the sagittal diameter. The tracheal wall is uniformly thickened and there is calcification of the cartilaginous rings. Present in older men with COPD.
Saber-sheath trachea
327
Characterized by presence of multiple submucosal osseous and cartilaginous deposits within the trachea and central bronchi of elderly men. The calcified plaques usually involve the anterior and lateral walls of the trachea with SPARING of the membranous POSTERIOR WALL of the trachea which lacks cartilage.
Tracheobronchopathia Osteochrondroplastica
328
A systemic autoimmune disorder that commonly affects the cartilages in tracheobronchial tree, larynx, ear, nose, joints and large elastic arteries. Diagnosis made by noting RECURRENT inflammation at TWO OR MORE cartilaginous sites, most commonly the pinna of the ear (producing cauliflower ears) and the bridge of the nose (producing a saddle nose deformity)
Relapsing polychondritis
329
A congenital disorder of the elastic and smooth muscle components of the tracheal wall. Abnormal compliance of the trachea and central bronchial collapse during coughing predisposing to recurrent pneumonia and bronchiectasis. On frontal radiographs, trachea and central bronchi measure greater than 3.0 and 2.0 cm respectively and coronal diameter.
Tracheobronchomegaly (Mounier-Kuhn syndrome)
330
Most common type of emphysema
Centrilobular emphysema
331
Most common etiologic factor associated with emphysema
Cigarette smoking
332
Type of emphysema that is associated with deficiency of the serum protein alpha 1 antitrypsin (alpha 1 protease inhibitor)
Panlobular emphysema
"pANTItrypsin deficiency"
333
Most important plain radiographic finding in emphysema and reflects the loss of lung elastic recoil
Hyperinflation
334
Refers to an inflammation of the small non-cartilaginous airways
Bronchiolitis
335
Most common condition to produce a transudative pleural effusion
Congestive heart failure
336
Most common cause of parapneumonic effusion and empyema
Staphylococcus aureus and gram-negative pneumonia
337
Most common intrathoracic manifestation of rheumatoid arthritis
Pleural effusion
338
Most common cause of pneumothorax
Trauma
339
Most common predisposing condition of secondary spontaneous pneumothorax
COPD
340
Most common connective tissue disease producing pneumothorax; usually from rupture of an apical bullae
Marfan syndrome
341
Most common inflammatory disease causing localized pleural thickening
Pneumonia
342
Defined as pleural thickening extending over more than 1/4 of the costal pleural surface. Most commonly results from resolution of an exudative pleural effusion, empyema, or hemithorax. May be seen as subpleural extension of diffuse interstitial fibrosis or encompass the entire lung producing entrapment.
Fibrothorax
343
Most common benign manifestation of asbestos inhalation
Pleural plaques
344
Earliest manifestation of asbestos-related pleural disease
Pleural effusion
345
Type of fiber most often implicated in malignant mesothelioma and is most commonly encountered since it is most used in the industry
Crocidolite
346
Most common histologic type of malignant mesothelioma and has the best prognosis among the different types
Epithelial
347
Most common organisms responsible for chest wall abscesses
Staphylococcus and Mycobacterium tuberculosis
348
Most common benign neoplasm of the chest wall
Lipoma
349
Most common malignant soft tissue neoplasms of the chest wall in adults
Fibrosarcomas and Liposarcomas
350
Most common congenital anomalies of the ribs
Bifid ribs and bony fusion
351
Most common cause of bilateral inferior rib notching
Coarctation of the aorta
352
Which ribs are UNINVOLVED in rib notching?
First two ribs
First and second intercostal arteries arise from the superior intercostal branch of the costocervical trunk of the subclavian artery, therefore do not communicate with the descending thoracic aorta.
353
Most common non-vascular cause of inferior rib notching
Multiple intercostal neurofibromas in Neurofibromatosis type 1
354
Most common site in the bony thorax involved by monostatic fibrous dysplasia
Ribs
355
Most common benign neoplasm of the ribs in adults
Osteochondroma
356
Most common primary rib malignancy
Chondrosarcoma
357
Most common metastatic lesions to ribs
Bronchogenic and breast carcinoma
358
Most commonly produce sclerotic rib metastases
Breast and prostate carcinoma
359
This congenital deformity involves a hypoplastic scapula and is elevated
Sprengel deformity
360
The scapula is superiorly displaced and its inferior portion is posteriorly displaced. It results from disruption in the innervation of the serratus anterior muscle (long thoracic nerve) that maintains the scapula against the chest wall
Winged scapula, Winging of the scapula
361
Most commonly fractured portion of the clavicle in blunt trauma
Distal third
362
Primary malignant neoplasms of the clavicle
Ewing or Osteogenic sarcoma
363
H-shaped or "Lincoln log" vertebrae on lateral chest and is pathognomonic of this disease
Sickle cell anemia
"Lincoln's Sickle cut H-shaped Log"
Lincoln Log vertebrae, Sickle cell anemia, H-shaped vertebrae
364
"Rugger jersey" appearance of the thoracic spine on lateral chest films
Hyperparathyroidism, Renal osteodystrophy
365
"Sandwich vertebral body" or "Sandwich vertebrae" represents densely sclerotic endplates of vertebral bodies distinctive for which disease
Osteopetrosis, a benign autosomal dominant disorder
366
Paradoxical superior movement of the diaphragm with sniffing. A result of the effects of negative intrathoracic pressure on a flaccid diaphragm during inspiration is diagnostic
Positive sniff test
Usually done for Diaphragmatic paralysis (Unilateral or Bilateral)
367
Most common type of diaphragmatic hernia
Hiatal hernia
368
Most common structure to herniate in a hiatal hernia
Stomach
369
Least common type of diagphragmatic hernia
Morgagni hernia
370
Most common primary malignant diaphragmatic lesion
Fibrosarcoma
371
Most commonly involved segment of lung in bronchial atresia
Apicoposterior segment of the left upper lobe
372
Most commonly involved segment of the lung in neonatal lobar hyperinflation (congenital lobar emphysema)
Left upper lobe (most common)
Right middle lobe (2nd most common)
Right upper lobe (3rd)
373
Congenital abnormality resulting from the INDEPENDENT development of a portion of the tracheobronchial tree that is ISOLATED from the normal lung and maintains its fetal systemic arterial supply. The isolated lung is cystic and bronchiectatic. Patients will present with recurrent pneumonia.
Bronchopulmonary sequestration
374
Type of bronchopulmonary sequestration:
- Contained within visceral pleura of normal lung
- Present with pneumonia (most)
- Found in lower lobes
- Supplied by a single large artery
Intralobar sequestration
More common than extralobar (3:1)
375
Most common pulmonary symptoms of arteriovenous malformations
Hemoptysis and dyspnea
376
This syndrome describes massive aspiration of gastric contents
Mendelson syndrome
377
Used to monitor response to chemotherapy of lymphoma
CT and Fluorodeoxyglucose (FDG) PET
378
Replaced by FDG PET in the initial diagnosis and staging of thoracic lymphoma
SPECT - Radionuclide scintigraphy with gallium-67
379
Superior to CT or MRI in distinguishing recurrent tumor from fibrosis in both hodgkins and non-hodgkins lymphoma
PET
380
Diagnostic for functioning neoplasms such as pheochromocytoma
PET radionuclide iodine-131
381
Diagnostic for pulsion diverticula
Barium swallow
382
Used for staging of esophageal carcinoma
CT scan
383
Provides a definitive diagnosis of mediastinal lipomatosis
CT scan
384
Provides superior accuracy in the nodal staging of lung CA
PET
385
Useful in characterizing pleural effusions in patients with lung cancer as malignant
PET
386
Used to detect metastases of bronchogenic carcinoma
Technetium 99, radionuclide bone scanning or whole-body FDG-PET
387
Methods used to distinguish adenomas from malignant (primary metastatic) adrenal lesions
CT scan, Chemical shift MRI, FDG-PET, FNAB
388
Best imaging modality to follow response of metastases to chemotherapy
CT scan
389
Modality used to distinguish Kaposi sarcoma from pneumonia and non-hodgkin's lymphoma
Combined thallium and gallium lung scanning
390
Diagnosis of PCP in AIDS
Sputum samples or bronchoalveolar lavage fluid specimens with methanamine silver staining
391
Method of choice for the diagnosis of a mediastinal cyst
CT scan
392
Modality of choice for imaging a suspected neurofibroma
MRI
393
Diagnostic technique of choice for lateral thoracic meningoceles
MRI
394
Radiologic study of choice for the diagnosis of acute mediastinitis
MDCT
395
Modality of choice for the diagnosis of chronic sclerosing mediastinitis
CT scan
396
First-line diagnostic modality for the evaluation of suspected pulmonary embolism
MDCT
397
Traditional considered to be the gold standard in the diagnosis of pulmonary embolism
Pulmonary angiography
398
Procedure of choice for tissue sampling of a solitary pulmonary nodule
Transthoracic needle biopsy
399
Modality of choice for imaging tracheal neoplasms
CT scan
400
Modality of choice for evaluation of pulmonary metastases
Helical CT
401
Definitive diagnostic procedure as it demonstrates relationship of mass with pulmonary arterial vasculature
Contrast enhanced CT scan
402
Diagnostic imaging modality of choice for broncholithiasis
Thin section CT scan
403
Modality of choice in the evaluation of malignant mesothelioma and depicts the extent of pleural involvement and invasion of the chest wall and mediastinum
CT scan
404
Modality of choice in the evaluation of sternal wound infection
CT scan
405
Most common histologic type of thymic carcinoid
Carcinoid tumor
406
Most common primary mediastinal neoplasm in adults
Hodgkin or non hodgkin lymphoma
407
Most common subtype of non hodgkin lymphoma
Lymphoblastic lymphoma and diffuse large b-cell lymphoma
408
Most common benign mediastinal germ cell neoplasm
Teratoma
409
Most common type of teratoma seen in the mediastinum
Cystic or mature teratoma
410
Most common malignant germ cell neoplasm
Seminoma
411
Most common source of metastasis to middle mediastinal nodes
Bronchogenic carcinoma
412
Most common structure in the hiatal hernia
Stomach
413
Most common primary malignancies of thoracic spinal metastases
Bronchogenic, Breast or Renal cell carcinoma
414
Most common posterior mediastinal mass in patients with neurofibromatosis
Meningocele
415
Most common cause of chronic sclerosing fibrosing mediastinitis
Granulomatous infection usually secondary to histoplasma capsulatum
416
Most common affected structure in chronic sclerosing mediastinitis
Superior vena cava
417
Most common source of pneumomediastinum
Air from lungs
418
Most common causes of small hila
- Atelectasis
- Lung resection (portion)
- Pulmonary artery hypoplasia
419
Most common form of pulmonary edema
Hydrostatic pulmonary edema
420
Most common finding in pulmonary embolism without infarction
Peripheral airspace opacities and linear atelectasis
421
Most important parasitic infections of humans worldwide
Schistosomiasis
422
Most common organisms seen in HIV-infected patients
S. pneumoniae
S. aureus
H. influenzae
E. coli
P. aeruginosa
423
Most common cause of pulmonary arterial hypertension
Increase in resistance to pulmonary blood flow
424
Most common radiographic finding of lymphoma
Solitary pulmonary nodule or focal airspace opacity
425
Most common site of granular cell tumor
Skin
426
Most common type of lung cancer
Adenocarcinoma
427
Most common subtype of lung cancer in non-smokers
Adenocarcinoma
428
Most common cause of SVC syndrome
Lung cancer
429
Most common primary tracheal neoplasm
Squamous cell carcinoma
430
Most common location of the tracheal neoplasm
Distal trachea , within 3 to 4 cm of the tracheal carina
431
Most common type of thyroid malignancy to invade the trachea
Papillary and follicular carcinoma
432
Most common mediastinal malignancies to invade the lung
Esophageal CA
Lymphoma
Malignant Germ Cell Tumor
Any malignancy metastasizing to the mediastinal or hilar lymph nodes
433
Most common extrathoracic malignancies to produce lymphangitic carcinomatosis
Breast CA
Stomach
Pancreas
Prostate
434
Most common pattern of disease and pulmonary infection
Lobular or bronchopneumonia
435
Most common cause of multifocal patchy airspace opacities
Bronchopneumonia
436
Most common cause of atypical pneumonia
Mycoplasma pneumoniae
437
Most common organism (nontuberculous mycobacteria) responsible for pulmonary disease
Mycobacterium avium intracellulare or M.kansasii
438
Most common viral pneumonia in adults
Influenza
439
Most common lung manifestation of blastomycosis
Homogenous nonsegmental airspace opacification with propensity for upper lobes
440
Most common method of pleuropulmonary involvement of amoebiasis
Direct intrathoracic extension of infection from a hepatic abscess
441
Most common complication of pneumonia
Parapneumonic effusion
442
Most common cause of pneumonia in immunocompromised hosts
Bacteria
443
Most common AIDS defining opportunistic infection
PCP
444
Most common cause of irregularity of lung interfaces
UIP and Sarcoidosis
445
Most common diseases associated with architectural distortion
Sarcoidosis and UIP
446
Most common radiographic finding of rheumatoid lung disease
Interstitial pneumonitis and fibrosis
447
Most common pleural manifestation of rheumatoid disease
Pleuritis
448
Most common manifestation of sjogren syndrome
Interstitial fibrosis
449
Most common of the idiopathic interstitial pneumonia
Usual interstitial pneumonia
450
Most common presentation of opacities in sarcoidosis
Bilateral symmetric reticulonodular opacities
451
Most common cause of pleural thickening
Pneumonia
452
Most common benign manifestation of asbestos exposure
Pleural plaques
453
Most common location of pleural plaques in the parietal pleura
Over the diaphragm and lower posterolateral chest wall
454
Most common benign neoplasm of the chest wall
Lipoma
455
Most common non vascular cause of inferior rib notching
Multiple intercostal neurofibromas in neurofibromatosis type 1
456
Most common site of the bony thorax involved by monostatic fibrous dysplasia
Ribs
457
Most common benign neoplasm of the ribs in adults
Osteochondroma
458
Most common primary rib neoplasm
Chondrosarcoma
459
Most common type of diaphragmatic hernia
Esophageal hiatal hernia
460
Most common subtype of congenital cystic adenomatoid malformation
Composed of one or several large cysts lined by respiratory epithelium with scattered mucous glands, smooth muscle, and elastic tissue in their walls
461
Most common cause of extrinsic mass effect in focal tracheal disease
Tortuous or dilated aortic arch or bronchiole cephalic artery
462
Most common type of emphysema
Centrilobular emphysema
463
Most common etiologic factor of emphysema
Cigarette smoking
464
Most common radiographic finding of constrictive bronchiolitis
Diffuse reticulonodular opacities with associated hyperinflation
465
Most common condition to produce a transitive pleural effusion
Congestive heart failure
466
Most common cause of parapneumonic effusion and emphysema
Staphylococcus aureus and gram-negative pneumonia
467
Most common side affected by pleural effusion in esophageal perforation
Left side
468
Most common intrathoracic manifestation of Rheumatoid Arthritis and is most frequently seen in male patients following the onset of joint disease
Pleural effusion
469
Most common cause of pneumothorax
Trauma
470
Most common subtype of malignant mesothelioma
Epithelial
471
Most common cause of chest wall abscesses
Staphylococcus aureus and mycobacterium tuberculosis
472
Most common malignant soft tissue neoplasms of the chest wall in adults
Fibrosarcomas and liposarcomas
473
Most common congenital anomalies of the ribs
Bony fusion and bifid ribs
474
Most common cause of bilateral inferior rib notching
Coarctation of the aorta distal to the origin of the left subclavian artery
475
Most common metastatic lesions to the ribs
Bronchogenic and breast carcinoma
476
Most common type of rib metastases in breast and prostate carcinoma
Sclerotic rib metastases
477
Most common primary malignancy associated with metastasis to the scapula
Bronchogenic and breast carcinoma
478
Most common site in the lung that is involved with bronchial atresia
Apicoposterior segment of the left upper lobe
479
Most common pulmonary symptoms of arteriovenous malformations (AVMs)
Hemoptysis and dyspnea
480
Most common cause of right heart failure
Left heart failure
481
Most commonly involved ribs in rib notching
3rd to 8th ribs
482
Most common location of ventricular aneurysms (What chamber is asked)
Left ventricle, posteroinferior aspect
483
Most common cause of dilated cardiomyopathy
Ischemic cardiomyopathy
484
Most common form of cardiomyopathies
Dilated cardiomyopathy
485
Least frequent form of cardiomyopathy
Restrictive cardiomyopathy
486
Most common cause of pulmonary venous hypertension
Elevation of the left atrial pressure secondary to left ventricular failure
487
Most common cause of mitral regurgitation
Mitral valve prolapse
488
Most common bacterial etiology of bacterial endocarditis BEFORE
Streptococcus viridans
489
Most common bacterial etiology of bacterial endocarditis now
Staphylococcus aureus
490
Most common fungal agent followed by aspergillus
Candida albicans
491
Most common location of cardiac thrombi
Left atrium and left ventricle
492
Most common location of atrial thrombi
Left atrium, Posterior wall
493
Most common benign type of cardiac tumor
Atrial myxoma
494
Second most common benign cardiac tumor
Lipoma
495
Most common malignant cardiac tumor
Metastatic tumors
496
Most common primary malignant cardiac tumor
Angiosarcoma
497
Most common primary neoplasms to metastasize to the heart
"B.L.ack LYfes M.atter" (BLLM)
B-reast
L-ung
LY-mphoma
M-elanoma
498
Most common abnormality of the pericardium
Pericardial effusion
499
Most common cause of constrictive pericardial disease
Post-pericardiotomy
500
Most common location of pericardial cysts
Anterior Cardiophrenic angles, right more common than left
501
Useful for diagnosing coronary ischemia and myocardial infarcts
Perfusion scans with thallium or new technetium agents
502
"Cold spot" imaging : Rest perfusion agents
"Hot spot" imaging : technetium pyrophosphate
Myocardial infarction scanning
503
Used for diagnosing and sizing myocardial infarction
Antimyosin antibody scans
504
Used to examine wall motion and allow left ventricular ejection fraction calculations
ECG-gated myocardial blood pool studies
505
Evaluation and quantification of right-to-left cardiac shunts
Technetium macroaggregated albumin or microspheres
506
Adds wall motion evaluation, ventricular volumes and ejection fraction
ECG-gated SPECT
507
Assess cardiac metabolism as well as perfusion , enhancing its ability to evaluate cardiomyopathies , ischemic , infarction , and "hibernating" or viable myocardium
PET
508
Uses a nasogastric tube with a steerable beam that views the heart and aorta from close posterior position provided by the esophagus
Transesophageal echocardiography
509
Produces a time motion study of cardiac structures
Returning echoes
510
Anterior structures are displayed at the top of the images; techniques in motion of the myocardium can be evaluated throughout the cardiac cycle
Transthoracic technique
511
Produced by a narrow ultrasonic beam that is directed at cardiac structures and observed over time or is swept across an area of anatomy
M-mode echocardiograms
512
Useful in evaluating aortic aneurysms, aortic dissections, injuries, vascular anomalies, central pulmonary emboli, into cardiac muscles, thrombi, pericardial thickening, fluid collections, and pericardial calcifications.
Cardiac MDCT
513
Provide functional information including wall motion analysis , systolic wall thickening , chamber volumes , stroke volumes , and right and left ventricular ejection fractions , and valvular evaluation
Cardiac MR
514
Allow prior assessment of resting wall motion abnormalities that are consistent with either profoundly ischemic , stunned, hibernating , or infarcted myocardium
Stress echocardiography
515
Evaluate the percent of stenosis , number of vessels involved , focal vs diffuse disease , coronary anatomy , ectasia or aneurysm , coronary calcification , and collateral flow
Coronary angiograms and CT coronary angiograms
516
Useful in detecting some of the long-term complications of ischemic disease including ventricular aneurysm , thinning of myocardium , akinesia , or dyskinesia
Echocardiography
517
Capable of establishing the patency of CABG
CT coronary angiography
518
Most accurate at detecting pseudoaneurysms
MRI
519
Used to identify cardiac masses
CT, Angiography, and Nuclear scintigraphy
520
Initial mode for evaluation of cardiac masses
Echocardiography
521
Used to differentiate tumor versus blood clot
MRI using gradient echo techniques
522
Useful in determining the morphology of cardiac masses
MRI Gradient echo
523
Excellent for detecting intracardiac tumors and evaluating direct intracardiac extension or pericardial involvement
MRI
524
Useful in detecting loculated precardial effusions
CT scan
525
Best imaging modality used to characterize pericardial fluid
MRI
526
Boot-shaped heart appreciated in the plain chest x-ray PA view
Tetralogy of fallot
527
Box shaped heart
Ebstein's anomaly
528
Cardiac pathology with snowman configuration or snow man sign on CXR PA view
Total anomalous pulmonary venous return type 1 (TAPVR 1)
529
Egg on its side or apple on a stem configuration on CHEST XRAY PA view
Transposition of the great arteries (TGA)
530
"Figure of 3" sign on chest x-ray and "reverse figure 3" on barium esophagogram
Juxtaductal coarctation of the aorta
531
Diverticulum of Kommerel
Aberrant left subclavian artery (ALSA)
"KOMMER (Come here), ALSA (random name of a girl)"
532
Double density sign on the right side of cardiac silhouette is a sign of what chamber enlargement?
Left Atrium, Left Atrial enlargement
"doubLAE density" sign
533
Tetralogy of fallot exhibits increased or decreased pulmonary vascularity?
Decreased pulmonary vascularity
534
A.k.a the Vascular sling. Arises from right PA (posterior aspect) to reach the left lung and crosses mediastinum. A variant of this anomaly is "Ring-Sling" complex - stenosis of right bronchus and hypoplasia of the right lung, "Bridging bronchus"
"ALPA males use SLINGS with RINGS to cross BRIDGES in the BRONX for MEDIA coverage"
Aberrant left pulmonary artery (ALPA)
SLING = Vascular SLING
RING = RING-SLING complex
BRIDGE-ing BRONX-us
MEDIA-stinum
535
"Atrial escape" and "Walking man sign" pertain to enlargement of what structure?
Left atrium
"The Walking Man Left the Atrium to Escape"
Walking man sign, Left Atrium, Atrial escape
536
"Hoffman-Riggler sign" pertains to enlargement of what structure?
Left ventricle
537
Enlargement of the pulmonary outflow tract is an indirect sign of the enlargement of which cardiac chamber?
Right ventricle
538
Most common cardiac tumor in the neonate and young infant
Rhabdomyoma
539
Most common cause of pulmonary venous hypertension
Left ventricular failure
540
Given a radiograph with a small cardiac silhouette and decreased pulmonary blood flow, which should you consider first before anything else?
Hypovolemia, first before congenital causes
541
What is the most common intracardiac mass?
Thrombi
542
Type of pulmonary stenosis commonly seen in Tetralogy of Fallot
Infundibular or subvalvular pulmonic stenosis
543
This pericardial abnormality predisposes to strangulation of cardiac structures (mechanical impairment of cardiac function) and possibility of sudden death
Partial absence / agenesis of pericardium
544
Atrial septal defect will demonstrate increased or decreased pulmonary vascularity?
Increased pulmonary vascularity
545
Most common cause of cyanotic congenital heart disease beyond the first 30 days of life
Tetralogy of Fallot
546
This cardiac anomaly exhibits a functional left-to-right shunt and an obligatory right-to-left shunt
Total anomalous pulmonary venous return type 1 (TAPVR 1)
547
Most commonly associated with a right-sided aorta in 30 to 35% of cases
Persistent Truncus Arteriosus
548
Most common cause of congestive heart failure in the first day or two of life
Hypoplastic left heart syndrome
549
Aneurysm of the ductus arteriosus will produce an unusually large bulge in what location of the mediastinum on plain chest x-ray films
Left upper mediastinum
550
The most common vascular anomaly
Aberrant right subclavian artery (ARSA)
"most common sARSA is Mang Tomas"
551
Most cases of Valvular pulmonary stenosis will show increased, decreased or normal pulmonary vascularity?
Normal vascularity
552
The most important or critical component of tetralogy of Fallot
Pulmonary stenosis
553
Periaortic hematoma is a direct or indirect sign of aortic injury?
Indirect sign
Direct signs:
- Abnormal contour of aorta
- Change in caliber of aorta
- Contrast extravasation
554
Double barrel aorta is seen in
Aortic dissection (Intimal flap, 2 lumens)
555
Most common primary pericardial tumor
Mesothelioma
556
Most common etiology for renal artery occlusive disease
Atherosclerosis
557
Anomalous left common carotid artery wall produce anterior or posterior tracheal compression?
Anterior tracheal compression
558
Most common cause of descending thoracic aortic aneurysm
Atherosclerosis
559
Causes of ascending thoracic aortic aneurysm
- Marfan
- Syphilitic
- Cystic medial necrosis
560
Most common cause of right heart failure
Left heart failure
561
A "Wall to wall" heart is associated with which valvular pathology
Tricuspid regurgitation
562
The earliest radiographic sign of congestive heart failure
Cephalization of pulmonary blood flow
563
Known as the "malignant" coronary anomaly
Interarterial
From the base of the aorta and pulmonary artery, prone to constriction and sudden cardiac death
564
Cardiac chamber most commonly involved in idiopathic cardiomyopathy
Left ventricle
565
"Swinging heart" is seen and what of normality
Pericardial effusion (A very large one, >500 mL)
566
A 50% reduction in the diameter of a coronary artery corresponds to how much reduction in its cross-sectional area
75%
567
Required minimum amount of fluid in the pericardial sac to be detected by plain film radiography
200 mL
568
Most important predisposing factor for aortic dissection
Atherosclerosis
569
Congenital subclavian steal syndrome is seen in which vascular anomaly
Isolated left subclavian artery
I'L S-teal = I-solated L-eft S-ubclavian Steal syndrome
570
Most common cause of dilated cardiomyopathy
Ischemia
Non-ischemic causes include:
- Alcoholism
- Diabetes
- Hypertension
571
Most common cause of renovascular hypertension in patients younger than 40 years old
Fibromuscular disease
572
Most common cause of renovascular hypertension in adults
Atherosclerosis
573
Most important indication for coronary ct angiography
To exclude presence of significant coronary artery disease
574
Majority of thoracic aneurysms involve which segment of the aorta
Ascending aorta
575
Among the types of total anomalous pulmonary venous return, which is most commonly associated with pulmonary venous hypertension and edema
Type III (3), Infracardiac/Infradiaphragmatic
576
Type of pulmonary stenosis that will demonstrate post-stenotic dilatation of the pulmonary artery
Valvular
577
Primary malignancy which has the highest frequency of metastases to the heart
Melanoma
578
The usual initial chest x-ray finding of a patient with a first episode of acute myocardial infarction
Normal in 50% of cases
579
This vascular anomaly produces a characteristic indentation of the posterior aspect of the trachea just above the carina and a corresponding indentation of the anterior wall of the barium filled esophagus
Aberrant left pulmonary artery (ALPA)
580
Transient hypertrophy of the interventricular septum in the subaortic region of the left ventricle occurs in
Diabetic cardiomyopathy of the neonate
581
This will demonstrate an almost globular enlargement of the cardiac silhouette with almost equal bulging to the right and left of the spine
Pericardial effusion
582
Most common cause of asymmetric pulmonary edema
Gravitational
583
In what vascular anomaly is a "Reverse S-shaped" indentation on the esophagus demonstrated in the barium esophagogram
Double aortic arch
584
Most common course abnormality of the coronary arteries
Myocardial bridging
585
Most common location of a TRUE left ventricular aneurysm as a complication of acute myocardial infarction
Anterolateral wall
"anTRUElateral wall" True aneurysm
P-osterior wall = P-seudoaneurysm, Retro in location
586
Threshold of an abnormally thickened pericardium
Greater than or equal to 4 mm
587
Angiographic hallmark of Buerger disease
Corkscrew appearance of arteries and absence of atherosclerosis findings often at wrists and ankles
DIABETIC = Vascular calcifications involving arteries of all sizes
ATHEROSCLEROSIS = multifocal diffuse luminal irregularities
GIANT CELL ARTERITIS = smooth and long-segment narrowing of axillary and/or brachial arteries
POLYARTERITIS NODOSA = microaneurysms
588
Most common primary malignant cardiac tumor in children
Rhabdomyosarcoma
589
Aortic valve stenosis with pressure gradient across the aortic valve greater than 25 mmHg
Mild stenosis
590
Aortic valve stenosis with pressure gradient across the aortic valve greater than 40-50 mmHg. Mild, moderate, or severe?
Moderate stenosis
591
Aortic valve stenosis with pressure gradient across the aortic valve greater than 80 mmHg
Severe stenosis
592
Mitral stenosis with orifice less than 1.5 cm squared
Mild mitral stenosis
593
Mitral stenosis with orifice less than 1.0 cm squared
Moderate mitral stenosis
594
Mitral stenosis with orifice less than 0.5 cm squared. Mild, moderate, or severe?
Severe mitral stenosis
595
Mean pulmonary artery pressure exceeding more than 35 mmHg
Pulmonary arterial hypertension
596
Chamber enlargement best confirmed by measuring the distance from the mid inferior border of the left main stem bronchus to the right lateral border of the left atrial density. Greater than 7 cm indicates enlargement of this chamber
Left atrial enlargement
597
Chamber enlargement described as a prominent bulge too far to the right of the spine more than 5.5 cm from midline. There is also elongation of this right chamber convexity to exceed 50% of the mediastinal cardiovascular shadow.
Right atrial enlargement
598
Cardiac chamber enlargement with the apex pointing downward on PA view
Left ventricular enlargement
599
This sign is exhibited when the left ventricle extends more than 1.8 cm posterior to the posterior border of the IVC, 2cm cephalad to the intersection of the left ventricle and IVC.
Hoffman-Rigler sign in Left ventricular enlargement
600
Chamber enlargement described as climbing more than one-third of the sternal length and fill too much of the retrosternal space.
Right ventricular enlargement
601
"Viking helmet sign" (cardio)
Hilar fullness in Pulmonary venous hypertension
602
"bat wing" or "butterfly" or "angel wing" configuration of opacities is seen in what
Alveolar edema
603
Failure of the structure and function of the right ventricle in the absence of left ventricular dysfunction. May occur as right heart failure resulting from a pulmonary disease.
Cor pulmonale
604
Measurement of pericardial fat stripe indicative of pericardial thickening or effusion
Percardial stripe >2 to 3 mm
605
Radiolucency surrounding the heart and separated from the lung by a thin white line of pericardium.
Pneumopericardium
606
Indicates that the heart is in the right hemithorax. Apex of the heart lies to the right, with the long axis of the heart directed from left to right
Dextrocardia
607
This syndrome is a combination of situs inversus with dextrocardia, bronchiectasis, and sinusitis.
"KART IN D.B.S.oria"
Kartagener syndrome
KART-agener syndrome
IN - versus (Situs)
D-extrocardia
B-ronchiectasis
S-inusitis
608
Heart is shifted toward the right hemithorax. Associated with hypoplastic right lung and increased incidence of congenital heart disease, particularly left to right shunts.
Dextroposition
609
Means cardiac apex is to the right but stomach and aortic knob remain on the left. The LV remains on the left but lies anterior to the RV.
Dextroversion
610
Most common cause of sternal fractures
Usually from MVA, 50% with cardiac contusion
611
Hyperpigmentation of sternum is associated with...
"D.E.C (Dao Eng Chai)"
D = Dao = Down syndrome (90% of patients)
E = Eng = Engdo = Endocardial cushion defect
C = Complete AV canal
612
Wavy restrosternal linear opacities are due to and associated with what vascular abnormality?
- Dilated internal mammy arteries associated with Coarctation of the aorta
613
Pectus excavatum is associated and with increased incidence of...
- Mitral valve prolapse (MVP)
- Marfan syndrome
614
Barrel shaped chest with pectus carinatum is associated with...
- VSD = 'V'arrel shaped chest
- Complete AV canal
615
Scoliosis with "Shield chest" can be seen in...
"M.A.C.Adi"
"M.A.C.Adi.mia"
M = Marfan syndrome
A = Aortic valve disease
C = Coarctation of the aorta
Adi = Aortic Dissection
616
11 or fewer ribs is associated with...
- Down syndrome
- AV canal
617
"Ribbon ribs" or bifurcated ribs and overcirculation pattern suggests...
- Truncus arteriosus
618
Rib notching and inferior rib sclerosis occurs with...
- Coarctation of the aorta
- Blalock-Tausigg procedure
619
In perfusion scanning with thallium, areas that show hypoperfusion on stress images while filling in on rest images are indicative of...
Ischemia
620
"cold spot" imaging uses what agents
Rest perfusion agents
621
"hot spot" imaging uses what agent
Technetium pyrophosphate
622
Paradoxical septal motion of the interventricular septum on echocardiography may be seen in
- Pericardial effusion
- Cardiac tamponade
- ASD
- Pulmonary hypertension
- Left bundle branch block
- Septal ischemia
- Asthma
623
Dilatation of the aortic root in echocardiography may be seen in
- Aortic stenosis
- Aortic insufficiency
- Aortic aneurysm
- TOF
624
Delayed closure of the anterior leaflet of the mitral valve on echocardiography may be suggestive of
MS
625
High frequency vibration of the anterior leaflet of the mitral valve on echocardiography is known as what phenomenon and is associated with what valvular problem?
Austin Flint phenomenon, AR
626
E-F slope of the mitral valve that appears flattened and more squared off than the normal M-shape is suggestive of
Mitral stenosis
627
E-F slope of Tricuspid valve that is DECREASED may be seen in
Tricuspid stenosis
628
Echocardiography:
E-F slope of Tricuspid valve that is INCREASED may be seen in...
"T.A.E"
T = Tricuspid regurgitation
A = ASD
E = Ebstein anomaly
629
What percent reduction of cross-sectional area is required to cause a significant reduction in blood flow?
75%
630
In general, this percentage of cross-sectional narrowing is considered clinically significant and will demonstrate decreased perfusion on stress myocardial perfusion imaging
>50%
631
Collateral flow develops when there is this percentage of coronary stenosis
>85%
632
Coronary pathology most often seen in the right coronary artery (RCA) as a smooth transient narrowing. 1-2 mm distal to the catheter tip. Patients remain asymptomatic.
Catheter-induced spasm
633
Angina secondary to prolonged coronary spasm. IV ergonovine may be used in a provocative tests to incite this coronary pathology. It is usually treated medically.
Prinzmetal variant angina
634
An inflammatory condition of the coronary arteries. Small to medium vessel vasculitis, predominantly in children. Predilection for coronary arteries. Present with fever, congestion of conjunctiva, reddening of lips and oral mucosa, strawberry tongue and swelling of cervical lymph nodes.
Kawasaki disease
"Kawasaki bikes, whether small to medium sized, are close to my heart"
Kawasaki disease, small to medium sized vessels, predilection for coronary arteries (close to my heart)
635
Normal variant which the coronary arteries penetrate and then emerge from the myocardium rather than running along the surface of the epicardium. Causes arterial constriction during systole which refers to normal flow during diastole.
Myocardial bridging
636
Coronary artery bypass grafting uses what
Saphenous vein grafts or native internal mammary arteries
637
This remains a significant problem of stent placement in up to 50% of cases to be occurring within the first six months.
Restenosis
638
With angioplasty, by balloon dilatation of the stenotic lesion, is considered successful when stenosis is reduced to less than what percentage of diameter narrowing
Less than 50%, <50%
639
Coronary angiography wall motion:
Diminished contractility or less systolic motion than normal
Hypokinesia
640
Coronary angiography wall motion:
No systolic wall motion
Akinesia
641
Coronary angiography wall motion:
Paradoxical wall motion during systole
Dyskinesia
642
Coronary angiography wall motion:
Delayed contractility
Tardikinesia
643
Coronary angiography wall motion:
Cardiac motion that is out of phase with the remainder of the myocardium
Asynchrony
644
Ventricular aneurysms that are lined by thinned and scarred myocardium. Broad mouthed, localized outpouching that do not contract during systole. Typically located near the apex or anterolateral wall.
True ventricular aneurysm
645
Ventricular aneurysms that are focal contained ruptures. Often larger but have narrower ostia / narrow mouthed. Most commonly located at the posterior and anterior aspect of the left ventricle
Pseudoaneurysms
Pseudoaneurysms of ventricle = Posteroanterior
True ventricular aneurysms = anTRUElateral
646
True or false:
Intramural thrombi may be seen in 50% of ventricular aneurysms
True
647
Cardiac artery calcium screening - Agatson score of 0-10
Very low to low risk
648
Cardiac artery calcium screening - Agatson score of 11 to 100
Moderate risk
649
Cardiac artery calcium screening - Agatson score of >400
High risk
650
Now known to be the leading cause of myocardial infarction
Vulnerable plaque development, sudden rupture, and thrombosis
651
Indications for coronary angiography include:
"Pilot w/ Abnormal Stress during Unstable flight"
- Angina refractory to medical therapy (Unstable angina)
- High-risk occupations (Pilot)
- Abnormal ECG or stress perfusion tests
652
True or false:
Use of Internal mammary artery has better long-term results than saphenous vein grafts, and correlated with increased survival.
True
653
What condition presents with systolic pressure <90 mmHg and typically associated with acute pulmonary edema
Cardiogenic shock
654
Common especially after inferior wall infarcts, from either ischemia or injury to the AV nodal branch of the RCA
AV block
655
This complication of myocardial infarction occurs 3 to 14 days after infarction with a high mortality rate approaching 100%. Chest radiograph shows acute cardiac enlargement secondary to leakage of blood into pericardium with acute pulmonary vascular engorgement and right sided cardiac enlargement because of left to right shunt. Pulmonary edema is NOT TYPICAL.
Myocardial rupture
656
Inferior infarcts are associated with which location of papillary rupture?
Posteromedial papillary rupture
657
Anterior infarcts are associated with which location of papillary rupture?
Anterolateral papillary rupture
658
This complication of myocardial infarction is suggested by an abrupt onset of mitral regurgitation with acute pulmonary edema on the radiograph. The left ventricle is only minimally enlarged whereas the left atrium is enlarged quickly.
Papillary muscle rupture
NOTE: Myocardial infarction is PRONE to RUPTURE. If presented with a case of infarct and sudden changes in radiograph such as pulmonary edema or enlargement of ventricles, think RUPTURE.
659
A.k.a post-myocardial infarction syndrome. Similar to postpericardiotomy syndrome, complicating cardiac surgery. Considered an autoimmune reaction. Responds well with anti-inflammatory medications
Dressler syndrome
660
Dressler syndrome will present with:
- Fever
- Chest pain
- Pericardial effusion & pericarditis
- Pleural effusion & pleuritis
661
True or false:
On "cold spot" imaging, acute infarction can be distinguished from remote infarction.
False. It cannot be distinguised from each other.
662
Myocardium that may act like postinfarction scar but remains viable and may improve in function with revascularisation
Hibernating myocardium
663
Myocardium that describes post-ischemic, dysfunctional myocardium without complete necrosis which is potentially salvageable
Stunned myocardium
664
Dilated cardiomyopathy can also be caused by acute myocarditis, most commonly with the etiologic agent
Coxsackie virus
665
Cardiomyopathy with global cardiomegaly seen on chest radiograph
Dilated cardiomyopathy
666
Cardiomyopathy with normal sized heart and pulmonary congestion seen on chest radiograph
Restrictive cardiomyopathy
667
Cardiomyopathy with chest xrays that are normal in 50% and presents with LAE in 30% of cases (because of mitral regurgitation)
Hypertrophic cardiomyopathy
668
Now described as an acquired disorder in infants or adults and is called Arrhythmogenic right ventricular dysplasia (ARVD). Limited to the RV with dilatation of the RV chamber, marked thinning of the ventricular wall and abnormal RV wall motion. MRI may show fatty infiltration of anterior RV free wall (essentially diagnostic)
Uhl anomaly
669
Right ventricular failure secondary to pulmonary parenchymal or pulmonary arterial disease. End result is alveolar hypoxia. Chest x-ray will show normal sized heart or mild cardiomegaly or even a small heart. Symptoms include marked dyspnea and decrease exercise endurance out of proportion to pulmonary function tests.
Cor pulmonale
670
This should be considered whenever the main pulmonary artery and left and right pulmonary arteries are enlarged. Signs of right atrial and ventricular enlargement or hypertrophy or often present. Systolic right ventricular and pulmonary arterial pressures >30 mmHg
Pulmonary arterial hypertension
671
Acyanotic lesions include
ASD, VSD, PDA, and PAPVR
Clue to Acyanotic lesions:
Most have the letter 'D' in their name excluding PAPVR. A good mnemonic is "Dont 'cyanose (Acyanotic) = asD, vsD, pDa"
672
Cyanotic lesions include
TGA, TA (Truncus arteriosus), TAPVR, and Endocardial cushion defects
Clue to Cyanotic lesions:
Most have the letter 'T' in their name excluding endocardial cushion defect.
Tga, Ta, Tapvr.
673
Small heart with decreased pulmonary blood flow may be caused by:
- Hypovolemia
- Malnourishment
- COPD
- Addison
674
Decreased pulmonary blood flow with an enlarged cardiac silhouette include:
- Cardiomyopathy
- Pericardial tamponade
- Ebstein
- Right to left shunts
675
This valvular heart disease is usually caused by rheumatic heart disease in the adult with 50% of patients giving a history of rheumatic heart fever
Mitral stenosis
676
The syndrome is a combination of mitral stenosis with a pre-existing atrial septal defect resulting in marked right-sided enlargement.
"Ms. SAD Lutembacher has Marked right sided enlargement"
Lutembacher syndrome
"MS. SAD Lutembacher (some random european-like surname) has Marked right sided enlargement"
- Mitral stenosis
- ASD
- Lutembacher syndrome
- Marked right sided enlargement
677
Classification of mitral stenosis with <1.5 cm2 area, Normal CXR, Left atrial pressures elevated only on exercise
Mild mitral stenosis
678
Classification of mitral stenosis with <1.0 cm2 area, LAE, Pulmonary venous hypertension, Dyspnea ON EXERTION is common
Moderate mitral stenosis
679
Classification of mitral stenosis with <0.5 cm2 area, marked left atrial enlargement, right ventricular enlargement, Kerly lines, Pulmonary edema and patients are often DYSPNEIC AT REST.
Severe mitral stenosis
680
Mitral regurgitation with normal xray. Classified as mild, moderate, or severe?
Mild Mitral regurgitation
681
Mitral regurgitation on radiography showing atrial enlargement and pulmonary venous hypertension
Moderate mitral regurgitation
682
Mitral regurgitation classification (mild, moderate, severe) on radiography showing progressive left atrial enlargement, left ventricular enlargement, pulmonary venous hypertension, and pulmonary edema.
Severe mitral regurgitation
683
Mitral regurgitation on MRI - Regurgitant jet grading
Turbulent flow extending less than 1/3 the distance to the back wall. What is the grade?
Grade 1
684
Mitral regurgitation on MRI - Regurgitant jet grading
Turbulent flow extending less than 2/3 the distance to the back wall. What is the grade?
Grade 2
685
Mitral regurgitation on MRI - Regurgitant jet grading
Turbulent flow extending more than 2/3 the distance to the back wall. What is the grade?
Grade 3
686
A.k.a "Floppy valve" or Barlow syndrome. Autosomal dominant. More common with pectus excavatum and narrow AP diameters of the chest. "Honking type" murmur or midsystolic click murmur is characteristic. On echocardiogram, characteristic BULGING LEAFLETS (anterior or posterior) during midsystole when valve should remain closed.
Mitral valve prolapse
"Barlow's Floppy, Honking, Bulging Prolapse"
687
Most common type of adult aortic valve stenosis, present in 95% of congenital aortic stenosis
Bicuspid aortic valve
688
Most common valvular heart disease
Aortic stenosis
689
Most common cause of aortic stenosis
Degeneration of the aortic valve / Degenerative calcification of the aortic valve
690
Aortic stenosis with orifice of 13-14 mm and greater than 25 mmHg gradient (Mild, Moderate, Severe?)
Mild aortic stenosis
691
Aortic stenosis with orifice of 8-12 mm and greater than 40-50 mmHg gradient
Moderate aortic stenosis
692
Aortic stenosis with orifice of <8 mm and >100 mmHg gradient (mild, moderate, severe?)
Severe aortic stenosis
693
Most common bacterial agent in bacterial endocarditis
Staphylococcus aureus
694
Radiographic sign for chronic pericardial effusions
Water bottle sign/configuration
695
Minimum amount of fluid for small pericardial effusion and imaging findings on radiographs
<100 mL, appear as anterior and posterior sonolucent region
696
Moderate pericardial effusion
100-500 mL, sonolucent zone around the entire ventricle
697
Very large effusion
>500 mL, extend beyond the field of view and may be associated with "swinging heart" inside the pericardium
698
Serous pericardial fluid on MRI
T1 Dark, Gradient echo Bright
699
Complicated or hemorrhagic effusions on MRI
T1 Bright, Gradient echo Dark
700
Refers to cardiac chamber compression by pericardial effusion under tension, compromising diastolic filling. Clinical exam shows distended jugular veins, distant heart sounds, pericardial rub. Chest radiograph shows rapid enlargement of cardiac silhouette with relatively normal vascularity. (+) pulsus paradoxus
Cardiac tamponade
Pulsus paradoxus is an exaggeration of the usual drop in systolic pressure greater than 10 mmhg during inspiration. It occurs as a paradoxical motion during right ventricular filling.
701
This condition is associated with a widely swinging cardiac silhouette on decubitus view.
Congenital absence of the pericardium
702
Pericardial disease that is associated with the heart shifted towards the left with a prominent bulge of the right ventricular outflow tract, main pulmonary artery, and left atrial appendage. Insinuation of the lung into antero-posterior window and beneath is characteristic
Complete absence of the pericardium
703
Associated conditions with congenital absence of the pericardium:
"VSD is Sequestering DiapHers during Brunch"
VSD = Ventricular septal defect
Sequestering = Sequestration
Diaphers = DIAP-hragmatic HER-nias
Brunch = Brunchogenic cysts (Bronchogenic cysts)
704
Type of cardiomyopathy
Ventricular wall - LV thin
Ventricular cavity - LV dilated
Contractility - Decreased
Compliance - Normal to decreased
Dilated cardiomyopathy
705
Type of cardiomyopathy
Ventricular wall - LV thick
Ventricular cavity - LV normal to decreased
Contractility - Increased
Compliance - Decreased
Hypertrophic cardiomyopathy
706
Type of cardiomyopathy
Ventricular wall - Normal
Ventricular cavity - Normal
Contractility - Normal to decreased
Compliance - Severely decreased
Restrictive cardiomyopathy
707
Type of cardiomyopathy
Ventricular wall - RV thin
Ventricular cavity - RV dilated
Contractility - Decreased
Compliance - Normal to decreased
Uhl anomaly (Limited to Right ventricle)
708
Which ventricle dilatation causes a clockwise rotation of the heart
Right ventricle
Clockwise direction is RIGHTward therefore, RIGHT ventricular dilatation.
709
Which ventricle dilatation causes a counterclockwise rotation of the heart
Left ventricle
Counter-clockwise is LEFT therefore LEFT ventricular dilatation
710
Chamber enlargement producing a "droopy" or "saggy" appearance of the cardiac silhouette
Left ventricle
Droopy or sagging is like downward displacement
711
Specific chamber enlargement depends on the site of the shunt:
Level of great vessels
Pure LEFT side enlargement
712
Specific chamber enlargement depends on the site of the shunt:
If the shunt is at the Ventricular level, what chambers will enlarge?
Predominantly LEFT side enlargement or BIVENTRICULAR enlargement
713
Specific chamber enlargement depends on the site of the shunt:
Shunt is located at the Atrial level
RA & RV undergo enlargement
LEFT side is NOT INVOLVED
714
Most common congenital heart defect
VSD
715
Second most common congenital heart defect
ASD
716
Most common type of ASD
Ostium Secundum
717
Type of ASD that results from the absence or defect in the flap of tissue derived from the septum primum, which covers and closes the foramen ovale.
Ostium secundum
718
Type of ASD that results from maldevelopment of the primitive endocardial cushions.
Ostium primum
Prim for Primitive endocardial cushions
719
Form of Ostium Primum with:
- Common AV valve usually with five leaflets.
- LOW Atrial, HIGH ventricular defects
- Large communication of all four chambers (Cardiomegaly)
- Diastole: GOOSE NECK DEFORMITY of Left ventricular outflow tract
- Systole: MV appears bilobed, irregular, scalloped
Complete form of Ostium Primum
720
Manifests the same as PDA. Communication between the pulmonary artery & aorta just above their valves. Lesions from failure of complete septation of the primitive truncus arteriosus. LA & LV enlargement, pulmo artery dilatation, increased pulmo vascularity and a prominent aorta is seen.
Aortopulmonary window
721
Most common anatomic arrangement of coronary artery fistula
One of the coronary arteries communicating with a cardiac chamber or pulmonary artery
722
Most common coronary artery involved in coronary artery fistula
Right coronary artery (RCA)
723
If a coronary artery fistula affects the right ventricle, which chamber enlarges
RV alone enlarges
724
If a coronary artery fistula affects the right atrium, which chamber enlarges
Both RA & RV enlarge
725
Which type of total anomalous pulmonary venous return will demonstrate a "snowman sign" or "snowman" anomaly
TAPVR Type I (1)
726
Most common type of total anomalous pulmonary venous return
TAPVR Type I (1)
727
Second most common type of total anomalous pulmonary venous return
TAPVR Type II (2)
728
Which types of total anomalous pulmonary venous return are supradiaphragmatic in insertion of the anomalous pulmonary vein
TAPVR Types I & II (1&2)
729
Which type of total anomalous pulmonary venous return is infradiaphragmatic when it comes to insertion of the anomalous pulmonary vein
TAPVR Type III (3)
730
Type of total anomalous pulmonary venous return where the anomalous pulmonary veins terminate at a supracardiac level
TAPVR Type I
731
Type of total anomalous pulmonary venous return where the anomalous pulmonary veins connect at a cardiac level, which drain to the coronary sinus then to the right atrium.
TAPVR Type II
732
Type of total anomalous pulmonary venous return where the anomalous pulmonary veins join into a common vertical descending vein behind the left atrium, passing through the esophageal hiatus of the diaphragm, then joining the portal system.
TAPVR Type III (3)
733
This congenital heart disease is described when all systemic and pulmonary venous blood goes to the right atrium and nothing drains to the left atrium
TAPVR
734
A right-to-left shunt is required for survival in these congenital heart anomalies
TAPVR, TGA
For TAPVR: PATENT FORAMEN OVALE or less commonly, an ASD, is needed for survival
For TGA:
- VSD
- ASD with PDA is needed for survival
735
A right-to-left shunt that is required for survival in a patient with total anomalous pulmonary venous return
- Large patent foramen ovale (more common)
- ASD (less common)
736
Type of patent truncus arteriosus that is now identified by the term "pulmonary atresia/agenesis with VSD and systemic collaterals"
Type IV
737
Most common type of patent truncus arteriosus
Type I
Both the aorta and main pulmonary artery arise from a common trunk, "Near" normal position
738
Type of patent truncus arteriosus wherein the pulmonary arteries arise separately from the posterior aspect of the trunk close to each other, or just above the valve.
Type 2
739
Type of patent truncus arteriosus that is the least common, wherein the pulmonary arteries arise independently from either side of the trunk
Type 3
740
Most common cyanotic congenital cardiac anomaly in the newborn period
Transposition of the great arteries/vessels (TGA/TGV)
741
An isolated TGA is incompatible with life at birth without one of the following additional anomalies
- VSD (most commonly associated)
- PDA (unstable due to closure at birth)
- ASD (uncommon)
- PFO (Patent foramen ovale, unstable)
742
Most commonly involved ventricle in Single Ventricle congenital cardiac anomaly
Underdevelopment of the RIGHT VENTRICLE
743
Congenital cardiac anomaly described as "Coeur en Sabot"
Tetralogy of fallot
"Coeur en sabot" means Boot-shaped heart
744
Components of Tetralogy of Fallot:
"V.a.P.O.R"
V = VSD
a = (some cases only) absence of pulmonary artery & pulmo valve, artery coarctations
P = Pulmonary stenosis
O = Overriding aorta
R = RVH
745
Critical component of Tetralogy of Fallot hemodynamically
Pulmonary stenosis
- Results in right ventricular hypertrophy
- regulates the degree of R-L shunting and aortic overriding
746
Hypoplastic right heart syndrome components
- Tricuspid atresia and stenosis
- Pulmonary atresia
- Hypoplastic RV
747
The bulge that has resulted in the so-called appearance of a squared or box shaped heart in Ebstein's anomay results from
Elevated "residual" RV
748
In this congenital cardiac anomaly, there is focal or complete absence of the right ventricle myocardium and the right ventricle becomes a thin-walled fiber elastic bag. Contracts poorly and impedes the emptying of blood from the right side of the heart. Tricuspid efficiency is also present. Cyanosis results from right to left shunting.
Uhl's disease
749
This cardiac anomaly will have angiocardiographical findings of a small bulbous or spherical right ventricle. On MRI, It will present as a lumenless, right ventricular muscle mass.
Hypoplasia of the right ventricle
750
Infantile hypercalcemia syndrome a.k.a "William's syndrome" presents with ELFin facies (Looks like an Elf). Which type of congenital valvular disease is associated with this?
Aortic stenosis (Supravalvular type)
751
This valvular pathology results in systemic overload and hypertrophy of the LV and in severe cases, enlargement of the LA. "Firm" or "Well rounded" appearance of the left side of the heart on CXR PA view. Prominence of the ascending aorta and aortic knob also noted. What is likely the valvular pathology?
Aortic stenosis / Valvular aortic stenosis
752
"Figure of 3" sign well-demarcated on CXR, Aortic knob is higher in appearance but shows NO PRESSURE GRADIENT across area of kinking
PSEUDOcoarctation of aorta
753
True or False:
PDA is always present in the Preductal/Isthmic/Infantile type of Coarctation of Aorta.
True
754
True or False:
VSD is also always present in the Preductal/Isthmic/Infantile type of Coarctation of Aorta
False. VSD is OFTEN present only. ASD is the only one that is ALWAYS present in this type of Coarctation.
755
A variable length of the aortic arch is absent or atretic, and blood is delivered to the descending aorta through a PDA. Locations include distal to the subclavian artery, distal to the left common carotid artery, or between the left common carotid and innominate arteries.
Interrupted Aortic Arch
756
Rare congenital anomaly with abnormal hemodynamics similar to congenital mitral stenosis. An extra chamber is present proximal to the left atrium, representing persistence of the common pulmonary vein and in which the pulmonary veins drain. Symptoms are similar to MS but differ in a way because there is ABSENCE of left atrial enlargement.
Cor triatriatum
757
Most common type of dextrocardia
"Mirror image dextrocardia"
758
Cardiac apex points to the right and there is complete inversion of the cardiac chambers. LA and LV become right sided and the RA and RV become left-sided. Normal anteroposterior chamber relationships.
Dextrocardia
759
Extreme right-sided rotation of the heart. Cardiac chambers lose their normal anteroposterior relationships. Chamber inversion does not occur. RA and RV becomes more posterior but remain on the right. LA and LV become anterior but remain on the left.
Dextroversion
760
Heart lies midline, halfway between normal levoposition and abnormal dextroposition and can be considered incompletely dextroverted. Apex points anteriorly.
Mesoversion
761
Chamber of the heart that is most commonly affected in idiopathic cardiomyopathy
Left ventricle
762
Most common PERICARDIAL tumor noted in childhood and especially in infancy is...
Pericardial teratoma
763
Most common cause of arterial aneurysm in the pediatric age group
Mycotic aneurysm secondary to infection due to umbilical artery catheterization
764
Imaging study used to document urinary tract stones
CT scan
765
Imaging study used to confirm and identify the cause of ureteral obstruction
CT scan
766
Imaging study for bowel ischemia and infection
Contrast-enhanced MDCT
767
Imaging study for hemochromatosis
MRI
768
Preferred SCREENING method for biliary obstruction
Ultrasound
769
Imaging study that provides excellent visualization of the biliary tree
MRCP
770
Imaging study used primarily to guide therapy such as stent placement for biliary strictures, stone extraction and sphincterotomy
ERCP
771
Imaging study utilizing technetium-99m and is useful for showing patency of biliary-enteric anastomosis and for demonstrating bile leaks and fistulae
Radionuclide scanning
772
Imaging study performed by using agents such as iopanic acid formerly used for oral cholecystectography
CT cholangiography
773
Imaging study that provides the most comprehensive initial assessment for the pancreas
Contrast-enhanced MDCT
774
Imaging study that is useful for follow-up specific abnormalities of the pancreas
Ultrasound
775
Imaging study that provides accurate tumor staging for the pancreas
CT with IVC and CT angiography
776
Imaging study that confirms functioning splenic tissue
Radionuclide scans
777
Primary imaging modality of stage of lymphoma
CT scan
778
Most common cause of pneumoperitoneum
Duodenal or gastric ulcer perforations
779
Most common calcified lymph nodes in the abdomen
Mesenteric nodes
780
Most common narrowed areas in ureter that trap calculi
- Ureteropelvic junction
- Pelvic brim
- Ureterovesical junction
781
Most common cause of toxic megacolon
Acute ulcerative colitis
782
Most specific sign of strangulation obstruction
Lack of enhancement of the bowel wall
783
Most common area where gallstone lodges in gallstone ileus
Distal ileum
784
Most common location of colonic obstructions
Sigmoid colon
785
Most common type of cecal volvulus
Twist and invert
786
Most common cause of large bowel obstruction in elderly and bedridden patients
Fecal impaction
787
Most common sarcoma of the retroperitoneum
Liposarcoma
788
Most common site of abscess formation
Pelvis
789
Most common GI malignancy associated with AIDS
Kaposi sarcoma
790
Most common abnormality demonstrated by hepatic imaging
Fatty liver
791
Most common cause of fatty liver
Alcoholic liver disease and Nonalcoholic fatty liver disease (NAFLD)
792
Most common area/segment involved in focal fatty sparing in the liver
Segment IV (4)
793
Most common locations of focal fat
Falciform ligament, gallbladder fossa, and porta hepatis
794
Most common cause of Budd-Chiari syndrome in western countries
Coagulation disorders
795
Most common cause of budd-chiari syndrome in asian countries
Membranous webs obstructing the hepatic veins and IVC
796
Most common malignant masses in the liver
Metastases
797
Most common primary malignancies to produce hypovascular metastases
"Hypovascular Colored P.L.U.G"
Colorectal
Prostate
Lung
Uroepithelial
Gastric carcinomas
798
Most common benign liver neoplasm and second to metastasis as the most common cause of liver mass
Cavernous hemangioma
799
Most common primary malignancy of the liver
Hepatocellular carcinoma
800
Second most common benign liver tumor
Focal nodular hyperplasia
801
Most common primary tumors associated with intraluminal biliary metastases
Colorectal cancers
802
Second most common malignant hepatic tumor
Cholangiocarcinoma
803
Most common cause of cholecystoduodenal fistula
Gallstone (a complication of)
804
Most common cause of chronic pancreatitis
Alcohol abuse (70%) and stone disease (20%)
805
Second most common digestive tract malignancy
Pancreatic adenocarcinoma
806
Most common pancreatic cystic lesions
Pseudocysts
807
Most common imaging appearance of serous cystadenomas
Honeycomb microcysts with innumerable small cysts (1-2mm)
808
Most common location of mucinous cystic neoplasm of the pancreas
Pancreatic tail
809
Most common location of intraductal papillary mucinous neoplasms in the pancreas
Uncinate process
810
Most common malignant tumor involving the spleen
Lymphoma
811
Most common cause of neurologic dysfunction of neuromuscular disorders
Cerebrovascular disease and stroke
812
Most common type of hiatal hernia
Sliding hiatal hernia
813
Most common type of paraesophageal hernia
Mixed compound hiatal hernia
814
Most common location of the lateral pharyngeal diverticula
Tonsillar fossa and Thyrohyoid membrane
815
Most common cause of esophageal ulceration
Reflux esophagitis
816
Most common cause of infectious esophagitis
Candida albicans
817
Least common part of the GI tract involved in tuberculosis
Esophagus
818
Most common cause of esophageal stricture
Reflux esophagitis (GERD)
819
Most common location of webs in the cervical esophagus
Distal to the cricopharyngeal impression
820
Most common form of cancer in pharyngeal and esophageal carcinoma
Squamous cell carcinomas
821
Most common benign neoplasm of the esophagus
Leiomyomas
822
Most common site of involvement of primary GI lymphoma
Stomach
823
Most common mesenchymal tumors to arise from the GI tract
Gastrointestinal stromal tumors (GIST)
824
Most common form of gastritis
H. pylori gastritis
825
Most common cause of thickened gastric folds
H.pylori gastritis
826
Most common cause of phlegmonous gastritis
Alpha hemolytic streptococcus
827
Most common location of varices in the stomach
Fundus
828
Most common location for neoplasm in the stomach
Distal stomach
829
Most common part of the duodenum associated with malignancy
Fourth portion of the duodenum
830
Most frequent malignant tumor of the duodenum
Duodenal adenocarcinoma
831
Most common primary tumors involved with metastases of duodenum
Breast, Lung and other GI malignancies
832
Most common location of GIST in the duodenum
Second and third portion of the duodenum
833
Second most common primary malignant tumor of the duodenum
Malignant GISTs
834
Most common congenital anomaly of the pancreas
Annular pancreas
835
Most common neoplasm of the small intestine
Carcinoid
836
Most common bowel involved in lymphomas
Small bowel
837
Most common site for extranodal origin of lymphomas
GI tract
838
Most common site of implantation of metastases in the small bowel
Terminal ileum, cecum, and ascending colon
839
Most common location of lipoma in the GI tract
Ileum
840
Mostly common location of Peutz-Jeghers syndrome
Jejunum
841
Most common location of juvenile GI polyposis
Colon
842
Most common solid mesenteric mass
Lymphoma
843
Most radiosensitive organ in the abdomen
Small bowel
844
Most common location of small bowel diverticula
Jejunum along the mesenteric border
845
Most common congenital anomaly of the GI tract
Meckel diverticulum
846
Most common malignancy of the GI tract
Colorectal adenocarcinoma
847
Most commonly involved bowel in radiation colitis
Rectosigmoid
848
Most common location of fistulas in acute diverticulitis
Bladder, vagina, and skin
849
Most common cause of acute abdomen
Acute appendicitis
850
Most common tumor of the appendix
Carcinoid
851
Most common location for carcinoid tumour accounting for 60% of all carcinoids
Appendix
852
Most common cause of gastric outlet obstruction
Edema or spasm from ulcer
853
Abdominal radiographic finding of adynamic ileus
Seen on abdominal radiographs as dilated small and large bowels with multiple air fluid levels on upright projection
854
True or false:
Portal venous gas on radiograph may be described as branching tubular lucency/ies seen at the periphery of the liver
True.
855
Most useful radiographic view to evaluate lesions in the distal esophagus
Double contrast Upright Left posterior oblique view (LPO view)
856
A 40 year old female presented with chest pain and dysphagia. Esophagogram revealed intermittently absent peristalsis in the thoracic portion of the esophagus producing alternating areas of narrowing. What is the diagnosis?
Diffuse esophageal spasm
857
What esophageal motility disorder presents as decreased or absent primary peristalsis in the mid to distal esophagus and not associated with non peristaltic contractions?
Gastroesophageal reflux (GERD)
858
True or false:
In GERD, Double contrast esophagogram shows fine nodular or granular appearance in the distal third of the esophagus
True
859
Most common submucosal mass of the esophagus
Leiomyoma
860
A stricture is present in the mid portion of the esophagus and is often associated with hiatal hernia. The walls of the stricture are irregular, flat and stiffened. Metaplasia of the esophagus. Considered a precursor of esophageal adenocarcinoma.
Barrett's esophagus
861
True or false:
Gastrointestinal stromal tumor (GIST) has malignant potential.
True
862
True or false:
Barrett's esophagus is not associated with esophageal adenocarcinoma.
False. There is an association of malignant potential in Barrett's esophagus such as esophageal adenocarcinoma.
863
True or false:
Presence of mass effect is not a major CT criteria used in staging esophageal cancer.
True.
864
A 50 year old man presented with dysphagia. Esophagogram shows a solitary outpouching in the right side of the distal esophagus. What is the diagnosis?
Epiphrenic diverticulum
865
Most common site of esophageal perforation secondary to endoscopic procedures
Cervical esophagus
866
True or false:
With esophageal traction type of diverticulum, it will appear as a solitary, triangular, or tented outpouching
True
867
Narrowed tubular stomach with smooth contour but having decreased or absent mucosal folds that is predominantly seen in the gastric body of fundus in barium contrast study
Atrophic gastritis
868
A flat round object was accidentally swallowed by a three year old boy and lodged in the esophagus would be oriented in what plane
Coronal
869
What description of ulcer favors a malignant type
When viewed in profile, ulcers do not project beyond the expected gastric contour
870
Type of polyp which has a malignant potential
Adenomatous polyps
871
A 55 year old male with long history of NSAID intake presented with dyspepsia and epigastric pain. esophagogram revealed punctate collections of barium surrounded by radiolucent halos. Diagnosis?
Erosive gastritis
872
A contrast CT scan feature suggestive of a benign gastric tumor
Uniform diffuse enhancement
873
Most common incidental finding in the duodenum seen on upper GI studies
Diverticula
874
Presence of intestinal wall pneumatosis and portal venous gas in patients with obstruction may be signs of...
Ischemia and infarction
875
What is the most common cause of small bowel obstruction in Adults
Adhesions
876
True or false:
Barium studies in gastric volvulus is useful in demonstrating gastric outlet obstruction.
True
877
A major risk factor in the pathogenesis of gastric carcinoma
H.pylori infection
878
True or false:
Gastric carcinoma can extend through regional lymphatics into the retroperitoneum causing ureteral obstruction.
True
879
True or false:
Dysfunction of the small bowel muscles will result in irregular, distended, or nodular thickening of the bowel loops.
False. Infiltration by cells or non-fluid material (primary or secondary involvement of tumor) will result in irregular, distended, or nodal or thickening of the bowel loops.
880
True or false:
Majority of the gastric lymphomas are non-hodgkin's lymphoma
True.
881
True or false:
Stomach is the most commonly involved portion in the gastrointestinal system in lymphoma.
True
882
A barium study of a 10 year old male with colicky abdominal pain showed convoluted, long, linear filling defects in the distal ileum. What is the diagnosis?
Ascariasis
883
What mesenteric lesion would present as "sandwich sign" on CT scan study?
Lymphoma
884
Barium study of a 17 year old patient with abdominal pain and diarrhea showed thickened bowel wall folds in the distal ileum with alternating areas of normal and deep bowel ulcerations. What is the diagnosis?
Crohn disease
Think "Crown". A crown has high and low areas like alternating areas of normal and deep bowel ulcerations
885
Most common location of small bowel tuberculosis
Ileocecal area
886
CT scan finding of a 10 year old boy with abdominal pain showed outpouching in the antimesenteric side of the distal ileum is indicative of what disease?
Meckel diverticulitis
887
What is the radiographic manifestation of diabetic gastroparesis?
Absent gastric peristalsis and gastric dilatation
888
True or false:
Crohn disease will demonstrate multifocal, symmetric pattern of mural enhancement.
False. Asymmetric pattern
889
Conditions that cause an extrinsic impression on the duodenum:
- Hypertrophy of the caudate lobe
- Presence of mass in the right kidney
- Presence of mass in the right side of the colon
890
The most common gluten-related disorder and is a T-cell mediated autoimmune chronic gluten intolerance condition characterized by a loss of villi in the proximal small bowel, seen radiographically as decreased mucosal folds and increased thickened folds in the ileum with gastrointestinal malabsorption.
Celiac disease
891
True or false:
A polyposis syndrome such as Cowden's disease has a higher risk for developing breast and thyroid cancers
True
892
This small bowel malignancy can cause aneurysmal dilatation of the bowel
Lymphoma
893
CT scan findings of a 56 year old patient with abdominal pain showed annular constricting mass in the jejunum with associated asymmetric wall thickening of the involved bowel. What is the most likely diagnosis?
Adenocarcinoma
894
Most common route of metastatic spread to the small bowel
Intraperitoneal
895
What is the hallmark of mechanical bowel obstruction
Point of transition between dilated and non-dilated bowel loops
896
True or false:
Decreased bowel wall enhancement on CT scan is highly specific for acute bowel ischemia
True
897
Ultrasound findings in a 45 year old male revealed herniating structures in the inguinal region that are lateral to the inferior epigastric vessels. What is the diagnosis?
Indirect inguinal hernia
898
What bowel segment commonly herniates in a left inguinal hernia?
Sigmoid colon
899
On barium studies, what radiographic view is helpful to demonstrate anterior abdominal wall hernia?
Lateral upright view with valsalva maneuver
900
What abdominal aortic branch is commonly involved in acute mesenteric ischemia?
Superior mesenteric artery
901
What is the most important indication for CT colonography?
To screen colorectal carcinoma
902
What condition results when a loop of small intestine, with part of its mesentery, invaginates into the lumen of a bowel segment distal to it?
Intussusception
903
Most common location of colorectal carcinoma
Rectum
904
True or false:
Ulcerative colitis will present with confluent shallow ulcerations, granular mucosa, and symmetric disease around the lumen
True
905
Most frequent complication of colorectal carcinoma
Obstruction
906
This disease entity in the right lower abdomen will appear as an incompressible tubular structure with an AP diameter of larger than 7(or >6) mm in ultrasound.
Appendicitis
907
What condition is present if the CT scan findings is a tubular, cystic mass with a calcified wall in the right lower quadrant of the abdomen, adjacent to the cecum?
Mucocele of the appendix
908
A patient with congestive heart failure presents with imaging findings of a swollen liver showing reflux of contrast material into the distended hepatic veins and inferior vena cava. What is the diagnosis?
Passive hepatic congestion
909
What fatty liver disease manifests as a geographic pattern of increased echogenicity?
Focal fatty sparing
910
A 40 year old female presents with a 2-cm well-defined hypodense mass in the periphery of the liver. Contrast-enhanced CT study shows homogeneous enhancement in early arterial phase and remains isodense with the portal vein in the portal venous phase. What is the diagnosis?
Focal nodular hyperplasia
911
True or false:
Hepatocellular carcinoma is predisposed to invade the biliary ducts.
False. Hepatocellular carcinoma is predisposed to invade the portal vein.
912
What primary carcinoma usually produces a bullseye or target type of hepatic metastases
Bronchogenic carcinoma
913
This feature differentiates a focal fatty infiltration from a hepatic mass
Angular or interdigitating geometric margins
914
Role of ultrasound imaging in hepatitis
It is done to ensure that there is no biliary obstruction as the cause of liver disease.
915
True or false:
There is hepatofugal flow in advanced liver cirrhosis on doppler studies.
True
916
True or false:
Ultrasound finding of stones within the biliary tree - Small stones layer in the dependent area with its anterior portion outlined by the bile producing a crescent sign
True
917
A 12 year old female with abdominal pain and jaundice presented with a right upper quadrant cystic mass that appears continuous to the common bile duct. What is the diagnosis?
Choledochal cyst
918
True or false:
Adenomyomatosis of the gallbladder may present as a small polypoid mass fixed to the gallbladder wall.
True
919
Imaging findings of a 50 year old diabetic female patient with abdominal pain shows the presence of cholelithiasis, with the gallbladder wall exhibiting dirty shadowing that has an arc-like configuration. What is the diagnosis?
Emphysematous cholecystitis
920
True or false:
Porcelain gallbladder has an associated risk of developing gallbladder carcinoma.
True
921
The most common vascular complication after liver transplantation
Hepatic artery thrombosis
922
Features of chronic pancreatitis:
- Decreased volume of pancreatic tissue
- Dilated pancreatic duct
- Calcifications in the pancreatic body
923
A favorable prognostic factor which may indicate surgical resectability of pancreatic carcinoma
Isolated mass with or without dilatation of the bile or pancreatic ducts
924
A patient with vomiting and weight loss shows a plain radiographic finding of a "double bubble' sign. On esophagogram, the distal aspect of the stomach is elongated and narrowed. What is the diagnosis?
Hypertrophic pyloric stenosis
925
True or false:
Regarding tumors of the spleen on sonography, metastatic lesions appear as small hemorrhages.
True
926
Characteristic finding of a small round fat containing mass with stranding of the adjacent colon. It is usually seen in the left lower quadrant.
Epiploic appendagitis
927
Conventional radiograph diagnostic of ascites require at least how many mL of fluid to be present
500 mL
928
Sign of ascites described as appearance of symmetric densities due to spilling out of the cul-de-sac on either side of the bladder
"Dog's ears" sign
929
Gelatinous ascites or "Jelly belly". Results from rupture of appendiceal mucocele, intrapersonal spread of benign or mucinous cysts of the ovary, or mucinous adenocarcinoma of the colon or rectum. On x-ray, punctate or ring-like calcifications scattered throughout the peritoneal cavity. On CT scan, mottled densities, septations and calcifications within the fluid. On ultrasound, hypoechoic to strongly echogenic intraperitoneal nodules.
Pseudomyxoma peritonei
930
Sign of pneumoperitoneum - Gas on both sides of the bowel wall
Rigler sign
931
Sign of pneumoperitoneum - gas outlining the peritoneal cavity
"Football sign"
932
Calcifications that are plaque-like and oval in configuration conforming to the size and shape of the gallbladder
Porcelain gallbladder
933
Most common component of gallstones
Calcium bilirubinate
934
Suspension of radiopaque crystals within the gallbladder bile
Milk of calcium bile
935
"Rice grain" calcifications in muscles may be suggestive of...
Cysticercosis
"cystRICErcosis"
936
Nodular or sheet-like peritoneal calcifications are most commonly from...
- Peritoneal dialysis
- Previous peritonitis
- Peritoneal carcinomatosis
937
Refers to a segment of intestine that becomes paralyzed & dilated as it lies next to an inflamed intraabdominal organ. Alerts one on the presence of an adjacent inflammatory process.
Sentinel loop
938
This is a manifestation of fulminant colitis characterized by extreme relation of all or a portion of the colon. In this state, peristalsis is absent and the large bowel loses all stone and contractility. Bowel wall becomes like a "wet blotting paper" and the risk of perforation is extreme.
Toxic megacolon
939
Term applied to necrotizing fasciitis of the perineum, perianal, and genital regions. Polymicrobial organisms cause rapid tissue destruction. On radiographs and CT scans, bubbles and streaks of gas are seen in affected soft tissues.
Fournier gangrene
940
A strong radiographic evidence of small bowel obstruction where air fluid levels at different heights are seen within the same loop
"Dynamic air-fluid levels"
941
A strong evidence of bowel obstruction wherein particulate feculent matter mixed with gas bubbles is seen within the small bowel
"Small bowel feces" sign
942
Most characteristic sign of small-bowel obstruction on CT scan
"Step ladder" or "hairpin loops" of small bowel
943
Most common type of intussusception
Ileocolic
944
Second most common type of intussusception
IleoIleocolic
945
Most common cause of intussusception in adults
GI malignancy (Colorectal cancer)
946
"Coiled spring" appearance on barium studies
Intussusception
947
A cause of bowel obstruction that presents with alternating hyperechoic and hypoechoic rings representing alternating mucosa, muscular wall, and mesenteric fat tissues in cross-section exhibit a "doughnut" configuration on ultrasound
Intussusception
948
Rigler triad in gallstone ileus
- Dilated small bowel loops
- Air in the biliary tree or gallbladder (Pneumobilia)
- Ectopic Gallstone
949
Sigmoid volvulus - what sign is expressed when the apex of the distended sigmoid colon may extend cephalad to the transverse colon
Northern exposure sign
950
Sigmoid volvulus - what sign is demonstrated when oblique lines are created by the orientation of the transition zones of obstruction
"X-marks the spot" sign
951
Sigmoid volvulus - single narrowing point of transition corresponding to what sign on barium enema
Beak sign
952
Coffee bean shaped loop of gas distended bowel having haustral markings, direct with its apex directed towards the left upper quadrant.
Cecal volvulus
(The term coffee-bean shaped bowel loop was mentioned in radiopedia that it could be used as a general term for closed-loop obstruction. In Brant, however, this is specifically written under the Cecal volvulus portion of the chapter. Answer with main reference or specialty books in mind)
953
Clinical disorder of acute colonic distention with abdominal pain but without the presence of mechanical obstruction. Current theory is imbalance in autonomic innervation of the colon.
Colonic pseudoobstruction
954
Poor enhancement of the bowel wall along its mesenteric border is evidence of...
Bowel Ischemia
955
Poor or absent mucosal enhancement with thinning of the bowel wall is evidence of...
Bowel infarction
956
In lymphoma, this sign refers to entrapment of mesenteric vessels by masses of enlarged lymph nodes in the mesentery
Sandwich sign
957
In lymphoma, this sign refers to masses of retroperitoneal nodes that silhouette segments of the normal echogenic wall of the aorta.
Sonographic silhouette sign
958
CT scan findings include nodular, irregular peritoneal and omental thickening and masses which merge to large plaques and cake-like thickening of the omentum. What is the disease and sign being described?
Peritoneal mesothelioma, "Omental cake" sign
959
CT scan demonstrates tumor nodules on peritoneal surfaces. What is the disease and sign being described?
Peritoneal metastasis, "Omental cake" sign (Also seen in Peritoneal mesothelioma)
960
Most common sarcoma of the retroperitoneum
Liposarcomas
961
Abdominal wall hernia that is not reducible
Incarcerated hernia
962
Abdominal wall hernia that is associated with bowel obstruction and bowel ischemia
Strangulation hernia
963
Abdominal wall hernia that entraps only a portion of the bowel wall without compromising viability. Also known as parietal hernias.
Richter hernia
964
Type of inguinal hernia that extends through the internal inguinal ring into the inguinal canal lateral to the inferior epigastric vessels
Indirect inguinal hernia
965
Type of inguinal hernia that occurs medial to the inferior epigastric vessels directly into the inguinal canal
Direct inguinal hernia
966
Abdominal wall hernia that is formed from complications of surgery with herniation through a surgical incision
Incisional hernia
967
Abdominal wall hernia that occurs through defects in the lumbar musculature posterolaterally below the 12th rib and above the iliac crest
Lumbar hernia
968
Abdominal hernia wall hernia that occurs in the lower abdominal wall lateral to the rectus abdominis and inferior to the umbilicus through a defect in the aponeurosis of the transversus abdominis and internal oblique muscles
Spigelian hernia
969
What sign is exhibited when fatty liver is dark on CT scan and bright on Ultrasound?
"Flip-flop" sign
970
Most common type of nodule in cirrhosis
Regenerative nodules
971
Type of dysplastic nodules in cirrhosis:
- minimal atypia
- not premalignant
- no mitosis
- no arterial phase enhancement
- supplied by portal vein
Low-grade dysplastic nodules
- also progress to high-grade nodules
972
Type of dysplastic nodules in cirrhosis:
- moderate atypia
- occasional mitosis
- secrete AFP
- premalignant, not frankly malignant
- blood supply from hepatic artery
- show arterial phase enhancement
High-grade dysplastic nodules
973
This liver pathology produces a characteristic "nodule within a nodule" appearance seen as a high signal focus within a low-intensity nodule. The high signal focus enhances avidly on arterial phase.
HCC (small)
974
Signs of pharyngeal dysfunction:
Defined as entry of barium into the laryngeal vestibule without the passage below the vocal cords
Laryngeal penetration
975
Signs of pharyngeal dysfunction:
Defined as barium passage below the vocal cords.
Aspiration
976
Signs of pharyngeal dysfunction:
Occurs when the soft palate does not make a good seal against the posterior pharyngeal wall.
Nasal regurgitation
977
Esophageal plaques that appear as longitudinally oriented linear or irregular discrete filling defects in white with intervening normal-appearing mucosa
Candida albicans (Infectious esophagitis, Candidiasis)
978
Esophageal strictures are typically smoothly tapering with concentric narrowing
Benign structures
979
Esophageal strictures that are abrupt, asymmetric, eccentric in location, with irregular nodular mucosa
Malignant strictures
980
On barium studies, this may present as smooth, long-segment narrowing of the esophagus or a series of ring-like structures called "ringed esophagus". Treatment is steroids.
Eosinophilic esophagitis
981
A pathologic ring-like structure at the level of the b-ring caused by reflux esophagitis
Schiatski ring
982
Most common radiographic pattern of esophageal carcinoma
Annular constricting lesion - appearing as an irregular ulcerated stricture
983
Rupture of the esophageal wall as a result of forceful vomiting. Always in the left posterior wall near the left crus of the diaphragm.
Boerhaave syndrome
984
Trauma to the esophagus by violent retching. Only involves the mucosa and not the full thickness of the esophagus. On upper GI series, represents a longitudinally oriented barium collection 1-4 cm in length, in the distal esophagus
Mallory-Weiss tear
985
Morphological growth pattern that can differentiate gastric carcinoma from lymphoma or vice versa
Gastric carcinoma = FOCAL plaque with central ulcer
Lymphoma = MULTIPLE submucosal nodules
But BOTH have growth patterns of:
- Polypoid mass
- Ulcerative mass
- Diffuse infiltration
986
This term is used to describe diffuse gastric mucosal involvement of adenocarcinoma leading to THICKNESS and RIGIDITY of the stomach. It may be likened to the appearance of a "water bottle" stomach.
Linitis plastica
987
Defects in the gastric mucosa that do not penetrate beyond the muscularis mucosae. These heal WITHOUT SCARRING.
Erosions
988
Complete erosions of the gastric mucosa and appear as tiny central flock of barium surrounded by radiolucent halo of edema on barium studies.
Aphthous ulcers
989
Chronic autoimmune disease of the stomach that destroys fundic mucosa but SPARES ANTRAL mucosa. Upper GI series findings of decreased or absent folds in the fundus or in the body termed "Bald fundus"
Atrophic gastritis
990
Acute, often fatal, bacterial infection of the stomach most commonly caused by alpha hemolytic streptococcus. Multiple abscesses are formed in the gastric wall and rugae are swollen.
Phlegmonous gastritis
991
Form of phlegmonous gastritis caused by gas-producing organisms such as E.coli and Clostridium. Caused by caustic ingestion, surgery, trauma, or ischemia.
Emphysematous gastritis
992
Characterized by diffuse infiltration of the stomach and small bowel by eosinophils. Any or all layers may be involved. When chronic, the gastric antrum is narrowed with nodular, "cobblestone" mucosal pattern.
Eosinophilic gastroenteritis
993
A.k.a "Giant hypertrophic gastritis" characterized by excessive mucus production, giant rugal hypertrophy, hypoproteinemia and hyperchlorhydria. Upper GI series show markedly enlarged and tortuous but pliable folds in the fundus and body, especially along the greater curvature, with sparing of the antrum. Hypersecretion has diluted the barium and impaired mucosal coating.
Menetrier disease
994
Ulcers with the following signs are considered benign or malignant?
- Ulcer within the lumen of the stomach
- Ulcer eccentrically located
- Shallow ulcer
- Width greater than depth
- Nodular, Rolled, Irregular or shouldered edges
- "Carmen meniscus sign"
Malignant ulcers
"Carmen meniscus sign" - large, flat based ulcers with heaped up edges that fold inward to trap a lens-shape collection that is convex towards the lumen.
995
Ulcers with the following signs are considered benign or malignant?
- Ulcer with smooth mound and tapering edges
- Edematous ulcer collar with overhanging mucosal edge
- Ulcer projecting beyond the expected lumen
- Radiating folds extending into the crater
- Depth greater than width
- Hampton line
Benign ulcers
Hampton line = thin, sharp, lucent line that traverses the orifice of the ulcer
996
The most common location of BENIGN pathologies or mass lesions among the segments of duodenum?
D1 or Duodenal bulb
B-ulb B-enign
997
Bilobed "dumb-bell" shaped enhancing mass in the duodenum
Duodenal adenocarcinoma
D-umbbell D-uodenal adenocarcinoma
998
Type of duodenal adenomas with a high incidence of malignant degeneration and characteristic "cauliflower" appearance on double contrast upper GI series.
Villous adenomas
999
Most common solid mesenteric mass in lymphoma
Bulky adenopathy
1000
Congenital, partial, or complete replica of the small bowel. Arise from the distal small bowel and may communicate with normal intestinal lumen at one or both ends or not at all
GI duplication cyst
1001
Produces atrophy of the muscularis of the small bowel by the process of progressive collagen deposition resulting in flaccid and dilated bowel. "Hide-bound" appearance of thinned folds tethered together is produced by contraction of the longitudinal layer to a greater extent than the circular layer. Duodenum and Jejunum are more severely involved in the ileum.
Scleroderma
1002
Mucosa becomes flattened and absorptive cells decrease in number, villi disappear but submucosa, muscular, and serosa remain normal. Radiographic findings include dilated small bowel, normal or thinned folds, decreased number of folds in the duodenum and jejunum and increased number of folds in the ileum.
Adult celiac disease
1003
Most common submucosal tumor of the colon
Lipoma
1004
Most susceptible bowel segments to ischemic colitis due to them being watershed areas
Splenic flexure & Descending colon
1005
An acquired condition in which the mucosa and muscularis mucosae herniate through the muscularis propria of the colon wall producing a circular outpouching.
Colon diverticulosis
1006
Major risk factor for diverticulosis
Low-residue diet
1007
True or false:
The saccular outpouchings in colon diverticulosis lack all the elements of the normal colon wall
True
1008
Ectasia and kinking of mucosal and submucosal veins of the colon wall. Maze of distorted, dilated vascular channels replaces the normal mucosal structures and is separated from the bowel lumen only with a layer of epithelium. On angiography, tangled vessels without an associated mass may be seen.
Angiodysplasia
Angio- = vessel
-Dysplasia = abnormal, disorderly, distorted, tangled
1009
Modality of choice for adrenal metastases
CT scan
1010
Diagnostic method of choice in angiomyolipoma
MDCT
1011
Effective in localizing pheochromocytoma
Radionuclide 131
1012
Used to determine the chemical composition of stones
Dual-energy CT scan
1013
Excellent screening modality for determining the presence of urinary tract dilation
Ultrasound
1014
Used for confirmation of vesicoureteral reflux
VCUG or Radionuclide Cystography
1015
Demonstrates urethral abnormality
Retrograde urethrography (RUG) or Voiding Cystourography (VCUG)
1016
Used to stage known bladder carcinoma
Cross-sectional imaging and cystoscopy
1017
Determines nodal metastases in transitional cell carcinoma
Biopsy
1018
What planes or views Improve the accuracy of staging transitional cell carcinoma on MRI?
Coronal and sagittal planes
1019
Modality used to study the anterior male urethra
Retrograde urethrogram (RUG)
1020
Demonstrate the distention of both the posterior and anterior urethra
Voiding cystourethrography (VCUG)
1021
Modality of choice for assessing the female urethra
Voiding cystourethrography (VCUG) or by retrograde urethrography (RUG)
1022
Other modalities that may be used to image the female urethra aside from voiding cystourethrography (VCUG) or retrograde urethrogram (RUG)
- Transrectal or perineal ultrasound
- CT scan
1023
Imaging method of choice for showing extent of carcinoma of the urethra
MRI
1024
Primary modality for imaging of the female genital tract
Transvaginal or transabdominal ultrasound with Doppler techniques
1025
Used to stage and follow-up pelvic malignancies and to supplement ultrasound by providing additional characterization of lesions
CT and MRI
1026
Best for characterization of size, number, and location of leiomyomas
MRI
1027
Best for the detection of adenomyosis
MRI
1028
Most effective for the diagnosis of adnexal tumors
Ultrasound
1029
Imaging used primarily for follow-up of known ovarian cancer
CT scan
1030
Optimal imaging modality to determine the extent of cervical cancer and to demonstrate residual or recurrent tumor
PET CT scan
1031
Used for initial evaluation of penile fracture
Ultrasound
1032
Most accurate for imaging staging and for demonstrating adenopathy and tumor recurrence
MRI
1033
Most common adrenal mass
Adrenal cortical adenoma
1034
Most common primary tumors of adrenal metastases
Lung, breast, melanoma, gastrointestinal, thyroid, and renal
1035
Most common cause of Addison disease in the U.S.
Idiopathic atrophy (probably autoimmune)
1036
Most common adrenal tumor to hemorrhage spontaneously
Pheochromocytoma
1037
Most common cause of adrenal hemorrhage in adults
Blunt trauma (80%) and infection
1038
Most common calcified adrenal masses in adults
Adrenal pseudocysts, attributable to previous hemorrhage
1039
Most common renal fusion anomaly
Horseshoe kidney
1040
Most common appearance of renal abscess
Focal renal mass with thick wall
1041
Most common cause of chronic pyelonephritis in children
Vesicoureteral reflux of infected urine
1042
Most common component of staghorn calculi
Struvite stones (From Proteus mirabilis)
1043
Most common cause of filling defects in the contrast-filled collecting system or ureter
Calculi / Stones
1044
Second most common primary renal malignancy
Transitional cell carcinoma
1045
Most common urinary tract neoplasm
Transitional cell carcinoma of the bladder
1046
Most common location of Malakoplakia
Bladder
1047
Most common stone in the urinary bladder
Solitary stones
1048
Most common complication of urethral stricture
False passage
1049
Most common site of urethral injury
Junction between prostatic and membranous urethra
(if not available in multiple choice, look for the words proximal urethra)
1050
Most common site of saddle injury
Bulbous urethra
"Hit the Saddle and Get BOLDbous (hubad)"
1051
Most common uterine tumor affecting 50% of women of reproductive age
Leiomyomas
1052
Most common germ cell neoplasm of the ovary
Benign cystic teratoma
1053
Most common gynecologic malignancy overall
Cervical cancer
1054
Most common invasive gynecological malignancy
Endometrial cancer
1055
Most common aggressive uterine malignancy
Uterine sarcoma
1056
Most common cysts of the prostate
Cysts associated with benign prostatic hyperplasia
1057
True or False:
Majority of adrenocortical adenomas
are non hyperfunctioning.
True
1058
Most common cause of non-iatrogenic cushing syndrome
Adrenal hyperplasia
1059
Most common cause of Conn syndrome
Adrenal cortical adenoma / Incidentaloma
1060
"Rule of tens" of pheochromocytoma
10% Bilateral
10% Malignant
10% Incidental
10% Familial
10% Extra-adrenal
1061
Most common cause of adrenal calcifications in both adults and children
Previous adrenal hemorrhage
1062
Most common histologic type of renal cell carcinoma
Clear cell carcinoma (80%)
1063
Most common renal mass
Simple renal cysts
1064
What is the Bosniak category?
Indeterminate lesions that may be benign or malignant and are usually treated surgically. Thick irregular calcifications, irregular margins, thick enhancing septae, areas of nodularity
Bosniak category 3
1065
A cystic renal mass that is also called "adult cystic nephroma" or "mixed epithelial and stromal tumors (MEST)". It is a cluster of multiple non-communicating cysts of varying sizes separated by connective tissue septations of varying thickness.
Multilocular cystic nephroma
M-ultilocular cystic nephroma
M-EST / M-ixed Epithelial and Stromal Tumore
M-ature/Adult cystic nephroma
1066
An autosomal dominant renal disease that manifests clinically later in life. The renal parenchyma is replaced by multiple non-communicating cysts of varying sizes.
Autosomal dominant polycystic disease
1067
Development of multiple cysts in kidneys of patients on long-term hemodialysis. Exceeds 90% in patients after 4 to 10 years of hemodialysis
Aquired uremic cystic kidney disease
Clue to answer:
Acquired = bec. of hemodialysis
Uremic = related to kidney failure, abnormal renal fxn, and indirectly related to hemodialysis
1068
Most frequent site of extrapulmonary tuberculosis
Urinary tract
1069
Also known as "Putty Kidney", demonstrating CASEOUS NECROSIS mixed with calcifications in dilated calyces
Renal tuberculosis
Clue: CASEOUS necrosis is a type of necrosis most common with tuberculosis
1070
Primary cause of renal failure in HIV infected patients
HIV nephropathy
1071
Most common component of staghorn calculi
Struvite (Magnesium ammonium phosphate)
1072
Stones that are radiolucent on conventional radiographs
Uric acid and Xanthine stones
1073
Most common cause of acute flank pain
Calculus obstructing the ureter
1074
Due to an aperistaltic segment of the lower ureter 5-40 mm in length causing functional obstruction which will lead to the dilatation of the proximal ureter.
Congenital megaureter
1075
Most common cause of filling defects in the contrast-filled collecting system or ureter
Calculi
1076
Most common of all uroepithelial tumors
Transitional cell carcinoma (85-90%)
1077
Squamous metaplasia with keratinization and desquamation results in irregular plaques in the renal pelvis, proximal ureter, and bladder. Key feature is the passage of flakes of discriminated epithelium in the urine. Considered as premalignant condition in the bladder but NOT in the ureter
Leukoplakia
1078
Uroepithelium-lined cavities in the renal parenchyma that communicates through a narrow channel with a fornix of a nearby calyx. Can be congenital, developing from a ureteral bud remnant or acquired, because of infection, reflux, or rupture
Calyceal diverticuli
1079
This bladder anomaly comes from congenital deficiency in the development of the lower anterior abdominal wall. The bladder is open and its mucosa is continuous with skin. Epispadias and wide diastasis of the symphysis pubis are associated.
Bladder exstrophy
1080
Persistent communication between the bladder and umbilicus causes a urine leak. Patients are asymptomatic until an obstructive lesion of the lower urinary tract opens to an obliterated urachus causing umbilical urinary fistula.
Patent urachus
Clue: The words 'persistent communication' leads you to think 'Patent'
1081
Blind ended dilatation to urachus at the umbilical cord end. This may cause persistent umbilical discharge. When imaging a tubular structure is seen in the midline abdominal wall extending from the umbilicus.
Umbilical-Urachus Sinus
1082
Outpouching of the bladder in the anterior midline location of the urachus. It is seen in adults with bladder outlet obstruction.
Vesical-Urachal diverticulum
1083
This develops if the urachus is closed at both ends but remains patent in the midline. On imaging, a fluid filled cyst is seen in the midline abdominal wall usually in the lower third region of the urachus
Urachal cyst
1084
Enlargement projects into the base of the bladder uplifting the bladder trigone and causing "J-hooking" of the distal ureter
Benign prostatic hypertrophy
1085
Type of cystitis characterized by multiple, fluid-filled submucosal cysts
Cystitis cystica
1086
Type of cystitis that is progression of cystitis cystica with proliferation of mucus secreting glands in the lamina propria. Precursor of adenocarcinoma of the bladder.
Cystitis glandularis
1087
Type of cystitis that is usually associated with chronic irritation from indwelling catheters. Grape-like cysts elevate mucosa
Bullous edema
1088
Type of cystitis characterized by hemorrhage into the mucosa and submucosa. Caused by bacterial or adenovirus
Hemorrhagic cystitis
1089
Type of cystitis with Infiltration of the bladder wall by eosinophils. Cause is uncertain. Wall is greatly thickened and nodular.
Eosinophilic cystitis
1090
Type of cystitis with gas within the bladder wall. Associated with poorly controlled diabetes mellitus, bladder outlet obstruction and E.coli
Emphysematous cystitis
1091
Weigert-Mayer rule
With complete ureteral duplication, the ureter draining the upper pole inserts inferior and medial to the normally placed ureter draining the lower pole.
Upper pole OBSTRUCTS
Lower pole REFLUXES (prone to reflux due to the ectopic ureter for upper pole obstructing/distorting the passage through the bladder wall)
1092
Most inflammatory strictures are caused by what etiologic agent?
Gonorrhea
1093
Most common complication of urethral stricture?
False passage
1094
Most common carcinoma of the urethra?
Squamous cell carcinoma
1095
Squamous cell carcinoma of the urethra most commonly involves which portion of the urethra, Anterior or Posterior?
Anterior urethra
1096
Classification of posterior urethral injury:
Contusion without imaging findings
Type 1
1097
Classification of posterior urethral injury:
Stretch injury with elongation of the urethra without extravasation
Type 2
1098
Classification of posterior urethral injury:
Partial disruption with extravasation of contrast and opacification of the bladder
Type 3
1099
Classification of posterior urethral injury:
Complete disruption of the urethra without of opacification of the bladder with urethral separation less than 2 cm
Type 4
1100
Classification of posterior urethral injury:
Complete disruption of the urethra without opacification of the bladder with urethral separation more/greater than 2 cm
Type 5
1101
Failure of complete fusion of the mullerian duct:
- two uteri
- two cervices
- two vaginas
Uterine didelphys
1102
Failure of complete fusion of the mullerian duct:
- two uterine horns
- One or two cervices
- One vagina
Bicornuate uterus
1103
Failure of complete fusion of the mullerian duct:
- Midline septum dividing the uterus into two cavities
Arcuate uterus
1104
Most common cause of hydrosalpinx
Pelvic infection , Pelvic inflammatory disease
1105
Adhesions from previous surgery or inflammatory process entrap the ovary within a fluid collection that extends into the peritoneal recesses. Imaging shows a fluid collection that includes the ovary extending to the recess, giving the collection an angled or pointed shape rather than spherical or oval shape.
Peritoneal inclusion cyst
1106
Meigs Syndrome
"Meigs likes to F.A.P"
"Meigs likes to FAP!"
- Fibromas (ovarian)
- Ascites
- Pleural effusion
1107
Gynecologic emergency resulting from twisting of the ovary, fallopian tube, or most commonly both structures' blood supply.
Adnexal torsion
1108
Signs of hemorrhagic infarction of the torsed adnexa
- Marked wall thickening of the adnexal mass (>10mm)
- Hemorrhage within the mass
- Hemorrhage within the twisted tube
- Hemoperitoneum
1109
A metastatic tumor of stomach and colon to the ovary. A "signet ring" subtype of metastatic tumor to the ovary.
Krukenberg tumor
1110
Features that favor multiple simple cysts versus polycystic kidney disease:
- Normal renal function
- No family history
- No cysts in other organs
1111
Provides the most comprehensive imaging characterization for female genital tract congenital anomalies
MRI
1112
Best for detection and characterization of adenomyosis
MRI
1113
Most commonly used to further characterize lesions shown on ultrasound and to assess whether they are amenable to hysteroscopic resection
Hysterosalpingogram (HSG)
1114
Diagnostic imaging method of choice for acute scrotal pain
Ultrasound with doppler / Doppler ultrasound
1115
Excellent method for initial tumor staging and follow-up of nonseminomatous tumors
CT & MRI
1116
Ultrasound mode used to document visualized cardiac activity
M-mode ultrasound
1117
More sensitive than ultrasound in demonstrating the muscle invasive disease seen as focal myometrial masses, dilated vessels, and areas of hemorrhage and necrosis
MRI
1118
Confirmation of placenta previa
Transperineal ultrasound
1119
Imaging method of choice for placenta accreta
MRI
1120
This modality will present with arterial waveforms at the fetal heart rate in vessels supplying chorioangioma is diagnostic
Spectral doppler
1121
Great assistance in clarifying the nature of the borders of an apparent well-circumscribed solid mass
Magnification compression views
1122
Imaging of choice to detect a primary breast lesion
MRI
1123
Most accurate in identifying silicone implant rupture in in localizing free silicon
MRI
1124
Most effective MRI sequence which suppresses the fat signal
IR sequence
1125
Used to investigate the cause of a spontaneous nipple discharge
Ductography
1126
Signal on T1WI MRI suggestive of benign etiologies
Bright / High T1
1127
Signal on T2 weighted imaging MRI for simple cysts
Bright / High T2
1128
Signal on T2WI MRI for most invasive carcinomas
Low / Dark T2
1129
Signal on T2WI MRI for medullary or mucinous carcinomas
Bright / High T2
1130
Most common form of adenomyosis
Diffuse form
1131
Most common cause of postmenopausal bleeding
Endometrial atrophy associated with a thin endometrium
1132
Most common symptom of submucosal leiomyomas
Bleeding throughout the menstrual cycle
1133
Most common ovarian mass
Functional ovarian cyst
1134
Most common ovarian neoplasm
Benign cystic teratoma / Dermoid
1135
Most common primary tumors to metastasize in the ovary
GI and Breast
1136
Most common causative agents of acute epididymo-orchitis
E.Coli, S. aureus, N.gonorrhea, and Tuberculosis
1137
Most common primary testicular neoplasms
Germ cell tumor
1138
Most common tumor still metastasize to the testes
Renal cell carcinoma (RCC) and Prostate carcinoma
1139
Most common cause of painless scrotal swelling
Hydrocele
1140
Most common correctable cause of male infertility
Varicocele
1141
Most common location of ectopic pregnancy
Ampulla (70%) in the fallopian tube
1142
Most common and most benign form of gestational trophoblastic disease
Hydatidiform mole
1143
Most common solid pelvic masses encounter during pregnancy
Leiomyomas
1144
Most common cystic pelvic masses found in pregnancy
Corpus luteal cyst
1145
Single most common cause of a poor neonatal outcome
Cervical incompetence / Incompetent cervix
1146
Most common tumor of the placenta
Chorioangioma
1147
Most common chromosome abnormality increasing in incidence and currently occurring in 1 out of 500 births
Trisomy 21
1148
Second most common chromosome abnormality
Trisomy 18
1149
Most common neural tube defect
Anencephaly
1150
Most common form of cleft lip and cleft palate
Lateral cleft
1151
Most common causes of hydronephrosis in the fetus
- Ureteropelvic junction obstruction
- Ectopic ureterocele
- Posterior urethral valves
1152
Most common site of teratomas in fetus
Sacralcoccygeal region
1153
Most commonly lethal skeletal dysplasia
Thanatophoric dwarfism
1154
Most common location of breast abscess
Subareolar region
1155
Most common well-circumscribed mass seen in women between ages of 35 to 50 years old
Cysts
1156
Most common well-defined solid masses seen on mammography
Fibroadenomas
1157
Most common primary cancer to produce breast metastasis
Melanoma
1158
Most common indication for breast imaging in men
Palpable asymmetric thickening or mass
1159
Most common presenting symptom of endometrial carcinoma
Postmenopausal bleeding
1160
Modality used to better evaluate interstitial and airway abnormalities under certain conditions
HRCT
1161
Modality used to verify diagnosis of central airway obstruction (tracheal obstruction)
Barium esophagogram
1162
Definitive evaluation of the vascular anatomy is best accomplished by what modality
MRI or Helical CT scan
1163
Valuable for distinguishing abscess from located empyema in the pleural space
CT scan
1164
Most helpful to characterize chest wall masses
Ct scan
1165
Used to evaluate for complications such as protrusion and migration
MDCT
1166
Used to evaluate postoperative anatomy and in complications such as aortic regurgitation and pulmonary stenosis
MRI
1167
Diagnostic modality used to detect single ventricle
Echocardiography
1168
Evaluation of patients with TOF and other conotruncal anomalies after surgical repair; Assessing ventricular volumes and function of extra cardiac vascular anatomy and aorta pulmonary collaterals, evidence of valvular regurgitation, and regions of scarring
Cardiac MRI
1169
Most reliable method to identify gastroesophageal reflux
24-hour esophageal pH and impedance monitoring
1170
Preferred examination for hypertrophic pyloric stenosis
Ultrasound
1171
Most commonly used to directly demonstrate obstruction in midgut volvulus
UGIS
1172
Very effective and reliable imaging modality for Intussusception
Ultrasound
1173
Study of viability of intestine
Doppler ultrasound
1174
Used for the detection of abscess formation
Ultrasound or ct scan
1175
Assess the adequacy of sphincter muscle complex; assess the position of the fistula and identify associated masses or GUT anomalies; post-operatively can establish that the pull through is properly positioned in relation to the sphincter
MRI
1176
Primarily used to evaluate acute complications such as abscess, perforation, or post-surgical leaks
MDCT
1177
Best modality for evaluation of perianal disease, fistulae, and abscesses
MRI
1178
Best initial examination to identify a bleeding meckel's diverticulum
Gadolinium MRI
1179
Letter method of evaluating pyelonephritis and renal scarring; Ability to provide high-resolution anatomical detail as well as functional information about perfusion and contrast concentration and excretion of biopsy
MR Urography
1180
More sensitive for vesicourereral reflux but provides poor anatomic detail
Nuclear scintigraphy
1181
Provides better definition of urethra, bladder, and ureteropelvic anatomy
Voiding cystourethrography (VCUG)
1182
Used to evaluate severity of hydronephrosis
Renal scintigraphy with furosemide wash-out
1183
Distinguish autosomal dominant and recessive forms of polycystic kidney disease
High-resolution ultrasound technology
1184
Ideal modality for adrenal hemorrhage
Ultrasound
1185
Useful for classifying vaginal abnormality in older patients
MRI
1186
Best defines a spinal origin of the mass and may associate tumor or spinal cord anomalies such as cord tethering
MRI
1187
Most common cause of lobar pneumonia throughout childhood
Streptococcus pneumoniae
1188
Most common bacterial infection that produces multiple bilateral alveolar opacities
Staphylococcal infection
1189
Most common cause of an interstitial pattern in the lung of a child that is seen as hazy, reticular, or reticulonodular opacities
Viral or Mycoplasma infection
1190
One of the most common causes of noncardiogenic causes of pulmonary edema predominantly in children
Acute glomerulonephritis
1191
Most common cause of intrathoracic compression of the fetal lungs
Congenital diaphragmatic hernia
1192
One of the most common causes of respiratory distress in the newborn
Surfactant deficiency disease (Hyaline membrane disease)
1193
Most common cause of massive pleural effusion in the neonate
Chylothorax
1194
Most common true lung masses
Postinflammatory granulomas or fungal infections
1195
Most common malignant neoplasm in the lung during childhood
Metastases
1196
Most common childhood tumors to metastasize to the lungs
- Wilms tumor
- Ewing sarcoma
- Osteosarcoma
- Rhabdomyosarcoma
1197
Most common cause of an apparent anterior mediastinal mass
Thymus gland
1198
Most common middle mediastinal mass
Lymphadenopathy
1199
Most common malignancies to involve the chest wall in children
Ewing sarcoma and Primitive neuroectodermal tumor
1200
Most common abnormality of the contour of the aorta
Coarctation of the aorta and dilatation of the aorta proximal and distal to the coarctation results in the characteristic "Figure of 3" sign
1201
Most common congenital heart abnormality after bicuspid aortic valve
Ventricular septal defect (VSD)
1202
Most common type of ventricular septal defect
Perimembranous defect
1203
Most common type of atrial septal defect
Ostium secundum defect
1204
Most common form of cyanotic congenital heart disease with increased pulmonary blood flow
Complete transposition of the great vessels (D-transposition)
1205
Most common form of total anomalous pulmonary venous return (TAPVR)
Type 1
1206
Most common anomaly to cause diminished pulmonary vascularity
Tetralogy of Fallot
1207
Most common cause of cyanotic congenital heart disease
Tetralogy of Fallot
1208
Most common inheritable cardiac disorder caused by genetic mutations that cause increased stress on myocytes and impaired function leading to hypertrophy and fibrosis
Hypertrophic cardiomyopathy
1209
Most common type of cardiac malposition
Mirror-mirror dextrocardia
1210
Most common congenital obstruction of the esophagus
Esophageal atresia
1211
Most common cause of duodenal obstruction
Duodenal hematoma
1212
Most common causes of distal small bowel obstruction in the neonate
Ileal atresia and meconium ileus
1213
Most commonly involved in transient intussusception
Small bowel
1214
Most common method for evaluating small bowel involvement
Contrast small-bowel fluoroscopic examination, Small intestinal series
1215
Most common cystic lesion of the pancreas
Pancreatic pseudocyst
1216
Most important causative factors of necrotizing enterocolitis
Ischemia and infection
1217
Most common sites of urinary tract obstruction
Ureteropelvic junction, Ureterovesical junction, and pelvic brim
1218
Most commonly urachal tumors
Adenocarcinoma
1219
Most common cause of urethral obstruction in male infants
Posterior urethral valve
1220
Most common cause of scrotal mass in children
Congenital hydrocele
1221
Most common testicular neoplasm before puberty
Yolk sac tumor
1222
Most common metastatic tumor to involve the testes in children
Leukemia and lymphoma
1223
Most common abdominal masses in infants and children
Enlarged kidneys due to hydronephrosis
1224
Most common renal neoplasm of childhood
Wilms tumor
1225
Most common renal tumor of the neonate
Mesoblastic nephroma
1226
Most common cause of adrenal enlargement in the newborn
Adrenal hemorrhage
1227
Most common type of choledochal cyst
Type 1
1228
Most common endocrine tumor
Insulinoma
1229
Most common malignant tumor of the small intestine
Non-hodgkin lymphoma
1230
Most common colon lesions
Inflammatory polyps or polyps associated with one of the colonic polyposis syndromes
1231
Most common ovarian neoplasm in children and adolescents
Germ cell tumor
1232
Most common germ cell tumors in young patients and is benign
Mature cystic teratoma
1233
Most common tumor to affect the lower urinary tract in children
Rhabdomyosarcoma
1234
Most common tumor in the newborn infant in the sacralcoccygeal region
Sacrococcygeal teratoma
1235
Most common pseudomass / pulmonary "mass" in children
Round/Spherical pneumonia
1236
Picture frame vertebrae, "Bone within a bone", Bone-in-bone
Paget disease
1237
Fish-shaped vertebrae
Sickle cell anemia, Osteoporosis, Renal osteodystrophy, Thalassemia
1238
Rugger jersey vertebrae
Hyperparathyroidism, Renal osteodystrophy
1239
Sandwich vertebrae
Osteopetrosis
1240
H-shaped vertebrae, Lincoln log
Sickle cell anemia
Sharp depression at the central portion of the endplate. Due to bone infarction
1241
Ivory vertebrae
Lymphoma (Hodgkin), Metastasis (Breast & Prostate), Paget disease
1242
True or False:
Left to Right shunts cause cyanosis at birth.
False. Patients born with Left to right shunts are acyanotic at birth.
L to R shunt = L is for Lets you breathe (Acyanotic)
R to L shunt = R is for Removes air (Cyanotic)
L to R shunts have 'D's in their abbreviations (vsD, asD, pDa)
R to L shunts have 'T's in their abbreviations (TOF, TAPVR, TGA, TA)
1243
Condition similar to patent ductus arteriosus (PDA) both hemodynamically and radiographically. Results from a failure of complete division of the primitive truncus arteriosus which leaves a communication between the aorta and the pulmonary artery just above the valves.
Aortopulmonary window
1244
Most common form of cyanotic congenital heart disease with increased pulmonary blood flow
Transposition of the great vessels (Complete/D-transposition)
1245
Pulmonary veins empty into a common drain that is abnormally incorporated into the left atrium. Radiographic findings of cardiomyopathy include cardiomegaly that is generalized or predominantly left-sided.
Cor Triatriatum
1246
Result of absence of ganglion cells, Auerbach and Meissner's plexuses, of the distal colon and rectum leading to abnormal peristalsis and inability to effectively evacuate to colon. Rectum is always involved.
Hirschsprung disease
1247
Findings of peptic esophagitis:
- Thickening of the esophageal wall
- Lack of normal peristalsis
- Tertiary contractions in the esophagus
- Ulcers that may be superficial or deep
1248
Most important causative factors of necrotizing enterocolitis
Ischemia and infection
1249
Pathognomonic finding of necrotizing enterocolitis
Pneumatosis intestinalis
1250
Vasculitis of unknown etiology. It affects the skin, GIT, joints, and kidneys. Half of the cases present with crampy abdominal pain and intestinal bleeding. Abdominal symptoms may proceed the characteristic skin rash. On UTZ, there is circumferential echogenic thickening of the bowel wall. On CT scan, there are multiple areas of bowel wall thickening, mesenteric edema, and lymphadenopathy.
Henoch-Schonlein Purpura
1251
Most common structural abnormality of the GIT
Meckel diverticulum
1252
This results from fibrous degeneration of the vitelline duct at the distal ileum. Presents with painless and sometimes profuse rectal bleeding. It arises from the ileum approximately 60 cm from the ileocecal valve.
Meckel diverticulum
1253
Meckel diverticulum: Rule of '2's
2 y/o
2/3 ectopic mucosa
2 feet (60cm) from ileocecal valve
2 inches (5cml long
2% of the population
1254
Most common cause of renal scarring in children, which occurs independently from vesicoureteral reflux.
Pyelonephritis
1255
What grade of vesicoureteral reflux is limited to the ureter?
Grade I
1256
What grade of vesicoureteral reflux causes mild dilatation of the ureter and renal collecting structures?
Grade III
1257
What grade of vesicoureteral reflux causes severe hydronephrosis with marked tortuosity and dilatation of the ureter?
Grade V
1258
What grades of vesicoureteral reflux resolve spontaneously?
Grades I through III
1259
What grades of vesicoureteral reflux are prone to scarring?
Grades III or higher
1260
What grades of vesicoureteral reflux require surgery such as reimplantation of the ureter?
Grades IV and V
1261
What type of posterior urethral valve results from abnormal migration and insertion of the urethrovaginal folds resulting in sail-like flaps of tissue that arise at the base of the prostatic urethra below the veromontanum.
Type I
1262
What type of posterior urethral valve is caused by incomplete canalization in the region of the urogenital diaphragm?
Type III
1263
What type of posterior urethral valve consists of a non-obstructive mucosal fold rather than an obstructing membrane?
Type II
1264
Type of choledochal cyst with multiple dilatations / cysts involving the INTRAHEPATIC DUCTS ONLY.
Numerous intrahepatic cystic dilatations throughout the biliary tree and liver.
Type 5, Caroli disease
1265
Type of choledochal cyst in which there is dilatation of an extrahepatic bile duct within the DUODENAL WALL or termed as CHOLEDOCHOCELE, at the ampulla of Vater region.
Type 3
1266
Type of choledochal cyst which is considered a TRUE DIVERTICULUM from an extrahepatic duct. A saccular diverticulum from the CBD
Type 2
1267
Most common etiology of acquired hepatic cysts in infants and children
Infectious in origin
1268
Most common benign liver tumor encountered in infancy
Hemangioblastoma
1269
This gastrointestinal mass commonly arises from the small bowel or colon. Most are asymptomatic. Can act as a lead point for intussusception and volvulus. On ultrasound, has a characteristic two-layered wall, consisting of an inner echogenic mucosa and peripheral hypoechoic muscle.
Enteric duplication cyst
1270
These develop when a portion of the thecal sac protrudes anteriorly into presacral space through a sacral defect.
Anterior sacral meningocele
1271
Currarino Triad (Anterior sacral meningoceles)
- Partial sacral agenesis
- Anorectal stenosis
- Presacral mass
1272
Also known as "Sickle shaped sacrum" or "Hemisacral agenesis". Unilateral, well-marginated, crescent-shaped defect in the lateral sacrum. It is pathognomonic for anterior sacral meningoceles. Expansion of the meningocele causes scalloping and lateral displacement of the sacral plate.
Scimitar Sacrum
1273
Most common benign cystic lesions in the phalanges
Enchondroma
1274
Most common bone lesion encountered by radiologists
Non-ossifying fibroma
1275
Most common location of Non-ossifying fibroma
Knee
1276
Most common presentation of myeloma
Diffuse permeative
1277
Most common differential diagnosis of a lytic lesion in the epiphysis of a patient less than 30 years old
Infection
1278
Most reliable plain film indicator for benign vs malignant lesions
Zone of transition
1279
Most common primary malignant bone tumor
Osteosarcoma
1280
One of the most common fractures of the forearm
Colles fracture
1281
Most common shoulder dislocation
Anterior dislocation
1282
Most common arthritide/arthritis
Osteoarthritis
1283
Most common cause of osteoporosis
Senile osteoporosis or osteoporosis of aging
1284
Most common cause of Osteomalacia
Renal Osteodystrophy
1285
Most common presentation of renal osteodystrophy
Osteopenia
1286
Most common cause of dwarfism
Achondroplasia
1287
Most common location of rim rent
Anterior at the insertion of the supraspinatus
1288
Most commonly seen cuff tear in mri
Rim rent
1289
Most common location of osteochondral lesion
Knee
1290
Second most common location of osteochondral lesion
Talar dome
1291
Most commonly torn ankle ligament
Anterior talofibular ligament
1292
Most common cause of a painful flatfoot
Tarsal coalition
1293
Most commonly fractured carpal bone
Scaphoid
1294
Second most commonly fractured carpal bone
Triquetrum
1295
Most commonly fractured tarsal bone
Calcaneus
1296
Benign Lytic Bone Lesions - FEGNOMASHIC
F - ibrous dysplasia
E - nchondroma
G - iant cell tumor
N - on ossifying fibroma
O - steoblastomq
M - etastatic diseases, Myeloma
A - neurysmal bone cyst
S - imple bone cyst
H - yperparathyroidism (Brown tumor)
I - nfection
C - hondroblastoma, Chondromyxoid
1297
FEGNOMASHIC:
No periosteal reaction
Fibrous dysplasia
1298
FEGNOMASHIC:
Older than age 40
Metastasis, Myeloma
1299
FEGNOMASHIC:
Expansile, Younger than 30
Aneurysmal bone cyst
1300
FEGNOMASHIC:
Central, Younger than 30
Solitary bone cyst
1301
FEGNOMASHIC:
Calcification present (except in phalanges), Painless (No periostitis)
Enchondroma
1302
FEGNOMASHIC:
Eccentric, Epiphyses closed, Abuts articular surface (in long bones), Well-defined with non-sclerotic margins (in long bones)
Giant cell tumor
1303
FEGNOMASHIC:
Younger than 30, Painless (No periostitis)
Non-ossifying fibroma
1304
FEGNOMASHIC:
Younger than 30, Epiphyseal
Chondroblastoma
1305
Refers to a fistulous connection between the gallbladder and the duodenum. It is considered the most common type of enterobiliary fistulation
Cholecystoduodenal fistula
1306
Giant Cell Tumor characteristics:
"C.A.E.N"
- Closed epiphyses
- Abuts Articular surface
- Eccentric
- Non-sclerotic margins
1307
Most common type of fibrous dysplasia
Monostotic
1308
Benign lytic bone lesion that can be wild looking, discrete lucency, patchy, sclerotic, expansile, or multiple. Will not have periostitis. Never undergoes malignant degeneration. Should not be painful unless fractured.
Fibrous dysplasia
1309
Benign lytic bone lesion with classic description of ground glass or smoky matrix. Often purely lytic and becomes hazy or takes on a ground glass look as the matrix calcifies.
Fibrous dysplasia
1310
When this lesion is encountered in the tibia, it resembles fibrous dysplasia. It is a malignant tumor that radiographically and histologically resembles fibrous dysplasia. Occurs almost exclusively in the tibia and a draw and is rare
Adamantimoma
1311
This syndrome has polycystic fibrous dysplasia which occasionally occurs in association with cafe au lait spots on skin (dark pigmented, freckle like lesions) and precocious puberty. Also presents with Chuberism (physical appearance of a child with puffed out cheeks having an angelic look. Jaw lesions regress in adulthood.
McCune Albright Syndrome
1312
Differential for Enchondroma:
- multiple enchondroma
- not hereditary
- does not undergo malignant degeneration
Ollier disease
1313
Differential for Enchondroma:
- multiple enchondroma with soft tissue hemangiomas
- not hereditary
- Undergoes malignant degeneration / Increased incidence
Maffucci syndrome
1314
Benign lytic bone lesions that occurs in any bone formed from cartilage and maybe central, eccentric, expansile, or non expansile. Contain calcified chondroid matrix except in phalanges.
Enchondroma
1315
Enchondroma versus Bone infarct: How to differentiate between the two?
Bone infarct = (-) endosteal scalloping
Enchondroma = (+) endosteal scalloping
1316
A benign lytic bone lesions that have different phases of the same disease manifesting in one. Almost exclusively in patients less than 30 years old. Occasionally has a bony sequestrum. Can mimic Ewing sarcoma and perforated (multiple small holes) lesion.
Eosinophillic granuloma
1317
True or False:
The rule that Giant Cell tumors abut the articular surface does not apply to FLAT BONES such as the pelvis or apophyses.
True. It does not apply to flat bones such as pelvis or apophyses which have no articular surfaces.
1318
True or False:
If ANY of the four (4) criteria of Giant Cell Tumor are not met, it may be excluded from the differential diagnoses.
True.
1319
Benign lytic bone lesion that occur in the metaphysis of a long bone emanating from the cortex. They are considered in patients less than 30 y/o that presents with no periostitis and no pain (asymptomatic). These lesions spontaneously regress and are rarely seen after 30 y/o. Also known as Fibroxanthoma. Most commonly seen in the KNEE but can occur in any long bone.
Non-ossifying fibroma
1320
Benign lytic bone lesion that looks like a large osteoid osteoma and are often called "Giant Osteoid Osteomas". They also simulate Aneurysmal bone cysts having a expansile, soap bubble appearance. If ABC is considered, so should this lesion. These commonly occur in the posterior elements of vertebral bodies and about half demonstrate speckled calcifications.
Osteoblastoma
1321
This bone lesion spares some of the vertebral body (if involved) leaving struts of cortical bone giving the appearance of a "mini brain" on CT and MRI, which is pathognomonic for this.
Plasmacytoma
1322
This benign lytic bone lesion most commonly presents as a diffuse permeative process in the skeleton. It can be solitary or multiple lytic lesions. On a lateral skull xray, it shows a typical presentation for this lesion as multiple, small holes throughout the calvarium which appear well-defined.
Myeloma / Multiple myeloma
1323
True or False:
The only metastatic lesion that is said to always be lytic is renal cell carcinoma.
True.
1324
True or False:
In general, lytic expansile metastatic diseases tend to come from thyroid and renal tumors.
True
1325
Benign lytic bone lesion that virtually always expansile, occurs in <30 y/o, presence of fluid/fluid levels, (+) pain, and can be located anywhere in the skeleton. Primary type has no known cause or association with other lesions. Secondary type occurs in conjunction with another lesion or trauma.
Aneurysmal bone cyst
1326
Benign lytic bone lesion that begins at the physeal plate and not at the epiphyses. It almost exclusively occurs in <30 y/o. Always central in location. Majority located in long bones such as proximal humerus and proximal femur. Fairly common location in the Calcaneus (inferior surface, almost exclusively). Asymptomatic unless fractured. "Fallen fragment" sign is pathognomonic.
Solitary bone cyst / Unicameral bone cyst
1327
What sign is elicited when a piece of cortex breaks off after a fracture in a solitary bone cyst, and the piece of cortical bone sinks to the gravity-dependent portion of the lesion?
Fallen fragment sign
1328
Benign lytic bone lesion that has subperiosteal bone resorption as a pathognomonic feature. Will present as frayed, ragged appearance of open physes, more commonly secondary to renal osteodystrophy (osteoporosis or osteosclerosis). Should be searched for in phalanges, distal clavicles, proximal tibias and sacroiliac joints.
Hyperparathyroidism / Brown tumors
1329
Benign lytic bone lesion that has a protean appearance, may have sclerotic or non-sclerotic border, or have associated periostitis. If a bony sequestrum, this may be strongly considered. Soft tissue findings such as fat obliteration and cartilage loss or effusion are unreliable and misleading.
Osteomyelitis
1330
A benign lytic lesion that only occurs adjacent to articular diseases such as a degenerative disease or arthritides. This lesion could be considered a...
Geode or subchondral cyst
1331
Benign lytic bone lesions that resemble Non-ossifying fibromas (NOF), May occur at any age, (+) painful, (+) extend to metaphyses (whereas in NOFs, painless and do not extend to metaphyses). These are also cartilagenous lesions that DO NOT HAVE CALCIFIED MATRIX. Mentioned when an NOF is mentioned as primary impression.
Chondromyxoid fibroma
1332
Benign lytic lesion seen in <30 y/o
"Younger people (<30) like S.N.A.C.I.Es" pronounced Snackies
S-olitary bone cysts
N-on ossifying fibroma
A-neurysmal bone cyst
C-hondroblastoma
I-nfection (Osteomyelitis)
E-osinophilic granuloma
1333
Bone lesions that arise from Epiphyses:
"E.C.I.G.G" (pronounced as E-Cig as in electronic cigarettes)
E-piphyseal
C-hondroblastoma/C-hondrosarcoma
I-infection (Osteomyelitis)
G-iant cell tumor
G - eode / Subchondral cyst
1334
Benign lytic bone lesions in patients older than 40:
"M&M Morbidity and Mortality"
M-etastasis
M-elanoma
(+) Infection / Osteomyelitis
1335
Classic differential for benign, cystic RIB lesion:
"F.A.M.E.ous RIBS"
F-ibrous dysplasia
A-neurysmal bone cyst (ABC)
M-etastatic and M-yeloma
E-nchondroma
1336
Multiply lytic bone lesions
"Multiple iEFEHM (iFM) radio stations"
i-nfection (Osteomyelitis)
E-nchondroma
F-ibrous dysplasia
E-osonophilic granuloma
H-yperparathyroidism (Brown tumor)
M-etastatic or M-yeloma
1337
The only benign lytic bone lesion that must exhibit calcified matrix
Enchondroma
1338
Benign lytic lesions that have NO PAIN OR PERIOSTITIS
"NO.F.EynS" pronounced as No Pains
N-on ossifying fibroma
F-ibrous dysplasia
Eyn-chondroma
S-olitary bone cyst
1339
True or false:
Infection and eosinophilic granuloma cause aggressive periostitis and mimic a malignant tumor that can have a wide zone of transition.
True.
1340
True or false:
A "permeative" zone of transition lesion consists of multiple small holes and has no perceptible border and therefore a wide zone of transition.
True
1341
Examples of tumors that have "permeative" zone of transition (in general, Young or Old)
- Multiple myeloma
- Ewing sarcoma
- Primary lymphoma of bone
1342
Lipoma MRI signal
High T1 (due to fat content) and smooth/sharp margins
1343
Hemangiomas and AVMs MRI signal
Mixed high and low signals on both sequences (fat and blood elements), characteristic LOW signal serpiginous vessels visible
1344
True or false:
All solid tumors enhance with contrast MRI with the exception of myxoid or necrotic areas or foci of matrix (osteoid or cartilaginous)
True
1345
"Sunburst" appearance of aggressive periosteal reaction occurs in...
- Osteosarcoma (frequently)
- Ewing sarcoma
- Osteoblastic metastasis (prostate, lung, breast)
1346
True or false:
Parosteal osteosarcoma occurs in an older age group than the central osteosarcomas and is not aggressive or as deadly as long as it has not extended into the medullary portion of the bone.
True.
1347
True or false:
Ewing sarcoma exhibits onion-skin type of periostitis but can also have a periostitis that is sunburst or amorphous in character.
True.
1348
Classic differential diagnosis for a permeative lesion in a child
- Ewing sarcoma
- Infection
- Eosinophillic granuloma
1349
Snowflake or popcorn-like, amorphous calcification seen in a long bone of a 43 y/o patient. (+) Pain
Chondrosarcoma
1350
The only malignant tumor that can involve a large amount of bone or the patient is asymptomatic
Primary lymphoma of the bone
1351
The only primary tumor that virtually never presents with blastic metastatic disease
Renal cell carcinoma (entirely lytic disease rather than blastic/sclerotic)
1352
Typically has a diffuse permeative appearance that can mimic Ewing sarcoma or Primary lymphoma of the bone. Frequently involves the calvarium. One of the only lesions that is not characteristically "Hot" on a radionuclide bone scan. Bone or skeletal surveys are performed in place of a radionuclide bone scan.
Myeloma
1353
True or false:
The diagnosis of Liposarcoma requires the presence of fat.
False. Liposarcoma might or might not have fat present. Lipoma, on the other hand, only requires visualization of fat on T1 to be determined.
1354
True or false:
Synovial sarcomas only very rarely originated in a joint. They are often adjacent to joints.
True.
1355
A benign joint lesion that occurs from metaplasia of the synovium that leads to multiple calcific loose bodies in a joint
Synovial osteochondromatosis
1356
A benign synovial soft tissue process that causes joint swelling in pain and occasionally joint erosion. It virtually never has calcifications. Characteristic appearance on MRI is marked low signal lining the synovium seen on T1 and T2 because of the hemosiderin deposits.
Pigmented villonodular synovitis
1357
Regarding bone lesions, what differentiates a true permeative pattern versus a pseudopermeative pattern?
Pseudopermeative pattern has INTACT CORTEX while a True permeative pattern occurs in intramedullary portion or the endosteal part of bone.
1358
Atypical synovial cyst that is seen in the popliteal region at the knee joint that can present as a soft tissue mass. It is well-defined, fluid-filled, and homogenously hyperintense on T2 and often septated.
Baker cyst
1359
A blow to the top of the head such as when an object falls directly on the apex of the skull can cause the lateral masses of C1 to slide apart splitting the bone ring of C1.
Jefferson fracture
"je-FIRST-son fx" First = C1 fracture
1360
Atlantoaxial joint becomes fixed and the C1 & C2 bodies move together as one (en masse), instead of rotating on one another. Diagnosed with open mouth odontoid views. One of the spaces, lateral to the dens, is wider than the other and stays wider even with rotation of the head to the opposite side. Normally, with rotation of the head to the left, space on the left widens and vice versa.
Rotatory Fixation of the Atlantoaxial joint
1361
Fracture of the C6 or C7 spinous processes
Clay shoveler fracture
"67ay shoveler" = C6 C7
1362
Unstable serious fracture of the upper cervical spine that is caused by hyperextension and distraction (such as hitting one's head on a dashboard). Fracture of the posterior elements of C2, usually displacement of the C2 body anterior to C3
Hangman fracture
"Hang | Man" (2 words = C2 fracture)
1363
Severe flexion of the cervical spine can cause a disruption of the posterior ligaments with anterior compression of a vertebral body. Usually associated with spinal cord injury often from the posterior portion of the vertebral body being displaced into the central canal.
Flexion teardrop fracture
1364
Severe flexion associated with some rotation can result in rupture of the apophyseal joint ligaments and facet joint dislocation. It can result in locking of the facets in an overriding position that causes some stabilization to protect against further injury. Occasionally occurs bilaterally.
Unilateral Locked Facets
1365
Injury secondary to hyperflexion at the waist, as occurs in an automobile accident while restrained by a lap belt. Causes distraction of the posterior elements and ligaments and anterior compression of the vertebral body. This usually involves the T12, L1 and L2 level.
"Seatbelt injury"
seatbe12, seatbeL1, seatbeL2 (T12, L1, L2)
1366
Also known as seatbelt fractures. These are flexion-distraction injuries of the spine that extend to involve all three spinal columns. These are unstable injuries and have a high association with intra-abdominal injuries such as pancreas and duodenum.
Chance fractures
1367
Break or defect into pars interarticularis portion of the lamina
Spondylolysis
1368
Scottie dog with collar sign
Spondylolysis
1369
Denotes the slippage of one vertebra relative to the one below. Can occur anywhere in the vertebral column but is most frequent in the lumbar spine, particularly when due to spondylolysis at L5/S1.
Spondylolisthesis
spondylo-SLIP-thesis = Slippage
1370
An eponymous name for osteonecrosis and collapse of a vertebral body. It represents delayed (usually two weeks) vertebral body collapse due to ischemia and non-union of anterior vertebral body wedge fractures after major trauma. Plain radiograph / CT scan shows collapse of affected vertebrae (typically lower thoracic and upper lumbar).
Kummel disease
1371
Fracture at the base of the thumb/first digit into the carpometacarpal joint.
Bennet fracture
1372
Commuted fracture of the base of the thumb/first digit that extends into the carpometacarpal joint
Rolando fracture
1373
Fracture of the base of the thumb/first digit that does not involve the carpometacarpal joint
Pseudo-Bennett fracture
1374
Avulsion injury at the base of the distal phalanx where the extensor digitorum tendon inserts
Mallet finger or Baseball finger
This is also like the injury related to basketball "Na-pingeran/fingeran"
1375
Avulsion on the ulnar aspect of the first metacarpal phalangeal joint where the ulnar collateral ligament of the thumb inserts. It requires internal fixation. Usually occurs when falling on a ski pole and having the pole jam into the webbing between the thumb and the index finger.
Gamekeeper's thumb
1376
Occurs when the ligaments between the capitate and the lunate are disrupted allowing the capitate to dislocate from the cup-shaped articulation of lunate. Can also occur with fall on an outstretched arm. Normally, the capitated should be seen in the cup-shaped lunate.
Lunate / Perilunate dislocation
1377
Failure to diagnose and treat lunate / perilunate dislocation will lead to permanent injury of what nerve?
Median nerve
1378
True or false:
On AP view, Lunate/Perilunate dislocation will present as a rhomboid shape.
False. Lunate/Perilunate dislocation will present as triangular or pie-shaped lunate on AP view.
1379
Most commonly associated fracture associated with Lunate / Perilunate dislocation
Transscaphoid/Scaphoid fracture
1380
What view should you order when you want to see a fracture of the hook of hamate?
Carpal tunnel view
1381
Most common cause of hook of the hamate fracture
Fall On Out-Stretched Hand (FOOSH)
1382
Rotary subluxation of the Schapoid bone is another wrist injury after FOOSH. It results from rupture of the scapholunate ligament. What sign is demonstrated when there is space between the scaphoid and the lunate where ordinarily they are closely opposed?
Terry Thomas sign
"ro-TERRY subluxation of Scaphoid"
Named after a famous british actor (1950s) with a GAP BETWEEN HIS TWO FRONT TEETH
1383
The eponymous name given to osteonecrosis involving the lunate. It is often referred to as lunatomalacia. Diagnosed by noting increased density of the lunate which may or may not go on to collapse and fragmentation.
Kienbock disease / Kienbock malacia
1384
Type of ulnar variance if the Ulna is SHORTER than radius and is associated with increased incidence of Kienbock disease/ malacia.
Negative ulnar variance
1385
Type of ulnar variance if the Ulna is LONGER than radius and is associated with increased incidence of Triangular fibrocartilage tears.
Positive ulnar variance
1386
A small chip of the bone on the dorsal aspect of the wrist seen on lateral film is virtually pathognomonic of an avulsion from which carpal bone fracture?
Triquetrial fracture
1387
Fracture of the distal radius and ulna after a fall on an outstretched arm/hand. Results in dorsal angulation of the distal forearm and wrist. Dinner fork deformity. Dorsally flexed FOOSH.
Colles fracture
"colle-D it!" pronounced Called it!
D-istal ra-D-ius
D-orsal angulation
D-istal forearm
D-inner fork deformity
D-orsally flexed FOOSH
1388
Ulnar or long bones suffer a traumatic insult and force on the bones causes BENDING instead of a fracture. No visible fracture line or visible cortical injury noted. If left untreated, may result in reduced supination and pronation.
Plastic bowing deformity
1389
Fracture of the ulna with dislocation of the proximal radius
Monteggia fracture
"MUGR" pronounced Mugger/Robber
M-onteggiA
U-lnar fracture
G-aleazzi
R-adial fracture
For dislocations, use this:
monteggiaA = A is proximal in the alphabet so PROXIMAL radial dislocation
galeaZZi = Z is distal in the alphabet so DISTAL ulnar dislocation
1390
Fracture or the Radius with dislocation of the distal ulna
Galezzi fracture
"MUGR" pronounced Mugger/Robber
M-onteggiA
U-lnar fracture
G-aleazzi
R-adial fracture
For dislocations, use this:
monteggiaA = A is proximal in the alphabet so PROXIMAL radial dislocation
galeaZZi = Z is distal in the alphabet so DISTAL ulnar dislocation
1391
A visible posterior fat pad sign of the elbow in an adult patient (closed epiphyses) is seen. This is indicative of what fracture?
Fracture of the radial head (elbow region)
1392
A visible posterior fat pad sign of the elbow in a child (open epiphyses) is seen. This is indicative of what fracture?
Supracondylar fracture
1393
True or false:
In the setting of trauma, a visible posterior fat pad sign is indicative of an elbow fracture.
True.
1394
In elbow injury, effusion displaces the normally visible anterior fat pad superiorly and outward from the humerus and has been likened to the appearance of a spinnaker sail. This sign is called?
Sail sign
1395
Occurs when the arm is forcibly external rotated and abducted. Commonly seen when football players arm tackle or when kayakers brace the paddle above their heads and allow their arms to get to far posterior. Radiographically seen as the humeral head lying inferior and medial to the glenoid.
Anterior shoulder dislocation
1396
Humeral head often impacts on the inferior lip of the glenoid causing an indentation on the posterior superior portion of the humeral head. Its presence indicates a greater likelihood of recurrent dislocation and some surgeons use it as an indicator to intervene surgically to prevent recurrence.
Hill-Sachs deformity
1397
A bony regularity or fragment of the inferior glenoid resulting from the impact of the humeral head on the inferior lip of the glenoid.
Bankart deformity
In Bankart deformity, the deformity is on the GLENOID whereas, in Hill-Sachs deformity, the deformity is on the HUMERAL HEAD.
1398
Often mistaken for a dislocated shoulder. This disease entity displaces the humeral head inferoLATERALLY on the AP view.
Traumatic hemarthrosis
Anterior dislocation displaces the humeral head inferoMEDIALLY on AP view.
1399
On Scap-Y / Transscapular view, the humeral head is displaced inferiorly in relation to the glenoid with absence of the crescent sign likely due to hemarthrosis. Not posteriorly or anteriorly displaced but INFERIORLY. Can suggest a subtle or occult humeral head fracture. Should be recognized to prevent attempts to reduce the shoulder.
Pseudodislocation of the shoulder
1400
True or false:
In looking for secure fractures one should examine the arcuate lines of the sacrum bilaterally to see if they are symmetric or asymmetric. If these arcuate lines are interrupted it might be due to fracture.
True
1401
Honda sign is a characteristic appearance of this fracture on radionuclide bone scan.
Bilateral Sacral stress fracture
Occurs in BILATERAL only, not UNILATERAL
1402
Fractures that also have been termed "insufficiency fractures" indicating that the underlying bone is abnormal similar to a pathologic fracture.
Sacral stress fractures
1403
Most serious stress fracture and is one of the rarest.
Femoral neck stress fracture / Stess fracture of the femoral neck
1404
Misalignment of the medial border of the 2nd metatarsal to the medial border of the 2nd cuneiform (intermediate cuneiform) should suggest what
Lisfranc fracture-dislocation
1405
Hallmarks of Osteoarthritis
"J.O.S.teoarthritis"
J-oint space narrowing
O-steophytosis
S-clerosis
1406
Erosive osteoarthritis is a form of hand osteoarthritis associated with osteoporosis and erosions. Present radiographically with joint space narrowing, subchondral erosions, joint ankylosis. However, there is absence of marginal erosion, soft-tissue swelling, and osteopenia. (-) Rheumatoid factor, (-) ANA, Slightly elevated ESR/CRP. This is also known as...
Kellgren Arthritis
1407
Exceptions to the classic triad of Degenerative joint disease / Osteoarthritis
TMJ, Acromioclavicular joint, Sacroiliac joint, Symphysis pubis
1408
Radiographic hallmarks of rheumatoid arthritis:
"J.O.S.E. may Rheumatoid Arthritis"
J-oint space narrowing
O-steoPOROSIS
S-oft tissue swelling (STS)
E-rosions (marginal)
1409
Associated with Swan neck deformity, which is hyperextension of the PIP with flexion of the DIP, and Boutonniere disease which is flexion of the PIP with extension if the DIP.
Rheumatoid arthritis
"'WAN Button RA" pronounced as One Button Rebuildable atomizer (vape)
sWAN neck deformity
BUTTONniere disease
1410
Migration of the femoral head in Osteoarthritis and Rheumatoid arthritis
"OAS.is AMun RA"
O-steo
A-rthritis
S-uperolaterally
i
s
A-xial
M-edial
u
N
R-heumatoid
A-rthritis
1411
HLA-B27 Spondyloarthropathies
"HiLA para mag-A.P.I.R"
HiLA = HLA-B27
A-nkylosing spondylitis
P-soriatic arthritis
I-nflammatory / Enteropathic arthritis
R-eactive arthritis / R-eiter syndrome
1412
Single/Unilateral Sacroiliac joint involvement
Reiter syndrome/Reactive arthritis
Psoriasis
"yung iisang SUSI nakay Reiter at Sora"
Iisang = One
S-ingle
U-nilateral
S-acro
I-liac joint I-nvolvement
Reiter disease
"Sora"iasis / Psoriatic arthritis
1413
Bilateral sacroiliac joint involvement in HLA-B27 Spondyloarthropathies
"A.P.I.R. nga diyan, BILAT!
A-nklyosis spondylitis
P-soriatic arthritis
I-nflammatory bowel disease (Enteropathic arthritis)
R-eiter syndrome / Reactive arthritis
BILATeral
1414
Metabolic disorder that results in hyperuricemia and leads to monosodium urate crystals being deposited in various sites in the body especially joints. Classic radiographic findings include well-defined erosions often with sclerotic borders or overhanging edges, soft tissue nodules that calcify in the presence of renal failure, and random distribution in the hands without marked osteoporosis. Typically effects metatarophalangeal joint of the great toe.
Gout
1415
Most common location of chondrocalcinosis in CPPD
- Knee
- Symphysis pubis
- Triangular fibrocartilage of wrist
1416
Classic triad of Pseudogout / Calcium PyroPhosphate Deposition disease
"CPPD has CCPD"
C-artilage C-alcification
P-ain
D-estruction of joint
1417
Classic radiographic findings of Gout
"I like my GOAT meat picked at RANDOM, SOFT, WELL-done, and OVERHANGING and NO burn Marks"
GOAT = Gout
RANDOM distribution
SOFT tissue nodules
WELL defined erosions with OVERHANGING edges
No marked osteoperosis
1418
Three diseases that have a high degree of association with CPPD
"PGH"
- Primary hyperparathyroidism
- Gout
- Hemochromatosis
1419
Disease of excess iron deposition in tissues throughout the body leading to fibrosis and eventual organ failure. Radiographic changes include degenerative joint disease of the 2nd to 4th MCP joints, Squarring of the metacarpal heads appearing enlarged and block-like, and "drooping" osteophytes.
Hemochromatosis
1420
Deposition of granulomatous tissue in the body, lungs, and bones. Predilection for the hands causing destructive lesions in the cortex with a lace like appearance which is characteristic. Skin nodules may also be appreciated in the hands.
Sarcoid
1421
Hallmarks of a Neuropathic joint or Charcot joint
- Joint destruction
- Dislocation
- Heterotropic new bone
1422
Most commonly seen Neuropathic/Charcot joint today is
Diabetic foot
Typically affects 1st - 2nd tarsometatarsal joints in a fashion similar to Lisfranc fracture
1423
Classic findings for juvenile rheumatoid arthritis and hemophilia
Overgrowth of the ends of the bones (epiphyseal enlargement) associated with gracile diaphysis (widening of the intercondylar notch of the knee)
1424
Most likely cause for the overgrowth of the ends of the bones seen in JRA, hemophilia, and paralysis and is a common denominator shared by the three
Disuse
1425
A relatively common disorder caused by a metaplasia resulting in deposition of cartilage in the joint. Most often calcify and are readily seen on radiograph. Most commonly seen in the knee, hip, and elbow. Classifications begin in the synovial and tend to shed into the joint where they can cause symptoms of free fragments "joint mice"
Synovial Osteochromatosis
1426
Also known as Shoulder-Hand syndrome or Chronic regional pain syndrome. Typically occurs after a minor trauma to one extremity resulting in pain swelling and dysfunction. Radiographic findings include severe patchy (aggressive) osteoporosis and soft tissue swelling. Typically affects the distal part of an extremity such as a hand or foot. Intermediate joints such as knee and the hip are occasionally involved.
Sudeck atrophy
1427
Uncommon chronic inflammatory process of the synovial that causes synovial proliferation. Swollen joint with lobular masses of synovial occurs and causes pain and joint destruction. Whenever this is considered, Synovial chondromatosis should be mentioned. Characteristic appearance on MRI shows low signal hemosiderin lining the synovial on T1 and T2.
Pigmented villonodular synovitis
1428
Most reliable radiographic sign for knee effusion is
Distance between suprapatellar fat pad and the anterior femoral fat pad.
<5mm = normal
5-10mm = equivocal
>10mm = effusion
1429
The only fat pad around the hip that gets displaced with hip effusion is the
Obturator Internus
1430
True or false:
In the setting of trauma, elbow joint effusions indicate fractures. Other joint effusions are clinically obvious and do not require radiographic validation.
True.
1431
Earliest sign of avascular necrosis or osteonecrosis in any joint
Joint effusion
1432
Radiographic hallmark of Avascular necrosis/Osteonecrosis
Increased bone density at an otherwise normal joint
Increased bone density at a NARROWED joint indicates Degenerative joint disease, Not Osteonecrosis
1433
True or false:
Presence of a subchondral lucency often develops which forms a thin line along the articular surface described as being an early indicator for Avascular necrosis.
False. It is a LATE sign for Avascular necrosis
1434
A smaller and more focal form of AVN. Most likely caused by trauma. Occurs most often in the knee or medial epicondyle. Frequently leads to a smaller fragment of bone sloughed ofdlf and becoming a free fragment in the joint, "joint mouse/mice"
Osteochondritis dissecans
1435
Avascular necrosis of the Navicular bone
Kohler disease
"KOH Ta Na" (Quota Na)
Kohler disease, Talus Navicular
"Legg = Femur"
Legg-Parthes, Femoral head
"LuBak"
LUnate, kieBOCK malacia
"naTATAMeme si Frei"
MeTaTarsals, Freiberg infarction
"Showman Fire Rings"
Scheuermann disease, APOYphyseal RINGS of vertebral bodies
1436
Avascular necrosis of the metatarsal heads
Freiberg infarction
"KOH Ta Na" (Quota Na)
Kohler disease, Talus Navicular
"Legg = Femur"
Legg-Parthes, Femoral head
"LuBak"
LUnate, kieBOCK malacia
"naTATAMeme si Frei"
MeTaTarsals, Freiberg infarction
"Showman Fire Rings"
Scheuermann disease, APOYphyseal RINGS of vertebral bodies
1437
Avascular necrosis of the femoral head
Legg-Parthes disease
"KOH Ta Na" (Quota Na)
Kohler disease, Talus Navicular
"Legg = Femur"
Legg-Parthes, Femoral head
"LuBak"
LUnate, kieBOCK malacia
"naTATAMeme si Frei"
MeTaTarsals, Freiberg infarction
"Showman Fire Rings"
Scheuermann disease, APOYphyseal RINGS of vertebral bodies
1438
Avascular necrosis of the apophyseal rings of vertebral bodies
Scheuermann disease
"KOH Ta Na" (Quota Na)
Kohler disease, Talus Navicular
"Legg = Femur"
Legg-Parthes, Femoral head
"LuBak"
LUnate, kieBOCK malacia
"naTATAMeme si Frei"
MeTaTarsals, Freiberg infarction
"Showman Fire Rings"
Scheuermann disease, APOYphyseal RINGS of vertebral bodies
1439
Main radiographic finding in osteoporosis
Thinning of the cortex
Most reliably demonstrated in the 2nd metacarpal at the mid diaphysis
1440
Disuse osteoporosis is a type of osteoporosis that results from immobilization from any cause, most commonly follows
Treatment of a fracture
(Patient is just lying down on a bed after fracture treatment)
1441
The only finding pathognomonic for osteomalacia (vs. osteoporosis). It is a fracture through the osteoid seams.
Looser fracture
1442
Most common cause of osteomalacia in children
Rickets
Causes the epiphysis to become flared and irregular and the long bones to undergo pending from the bone softening.
1443
Most common cause of primary hyperparathyroidism
Parathyroid adenoma (80%)
1444
Most common cause of secondary hyperparathyroidism
Renal disease / Renal osteodystrophy with chronic hypocalcemia
1445
Radiographic sign that is pathognomonic for hyperparathyroidism
Subperiosteal bone resorption
Most commonly seen on radial aspect of the middle phalanges of the hand, medial aspect of the proximal tibia, sacrum joints, and in the distal clavicle.
1446
True or false:
Metabolic bone surveys are no longer recommended to assess bone lesions of Hyperparathyroidism
True
1447
Clinically, you notice that a patient is obese and of short stature with round facies. Bilateral hand xray revealed brachydactyly in several of the metacarpals. Diagnosis?
Pseudohypoparathyroidism
1448
Pituitary gland hyperfunction, due to secreting adenoma or hyperplasia of the anterior lobe of the pituitary gland, before the epiphysis close causes what?
Gigantism
1449
Pituitary gland hyperfunction, due to secreting adenoma or hyperplasia of the anterior lobe of the pituitary gland, after the epiphysis close causes what?
Acromegaly
1450
Patient presents with calvarial thickening, enlarged sinuses, and enlarged sella turcica. Prognathic jaw. Terminal tufts of the distal phalanges become hypertrophied and have a so called spade appearance. "Spade tufts"
Acromegaly
1451
Congenital hypothyroidism / Thyroid gland HYPOfunction leads to decreased thyroid secretion, which results in delayed skeletal maturation in children
Cretinism
1452
Bone infarcts, Step off deformities of the vertebral body endplates, and "fish" vertebrae (appearance like the vertebrae found in fish)
Sickle cell disease
1453
A myeloproliferative neoplasm in which there is replacement of bone marrow with collagenous connective tissue and progressive fibrosis in patients older than 50 y/o. Leads to anemia, splenomegaly, and extramedullary hematopoiesis. Osteosclerosis is seen in patients older than 50
Primary Myelofibrosis
1454
Pencil-in-cup deformity is classically associated with...
Psoriatic arthritis
However, it is not pathognomonic for it. It may also be seen in Rheumatoid arthritis and Reactive arthritis.
1455
A congenital abnormality that demonstrates dense bones. Patients are typically short and have hypoplastic mandibles. Radiographic findings of acroosteolysis (a.k.a phalangeal osteolysis, refers to resorption of the distal phalanx. Terminal tuft most commonly affected) with sclerosis are pathognomonic. Distal phalanges have the appearance of chalk that has been put into a pencil sharpener.
Pyknodysostosis
Y = You, kno = Know, dys = This
"P-YouKnowThis-Ostosis" imagine a teacher pointing a sharp CHALK at you, with the Distal phalanx / Terminal tuft near the chalk as well.
1456
This line in the pelvis MUST be thickened if Paget disease is present since the disease is almost commonly present in the pelvis
Iliopectineal line
1457
Classification of this ligament is said to be characteristic of Fluorosis
Calcification of the sacrotuberous ligament
1458
Dripping candle wax appearance of thickened cortical new bone that accumulates near the ends of long bones, usually on one side.
Melorheostosis / Leri disease
1459
Classically described radiographic appearance is a cortically based sclerotic lesion in a long bone that has a small lucency within it called the nidus. A painful lesion that occurs almost exclusively in patients less than 30 years old. It is treated successfully with surgical excision or thermal ablation. When the nidus is surgically removed or thermally ablated, complete cessation of pain.
Osteoid osteoma
1460
Osteoid osteoma will have an area of increased uptake corresponding to the area of reactive sclerosus but in addition, will demonstrate a secondary of increased uptake corresponding to the nidus. This has been termed...
"Double density" sign
1461
Also known as Voorhoeve disease. Manifested by multiple 2-3 mm thick linear bands of sclerotic bone aligned parallel to the long axis of the bone. Usually affects multiple long bones and is asymptomatic.
Osteopathia striata
1462
Hereditary, asymptomatic disorder that is usually an incidental finding of multiple small (3-10mm) sclerotic bony densities affecting primarily the pelvis and ends of long bones. Maybe confused for diffuse osteoblastic metastasis.
Osteopoikilosis
1463
Rare, familial disease manifested by thickening of the skin of extremities and face, clubbing of fingers, and widespread periostitis. More common in black patients. Periosteal reaction is similar to hypertrophic pulmonary osteoarthropathy but is only occasionally painful. Characteristic lace-like pattern of bony destruction in the hands. Multiple calendars are typically affected in either or both hands.
Pachydermoperiostitis
1464
Begins with a painful hip with no underlying disorder or other findings rather than osteoporosis which is limited to the painful hip. Self limited with full resolution. Occur more often in males. Percent with more edema than AVN and no well-demarcated margin is seen. Treated with pain management and protected weight bearing.
Transient osteoporosis of the hip / idiopathic transient osteoporosis of the hip (ITOH)
1465
Also called Transient osteoporosis of the knee. Most commonly occurs in medial condyle but can occur in the proximal tibia. T2 with fat suppression shows marked high signal in the medial condyle in a middle-aged woman with sudden onset of pain. Pain resolved over a 6 month period. Protected weight-bearing is recommended. Edema has been reported. Can occur in several different locations over time or simultaneously and is then called regional migratory osteoporosis.
Painful bone marrow syndrome
1466
Meniscal signal that does not disrupt an articular surface is representative of intrasubstance degeneration which is myxoid degeneration of the fibrocartilage. Most likely represents aging and normal wear and tear.
Meniscal degeneration
1467
Grading scale for menisci:
Rounded or amorphous signal that does not disrupt an articular surface
Grade 1
1468
Grading scale for menisci:
Rounded or linear signal that disrupts an articular surface
Grade 3, "Meniscal tear"
Note: Grade 1&2 are intrasubstance degeneration and NOT TEARS. If mentioned as a tear, may lead to unnecessary arthroscopy.
1469
Grading scale for menisci:
Linear signal that does not disrupt an articular surface
Grade 2
1470
Most common type of meniscal tear
Oblique tear (Extending to inferior surface of posterior horn of medial meniscus)
1471
A displaced, vertical longitudinal meniscal tear that can result in the inner free edge of the meniscus displaced centrally and the humerus becoming displaced into the intercondylar notch. Commonly occurs with medial meniscus and are associated with ACL tears. On coronal view, meniscus may be shortened or truncated. Other findings include absent bow tie sign on sagittal view.
Bucket-handle tear
NOTE: Double PCL sign (bucket-handle tears of medial meniscus) and Double ACL sign (bucket-hand tears of lateral meniscus) on sagittal view.
1472
Large meniscus that can have many different shapes such as lens shape, wedge or flat. More prone to tear than a normal meniscus. Can be symptomatic even without being torn. Easily identified on coronal view by noting extension of meniscal tissue into the tibial spines at the intercondylar notch.
Discoid meniscus
1473
Most common appearance of ACL tear
Most often simply NOT VISUALIZED
1474
Partial tears or sprains of the ACL present on MRI as
High signal within an otherwise intact ligament
1475
This cruciate ligament is infrequently torn and even less frequently repaired by surgeons. When torn it appears as chicken and has diffuse intermediate signal throughout. Always thicker than 7 mm. Rarely a cause of instability.
Posterior cruciate ligament tear
1476
This collateral ligament gets Injured usually from a valgus stress to the lateral part of the knee such as "clipping" injury in football.
Medial collateral ligament injury
1477
Medial collateral ligament injury grading:
Represents a mild sprain and diagnosed on mri by presence of fluid or hemorrhage in the soft tissues medial to the MCL. Ligament is normal.
Grade 1
1478
Medial collateral ligament injury grading:
Considered a partial tear and is seen as a high signal in and around the mcl on T1 and T2. Ligament is intact but deep and superficial fibers may show minimal disruption.
Grade 2, Partial tear
1479
Medial collateral ligament injury grading:
Complete disruption of the MCL.
Grade 3, complete tear
1480
Occurs when the medial meniscus is torn from its attachment to the joint capsule. Most commonly occurs at the site of the MCL and often occurs concomitantly with an MCL injury. Easily recognized on T2 coronal image by noting joint fluid extending between the medial meniscus and the capsule.
Meniscocapsular separation
1481
Patellar cartilage commonly undergoes degeneration causing exquisite pain and tenderness. More easily identified on axial images. Begins with focal swelling and degeneration of the cartilage seen as high signal foci. Progression causes thinning and irregularity of the articular surface of the cartilage. Finally, the underlying bone is exposed. Final stage occurs more commonly from trauma than wear and tear.
Chondromalacia patella
1482
An embryologic remnant from where the knee was divided into three compartments. It is a thin fibrous band that extends from the middle capsule toward the medial facet of the patella. On rare occasions, can thicken and cause clinical symptoms indistinguishable from torn meniscus termed "Plica syndrome"
Patellar plica
1483
Most frequently encountered bony abnormalities seen with MRI
Bone Contusion
1484
These represent microfractures from trauma and are also called bone bruises. On T1, subarticular areas often inhomogeneous low signal are seen. On T2, increased signal for several weeks depending on its severity. Can progress to osteochondritis dissecans if not treated with decreased weight-bearing.
Bone contusions
1485
True or false:
An isolated bone contusion with no other internal derangement is a serious finding that requires protection.
True.
Bone contusion can progress to osteochondritis dissecans if not treated with decreased weight-bearing.
1486
A bone contusion that occurs on the posterior part of the lateral tibial plateau have associated tears of what ligament in 90% of cases?
ACL tears, Acute ACL tears (90%) of cases
1487
An avulsion fracture of the knee that involves the lateral aspect of the tibial plateau and is very frequently (~75% of cases) associated with disruption of the anterior cruciate ligament (ACL). A small bony fragment pulled off the posterior lateral tibial joint line by an avulsion of the lateral joint capsule. It is almost always associated with an ACL tear.
Segond fracture
1488
A bursal abnormality that can cause joint pain and clinically mimic a syndrome or a torn meniscus
Bursitis
1489
True or false:
Pes Anserine Bursitis / bursa inflammation can mimic Plica syndrome and Torn medial meniscus.
True.
1490
True or false:
Medial bursae inflammation / Medial bursitis can mimic Meniscal cysts
True.
1491
Occurs from abduction of the humerus which allows the tendon to be impinged between the anterior acromion and the greater tuberosity. Can also be impinged by the undersurface of the AC joint if downward-pointing osteophytes or a thick and capsule is present.
Impingement of the supraspinatus tendon (Impingement syndrome)
1492
True or false:
Joint effusion, when present, the intra-articular structures such as the labrum, biceps, and articular surface of the cuff are more easily evaluated.
True.
1493
True or false:
Tendon degeneration (tendinopathy) is seen as a high signal in T1 that does not increase with T2. Can be seen asymptomatic shoulders of all ages. If the signal gets brighter on T2, must consider pathologic causes such as tendinitis or a partial tear.
True
1494
True or false:
Partial tears have more clinical to clinical significance if they are greater than 25% of the cuff thickness.
True
1495
A term of a particular type of articular sided partial tear. It occurs at the insertion of the fibers of the cuff onto the greater tuberosity. Most commonly occurs entirely at the insertion of the supraspinatus. It is the most commonly seen cuff tear on MRI.
Rim rent
1496
This bony abnormality is a posterolateral humeral head depression fracture, resulting from the impaction with the anterior glenoid rim, and indicative of an anterior glenohumeral dislocation. Bony impaction on the posterior superior aspect of the humeral head can be seen in patients with anterior instability of the humeral head.
Hill-Sachs lesion
"Humeral Hill" Humeral head, Hill-Sachs lesion
1497
Most common normal variant in the labrum that can mimic a torn or detached labrum
Sublabral recess (70% of shoulders)
Often seen on the oblique coronal images that can make a Superior Labrum Anterior to Posterior (SLAP) tear. Should only be thin, smooth and seen only in the anterior part of the superior labrum.
1498
Difference between Tenosynovitis versus Tendinosis:
Tenosynovitis = Fluid seen in the tendon sheath surrounding an otherwise normal tendon
Tendinosis = Tendon is enlarged and/or has high signal within
1499
True or False:
A subscapularis tear must be present if the biceps tendon is dislocated.
True
1500
A fairly common finding is a ganglion in the spinoglenoid notch that impresses the infraspinatus portion of the nerve with resultant pain and atrophy of the infraspinatus muscle. Commonly seen in males were athletic particularly weightlifters. Always associated with a torn posterior labrum, and can clinically mimic rotator cuff tear.
Suprascapular nerve entrapment
1501
Quadrilateral space syndrome most commonly occurs from
Fibrous bands or scar tissue in the quadrilateral space impinging on the axillary nerve
1502
If supraspinatus is smaller than other muscles and/or fatty infiltration, this is the likely diagnosis
Suprascapular nerve entrapment, secondary to a ganglion in spinoglenoid notch
1503
If the teres minor has fatty atrophy, this is most likely the diagnosis
Quadrilateral space syndrome
1504
Neurogenic edema is found in muscle groups that correspond to a particular nerve. Not pathognomonic because a traumatic nerve injury could have a similar appearance. No history of trauma, sudden onset of severe pain, followed by profound weakness, and edema. Seems to have an association with prior vaccinations viral illness or general anesthesia.
Parsonage-Turner syndrome
Supraspinatus/infraspinatus = Suprascapular nerve
Teres minor/Deltoid=Axillary nerve
1505
True or False:
Achilles tendon will not have tenosynovitis because it does not have a sheath associated with it.
True.
Tenosynovitis is fluid within a tendon sheath with underlying tendon normal. Since the Achilles tendon doesnt have a sheath, it cannot have tenosynovitis.
1506
Rupture of the posterior tibial tendon results clinically in what kind of foot
Flat foot, due to loss of arch support
1507
This ligament runs deep to the posterior tibial tendon and then goes underneath the neck of the talus which it supports in a sling like fashion. When the posterior tibial tendon tears, stress is then placed on this ligament to support to talus and the arch
Spring ligament
1508
True or false:
Spring ligament as a high incidence of destruction when the posterior tibial tendon is torn.
True
1509
This structure will be next to fail after the posterior tibial tendon and spring ligament tear from stress
Subtalar joint ligaments, in the sinus tarsi
1510
Ballet dancers will often have tenosynovitis all this tendon, seen on MRI as fluid in the sheath surrounding the tendon. Rupture of this tendon is rare.
Flexor Hallucis Longus tendon (FHL)
1511
Avulsion of the fifth metatarsal from a fool by the peroneus brevis tendon is known as
"Dancer's fracture" or Jones fracture
1512
Most commonly injured ligament in over 90% of ankle sprains
Lateral ligament
1513
Patient presents with lateral ankle pain and tenderness and perception of hindfoot instability the ligaments are torn and the fat is replaced with granulation tissue or scar tissue. T2 High (granulation tissue) and T2 Low (scar), while T1 will be low in signal.
Sinus tarsi syndrome
1514
Results from hypertrophy and scarring of the sinovium in the lateral gutter of the ankle. Patients present with lateral ankle pain and inability to dorsiflex normally. Often have a click on dorsiflexion. The anterior talofibular ligament is commonly torn or fibrosed.
Anterolateral impingement syndrome
1515
Bony sequestrum
"E.L.F. O.n a QUEST"
E-osinophilic granuloma
L-ymphoma
F-ibrosarcoma
O-steomyelitis
QUEST = se-QUEST-rum
1516
Bone lesions with No Periositits
”No Pera? FINES" (English of Oks lang)
F-ibrous dysplasia
I-nfection
N-on ossifying fibroma
E-nchondroma
S-olitary bone cyst
1517
Painless bone lesions
"NO F.Eyn.S" (read as No Pains)
N-on O-ssifying fibroma
F-ibrous dysplasia
Eyn-chondroma
S-olitary bone cyst
1518
Sclerotic bone lesions
"BIG FiDOO" if you remember, Fido dido was white like sclerotic
B-rown tumor
I-nfection
G-iant cell tumor
Fi-brous D-ysplasia
O-steoid O-steoma
1519
Expansile lytic lesions of posterior elements of the spine:
"T.A.O lang ang nagpapalaki (expansile lytic) ng nakaraan (posterior elements)"
T-uberculosis
A-neurysmal bone cyst
O-steoblastoma
1520
Also known as the superior sulcus tumor
Pancoast tumor
May be associated with SVC syndrome, Brachial plexus compression, and Horner syndrome
1521
Barcode/stratosphere sign on chest ultrasound
Pneumothorax
1522
Seashore sign on chest ultrasound
Normal chest lung on ultrasound
1523
This modality provides the greatest anatomic detail in pelvic imaging
MRI of the female pelvis
1524
A benign endometrial pathology that can cause mucous discharge or irregular vaginal bleeding. On ultrasound, represent as a focal nodular area of endometrial thickening with a feeding vessel by doppler. Hysterosonogram is definitive.
Endometrial polyp
1525
A benign endometrial pathology that manifests as abnormal proliferation of the endometrial glands and stroma. Causes abnormal uterine bleeding. Etiology is unopposed estrogen stimulation (on Tamoxifen). On ultrasound, there is smooth endometrial thickening and or cystic changes.
Endometrial hyperplasia or metaplasia
1526
True or false:
Larger endometrial polyps (>1.5 cm) in postmenopausal women have malignant potential.
True
1527
Most common location of fibroid/leiomyoma
INTRAMURAL (within the myometrium)
1528
Most common congenital uterine abnormality / malformation
Septate uterus, followed by bicornuate uterus
1529
Women's imaging:
On ultrasound, uterine enlargement with heterogenous and multicystic bunch of grapes appearance.
Complete hydatidiform mole, does not contain any fetal parts
Incomplete / partial mole contains fetal parts.
1530
On second trimester scan, a thickened nuchal fold is suggestive of what syndrome
Down syndrome
1531
On first trimester scan, a nuchal translucency of more than or equal to 3 mm is suggestive of
Aneuploidy, an abnormal number of chromosomes / chromosome abnormality
1532
Amniotic fluid index of more than 25
Polyhydramnios
Most commonly associated with:
GI abnormalities, Severe CNS abnormalities, Swallowing problems, Twin-twin transfusion syndromes
1533
Amniotic fluid index of less than 7
Oligohydramnios
Most commonly associated with:
Renal agenesis, Renal dysplasia, ARPKD, Congenital bladder outlet obstruction
1534
Most common associated neural tube defect in Chiari II
Lumbar myelomeningocele
1535
Chiari II malformation - flattened cerebellar hemispheres in the small posterior fossa
Banana sign
1536
Chiari II malformation - flattening of the frontal bones
Lemon sign
1537
Boomerang shape on antenatal ultrasound
Holoprosenceohaly
1538
Most frequent occult cancer detected Carcinoma contained within the duct with an intact basement membrane in place. Lowest stage of breast cancer, Stage 0. Presents mammographically as classifications. On MRI, pattern of linear or segmental clumped enhancement.
Ductal carcinoma in situ (DCIS)
1539
Most common subtype of breast cancer representing 70-80% of cases. Presents with palpable mass and on mammogram as irregular mass with spiculated margins and associated pleomorphic calcifications.
Invasive ductal carcinoma (IDC)
1540
Breast malignancy that have tendency to spread through the breast tissue without forming a discrete mass. Very difficult to diagnose through mammography because it ranges from one-view asymmetry to architectural distortion to a spiculated mass.
Invasive lobular carcinoma (ILC)
1541
It is an aggressive breast cancer where the tumor invades the dermal lymphatics. Patients have poor prognosis. Physical exam findings show erythema, edema, and firmness, peau d' orange or orange peel appearance. On mammography, the affected breast is larger and denser, with trabecular and skin thickening. Primary differential is mastitis.
Inflammatory carcinoma
1542
A form of DCIS that infiltrates the epidermis of the nipple. Presents with erythema, ulceration, and eczematoid changes of the nipple.
Paget disease of the nipple
1543
True or false:
Cancers with HER2/neu overexpression may respond to monoclonal antibody trastuzamab (brand name Herceptin), or tyrosine kinase inhibitors such as Lapatinib.
True
1544
True or false:
Triple-negative cancers are ER, PR, and HER2/neu negative, and the majority are biologically aggressive with poor prognosis.
True
1545
Most common aneuploidy detected at birth
Trisomy 21, Down syndrome
1546
Most accurate means for sonographic dating of pregnancy in the first trimester
Crown rump length (CRL)
1547
Most common abnormalities that result in first trimester abortions
Trisomy 16 and 45,X
1548
Most common clinically significant type of human chromosomal abnormality
Aneuploidy
1549
Most common cause of maternal infection
Cytomegalovirus
1550
Most prominent radiation-associated abnormalities are
CNS defects
1551
Single most powerful marker in screening for down syndrome
Fetal nuchal translucency (1st trim)
1552
Most common cardiac defect associated with infants with down syndrome
VSD
1553
Leading cause of intestinal obstruction in the newborn
Duodenal atresia
1554
One of the most important markers in most sensitive and specific marker for mid trimester detection of down syndrome
Nuchal fold
1555
Most common pathologic condition of the umbilicus and is associated with what trisomy
Single umbilical artery, Trisomy 18
1556
The single most common cause of mental retardation
Down syndrome, Trisomy 21
1557
Cause of 95% stillbirth or spontaneous abortion
Trisomy 18
1558
With the early rupture of the amnion, the fetal parts get entrapped in bands which reduces the flow on the affected limb causing amputation. On ultrasound, constriction rings around digits arms and legs swelling of extremities distal to constriction, facial clefts, cephalocele, club feet, club arms, micropthalmia, and other ocular anomalies.
Amniotic band syndrome
1559
Most characteristic prenatal feature of turner syndrome
Cystic hygroma
1560
True or false:
Twin-twin transfusion syndrome only occurs in monochorionic, diamniotic pregnancy.
True
1561
First definitive finding to SUGGEST early intrauterine pregnancy
Gestational sac
1562
True or false:
Gestational sac should be detected by transvaginal sonography or transabdominal sonography when mean sac diameter (MSD) is at least 4 mm.
False. 5mm
1563
Most common congenital CNS malformations
Neural tube defects
1564
Most common syndrome associated with agenesis of the corpus callosum
Aicardi syndrome
1565
Most common craniosynostosis
Scaphocephaly
1566
Most common spinal abnormalities seen in skeletal dysplasia
Platyspondyly
1567
Most common non-lethal skeletal dysplasia
Achondroplasia
1568
Most common congenital diaphragmatic hernia is
Bochdalek hernia
1569
Most common cause of congenital hydrothorax
Chylothorax
1570
It is the leading cause of meconium ileus
Cystic fibrosis
1571
Most common location of duplication cyst in the small bowel
Terminal ileum, at its mesenteric side
1572
Most common origin of intestinal obstruction in the neonate
Hirschsprung disease
1573
Most common congenital anal anomaly
Anal atresia
1574
Most common type of anal atresia
Low
1575
Most common benign tumor of the liver in fetus and units
Hemangioma
1576
Most common hepatic malignancy in young children
Hepatoblastoma
1577
Most common cause of obstructive jaundice in the newborn
Biliary atresia
1578
Most common location of ectopic kidneys
Pelvis
1579
Most common cause of urinary tract dilatation in the newborn
UPJ obstruction
1580
Most common cause of non inherited renal cysts
Parenchymal dysplasia
1581
Most common cause of inherited renal cystic disease
ADPKD
1582
Most common origin of congenital abdominal masses
Kidneys
1583
Most common renal tumor in the fetus
Mesoblastic nephroma
1584
Most common site of placental abruption
Placental edge, Marginal
1585
Most common cause of bleeding in the third trimester
Placenta previa
1586
Placenta that is adherent to villa
Placenta accreta
1587
Placenta that invades myometrium
Placenta increta
1588
Placenta that perforate serosa or surrounding structures
Placenta percreta
1589
Most common non trophoblastic placental tumor
Chorioangioma
1590
Most common benign neoplasm of the placenta
Chorioangioma
1591
Most common tumor of the umbilical cord
Hemangioma
1592
Most common ovarian germ cell tumor
Ovarian teratoma
1593
Most common type of ovarian teratoma
Mature cystic teratoma or dermoid cyst
1594
Most common location of an abdominal ectopic pregnancy
Broad ligament
1595
Viral etiology that causes cervical cancer
HPV 16, 18
1596
Most common sex cord tumor of the ovaries
Fibroma
1597
Most common primary ovarian carcinoma
Epithelial type
1598
Most common site of metastasis to female genital tract
Ovaries
1599
These endometrial abnormalities are hyperplastic growths consisting of dense fibrous tissue or smooth muscle with disorganized endometrial glands
Endometrial polyps
1600
An extreme form of mullerian duct anomaly with complete agenesis of the proximal vagina and anomalous cervix and uterus and patients usually present in early puberty with primary amenorrhea
Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH)
1601
Complete or partial agenesis of a unilateral mullerian duct leads to development of what anomaly of the uterus?
Unicornuate uterus
1602
Most common type of mullerian anomaly
Septate uterus
1603
A normal variant of uterine configuration in which the thickened fundal portion of the myometrium slightly indents the endometrial canal creating a heart shape endometrial cavity
Arcuate uterus
1604
This is a disease characterized by migration of endometrial glands and stroma from the stratum basale into the myometrium often occurring in association with the reactive hyperplasia of the surrounding myometrial smooth muscle.
Adenomyosis
1605
Retention cyst that develop secondary to obstruction of the cervical glands or crypts are called
Nabothian cysts
1606
These lesions appear on ultrasound images as well circumscribed masses of variable echogenicity seen in the cervix and are typically relatively avascular
Cervical leiomyoma
1607
Adnexal pathology that occurs when there is partial or complete rotation of the adnexal structures around there was fear pedicle with associated obstruction of venous outflow and arterial inflow
Adnexal torsion
1608
Most consistently reported grayscale ultrasound finding of adnexal torsion
Unilateral enlarged ovary (>4cm) with or without an associated mass
1609
This sonographic sign is described as a perifollicular hyperechoic rim that is 1-2 mm in thickness, seen surrounding the small peripheral antral follicles of the torsed ovary
Follicular ring sign
1610
Most henorrhagic cysts typically resolve within how many weeks?
8 weeks
1611
A sign of pelvic inflammatory disease wherein there are thickened and inflamed endosalpingeal folds that may suggest small mural nodules, that help differentiate pyosalpinx from an inflamed appendix.
Cogwheel sign
1612
Most frequent site of extrapelvic disease
Anterior abdominal wall
1613
This is a sonographic confirmatory diagnostic sign of leiomyoma wherein there is demonstration of a vascular supply into a mass derived from the uterus
Bridging vascular sign
1614
Most common type of benign degeneration of leiomyoma
Hyaline degeneration
1615
An acute form of benign leiomyoma degeneration is
Red degeneration
1616
This sonographic finding is highly specific of a hemorrhagic ovarian cyst
Retracting clot
1617
Most significant potential complication of a hemorrhagic ovarian cyst
Rupture with hemoperitoneum
1618
Characteristic sonographic appearance of a mature cystic teratoma wherein there are areas of marked acoustic shadowing of the echogenic cyst contents of sebum and hair
Tip of the iceberg sign
1619
This refers to the hyperechoic component of a mature cystic teratoma that typically corresponds to mixed hair and sebaceous material or occasionally to classification, sometimes related to a bone or tooth
Rokitansky nodule, Dermoid plug
1620
This type of epithelial ovarian carcinoma is highly aggressive that present with advanced stage at diagnosis and likely originated from precursors arising in the fibriated segments of the fallopian tube epithelium.
Type II
1621
This type of epithelial ovarian carcinoma is composed of low-grade neoplasms that present at an early age with an indolent course and are believed to arise from precursor lesions in the ovary, such as cortical inclusion cysts lined by tubal epithelia, serous cystadenomas, borderline neoplasms, or endometriosis
Type I
1622
Most important sonographic feature for predicting ovarian malignancy
Presence of a solid component
1623
Primary consideration once a solid ovarian mass is seen
Sex cord stromal tumor
1624
Granulosa cell tumors most commonly secrete what hormone?
Estrogen
1625
Sertoli-Leydig cell tumor most commonly secrete hormone?
Androgens, Testosterone
1626
These ovarian tumors are uncommon surface epithelial tumors that often differ from others in that they are mostly solid appearing with internal classifications and are generally benign
Brenner tumors
1627
Primary consideration if one encounters a lobulated solid ovarian mass particularly in a 20 to 30 year old woman
Dysgerminoma
1628
A sonographic sign of tubal dilatation wherein the dilated tube folds back on itself and there is juxtaposition of the two inner folds of the fallopian tube
Incomplete septation sign
1629
Hallmark of pelvic inflammatory disease
Sonographic involvement of the fallopian tube or ovary
1630
Tuberculosis reaches and infects the fallopian tubes most commonly via what route?
Hematogenous route
1631
In the non pregnant patient, hematosalpinx is most commonly due to what disease
Endometriosis
1632
Primary fallopian tube carcinoma has a classical clinical presentation of LATZKO'S TRIAD composed of:
- Pelvic mass
- Vaginal discharge (bloody)
- Colicky pain (relieved by the discharge)
1633
Most common predisposing factor for ectopic pregnancy
Tubal scarring secondary to sexually transmitted infections (STI)
1634
What disease is characterized by nodular thickening of the isthmic portion of the fallopian tube accompanied by multiple diverticula
Salpingitis isthmica nodosa
1635
Term referring to a pregnancy that is detected biochemically but not yet visible sonographically or laparoscopically
Pregnancy of Unknown Location
1636
Most reliable sonographic finding for ectopic pregnancy with a 100% positive predictive value
Extrauterine embryo with or without a heartbeat
1637
Transvaginal ultrasound reveals an hourglass shaped uterus composed of a uterine corpus and disproportionately enlarged cervix with a "waist" at the level of the internal os. There is trophoblastic flows seen. Diagnosis is likely what?
Cervical pregnancy
1638
Transvaginal ultrasound shows two endometrial cavity with a midline partition extending into the internal cervical os. A single cervix is present. The outer fundal contour of the uterus appears broad. This likely represents what anomaly of the reproductive tract?
Septate uterus
1639
The most common anomaly of the female reproductive tract
Imperforate hymen
1640
The usual cause of prepubertal bleeding
Vulvovaginitis
1641
Most common vaginal foreign body in pediatric or adolescent patients
Fibrous material from clothing
1642
Most frequent ovarian malignancy in childhood
Dysgerminoma
1643
AAST Liver injury grading:
- Laceration <1 cm
- Subcapsular hematoma <10% surface area
Grade 1
1644
AAST Liver injury grading:
- Laceration 1-3 cm, <10 cm in length
- Subcapsular hematoma 10-50% surface area
- Intraparenchymal hematoma <10 cm
Grade 2
1645
AAST Liver injury grading:
- Laceration >3 cm
- Subcapsular hematoma >50% surface area
- Intraparenchymal hematoma >10 cm
- Vascular injury with active bleeding contained within liver parenchyma
Grade 3
1646
AAST Liver injury grading:
- Laceration with parenchymal disruption 25-75% of liver or involves 1-3 Couinaud segments
- Vascular injury with active bleeding breaching liver parenchyma into peritoneum
Grade 4
1647
AAST Liver injury grading:
- Laceration with parenchymal disruption >75% of hepatic lobe
- Vascular injury involving juxtahepatic venous injuries (IVC, Central major hepatic veins)
Grade 5
1648
AAST Splenic injury scale:
- Subcapsular hematoma <10% surface area
- Parenchymal laceration < 1 cm
- Capsular tear
Grade 1
1649
AAST Splenic injury scale:
- Subcapsular hematoma 10-50% surface area
- Parenchymal laceration 1-3 cm
- intraparenchymal hematoma <5 cm
Grade 2
1650
AAST Splenic injury scale:
- Subcapsular hematoma >50% surface area
- Parenchymal laceration >3 cm
- intraparenchymal hematoma >5 cm
Grade 3
1651
AAST Splenic injury scale:
- Splenic vascular injury or active bleeding CONFINED within splenic capsule
- Laceration involving segmental or hilar vessels producing >25% devascularization
Grade 4
1652
AAST Splenic injury scale:
- SHATTERED SPLEEN
- Splenic vascular injury with active bleeding extending beyond the splenic capsule into the peritoneum
Grade 5
1653
AAST Renal injury scale:
- Subcapsular hematoma or contusion
- No laceration
Grade 1
1654
AAST Renal injury scale:
- Hematoma confined within perirenal fascia
- Laceration <1 cm
Grade 2
1655
AAST Renal injury scale:
- Vascular injury or active bleeding CONFINED within perirenal fascia
- Laceration >1 cm not involving collecting system
Grade 3
1656
AAST Renal injury scale:
- Vascular injury or active bleeding BEYOND perirenal fascia
- Laceration involving collecting system with urinary extravasation
- Vascular injury to SEGMENTAL renal artery or vein
Grade 4
1657
AAST Renal injury scale:
- SHATTERED KIDNEY
- Avulsion of renal hilum or laceration of main renal artery or vein
- Devascularized kidney with active bleeding
Grade 5
1658
Stanford classification of Aortic dissection:
Involves any part of the aorta proximal to the origin of the left subclavian artery
Stanford A
"Stanford A A-ffects A-scending A-orta"
1659
Stanford classification of Aortic dissection:
Arises distal to the left subclavian artery origin
Stanford B
B for Baba = Descending aorta
1660
DeBakey classification of Aortic Dissection:
Involves ascending and descending aorta (Stanford A)
DeBakey Type I
1661
DeBakey classification of Aortic Dissection:
Involves ascending aorta ONLY (Stanford A)
DeBakey type II
1662
DeBakey classification of Aortic Dissection:
Involves descending aorta ONLY, commencing after origin of left subclavian artery (Stanford B)
DeBakey type III
1663
Most common location of thoracic aortic aneurysm
Ascending aorta, Aortic root (60%)
1664
Most frequently injured viscous secondary to penetrating injury (firearms & stabbing)
Liver
1665
Most common cause of subcapsular liver hematoma
Iatrogenic hepatic injury secondary to liver biopsy
1666
A self-limiting, viral type of illness which is referred to as Valley fever when associated with erythema nodosum and arthralgias. Chest radiographs may be normal or show focal or multifocal segmental airspace opacities that resolve over several months. Hilar and mediastinal adenopathy and pleural effusions may be seen.
Acute coccidioidomycosis
"Cox Valley"
C. immitis
Coccidioidomycosis
Valley fever
1667
Also known as fungus ball, consisting of hyphae, mucous, and cellular debris that colonizes a pre-existing bulla or a parenchymal cavity created by some other pathogen or destructive process. It is usually asymptomatic but may cause hemoptysis which may be massive. Presents as a solid round mass within an upper lobe cavity with an "Air crescent" sign separating from the cavity wall.
Aspergilloma / Mycetoma
1668
Pulmonary disease caused by the Lung fluke. Acquired by eating raw crabs for snails. Patients may be asymptomatic or present with cough, hemoptysis, dyspnea, and fever. Radiographic findings include: multiple cysts with variable wall thickness, cystic opacities may become congruent with focal atelectasis and sub-segments of consolidation, dense linear densities representing burrows of the organism.
Paragonimiasis
By Paragonimus westermani
1669
Refers to the extension of an empyema out of the pleural space and into the neighboring chest wall and surrounding soft tissues
Empyema necessitans / Empyema necessitatis
1670
A rare complication of pulmonary infection when a portion of the lung is sloughed off. Imaging findings include an ordered aura mass within a cavity with a crescent of air surrounding the sloughed portion of the lung.
Pulmonary gangrene
1671
Uncommon post-infectious form of constrictive bronchiolitis that typically results from severe viral or mycoplasma infection in infancy or childhood. Radiologic findings include: hyperlucent lung with normal or small-volume, attenuated vasculature, expiratory air trapping, and occasional proximal bronchiectasis.
Swyer-James syndrome
1672
Honeycomb cysts are frequently seen in:
"Honey, don't C.U.Ss in front of the kids"
C-hronic hypersensitivity pneumonitis
U-sual interstitial pneumonitis
S-arcoidosis
1673
True or false:
Cysts of LCH and LAM have shared walls.
False. Honeycomb cysts have shared walls whereas the cysts in LCH and LAM do not.
1674
True or false:
Honeycomb cysts tend to occur in the subpleural regions of lower lobes. Cysts of LCH and LAM are usually evenly distributed from central to peripheral in the upper lobes with or without lower lobe involvement.
True.
1675
True or false:
Honeycomb cysts uniformly destroys lung and produces distortion of the lung interfaces and traction bronchiectasis.
True.
1676
Disease of young and middle-aged women typically involve inflammation of multiple organs mediated by autoantibodies and circulating immune complexes. Radiographic findings include pleural effusions and pleural fibrosis, which may result in diffuse pleural thickening (present in long-standing disease)
Systemic lupus erythematosus (SLE)
1677
Pulmonary disease associated with SLE presenting with rapid onset of fever, dyspnea, and hypoxemia and may require mechanical ventilation. Indistinguishable from ARDS with diffuse alveolar damage producing an exudative intra-alveolar edema with hyaline membrane formation. Present radiographically as rapidly coalescent bilateral airspace opacities and on CT scan as ground-glass opacities. Diagnosis by excluding pneumonia and pulmonary edema and improvement following immunosuppressive therapy.
Acute lupus pneumonitis
1678
Produces inflammation and fibrosis of the skin, esophagus, musculoskeletal, lungs, kidneys in young and middle-aged women. Lungs are involved in nearly 90%. Pulmonary testing is more sensitive than conventional radiographs and shows typical diminished lung volumes, preserved flow rates, and low diffusing capacity. Pulmonary arterial hypertension with enlarged pulmonary arteries and right ventricular dilatation is seen in 50% of patients.
Scleroderma (Progressive systemic sclerosis)
Thickening and obliteration of small muscular pulmonary arteries and arterioles are responsible for development of pulmonary arterial hypertension in Scleroderma.
1679
Autoimmune inflammation and destruction of skeletal muscle resulting in proximal muscle pain and weakness and skin rash. Thoracic manifestations include respiratory and pharyngeal muscle weakness. Fine reticular interstitial pattern in acute disease leads to a chronic course, reticular, and reticulonodular process predominantly basilar in distribution. Other radiographic findings: small lung volumes, diaphragmatic elevation, basilar linear atelectasis. Pharyngeal and upper esophageal muscle weakness predisposed to aspiration pneumonia.
Dermatomyositis and Polymyositis
1680
Subacute illness with several months history of nonproductive cough and dyspnea. PFTs show restrictive pattern with diminished lung volumes and normal to increased flow rates. Histopath: Mononuclear cell exudate in bronchioles and surrounding alveoli organizes to form intro bronchial and intra-alveolar granulation tissue. Radiologic findings: patchy ground glass opacities surrounded by crescentic regions of more dense consolidation turned "reversed halo" sign.
Cryptogenic Organizing Pneumonia (COP)
1681
This sign is also known as the ATOLL SIGN. On chest CT, seen as central ground-glass opacity surrounded by denser consolidation of crescentic shape (forming more than three-fourths of a circle) or complete ring.
Reverse halo sign
As seen in Organizing pneumonia, Cryptogenic Organizing Pneumonia
1682
Interstitial pneumonia that is characterized by accumulation of macrophages within the alveolar spaces
Desquamative interstitial pneumonia
1683
Eggshell calcifications in Thorax and Mediastinum:
"Silly Sarco Likes Her Smart ABC while Mike likes EGGS"
"Silly Sarco Likes Her Smart ABC and Mike likes EGGS"
S: silicosis (5%)
S: sarcoidosis: (5%)
L: lymphoma (postradiation Hodgkin disease, usually 1-9 years following treatment)
H: histoplasmosis (rare)
S: scleroderma (rare)
A: amyloidosis (rare)
B: blastomycosis (rare)
C: coal workers' pneumoconiosis (1%)
M: mycobacterium tuberculosis
1684
This inhalational disease is seen pathologically as a large number of bodies with a transparent core surrounded by a coat of iron and protein deposited in lung tissue
Asbestos bodies in Asbestosis
1685
This inhalational disease has pathologic findings of nodules with dense concentric lamellae of collagen in lung tissue.
Silicotic nodules in Silicosis
1686
This inhalational disease is caused by inhaling large amounts of carbon containing inorganic material. Results from deposit of carbonaceous material within the lung. Appear as round or stellate nodules ranging in size from 1 to 5 mm. Pathologically seen as pigment laden macrophages with minimal or absent collagen formation.
Coal dust macule in Coal Worker's Pneumoconiosis
1687
This is also known as Extrinsic Allergic Alveolitis. This is an immunologic pulmonary disorder associated with inhalation of one of the antigenic organic dusts. Mediated by Type 3 hypersensitivity reaction. Radiographic findings include: fine nodular or ground glass opacities in the lower lobes or progressive airspace opacification which may resolve within hours to days. Chronic changes include: diffuse course reticular or reticulonodular opacities in the mid lung and upper lung zones, honeycombing with loss of lung volume.
Hypersensitivity pneumonitis
1688
Schaumann bodies, which are laminated calcium-containing concretions, are characteristic of this granulomatous disease.
Sarcoidosis
1689
Granulomatous disease with early histopathologic changes showing palisading epithelioid histiocytes with intermixed multinucleated giant cells
Schaumann bodies in Sarcoidosis
1690
Bowler hat sign
GI polyps or diverticulum
The orientation of the bowler hat helps differentiate between the two conditions. When the top of the bowler hat is directed towards the center of the long axis of the colonic lumen it is a polyp. When the bowler hat is directed away from the colonic lumen it is a diverticulum.
1691
Pathologically demonstrates multiple small nodules found predominantly in the axial interstitial tissues of the upper and mid lung zones around small bronchioles around small bronchioles. These are composed predominantly of cells with eosinophilic cytoplasm.
Langerhans cell histiocytosis
1692
Systemic autoimmune disorder characterized pathologically by a necrotizing granulomatous vasculitis involving the upper and lower respiratory tracts and kidneys. Characteristic lesions in the lungs are discrete nodules or masses of granulomatous inflammation with central necrosis and cavitation. High serologic titers of antineutrophil cytoplasmic antibody are specific for the diagnosis.
Wegener granulomatosis
1693
Most commonly results from damage to type 2 pneumocytes secondary to acute insult to the lungs. Initially manifests as pulmonary edema in a geographic or non-dependent distribution without pleural effusion interlobular thickening.
Diffuse alveolar damage (DAD)
1694
Drugs that induce Diffuse Alveolar Damage:
"DAD is OP (Overpowered), drinks CHEvas GOLD, eats MIT (meat)"
D-iffuse A-lveolar D-amage
OP-iates
CHE-motherapeutic agents
GOLD
MIT-omycin
1695
Characterized by formation of bone within lung parenchyma.
Diffuse pulmonary ossification
1696
Diffuse tracheal and central bronchial dilatation resulting from an acquired or congenital defect of tracheal cartilage. Acquired more common. Imaging hallmark: excessive airway collapse on expiration. On CT: "FROWN-LIKE" configuration / Frown sign on Axial
Tracheobronchomalacia (TBM)
Frown sign = caused by anterior bowing of the posterior tracheal wall during expiration on Axial view
1697
Production of abnormally thick tenacious mucus which plugs the small airways causing bronchial obstruction in dyspnea. Radiographs show hyperinflation with predominantly upper lobe bronchiectasis with mucous plugging. Diagnosis: Positive family history and sweat test showing an abnormally high concentration of chloride.
Cystic fibrosis
1698
Abnormal and ineffective epithelial cilia motion resulting in rhinitis, sinusitis, bronchiectasis, dysmotile spermatozoa and sterility, situs inversus and dextrocardia. Associated with Kartagener syndrome (Sinusitis, Situs inversus, Bronchiectasis). Diagnosis: Clinical & Radiographic findings and nasal biopsy samples of CILIA anatomy and motion samples.
Dysmotile cilia syndrome
1699
Type of emphysema that is characterized by airspace distension in the central portion of the lobule and sparing of the distal portions
Centrilobular emphysema
1700
Type of emphysema that is seen as selective distention of the peripheral airspaces adjacent to interlobular septa with sparing of the centrilobular region
Paraseptal emphysema
1701
Cigarette smoking is associated predominantly with what type of emphysema
Centrilobular emphysema
1702
A sign of pneumothorax in the SUPINE patient:
When both diaphragmatic dome and anterior portions of the diaphragm are visualized (being outlined by lung and pleural air). Air may outline the anterior portions of the hemidiaphragm and cause visualization of the anterior costophrenic sulcus.
Double diaphragm sign
1703
Most common primary malignancies to produce secondary spontaneous pneumothorax
- Osteogenic sarcoma
- Lymphoma
- Germ cell malignancies
1704
A rare type of pneumothorax that occurs with menstruation. Effects women in their fourth decade and is most likely caused by cyclic necrosis of pleural endometrial implants which creates an air leak between the lung and pleura. Manage by preventing menstruation with oral contraceptives.
Catamenial pneumothorax
1705
HOLLY LEAF sign refers to the appearance of this benign pleural manifestation of ASBESTOSIS on chest radiographs. Their irregular thickened nodular edges are likened to the appearance of a holly leaf.
Pleural plaques
1706
Prevention of contralateral mediastinal shift despite extensive pleural tumor volume and effusion is a finding that helps distinguish this asbestos-related pleural disease from metastatic disease.
Mesothelioma
1707
Lipoma that may be intra or extrathoracic and may project partially within and outside the thorax
Dumbbell lipoma / Dumb-bell lipoma / Dumb bell lipoma
1708
A relatively common congenital anomaly which arises from the 7th cervical vertebral body. It is usually is asymptomatic and a minority of cases present with secondary weakness and swelling of the upper extremity. Surgical resection can relieve the symptoms.
Cervical rib
1709
Congenital anomalies of the bony thorax:
These may be associated with thin, wavy, "RIBBON" RIBS
Neurofibromatosis and Osteogenesis imperfecta
1710
What vessels are particularly involved in rib notching from Coarctation of the aorta?
Intercostal arteries
The tortuosity and dilatation of these vessels causes erosion of the INFERIOR MARGIN of the adjacent ribs. Also, notching predominantly affects the POSTERIOR aspect of ribs bilaterally. So, a possible answer in PBR2 maybe "Posteroinferior" margin or either of the two separately.
1711
A type of vertebral anomaly and results from a lack of formation of one half of a vertebral body. It is a common cause of congenital scoliosis.
Hemivertebra/e
1712
Hemivertebra/e are associated with:
- Cleidocranial dysostosis (partial or complete aplasia of the clavicle)
- Gastroschisis
- VACTERL association
- Mucopolysaccharidosis
1713
A type of vertebral anomaly that results from the failure of fusion of the lateral halves of the vertebral body because of persistent notochordal tissue between them.
Butterfly vertebra/e
1714
Butterfly vertebra/e are associated with:
- Anterior spina bifida
- Anterior meningocele
- VACTERL
1715
STERNUM related abnormality:
- Heart displaced to LEFT
- Depressed soft tissues of anterior chest wall
- VERTICALLY oriented anterior ribs results in loss of right heart border
Pectus excavatum
1716
Rounded, oval, or branching central lung opacity representing the obstructed, mucus-filled, dilated bronchus (mucocele/bronchocele) with hyperlucency in that portion of the lung supplied by the stenotic bronchus. Diagnosis: Central mucocele/bronchocele with peripheral hyperlucency in a young, asymptomatic patient.
Bronchial atresia
1717
Echocardiography:
Increased E-F slope is associated with?
"E.T.A (Estimated Time of Arrival)"
-Ebstein anomaly
-Tricuspid regurgitation
-ASD
1718
Most common morphologic variant of Hypertrophic cardiomyopathy present in 60-70% of cases?
Asymmetric hypertrophic cardiomyopathy / Asymmetric septal hypertrophy (ASH)
1719
Subtype of Subvalvular / Subaortic stenosis:
Thin membrane less than 2 cm below the valve
Type 1
1720
Subtype of Subvalvular / Subaortic stenosis:
Thick, collar type constriction
Type 2
1721
Subtype of Subvalvular / Subaortic stenosis:
Irregular, fibromuscular type of narrowing
Type 3
1722
Subtype of Subvalvular / Subaortic stenosis:
FUNNEL-like constriction
Type 4
1723
True or false:
Valvular pulmonic stenosis is caused by PARTIAL FUSION in 95% of cases
True
1724
Pulmonary valve cusps are immobile, thick, and redundant. No click noted and no post-stenotic dilatation.
Dysplastic pulmonary stenosis
1725
Most common fungal agent in endocarditis
Candida
Followed by Aspergillus
1726
These can be detected in 50-90% of patients with known bacterial endocarditis. Cause excessive vibration of the valves during systole and the leaflets may appear slightly thickened or fuzzy. Cause valvular incompetence or acute aguilar destruction. Remain even after successful antibiotic therapy.
Valvular vegetations, from Bacterial endocarditis
1727
What is the pericardial disease?
- Calcified or fibrous thickening or the pericardium
- Chronically Compromise diastolic filling
- post-periCardiotomy is most common cause.
Constrictive pericardial disease
1728
Widely swinging cardiac silhouette on DECUBITUS VIEW
Congenital abscence of the pericardium
1729
Loud, continuous, MACHINE-like murmur
Patent ductus arteriosus (PDA)
1730
Results from a deficiency in the supporting structure of the aortic valve cusps. Results in aneurysmal bulging of the aortic sinuses and in some cases, rupture. Most often affected is the RIGHT ANTERIOR aortic sinus.
Ruptured aneurysm of sinus of valsalva
1731
Type of Pulmonary Atresia:
- RV is severely hypoplastic
- tricuspid valve is atretic
- no significant tricuspid regurgitation
- no RAE
- Intact intraventricular septum
Type 1
1732
Type of Pulmonary Atresia:
- RV more developed
- Tricuspid valve more patent
- Gross tricuspid insufficiency
- Marked enlargement of RA
- Intact intraventricular septum
Type 2
1733
Small hypoplastic RV and Tricuspid valve are present. RV pressures are exceedingly high, Shunting from right to left occurs at Atrial level. On Chest xray, decreased pulmonary vascularity and a shallow or concave pulmonary artery.
Pulmonary atresia
1734
Cardiac anomalies that result in DECREASED PULMONARY VASCULARITY:
"Tetra H.U.E"
- TETRAlogy of fallot
- Hypoplastic right heart syndrome (Pulmonary atresia, Tricuspid atresia, Tricuspin stenosis)
- Uhl disease
- Ebstein anomaly
1735
This refers to a heterogeneous group of congenital, non-sex-linked, genetic disorders of collagen type 1 production, involving connective tissues and bones. The hallmark feature is osteoporosis and fragile bones that fracture easily, as well as, blue sclera, dental fragility and hearing loss. Presence of ZEBRA STRIPE sign - cyclic bisphosphonate treatment produces sclerotic growth recovery lines in the long bones
Osteogenesis imperfecta
1736
Complete vascular ring causes focal tracheomalacia or fixed tracheal stenosis. It is composed of what:
- Right aortic arch and descending aorta
- ARSA
- LEFT ductus arteriosus or ligamentum arteriosum
1737
This vascular anomaly has no symptoms ENT-wise (no stridor) or GI-wise (no dysphagia) BUT has decreased blood supply to UPPER EXTREMITY leading to DECREASED PULSES and ISCHEMIA of the extremity.
Isolated Left Subclavian Artery (ILSA)
While, Isolated Right Subclavian Artery (IRSA) findings are reversed from ILSA. They are like twins but different.
1738
Vascular anomalies that pass anterior and compresses the trachea resulting in respiratory distress, wheezing, stridor, and difficulty in feeding. Tracheal indentation always ANTERIOR.
"AINNA & ALCCA are TROUBLESOME twins OUT FRONT, but ALLCA is CLOSEST to Archie."
AINNA = Abberant INNominate Artery
ALCCA = Abberant Left Common Carotid Artery
OUT FRONT = Both pass ANTERIOR to trachea
TROUBLESOME = Tracheal compression, Respiratory distress, Wheezing, Stridor, Difficulty feeding
CLOSEST TO ARCHIE = ALCCA arises more PROXIMAL to AORTIC ARCH.
1739
Most common cause of myocarditis
Viral, Coxsackie virus
1740
Most common fetal cardiac tumor
Rhabdomyoma
1741
This uterine mass causes abnormal bleeding by erosion of overlying endometrium. Compared to endometrial polyps, this uterine mass tends to be more hypoechoic, larger, and have multiple feeding vessels. Most common symptom is bleeding throughout the menstrual cycle. Acoustic shadowing may be seen emanating from the mass.
Submucosal Leiomyoma
1742
Most common solid benign uterine neoplasm
Leiomyoma (Fibroids)
1743
Ovarian epithelial tumor:
Thin-walled, usually unilocular, with anechoic fluid mimicking a functional ovarian cyst
Serous cystadenoma
1744
Ovarian epithelial tumor:
Multiloculated with thick walls, thick septae and papillary projections into the fluid. On doppler study, blood flow is seen within the septa and papillary projections.
Serous cystadenocarcinoma
1745
Ovarian epithelial tumor:
Maybe huge, filling the pelvis and extending high into the abdomen. Most have multiple septations and contain fluid that is echogenic because of the presence of MUCIN. Its rupture will spread mucin throughout the peritoneal cavity and may result in Pseudomyxoma peritonei.
Mucinous cystadenoma and cystadenocarcinoma
1746
Polycystic ovary syndrome (PCOS)
- Ovaries ENLARGED
- Multiple follicles (>12 per follicle)
- Follicles size < 10 cc with no dominant follicle >10 cc present
1747
Serves as a sanctuary for disease because of ineffective access of chemotherapy
Testes
1748
Presents on ultrasound as diffuse, punctate, non-shadowing, hyperechoic foci throughout the testicular parenchyma. Most patients have bilateral microlithiasis. It is a benign condition of microcalcifications within the seminiferous tubules but is associated with incidence of testicular carcinomas as high as 40%. Additional associations include cryptorchidism and infertility.
Testicular microlithiasis
1749
Appear as mobile echogenic foci that move freely in the space between the layers of the tunica vaginalis. Most are small. Larger ones have been called "Scrotal pearls". Cause is uncertain, possibly related to prior epididymitis. Incidental and of no clinical significance.
Scrotal calculi
1750
Also known as lacunar skull or craniolacunae, is a dysplasia of the membranous skull vault and is associated with Chiari II malformations (seen in up to 80% of such cases). The inner table is more affected than the outer, with regions of apparent thinning (corresponding to unossified fibrous bone) of the skull vault. If particularly severe, with the individual lacunae coalescing into larger defects the term craniofenestrae is used.
Luckenschadel skull
1751
Most common cause of symptomatic partial upper airway obstruction in infants
Croup
1752
Most common cause of pulmonary infection in infants and young children
Respiratory syncytial virus
1753
Most common cause of congenital bladder outlet obstruction
Posterior urethral valves
1754
The most common extracranial solid childhood malignancy/neoplasm
Neuroblastoma
1755
Most common chronic musculoskeletal disease of childhood
Juvenile idiopathic arthritis
1756
Mri grade of stress injury:
- Perisoteal edema
- Mild bone marrow edema
Grade 2
1757
Mri grade of stress injury:
- Periosteal edema
- Extensive bone marrow edema
Grade 2
1758
Mri grade of stress injury:
- Periosteal edema
- Extensive bone marrow edema
- Multiple areas of intracortical changes / Fracture line
Grade IV
1759
Refers to a depressed skull fracture of the infant skull caused by inner buckling of the calvarium. It is seen in newborns because of the soft and resilient nature of their bones (like greenstick fractures of long bones) and the fracture line is not visualized radiologically.
Ping pong skull fracture or pond skull fracture
1760
First step in the orderly approach to the radiographic analysis of skeletal dysplasia
Assessment of Disproportion
1761
Bone lesions that begin in the METAPHYSIS and with maturation , may migrate into diaphysis
- Aneurysmal bone cyst
- Chondromyoid fibroma
- Enchondroma
1762
Bone lesions arising from Metaphysis:
"S.O.F.A.CH.ER (sofachair) is Meta now. (Uso ngayon)"
- SBC
- Osteosarcoma
- Fibrous dysplasia
- ABC
- osteoCHondroma
- Enchondroma
1763
Bone lesions arising from Diaphyses:
"DIA agents M.A.L.E O.fficers O.nly"
- Multiple myeloma
- Adamantimoma
- Leukemia
- Ewing sarcoma
- O.steoid O.steoma
1764
This sign refers to localized bilateral metaphyseal destruction of the medial proximal tibias. It is a pathognomonic sign of congenital syphilis.
Wimberger sign
1765
This sign is a triangular or tubular echogenic cord of fibrous tissue, representing the ductal remnant of the extrahepatic bile duct, seen in the porta hepatis at ultrasonography, and is relatively specific for the diagnosis of biliary atresia.
Triangular cord sign
1766
Most common type of tracheo-esophageal fistula
Proximal atresia with distal fistula (85%)
1767
These are hernias containing a Meckel diverticulum, and are also known as persistent omphalomesenteric duct hernias. They are most frequently encountered in the inguinal region. On CT scan, seen as a blind-ending tubular structure arising from antimesenteric border of small bowel and extending into inguinal sac. Normal appendix would be seen.
Littre hernia
1768
Most common cause of small bowel obstruction in CHILDREN
Intussusception
1769
The rarest among gastrointestinal duplications (<10%). Greater curvature is the most site of occurrence. Ultrasonography is an excellent imaging modality for characterization of these cystic masses. Often demonstate the typical "gut signature" or "double wall" sign
Gastric duplication cysts
1770
The most common ingested foreign body
Coins
1771
The most common cause of esophageal perforation in CHILDREN
Iatrogenic trauma
1772
Primary imaging modality for the initial diagnosis of intussusception
Ultrasound
1773
The most important factor that predicts unsuccessful enema reduction in Intussusception is
Longer duration of symptoms
(Bowels may be ischemic and/or infarcted after a long period of time. Can no longer be salvageable and must be removed surgically)
1774
Type of choledochal cyst that presents with multiple cystic dilatation of both intra- and extrahepatic ducts.
Type 4
1775
Most common malignancy of the spleen
Angiosarcoma
1776
A syndrome of sequestration of blood elements within an enlarged spleen
Hypersplenism
1777
Most common primary tumours of the spleen
Hamartoma & Hemangioma
