Radiology

Question 1

Superior Vena Cava Obstruction

Answer 1

Most common cause is Lung Cancer / Lymphoma
Compression or Invasion

Shortness of Breath
Facial and upper body odema

Initial imaging - Chest X ray - abnormality
Most appropriate investigation - CT with contrast (to find out the obstructed place and put a stent there )

Question 2

Severe Colicky abdominal Pain / Vomiting and Abd distension
Has not opened her bowels in 10 days
Last 6 month hysterectomy for uterine Fibroid (distractor )

Answer 2

Intestinal obstruction due to Adhesion of intestine due to surgery

If Paralytic iliac it will Happen after 2-3 day post op

Question 3

Large bowel obstruction vs Small bowel obstruction

Answer 3

Large bowel obstruction–> placed more peripherally
haustera–> large lines only to the half of diameter of intestine

Small Bowel obstruction–> placed more centrally
valvulae conneventies–> Small lines passing through full diameter of intestinal loop

The small bowel usually lies more centrally, with the large bowel framing it. The small bowel’s mucosal folds are known as valvulae conniventes and are visible across the full width of the bowel. The large bowel wall features pouches or sacculations that protrude into the lumen, known as haustra.

Question 4

2 year history of soft swelling in his right scapula
within 6 month grow in size
no pain no weight loss no other lumps
Most appropriate investigation

Answer 4

Ultrasound

Not excisional biopsy

Question 5

Women with weakness of both of her hands and neck pain immediately after a fall
where is the lesion level on Lateral Cervical X ray?? within C5- T1

Answer 5

C7-T1
Remember there is no C8 vertebra / the C7and C8 nerve roots both originate between from the C7 and T1 vertebra

C7 and C8 origin of Radial nerve
C8 and T1 level - origin of Ulnar and Medial nerve

Question 6

Pleural Effusion
Search for COSTO PHRENIC BLUNTING
Fluid level in the Lung

Answer 6

Transudative pleural effusion (Clear fluid )

fluid leaking into the pleural space.
increased pressure in the blood vessels or a low blood protein count.
Heart failure / Liver failure is the most common cause.

Exudative effusion (White / Red / Pus / Cancer )

blocked blood vessels or lymph vessels,
inflammation, infection, lung injury, and
tumors.

Question 7

Infection / chronic productive cough for 8 months / purulent sputum
finger clubbing
course early inspiratory crackles

Answer 7

Bronchiectasis (ectasis = dilation )

Trim track opacities - abnormally widen and thickened airway with an irregular wall