Photos

Question 1

PE ECG

Answer 1

• RBBB
• Extreme right axis deviation (+180 degrees)
• S1 Q3 T3 pattern
• T-wave inversions in V1-4 and lead III
• Clockwise rotation with persistent S wave in V6

Question 2

PE echo

Answer 2

• RV dilation
• RV hypokinesis (with sparing of the apex) “McConnell’s Sign’
• Abnormal interventricular septal motion (D-shaped LV)
• Tricuspid regurgitation
• Pulmonary arterial hypertension
• Lack of decreased inspiratory collapse of IVC
• Direct visualization of thrombus (rare)

The 60/60 sign:

• RV systolic pressure (RVSP) < 60 mmHg and
• Pulmonary acceleration time (PAT) < 60 msec

Question 3

Aortic aneurysm CXR

Answer 3

• Mediastinal Widening >8 – 8.8 cm at level of Aortic knob
• Left para spinal stripes
• Displacement of intimal calcifications
• Apical pleural cap
• Left pleural effusion
• Displacement of Endotracheal tube & NGT
• Double Aortic Contour
• Irregular Aortic Contour

Question 4

SAH CT

Answer 4

• The scan shows a swollen brain with loss of grey white differentiation
• There is widespread sulcal and cisternal white hyper density (fresh blood)

Question 5

Brain death CT

Answer 5

There is complete loss of grey-white matter differentiation affecting the whole of the brain, including the brain stem

Question 6

Brain death CT angio

Answer 6

This is CT ANGIO brain and neck. There is extra cerebral blood (arrow) flow, but no intracerebral blood flow signifying brain death.

Question 7

ARDS CXR

Answer 7

Diffuse bilateral alveolar radio opacities, more peripheral fields, with multiple air bronchorgams

Question 8

PE CTPA

Answer 8

• Hypodense filling defects in both right and left main pulmonary arteries (thrombus).
• Evidence of RV dilation (RV > LV = ratio is 1.69)
• Rim of pericardial effusion

Question 9

Acute pancreatitis CT

Answer 9

Swollen, oedematous pancreas with non-enhanced areas of necrosis.
This is indicative of acute pancreatitis.