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AA ST2 > Questions > Flashcards

Questions Flashcards

1
Q

What pressures need proving in ARDs

A

partial pressure of arterial 02 / inspired 02 to be <200mmhg with no evidence of heart failure

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2
Q

what can ARDS mimic without knowing the PA 02 / Fi02 level

A

heart failure pulmonary oedema

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3
Q

PIOPED II study was for what condition?

A

PE

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4
Q

Low probability and negative PE do what

A

No need for anticoag or anything else

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5
Q

High probability and negatvie CTPA do what?

A

MR angiography or venous ultrasound

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6
Q

how do you differentiate between RBILD and DIP

A

RBILD is nodular, in the centrilobular region with upper lobe GGO

DIP is lower lobe and peripheral, sometimes cystic within GGO

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7
Q

what are the complications of bronchial artery embolization?

A

Can knock off branches to spine, oesophagus and develop chest pain

also operative complications

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8
Q

most common malignant oesophageal malignancy

A

SSC

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9
Q

Aseptic lymphocyte-dominated vasculitis associated lesion (ALVAL) from what

A

metal on metal implant

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10
Q

McCune-Albright syndrome - this almost always only affects girls and consists of a triad of

A

cafe-au-lait spots, precocious puberty (or other endocrine pathology), and polyostotic fibrous dysplasia. The cafe-au-lait pigmentation is often on the back and can commonly be seen to respect the midline.

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11
Q

Juxta-articular osteoporosis, marginal erosions, gradual reduction of the joint space

A

Phemester triad

triad in TB

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12
Q

This disease is more similar to osteopoikilosis than the other bony dysplasias. It is inherited in an autosomal dominant fashion, but can arise sporadically too. It causes striking longitudinal striations in the metaphyseal regions of the long bones but patients are generally asymptomatic and it is usually therefore an incidental finding. The appearance is said to resemble stalks of celery.

A

Osteopathia striata

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13
Q

This benign condition leads to multiple small oval bone islands forming around the skeleton. Purportedly, once the epiphyses have fused the number remains static. They can show mildly increased uptake on a nuclear medicine bone scan. Whereas a bone island may exist in isolation or near isolation, the finding of multiple such lesions suggests the diagnosis of osteopoikilosis.

A

Osteopoikilosis

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14
Q

Cirrhosis – the presence of the excess iron in the liver leads to unusual signal properties on an MRI scan. Iron is paramagnetic and causes spin dephasing. T2* and T2 sequences are particularly vulnerable to this effect but lower than expected signal will be seen on all sequences. Importantly the signal from the spleen and bone marrow should be normal. By contrast they will be involved in cases of transfusional siderosis.
Generalised osteoporosis
Hook like osteophytes on the radial aspect of the metacarpal heads – these are highly characteristic
Chondrocalcinosis, particularly affecting the knees
Insulin dependent diabetes
Congestive cardiomyopathy
Skin pigmentation

A

Haemachromatosis

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15
Q

This is a non-comminuted fracture at the base of the thumb metacarpal, which requires operative fixation due to the action of Abductor Pollicis Longus causing dorsolateral dislocation.

A

Bennet

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16
Q

This describes a comminuted fracture through the proximal thumb metacarpal.

A

Rolando

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17
Q

Women over the age of 55 is the typical demographic for SIFK but it does also occur in men. It is the adult equivalent to osteochondritis dessicans of the knee. Typically the medial condyle is affected and often there is an associated meniscal tear. On x-ray the appearances are of medial femoral condyle flattening with or without a subchondral radiolucent area. On MRI bone marrow oedema can be seen (high signal on STIR sequences).

A

sonk - Subchondral insufficiency fractures of the knee

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18
Q

Enlargement of the paranasal sinuses – 75%
Posterior vertebral scalloping – 30%
Widening of the terminal tufts
Heel pad thickness >25mm
Premature osteoarthritis
Enlargement and erosion of the sella
Hyperostosis of the inner table of the skull

A

acromegaly

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19
Q

the name given to the symptoms caused by compression of the tectal plate. These are highly testable and the main feature is paralysis of vertical gaze.

A

Parinaud syndrome is

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20
Q

NF1 get what in brina

A

optic glioma
plexiform neurofibromaas
CNS hamartomas

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21
Q

NF1 for skeletal

A

sphenoid bone dysplasia
tibia bowing
posterior vertebrla scalloping

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22
Q

NF1 eyes and skin

A

Lisch nodule
Cafe au lait
xillary freckling

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23
Q

NF2 get what

A

central

schwannomas

meningiomas

ependymomas

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24
Q

a very nasty condition which develops a few weeks or months after a patient has received Gadolinium in patients with acute or chronic renal failure, in particular post liver or kidney transplant patients (NB. hepatorenal syndrome). No particular therapy for it has been found to be effective. Dyspnoea has been described in association with

A

Nephrogenic systemic fibrosis

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25
Q

the ossicles, lateral semicircular canal (Known by some as the Clint Eastwood sign) and lateral epitympanic wall (i.e. scutum) are often involved.

A

Cholesteatoma

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26
Q

Serpiginous flow voids over the surface of the cord are the main described feature on MRI.

A

dural AVFs

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27
Q

caused by either a vertebral artery occlusion or PICA occlusion.

A

Lateral Medullary Syndrome (Wallenburg syndrome)

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28
Q

The anterior choroidal artery arises from the

A

internal carotid artery

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29
Q

MRI blood over time

A

hyper acute - T1 iso T2 bright
acute - dark dark
easrly subacute - T1 bright, T2 dark
late subacute - bright bright
chronic - dark dark

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30
Q

Bilateral caudate lobe atrophy is which neurodegenerative disease

A

Huntingdons

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31
Q

High T2 and FLAIR in the thalami is what neurodegenerative disease?

A

Wenickes

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32
Q

Abnormal signal in the putamen and lateral thalami

which neuro degenerative diseease

A

Wilson disease

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33
Q

Medial caudate nuclei and putamina high t2 /FLAIR

what neuro degen condition

A

CJD

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34
Q

What happens in Keans - Saye syndrome

what are the MRI changes

A

basal ganglia changes

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35
Q

Leigh syndrome affects who and where in the brain are the MRI changes

A

kids
putamina

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36
Q

which part of the substntia nigra are involved in Parkinson

A

pars compacta

(thinned or blurred)

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37
Q

In Picks disease, precuneus is….

A

spared

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38
Q

Lewi Body dementia can spare the

A

Hippocampi

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39
Q

Brown-Sequard syndrome

A

damage to the dorsal columns leads to ipsilateral loss of touch sensation

contralateral loss of pain and temperature sensation due to damage to the lateral spinothalamic tracts (contralateral since these ascend after having crossed). There is also ipsilateral motor function loss.

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40
Q

lateral medullary syndrome is also called

A

wallenberg syndrome

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41
Q

what is lateral medullary syndrome caused by

A

cause by vertebral artery occlusion or PICA occlusion

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42
Q

Browns tumours are a feature of which systemic disease

A

hyperparathyroidism

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43
Q

in MS, involvement of which anatomical location is highly specific to MS

especially when differentiating to small vessel ischaemic changes

A

middle cerebellar peduncle

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44
Q

Thalamic involvement when querying MS might instead point to which condition?

A

ADEM

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45
Q

which form of CJD is the most common

A

sporadic
(85%)

familial is only 10%

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46
Q

Variant CJD will look like what on MRI

A

thalamuc will have high signal hockey stick sign

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47
Q

Autoimmune encephalitis can be a result of which phenomenon

where does it affect

A

limbic system

paraneoplastic syndrome

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48
Q

post viral thyroiditis is called what

A

De Quervains thyroiditis

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49
Q

anatomy of the eye regions can be split into…

A

Globe

Extra conal

Conal

intraconal

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50
Q

Pathology affecting the eye globe

A

retinoblastoma
melanoma

haemorrhage detachement

IgG4 endophthalmitis

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51
Q

Which eye conditions can affect all the eye compartment s

A

Sarcoidosis

Pseudotumour

Lymphoproliferative lesion

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52
Q

what are the eye conal pathologies

A

Rhabdomyosarcoma
Thyroid eye disease

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53
Q

Intraconal pathology

A

optic nerve
haematoma / angioma

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54
Q

glomus tympanicum can cause what symptom

A

tinnitus

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55
Q

most common posterior fossa tumour in kids

A

medullobnlastoma

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56
Q

Features of a spinal cord infarction vs subacute combined degeneration

which is a V shpape

A

subacute dorsal columss only

infarction will be whole column, often length down 2 vertebral bodies.

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57
Q

Acute infarction on DWI are

A

bright

with low ADC map values (restrict)

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58
Q

Cavernoma classicaly appearance is

A

popcorn

bright lobulated centre and rim of hypointensity.

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59
Q

Cerebral amyloid angiopath can give rise to

A

micro-haemorrhages at GW junciton

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60
Q

Causes of opaque maxillary antrum

A

Malignant - carcinoma / lymphoma

inflammatory - sinusitis, allergies, mucocele

other - FD, Cysts, Wegeners,

traumatic -

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61
Q

arachnoiditis

thickened nerve roots

why ?

A

Nerve roots adhere to the aspect of the space.

infection secondary to surgery / meningitis / subarachnoid haemorrhage.

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62
Q

Limbic system is made up of

A

Olfactory
parahippocampal gyrus
Hippocampus
cingulate gyrus
subcallosal gyrus

amygdala
septum pallucidem
hypothalamus
anterior thalamic nuclei
mamillary bodies

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63
Q

Anti - onconeuroantibody

Breast

A

Anti-amphiphysin
yo
ri

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64
Q

Anti - onconeuroantibody

Lung

A

hum ri, amphysisi, zic4
anna3
pca2
antivgkc
vgcc
nachr

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65
Q

Anti - onconeuroantibody

thymoma

A

GAD
CV2/CRMP5
VGKC
AChR

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66
Q

Anti - onconeuroantibody

Hodgkin lymphoma

A

Tr
mGluR1

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67
Q

Anti - onconeuroantibody

Colon

A

none

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68
Q

Legg Calve Perthese disease

age
best radiograph view

A

4- 12

frog leg

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69
Q

Duration of symtpoms for JIA

A

6 weeks

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70
Q

Infantile haemangioendothelioma

age
ax symptoms
features on image

A

<6month
heart failure
low platelets
vascular lesion
calc within

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71
Q

age for hepatoblastoma

A

6m - 3y

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72
Q

imaging appearance for hepatoblastoma

A

rim nehancement

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73
Q

HCC age in children

A

> 5

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74
Q

imaging appearance of HCC in kids

A

central scar that can calcify

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75
Q

which ovarian tumour produces oestrogen and pregesterone

A

Leydig Sertoli

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76
Q

Yolk sac tumour size

A

normally large at presentation

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77
Q

Granulose cell tumours produce oestrogen

what symptoms does this causes

A

irregular or post menopausal bleeding

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78
Q

tuberous sclerosis tria

A

epilepsy
facial angiofibroma
mental retardation

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79
Q

Neuroblastoma vs Wilms tumour

Peak age
Sign on kidney
midline crossing
calc
IVC

A

Neuro
- 2 years, drooping lily sign, crosses midline, calc is stippled, encases IVC

Wilms
- 3 - 4, claw sign, doesn’t cross midline, calc is less common /curvilinear, displaces ivc

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80
Q

ring enhacning lesions

mnemonic

A

Dr MAGIC

Demyelinating
radiation necrosis

mets
abscess
glioma
infarction
contusion

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81
Q

pyloric stenosis, most specific sign

A

string sign

narrow track of barium passing through a long pyloric canal

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82
Q

fibromatosisi coli is what

A

fibrous thickening of the SCm muscle, often after a difficult birth

no acutal mass

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83
Q

hirschsprung biospy which type

A

suction biopsy below transition point

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84
Q

(Pivot shift)

A
  • High signal on STIR to the lateral femoral condyle and posterolateral tibial plateau with an associated tear of the anterior cruciate ligament tear
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85
Q

(Clip injury) - injury and MRI signal to which bones

A
  • High T2 signal to the anterior aspect of the lateral femoral condyle and lateral tibial plateau with an anterior cruciate ligament and medial collateral ligament tear
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86
Q

Neuroendocrine tumour

Blueberry muffin syndrome

A

Metastatic cutaneous deposits

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87
Q

Opsomoclonus

neuroendocinre tumour

A

rapid jerky eye.

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88
Q

Neuroendocrine tumour

Hutchinson syndrome

A

limping due to bony metastases

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89
Q

wilms vs neuroblastoma

invade or encase IVC

A

wilms invades

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90
Q

Glomus tumours are what

A

benign vascular tumours which arise in patients in their 40s and 50s.

tender blue/red nodule under the finger nail.

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91
Q

what is a subungual exostosis

A

bone outgrowth.

adolescent

cortical and medullary continuity.

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92
Q

ring and arc calc

A

enchondroma

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93
Q

Acute idiopathic scrotal wall oedema syndrome

age
what is it

A

under 10

skin hypersensitivity but get unilateral scrotal wall swelling

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94
Q

risk factors for NEC

A

Prem
low birth weight
heart disease
jirschsprungs
perinatal asphyxia

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95
Q

The patient will be youngish, with a temporal lobe lesion (in fact approximately a third are frontal lobe lesions), a history of epilepsy (often refractory) and the lesion is described as bubbly – here given as multiple cysts. The lack of oedema or enhancement is also typical.

A

DNET

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96
Q

Auto Rec PKD ax to what

A

hepatic fibrosis
pancreatic fibrosis
caroli disease
portal hypertension

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97
Q

neonatal septic arthritis

bug

A

group D strep

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98
Q

sinus mucocele vs tumours

what sign

A

peripheral enhacnemetn typical for mucocele

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99
Q

renal masses by age

neonate

vs

pre-school

A

neonate - MDK, mesoblastic nephroma, nephroblastomatosis

pre-school
- Multilocular cystic (boys)
wilms
lymphomaea

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100
Q

heart disease is worse in which heterotaxy?

A

right sided - 80% die by 1 year

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101
Q

which heterotaxy is horsehoe ax with

A

Right sided

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102
Q

First branchial cleft cyst located

A

periparotid region

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103
Q

A third branchial cleft cyst is situated at

A

the base of the sternocleidomastoid muscle.

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104
Q

appearance of a cystic hygroma

A

multi loculated

found in the posterior triangle

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105
Q

what is a bochdalek hernia

A

hernia in diaphragm

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106
Q

morgani hernia

A

small diaphragm hernia at the front

contain mesenteric fat only

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107
Q

fibrous dysplasia in the skull

A

Fibrous dysplasia can affect the skull. It is usually described as having a ground glass appearance with cortical expansion and a swell-defined sclerotic margin.

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108
Q

timeframe for bronchopyulmonay dysplasia in neonate

A

28 days of being ventilated

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109
Q

cysts in communication with each other

MDK vs hydronephris

A

MDK they do not communicate so this would be hydronephrosis

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110
Q

Renal masses by age

Neonate:

A

Multicystic dysplastic kidney (second most common neonatal renal mass)
Mesoblastic nephroma (most common SOLID neonatal renal mass)
Nephroblastomatosis (can be a precursor to Wilms tumour)

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111
Q

Renal masses by age

Pre-school:

A

Multilocular cystic nephroma (affects boys, slightly younger than Wilms)
Wilms tumour (most common SOLID mass of childhood)
Lymphoma (can affect teenagers and adults as well)

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112
Q

An 18-month-old presents with abdominal enlargement and respiratory difficulty. The serum AFP is noted to be negative and endothelial growth factor is normal. A CT scan demonstrates a very large multicystic hepatic mass with no evidence of calcification. There is no evidence of any calcification or haemorrhage within the mass.

A

Mesenchymal hamartoma

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113
Q

wilson disease is inherited in what pattern?

A

autosomal recessive

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114
Q

what neuro symptoms do wilsons patients get

A

dysarthria
tremor

lentiform nucleus copper deposition

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115
Q

why is liver MRI normal in Wilsons

A

fatty depsoition is blaance dout by the paramagnetic effeects of copper

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116
Q

Musculoskeletal manifestations of wilsons

A

Generalised osteoporosis, subarticular cysts, chondrocalcinosis and arthropathy which can mimic CPPD

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117
Q

Kasabach-Merritt sequence

A

platelet trapping in haemangioendothelioma

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118
Q

prior to a HIDA scan for biliary atresia what can be given that speeds up biliary excretion

A

phenobarbitol

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119
Q

A 7-month-old boy with uncontrollable crying and vomiting is brought to A and E by his parents. He subsequently undergoes a CT which shows a hyperdense mass with intense homogeneous enhancement. The mass is sitting in the trigone of the left lateral ventricle. It is large but smooth with a lobulated border and no evidence of invasion. There are small foci of calcification. The lateral ventricle is dilated. On MRI there is isointensity on T1 and hyperintensity on T2 relative to the white matter, with punctate foci of T2 hypointensity.

A

Choroid plexus papilloma

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120
Q

in children predominate in the 4th ventricle, show T1 hypointensity with foci of high T2 signal.

A

Ependyomoma

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121
Q

Galeazzi fracture

A

Dislocation at the distal radio-ulnar joint in association with a radial fracture

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122
Q

kissing ovaries sign

A

from endometriosis

On an MRI scan a T2 low signal plaque may be seen between/around them.

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123
Q

appearance of a chondroblastoma

A

long bones
lucent, lobulated lesion, thin sclerotic margin,

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124
Q

Ovarian germ cell tumours include

A

teratomas, yolk sac tumours, choriocarcinomas and mixed germ cell tumour

embryonal carcinoma and dysgerminomas

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125
Q

ovary mass

elevation of AFP levels although this would be more classically associated with a

A

yolk sac tumour

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126
Q

difference between dermoid and teratoma

A

a dermoid is composed only of dermal and epidermal elements (which are both ectodermal in origin), whereas teratomas also comprise mesodermal and endodermal elements.

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127
Q

what are the nenatal cardiac duct dependant lesions

A

Duct dependent lesions:

Hypoplastic left heart syndrome
Severe coarctation
Interrupted arch
Pulmonary atresia
Severe Ebsteins anomaly
TGA (if no VSD)

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128
Q

age for wilms / nephrobalstoma

A

preschool 4

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129
Q

Neuroblastoma secretes what

A

chatacholamines or VIP

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130
Q

which neuroblastoma stage does best

A

IV

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131
Q

Mutilocular cystic nephroma has what appearance

A

mass of cysts
thick fibrous capsule

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132
Q

Mesoblastic nephroma affects what age and appears

A

neonate

solid

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133
Q

Predisposing syndromes for Wilms

A

Beckwith-Wiedemann syndrome - macroglossia, hemihypertrophy, visceromegaly, omphalocoele

DRASH syndrome - progressive glomerulonephritis and male pseudohermaphroditism

WAGR syndrome - Wilms tumour, aniridia, GU abnormalities, mental retardation

Perlman syndrome - polyhydramnios, macrocephaly, visceromegaly

Golabi-Behmel syndrome - macrostomia, macroglossia, occular hypertelorism

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134
Q

Bronchial atresia can affect any segment but which is classical

A

apicoposterior segment of the left upper lobe is absolutely classical, as is the age of the patient.

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135
Q

leighs disease is what kind of disease

A

sporadic mitochondrial genetic disease

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136
Q

Kearns-Sayre syndrome is another mitochondrial disorder which is associated with WHAT IN THE BRAIN

A

Subcortical calcifications and basal ganglia siderotic deposits.

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137
Q

Birt-Hogg-Dube syndrome is a very rare condition which predisposes to WHCI HKIDNEY LESIONS

A

chromophobic RCCs

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138
Q

what are branchial cleft cysts and how are they numbered

A

abnormalities from embryology.

1 is deep
2 is at the mandible / ear lboe

3 and 4 are below and idfficult to distinguish betwene on imagagin. around hyoid

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139
Q

conotruncal anomaly is what

A

It is an anomaly of the vessels leading from the heart

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140
Q

ovary
small (<3 cm) thick walled, rounded, cystic structure with peripheral vascularity

A

corpus luteal cyst

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141
Q

how to investigate endometriosis

A

TV ultrasound

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142
Q

commonest location of ectoic pregnancy

A

Ampulla of Fallopian tube

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143
Q

What are some differentials for an endobronchial lesions

A

SCC
mets
carcinoid
hamartoma

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144
Q

TA is ax with what conditions

A

DiGeorge
CHARGE
VSD
Right sided arch

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145
Q

differentials for cavitating neoplastic culprits

A

bronchogenic carcinoma (SCC)
metastatic squamous cell carcinoma
adenocarcinoma (Colon + breast)

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146
Q

what is may-thurner syndrome

A

left leg selling and thrombosis.

right common iliac ARTERY crosses over the left common iliac vein - compression

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147
Q

The azygo-oesophageal recess is formed by the interface of the

A

right lung and the mediastinal reflection of the azygos vei

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148
Q

The anterior junctional line is formed by the meeting of the

A

parietal and visceral pleura anteromedially.

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149
Q

posterior junctional line is formed by the meeting of the

A

pleural surfaces of the upper lobes behind the oesophagus.

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150
Q

right paratracheal line is formed by

A

the right wall of the trachea against the right lung.

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151
Q

IPF and NSIP

architecture pattern

A

IPF - macrocystic honeycombing

NSIP - GGO

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152
Q

IPF and NSIp

location of disease

A

IPF - apicobasilar gradient

NSIP - peripheral

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153
Q

IPF and NSIP

bronchiectasis / nodules

A

IPF - traction bornchiectasis s

NSIP - no nodules

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154
Q

IPF and NSIP

smoking association

A

IPF. - there is an assocation

NSIP - no association

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155
Q

Lung nodule follow up should not be done what what nodules

A

Calcification – diffuse, central, laminated or popcorn patterns
Perifissural nodules
<5mm maximum diameter nodules
<80mm3 nodules

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156
Q

BTS nodule guidlines for follow up

A

sizes
<5mm

5-6mmm

> 6mm

solid nodule, no follow up, 12 months, 3 months
sub-solid nodule - no follow up if <5 but then (3 months, 12 months, 2 years, 4 years)

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157
Q

azygo-oesophageal recess is formed by the interface of the

A

right lung and the mediastinal reflection of the azygos vein

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158
Q

anterior junctional line is formed by the meeting of

A

the parietal and visceral pleura anteromedially

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159
Q

posterior junctional line is formed by

A

the meeting of the pleural surfaces of the upper lobes behind the oesophagus.

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160
Q

Specifically egg-shell calcification

A

Silicosis and coal workers pneumoconiosis
Sarcoidosis

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161
Q

Aneurysm

Distance to the renal arteries –

A

10mm used to be the absolute minimum landing zone distance required

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162
Q

Aneurysm

aceeptable neck

A

Angle of the neck – this is measured one of two ways in the literature. Consequently there are two different values for an acceptable angle. A purely straight aneurysm would have a neck angle of either 180o or 0o in each of the different measuring systems. Thus the acceptable neck cut-off values are 120o or 60o in each case.

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163
Q

aneurysm

Common iliac artery (CIA) length –

A

Ideally the CIA should be longer than 20mm to accommodate the stents used.

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164
Q

Halo sign also seen in

A

Hameorrhagic mets

bronchioalveolar carcinoma (min invasive adeno)

fungal

mycobaterial infeciton

Wegeners

hypersenstiivty pnuemopnititis

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165
Q

contraindications to GTN on cardiac CT

A

Systolic blood pressure <100 mmHg
Hypertrophic obstructive cardiomyopathy
Sildenafil usage within the previous 24-48 hours
Aortic stenosis
Profound anaemia

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166
Q

involveme nt of the upper lung zones

BREASTS

A

Beryllosis
Radiation
EG
Ank spond
Sarcoid
TB
Silicosis

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167
Q

Lower long zone involvement

BADAS

A

Bronchiectasis
Asp Pneumonia
Drugs and Desquamative interstitial pneumonia
Asbestosis
Scleroderma

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168
Q

Peripheral, associated with CREST/Sjogrens/RA, chemotherapy

A

NSIP

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169
Q

Patchy. Associated with connective tissue diseases, CF, methotrexate, post-transplant

A

COP

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170
Q

Smoking, young patients, no bronchiectasis or honeycombing

A

RBILD

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171
Q

Smoking, GGO, difficult to tell apart from RBILD

A

DIP

172
Q

Diffuse pattern, associated with Sjogrens, autoimmune conditions, hep B, EBV, PCP

A

LIP

173
Q

Endoleaks types

A

1 - landing zone
2 - collateral filling of aneurysm sac (eg lumbar arteries).
3 - defect in wall of the graft
4 - poroous fraft material
5 - CATCFH ALL

174
Q

CT signs of impending aortic aneurymsm rupture

A

Crescenteric high attenuation on an unenhanced scan - acute mural thrombus is strongly associated with rupture
Focal discontinuity of calcified intima / tangential calcium sign - where the intimal calcification appears to point away (in a tangent) from the expected circumferential course
Draped aorta - the posterior contour of the aorta follows that of the adjacent vertebral body

175
Q

ddx
mediastinal lymph node calc

A

Tuberculosis
Histoplasmosis
Amyloidosis (rare)
Metastases: papillary/medullary thyroid cancer, osteosarcoma, mucinous adenocarcinoma

176
Q

Certain Cancers Spread By Plugging The Lymphatics

A

Cervix
Colon
Stomach
Breast
Pancreas
Thyroid
Larynx (or lung – bronchogenic)

176
Q

Cardiac MRI patterns

ischaemic patterns

A

Subendocardial infarction

transmural infarction

176
Q

Cardiac MRI patterns

global endocarcdial

ddx

A

amyloidosis
CREST
Post heart transplant

177
Q

Cardiac MRI patterns

Midwall

A

dilated cardiomyopathy
myocarditis

178
Q

Cardiac MRI patterns

Affecting any of epicardial, miedwall

A

sarcoidosis
myocarditis
anderson-Fabry
Chagas disease

179
Q

Adneonsine stress MRI is good for

A

investigating the presence of ischaemia or infarction

180
Q

adenosine causes

A

coronary dilatation

181
Q

how does adneosine affect a stenosed vessel

A

if won’t be able to dilate any further if already ischameic

182
Q

contra indiactions to adneonsine

A

second or third degree HB
Bronchospaslm
low BP
mI in last 48 hours
arrhythmia uncontrolled
crit AS

183
Q

Contraindications to thrombolysis include:

A

Absent sensation or motor function – ie a non-viable limb
Haemorrhage
Brain tumour (due to risk of haemorrhage)

184
Q

Common findings to both LCH and LAM

A

Cysts
Spontaenous pneumothorax
Effusions
Young patient

185
Q

Mediastinal lymph nodes are LCH or LAM

A

LAM

185
Q

Honeycombing gound in

LCH or LAM

A

LCH

186
Q

This is a rare infection which occurs particularly in bone marrow transplant patients as well as those with AIDs. Lobar consolidation and nodules with cavitation are seen but lymph node enlargement is notably absent.

A

Nocardia

187
Q

testicles by age

10s

20s and 30s

A

Yolk sac tumour/teratoma

Choriocarcinoma

188
Q

testicles by age

30s

40s

A

Embryonal cell carcinoma

Seminoma

189
Q

Gardner syndrome triad

A

FAP subtype

colonic polyps
osteomas of the skeleton
soft tissue tumours

190
Q

is is a rare hamartomatous syndrome which is inherited as an autosomal dominant defect on chromosome 10. The polyps are predominantly (but not exclusively) in the rectosigmoid colon. There is an association with fibrocystic disease and fibroadenomas of the breast; around half of patients have breast pathology

A

Cowden

191
Q

Colonic carpet of polyps
Stomach hamartomas
Duodenal adenomas
Periampullary carcinoma
Desmoid tumours

A

FAP

192
Q

Diarrhoea – colonic polyps
Seizures – glioblastoma

A

Turcot syndrome

193
Q

Hamartomatous polyps
Mucocutaneous pigmentation
Increased risk of many cancers

A

Peutz - Jegher

194
Q

Thallium is used in the differentiation of lymphoma and Toxoplasmosis

A

(lymphoma demonstrating increased uptake)

195
Q

Eggshell calcification

DDX

A

Fibrosing mediastinitis
Amyloidosis
Pneumoconioses - silicosis and coal workers only. Not seen in most others.
Sarcoidosis
Scleroderma
Treated lymphoma (ie post radiotherapy)
TB
Histoplasmosis

196
Q

Curiously these occur almost exclusively in women. Anatomically they sit within the presacral or retrorectal fat. They tend to be an incidental diagnosis and can be associated with bony defects within the sacrum. An uncomplicated cyst will return low signal on T1 and high signal on T2 but often they contain mucein whereupon they appear characteristically high in signal on T1 weighted MRI sequences. They can be surprisingly large and are often multiloculated.

A

tailgut duplication cyst also known as retrorectal cystic hamartoma

197
Q

A 60-year-old man undergoes ultrasound for investigation of bilateral testicular lumps. Ultrasound reveals bilateral poorly defined areas of low echogenicity suspected to be metastases.

what is it likely to be ?

A

A mass in the testes of patient older than 50 is more likely to be a secondary tumour than a germ cell tumour. Prostate (35%) is the most common tumour to metastasize to the testicle, followed by lung, then melanoma, colon and renal.

198
Q

The two main conditions where arthritic changes will be present in the absence of demineralisation are

A

Psoriatic arthritis and Gout.

199
Q

Demineralisation arthritis

HORSE

A

Haemophilia
Ostemalaica
RA / Reiter syndrome
Scleroderma
SLE

200
Q

No demineralisation in the arthritis

PONGS

A

Psoritatic arthritis
aosteomyelitis
neuropathic joint
gout
sarcoidosis

201
Q

Gonococcal infections classically cause what kind of stricture

A

Gonococcal infections classically cause long strictures. They are most commonly irregular in nature and located in the bulbous urethra. The distal bulbous urethra is most frequently affected.

202
Q

What is adneomyosis

A

Thought by some to be a variant on the theme of endometriosis, adenomyosis is the ectopic presence of endometrial tissue within the myometrium

203
Q

Increased risk of endometrial cancer

A

Iatrogenic oestrogens
Tamoxifen
Early menarche or late menopause
No children
PCOS
Obesity
Diabetes

204
Q

what endometrial thickness can you be certain of NO endometrial cancer

A

. <5mm of endometrial thickness has a 100% negative predictive value for endometrial carcinoma

205
Q

L3/4

A

Quadriceps, patella reflex, sensation over knee and shin

206
Q

L4/5

A

Dorsiflexion of the foot, ankle eversion, sensation to medial calf

207
Q

L5/S1

A

Hip extension, extension of the big toe, ankle inversion, ankle reflex, sensation to sole of foot

208
Q

risk of AML rupture relates to

A

siz>40mm

209
Q

Nabothian cyst are what

A

blockage of the mucinous glands of cervix.

small yellow bumps on colposcopy. On MRI they are cystic with high T2 signal and can show high T1 signal owing to their mucein content. They are an incidental finding.

210
Q

Skene duct cyst

A

retention cysts of the paraurethral ducts and usually they are asymptomatic. On MRI they are seen inferior to the pubic symphysis but lateral to the external urethral meatus. Signal characteristics reflect their cystic nature with high T2 signal but fluid-fluid levels may also be present if there has been intracystic haemorrhage.

211
Q

Which of the following best describes the most common appearance of renal lymphoma?

A

multiple bilateral masses, low attenuation as enhance poorly

212
Q

malignant hepatic masses in kids are

A

Mets
Wilms/neuroblastoma
Hepatoblastoma
HCC (older kids)

213
Q

which cardiac malignancy is associated with Tuberous sclerosis?

A

Rhabdomyoma

214
Q

how to diagnose a missed torsion

A

Where ultrasound features of heterogeneous testis with increased peri-testicular flow but absent testicular flow are found in a patient with symptoms lasting longer than 24 hours, a missed torsion can be diagnosed.

215
Q

features of acromegaly

A

largement of the paranasal sinuses – 75%
Posterior vertebral scalloping – 30%
Widening of the terminal tufts
Heel pad thickness >25mm
Premature osteoarthritis
Enlargement and erosion of the sella
Hyperostosis of the inner table of the skull

216
Q

Calcification within a lymph node is most suggestive of

in thyroid mass

A

Calcification of a malignant thyroid mass is most suggestive of a Papillary thyroid cancer, which is also by far the most common of the thyroid cancers, however medullary thyroid cancers can also give lesional calcification.

Calcification within the lymph nodes is a feature more classical Medullary thyroid cancer, although it has been reported in cases of Papillary thyroid cancer.

216
Q

demonstrates granular calcification and nodal spread in 50% of cases.

A

medullary thyroid

217
Q

unctate calcification and regional lymph nodes in 40% of patients and is of a low reflectivity on ultrasound

A

papillary

218
Q

if pleural plaques are bilateral think

A

exposure to asbestos

219
Q

post nerve injury inflammation mRI changes in muscle

A

high T2 (oedema)
Low T1

220
Q

TB discitis vs staph discitis

A

TB
- Calc, posterior element involved, insiduous onset, no real loss of disc space, Gibbus deformity, multiple levels.,

Staph
- no calc, posterior elements spares, acute onset, loss of disc space, no gibbus, one level

221
Q

microadenoma in pituitary on mri

A

Low T11

222
Q

What are the IOTA rules

A

B rules
1 - 5
unilocular cyst, <7mm solid, acoustic shadow, multilocular cyst <10cm, no blood flow

M-rules
1-5
Solid irregular mass, ascites, >3 papillary structures, multilocular solid mass >10cm, blood flow

223
Q

HCC in a non cirrhotic liver - how ?

A

in patient with heb B

224
Q

Long strictures can develop and on a barium swallow the mucosa appears to have a reticular pattern. Tertiary contractions may also be seen.

A

Barretts oesophagus

225
Q

differentiate between Askin tumour and pleuropulmonary lastoma

A

askin eats into ribs

226
Q

MRI arthrogram
Where should the contrast be injected?

FOR THE WRIST

A

Dorsal approach to radiocarpal compartment

227
Q

Menetrier triad

A

gastric glandular hypertrophy
achlorydia
hypoproteinaemia

228
Q

MRI there is nodular thickening of the synovium in the suprapatellar space which returns low signal on both T1 and T2 weighted sequences.

A

PVNS

229
Q

what is PVNS

A

Haemorrhagic proliferation of the synovium in a frond-like villonodular fashion gives rise to the classic low signal ‘feathery’ sea-anenome-like finding.

230
Q

does it restrict does it enhance

recurrent cholesteatoma

A

Restricts - YEs
enchnace - NO

231
Q

does it restrict does it enhance

Granulation tissues

A

Restrict - NO
Enhance - Yes

232
Q

does it restrict does it enhance

Fluid

A

No

NO

233
Q

Cholesteatomas (Acquired or congenital) are histolologically ….

A

epidermoid cysts

234
Q

here are two types of acquired cholesteatoma:

A

Pars flaccida (80%) – classically erodes the scutum and extends superiorly
Pars tensa (20%) – classically erodes the ossicles, extending medially

235
Q

cholesteatoma vs cholesterol granuloma on MRI

A

a cholesteatoma on MRI is isointense to brain parenchyma on T1,

a cholesterol granuloma will show high signal in the middle ear on T1 due to the paramagnetic effects of methaemoglobin.

Cholesteatoma will restrict, granuloma wont

236
Q

blood from an aneurysm of the PCom will extend into

A

the interpeduncular cistern, ambient cisterns and thereby to the quadrigeminal cistern.

237
Q

If a patient has a painful ptosis, a PCOM aneurysm should be considered. It will be an

contralateral or ipsilateral

A

ipsilateral pathology because the Oculomotor nerve is post-ganglionic at this point.

238
Q

BRCA 1 inheritance is predominantly associated with

A

ductal carcinomas

239
Q

BRCA 2 inheritance can be associated with both

A

lobular and ductal carcinomas

240
Q

a mass seen on MRI that is not seen on mammography or ultrasound would be a

A

lobular carcinoma

241
Q

Bone marrow on MRI

Normal bone marrow

T1 and T2

A

T1 - high (fatty)
T2 - intermediate

242
Q

Post radiotherapy bone marrow on MRI

A

T1 - Very high
T2 - intermediate, can be high if oedema

243
Q

MRI of bone marrow haemangioma

A

T1 - high
T2 - high

244
Q

MRI of abnormal bone marrow (mets, myeloma, regeneration)

A

T1 - low
T2 - high (fluid)

245
Q

MRI
blastic mets (prostatem breast, TCC) and myelofibrosis

A

T1 low
T2 low

246
Q

lytic or sclerotic mets more likely to enhance with contrast?

A

lytic

247
Q

fold thickening and lymph node enlargement - small bowel

dx

A

small bowel lymphoma

248
Q

nodular fold thickening with sclerotic bone lesions

A

mastocytosis

249
Q

dilatation without increase in fold thickness

A

coeliac

250
Q

causes of bony sclerosis

metabolic

A

hyperparathyroidism
hyperthyroidism

251
Q

causes of bony sclerosis

congential

A

Pyknodysostosis
Osteopetrosis

252
Q

causes of bony sclerosis

malignant

A

lymphoma
leukaemia

253
Q

causes of bony sclerosis

haematological

A

sickel cell
myelofibrosis
mastocystosis

254
Q

which renal nuclear meidince scan is dynamic

A

MAG3 and DTPA.

DTPA on cleared by glomeruli, good for egFR.

255
Q

prostate contrast MRI curves

which is concerning

A

Type 3 - in and washes out

T1 - is progressive upwards
T2 - is plateau

256
Q

which colon is most freequently affected by angiodysplasia

A

caecum and ascending colon

257
Q

does myositis ossificans affect the bone

A

No

258
Q

Multicentric subtype of osteosarcoma

A

5-10
poor prognosis

258
Q

Parosteal osteosarcoma

A

lower grader , 20- 50s

259
Q

Telangiectatic subtype of osteosarcom a

A

purely lytic, poor prognosis, fluid - fluid level

260
Q

which heart block is contraindicated to adenosine

A

2nd and third

261
Q

What can cause egg shell calcification of the lymph nodes

A

Fibrosing mediastinitis
Amyloidosis
Pneumoconioses - silicosis and coal workers only. Not seen in most others.
Sarcoidosis
Scleroderma
Treated lymphoma (ie post radiotherapy)
TB
Histoplasmosis

262
Q

Carney syndrome

A

atrial myxoma, facial/buccal pigmentation, sertoli tumours of the testis and multiple other findings.

263
Q

Carney triad

A

pulmonary hamartomas, gastric leiomyosarcomas and extra-adrenal paragangliomas

264
Q

small mass attached to the interatrial septum by a stalk is classical

cardiac mass - what ype

A

atrial myxoma

265
Q

A 51-year-old woman undergoes an HRCT which shows diffuse cysts, nodules and bronchial wall thickening.

what is the likely diagnosis

A

LIP

266
Q

Hypersensitivity pneu onitis is inhaled and therefore found

A

in the upper lobes

267
Q

GGO initially.

Subsequently traction bronchiectasis and honeycombing in non-dependant lung

Bilateral, symmetrical, lower lobes.

Spares costophrenic angles

A

AIP

268
Q

Patchy appearance

GGO

Consolidation

Reverse halo appearance
Peripheral, peribronchial.

Basal

A

COP

269
Q

RBILD vs DIP

A

DIP lower lobes

270
Q

if a lung nodule is less than 5mm

A

no folow up needed

271
Q

lung nodule 5 - 6 mm f/u

A

12 months for solid noudle

sub solid - 3 month, 12 months, 2 years, 4 years,

272
Q

lung nodule >6mm f/u

A

solid nodule - 3 months

sub solid 0 same as if it was 5- 6mm

273
Q

: Certain Cancers Spread By Plugging The Lymphatics

A

Cervix
Colon
Stomach
Breast
Pancreas
Thyroid
Larynx (or lung – bronchogenic)

274
Q

Partial anomalous pulmonary venous circulation (PAPVC), scimitar syndrome

usually drains to

A

IVC

275
Q

profunda femoris is given off where?

A

profunda femoris. This is given off posterolaterally just below the femoral sheath 3.5 cm below the inguinal ligament.

276
Q

A 47-year-old office receptionist presents to her GP with a cough. She is referred for a CXR which shows widening of the right mediastinum and a CT is recommended. There is mediastinal calcification and right heart dilatation. Septal thickening, peribronchial cuffing, and wedges of consolidation are also seen.

A

Fibrosing mediastinitis

277
Q

There is a familial preponderance in around 50% of cases. Resultant arrhythmias are usually LBBB or ventricular tachycardia. There is fibro-fatty degeneration of the right ventricular wall as well as right ventricular dilatation.

A

Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC)

278
Q

Diffuse subendocardial gadolinium enhancement and diffusely increased T1 myocardial signal are the classical features.

A

Amyloid

279
Q

Contra indications to adenosine stress test

A

Second or third degree heart block
Bronchospasm
Hypotension <90mmHg systolic
Myocardial infarction within 48hrs
Uncontrolled arrhythmia
Severe/critical aortic stenosis

280
Q

a mnemonic for involvement of the upper zones is BREASTS:

A

B = Beryllosis

R = Radiation

E = Eosinophilic granuloma (Langerhans cell histiocytosis) and Extrinsic Allergic Alveolitis

A = Ankylosing spondylitis

S = Sarcoidosis

T = Tuberculosis

S = Silicosis

281
Q

Involvement of the lower zones can be remembered with the mnemonic BADAS:

A

B = Bronchiectasis

A = Aspiration pneumonia

D = Drugs and Desquamative interstitial pneumonia

A = Asbestosis

S = Scleroderma (and Rheumatoid arthritis)

282
Q

Caridac MRI

ischaemic will involve the

A

subendocardial

283
Q

Cardiac MRI

Epicardial and midwall ddx

A

Sarcoidosis
myocarditis
Anderson - Fabry
Chagas

284
Q

Cardiac MRI

Mid wall blotches

A

HOCM

285
Q

Cardiac MRI

Mid wall thin line

A

dilated cardiomyopathy
myocarditits

286
Q

Contraindications to CT guided lung biopsy are:

A

Severe COPD
Pulmonary hypertension
Coagulopathy
PLT <50
INR >1.4
Contralateral pneumonectomy
(echinococcal cysts)

287
Q

imaging of recurrent cholessteatoma

A

restricts

doesn’t enhance

288
Q

granulation tissue

A

no diffusion

enhances

289
Q

adenoid cystic spread

A

perineural

290
Q

spine inverted V

A

sUB ACUTE COMBINE DDEG

B12 DEF

291
Q

Ureter - goblet sign

A

TCC
vause dilatation above and below the lesion in the ureter

292
Q

Ureteric reflux stages

A

1 - -5
1 - into the ureter
2 - into the pelvis
3 - widened pelvis
4 - widened calcyes
5 - blunted calcyce, bad

4 and 5 need operating on

293
Q

What is eagle barrett also called and the triad

A

prune belly

cryptoorchidism
prune belly
dilated ureters and renal pelvis

294
Q

renal emphysema

distinguishing between what two patholigies

A

Pyoitis
- gas in the collecting system

pyelonephritis
- gas in the cortex

295
Q

over 60s testes mass likely

A

lymphoma

296
Q

testes mass in 40year old

A

Seminoma

297
Q

What is maklopakia

A

yellow plawue in kidneys and urters from chronic e coli infetion .

298
Q

MIBG is used for

A

Neuroblastoma tumours

299
Q

Renal artery stneosis parameters

A

Peak Systolic > 180cm/s

300
Q

An RI greater than what is considered to be agood candidate for renal artery intervention

A

0.7

301
Q

list the different ovarian neoplastic lesions (3 groups)

A

Germ Cell

Sex cord

Epithelial

302
Q

what are the ovary germ cell tumours

A

Dysgerminoma

Endometrial sinus (aka yolk sac tumour)

Immature teratoma

303
Q

What are the ovary sex cord tumours

A

Fibroma/Thecoma/fibrothecoma

Sertoli
Leydig

Granulosa cell tumour (adult and juvenile)

304
Q

what are the ovarian epithelial tumours

A

serous and mucinous cystadenocarcinoma
endometroid

clear cell

305
Q

how to differnetiate serous from mucinous cysteadenocarcinoma

A

mucinous will be T1 bright from proteinacious content

306
Q

three categories of ovarian masses

A

Funcutional

Endometrioma

Neoplasm

307
Q

What are the functional ovarian masses

A

Follicular / simple cyst

Corpus luteal cyst

Thea-lutein cyst -

308
Q

Corpus luteal cyst will appear

A

complex due to haemorrhage ithin

309
Q

follicular / simple cyst occur due to

A

failed ovulation

310
Q

corpus luteal cyst form due to

A

failure to involute

311
Q

measurement parameters for a smiple cyst

A

<3cm don’t report
3- 5 comment

> 7cm - need f/u (PostMeno 5cM)

312
Q

need to follow up haemorrhagic cyst for what measurement

A

> 5cm

313
Q

if at 6 weeks repeat US of haemorrhagic cyst as not resolved –>

A

considered an endometrioma

chocolate cyst

314
Q

indeterminate ovary lesions what to do

A

pre meno - f/u in 6 weks

post meno –> surgery

315
Q

OHSS appearance

A

spoke wheel ovary
>5cm
ascites

with

LFT
WCC
HCT

316
Q

how many follicles and volume for PCOS

A

12 follicles
>10ml ovary

317
Q

bell clapper deformity

A

testicle on the side
risk torsion

318
Q

how to distinguish segmental infarciton from mass

A

may need MRI

319
Q

doppler flow in testicular haematoma

A

nil

320
Q

Features of testicular rupture

A

capsule disrution
needs urgent surgery

321
Q

Features of epididymitis

A

enlarged and increased flow

322
Q

malignant germ cell tumour types

A

seminoma

non seminomatous
- mixed
- yolk (AFP)
- Teratoma
- Embryonal
- Choriocarcinoma (BHCG)

323
Q

how to treat a burnt out germ cell tumour

A

orchidectomy and chemo

324
Q

microlithiasis - number of calc

A

5 per image

325
Q

benign testicular masses are

A

epidermoid (keratin filled onion skin)

Sex cord stromal tumours
- Leydig (oestrogen)
- Sertoli (ax with PeutzJaghers and Klinefleters)

326
Q

marker of medullary thyroid cacner

A

calcitonin
made by c cells

327
Q

which cells produce thyroglobulin

A

follicular cells

328
Q

medullary sponge kidney si charachterised by

A

cystic dilatation of collecting tubules

Urine statis predisposes to infection. and stones.

dilated tubules causes the striated paintbrush appearance of renal pyramids

329
Q

breast

phylloides speed of growth

A

rapid

330
Q

painless palpable swelling in his left parotid. USS shows it to be mobile and superficial to the facial nerve. On MRI there is a septated well defined mass in the parotid tail with low intensity on T1 and high intensity on T2.

A

warthins tumour

331
Q

hydrocephalis and calcfication in basal ganglia

A 9-month-old boy undergoes an MRI scan for investigation of severe developmental delay. The scan demonstrates basal ganglia calcification with hydrocephalu

A

think toxo

rather than CMV if there is hydrocephalus

332
Q

optic nerve meningioma vs glioma

A

meningioma will enhance with contrast and may have calc as tram track sign, dural tail

glioma will be along the whole length and fusiform

333
Q

What are the normal parameters and abnormal parameters for a carotid doppler

A

Normal < 125cm per second
>130 then exepct 50% stenosis

> 230cm per second then consider >70% stenosis

333
Q

The ring enhancing of toxoplasmosis is what

A

thin and smooth

334
Q

What is dandy walker malformation

A

Decreased vermis and cephalad rotation of the vermian remnant
cystic dilatation of the 4th ventricle
widely spread hemisperes, torcular labmdoid inversion

patients present in first year of life with neuro abnormalities

335
Q

what is dandy walker variant

A

hypoplasia of just the vermis with some obstruction of the fourth ventricle

less severe

336
Q

A high AFP in an ovaria mass should consider what

A

Leydig Sertoli
Embryonal carcinoma (which is the adult version of yolk sac tumour!)

337
Q

what are the contraindications to a wide local excision of a breast lump

A

if cancer is present in more than 1 quadrant – mastectomy

338
Q

Oesophagitis candida - will affect which bit of the oesophagus and appearance on barium

A

Longitudinal plaques irregular
Upper half of the oesophagus
history of immunocompromise

can be shaggy if severe

339
Q

Herpes simplex in the oesophagus appear as

herpes oesophagitis

A

multiple small ulcers with a halo of oedema

middle third of oesophagus

340
Q

CMV/HIV oesophagitis

A

one large flat diamond / oval shaped ulcer

341
Q

caustic oesophagitis affects which bit

A

midlde and lower
will get progressive change

342
Q

Barrett appearance on barium

A

long stricture
reticular mucosal pattern

343
Q

what is glycogen aconathosis?

A

bengin age related squamous hyperplasia

344
Q

what is klippel feil

A

renal agenesis
cervical rib
deafness
scoliosis
sprangal shoulder
vertebral body coalition

345
Q

Sprengla shoulder is ax with

A

renal abnormalities

346
Q

Iron toxicitiy in the brain causes what

A

signal drop out in the basal ganglia

especially the globus pallidus

347
Q

what is marcharafari bignami

A

poor nutiriton and alcoholics
affets corpus callosum - necrosis and demyelination
swelling and bright T2 signal

sandwich sign is that is spares the dorsal and vetral aspects of corus callosum

348
Q

prostate cancer - adeno - will MRI features be what

A

low T2 and will restrict

349
Q

which neuro disease is the cingulate island sign seen in

A

Lewy body dementia

350
Q

Alzhemiers spares what

A

the occipital

contrast to lewy body which will ravage this

351
Q

What are the different criteria for bozniak

A

1 - simple and smooth
2 - 1-3 septa
2F - 3mm or with septal thickening (6 months and then annually for 5 years)
3 - >4mm wall, irregular - resect
4 - nodule enhancing - resect

352
Q

what is a normal PSA density

A

0.1 ng / ml / cc

353
Q

Coeliac small bowel barium

A

dilated but with normal folds

354
Q

scleroderma small bowel barium

A

dilated with Loooooooooooong transit

355
Q

ZE on barium

A

dilated due to plus plus secretion

356
Q

Lymphoma barium findings

A

enlarged folds with lymph nodes

357
Q

Crohns disease on barium

A

nodular fold thickening

358
Q

Whipple disease

A

thickened folds no dilatation
normal transit

359
Q

what are the features of mastocystosis

A

high histamine
asthma symptoms
sclerosis
big spleen and .liver

360
Q

Testicular tumours by age

A

Yolk sac and teratoma - 10s
Chorio is 20s and 30s
30s Embryonal cell carcinoma (basically adult yolk sac)
40s seminoma

361
Q

What are the ovarian germ cell tumours

A

epidermoid / dermoid
stroma ovarii
seminomatous

ovarian teratoma(s): commonest primary benign tumour of ovary and commonest germ cell tumour:
mature (cystic) ovarian teratoma
immature ovarian teratoma
specialised teratomas of the ovary
struma ovarii tumour
ovarian carcinoid tumours
ovarian dysgerminoma
ovarian yolk sac tumour: endodermal sinus tumour
ovarian embryonal carcinoma
ovarian choriocarcinoma
pure primary ovarian choriocarcinoma: extremely rare
malignant mixed germ cell tumour of the ovary
Treatment and prognosis

362
Q

medial to lateral of the popliteal fossa

A

AVN

artery
vein then nerve

363
Q

causes of pneumatoceles

A

intubation or infection

also truma.
hydrocarbon ingestion

364
Q

features favouring pnematocle over an abscess

A

smooth inner margins
little if any fluid
thin regular wall
persist despite no symptoms

365
Q

how long for pnumatoceles to appear vs disappear

A

take a week to appear

gone within a few months normally

366
Q

carcinoid syndrome will affect what proportion of people with carcinoid tumour

A

8%

367
Q

carcinoid marker is what in the blood

A

5 - hydroxyindoleacetic acid

368
Q

what is Hedinger syndrome?

A

carcinoid heart disease

vasoactive substances aren’t inactivatd by the liver if can bypoass
- eg lung or ovarian vein (primary ovarian carcinoid tumour)

369
Q

appearance of bladder infalmmatory pseudo utumour

A

exophytic
ulcerationpost contrast periphery enhances

370
Q

what is cystitis galndularis

A

metaplasa of the transitinal cells

chronic inflammaotry disorder

found in the trigone

371
Q

with contrast, infected bone marrow will

A

avidly enhance

372
Q

what is the different between CPPD and Hydroxyapatite Crystal disease

A

CPPD triad
- chondrocalcinosis
- typical arthropathy
- pain

Hydroxyapatite crystal deposition
- shoulder. calcific tenonitis.

373
Q

What are the causes of chondrocalcinsois

A

many

hyperparathyroidism
Gout
Wilson disese
Haemachromatosis
Ochronosis
Truama
OA
Low thyroid
low mangesium
acromegaly
HADD

374
Q

most common cause of chondrocalcinosis

A

CPPD

375
Q

cafe au laits

A

NF1 and NF2
Blooms

376
Q

Angiofibroma think

A

TS

377
Q

pits in the pals and sole
BCC
multiple teeth

A

Gorlin

378
Q

Macroglosia

A

BWS

379
Q

Hyperpigmentaiton

A

NF1
Fanconi
Blooms

380
Q

Hemihypertrophy

A

NF1
BWS
KF

381
Q

Thumb malformation

A

Fanconi anaemia

382
Q

hepatoblasomt aax with which syndorme

A

BWS
FAP

383
Q

adrenocrortical and breast cancer ax with

A

Li-Fraumani syndrome

384
Q

Men 2 what can be done to pre-empt cancer

A

thyroidectomy

385
Q

as gestation advances what happens to the echogenicity of the lungs

A

increases

gets more T2 bright too as more alveolar fluid is made

386
Q

what is meconium on MRI

A

bright T1
dark on T2

387
Q

which lines are disrupted in acetabular fractures

A

ilioischial - posterior column

iliopectineal for anterior columns

388
Q

how does SLE cause thrombosis

A

through anti-phospholipid sydnrome

389
Q

PAN affects who and where

A

men in their 60s
renal vasclature. infarction. nultiple aneurysms

present with fever, malaise and weight loss

390
Q

what is an appendiceal mucocele

A

just obstruction of the appendix - cna be from a number of causes

391
Q

appendiceal mucocele due to mucinous tumour bursts can cause what

A

pseudomyxomoi peritonei

392
Q

TB vs pyogenic spondylitis

why does TB not form an anterior spinal mass / encase intervertebral artereis

A

doesn’t go beyond the anterior longitudinal ligament

393
Q

what is a bladder contusion

A

This is commonly seen but not classed as true rupture, since it involves an incomplete mucosa tear. It is equivalent to an intramural hematoma

therefore focal thickening !

394
Q

appearance of eosinophilic cystiis

A

nodules are echogneic in the bladder wall

395
Q

NON ossifying fibroma / cortical defect

A

lucent
thin sclerosis outlining
no periosteal reaction
no involvement o the medullary cavity

low on t1 and t2
they will heal, even if fractured

396
Q

cortical demsoid found where

A

postermediual aspect of the distal femur

397
Q

ct findings in tb meningitis

A

basal encement of the meninges

398
Q

high risk CT head factors requiring imaging within 1 hout

A

GCS 12
or < 15 2 hours after injury

?skull fracture

neuro deficit or seizure

vomitting

399
Q

risk factors assocaited with LoC that would need CT scanning

A

65 +
bleeding disorder/ anticoag (would do even without LOC/amensia)
Mechanism is dangerous
30 minutes of retrorage amensia

400
Q

CT head guidelines or kids
to be done within 1 hour

A

NAI
seizure
GCS<14
2hours post injury GCS <15
?fracture
Neuro deficit

if less than 1 - if have a bruise bigger than 5cm

401
Q

paeds - ct head risk factors requiring at least 2 things

A

LoC - 5 mins
Abnormal drowsiness
3 + vomitting
Dangerous mechanism of injury
Amensia (5 years plsu onl)

402
Q

Cam impingement affects who

A

young men

403
Q

alpha angle in cam

A

over 55

404
Q

choledochal cyst types

A

1 - cbd
2 - diverticulum
3 - into the duodenum
4 - multiple
5 - caroli intrahepatic

405
Q

appearance of a biliary cystadenocarcinoma

A

large, right lobe of liver with septations which will enhance with contrast

406
Q

leukoplakia is charachterised by

A

passing bit sof soft tissue in urine

407
Q
A
408
Q

what are the common causes of optic canal enlargement?

A

glioma
meningioma
mets
neurofibromatosis

409
Q

what is CPAM

A

multicystic masses of segmental lung tissue with abnormal bronchial proliferation.

410
Q

what are the types of cpam

A

1 - large cysts
2 - <2cm cysts. ax with renal agensis, pulmonary sequestration, congenital cardiac anomalies
3 - microcysts, entire lobe. poor prognosis
4 - similar to 1

411
Q

what is pyknodysostosis (osteopetrosis)

A

osteosclerosis and short stature
delayed cranial suture closure
frontal bossing
nail hypoplasia
nasal beaking

distal phalanges are SHARP. pencil like

lysosomal storage disease - poor osteoclast function.

412
Q

PMF vs lung cancer on MRI

A

T2 - bright cancer. dark fibrosis

pmf is t1 brightish with ring enhancement.

PET - pmf is avidly bright (same as cancer so not useful) - biopsy

413
Q

superior orbital fissue syndrome vs orbital apex syndrome

A

post trauma fracture can extend into fissure with disruption of nerve 3-6.

orbital apex sytndrome can damage nerve 2 - unilocular vision los.

414
Q

what are the common causes of delayed bone age

A

Constitutional: familial and IUGR
Metabolic: low thyroid, pituitary, gonads, cushings, dm, malnutrition

systemic disease: heart failure, rneal failure, coeliac, crohns, UC and anaemia

syndromes: Trisomies, Noonan, cornelia de lange, cleidocranial dysplasia.

415
Q

branching lucencies in the liver think

A

portal gas badness

416
Q

types of bladder cancer

A

Sqamous - ax with risk factors like schisto/inflammation
TCC - MOST common, enhance avidly though appearance similar to scc
leimyoma - smooth masses
adeno - midline

417
Q

what is a pathonemonic feature of second branchial clef tcyst

A

beaking of fluid between the carotid bifurcation

418
Q

what is the currarino triad

A

sacrocoxygeal osseous defect

presacral mass

anorectal malformation

419
Q
A

AA ST2 (14 decks)

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