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Radiology Flashcards

1
Q

Name 4 radiological modalities that use radiation

A

• Xray
.Ct scan (ct Angio highest)
• mammogram (least)
• pet scan

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2
Q

Name 2 radiological modalities that don’t use radiation and therefore is safe for pregnancy and paeds

A

• Ultrasound
• MRI

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3
Q

List radiological modalities from least to most expensive (5)

A

• Xray
.Ct and US
• MRI
• Ct Angio
• pet scan

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4
Q

What is the ALARA principle

A

As low as reasonably achievable dose of radiation and still provide detailed exams

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5
Q

Define the stochastic effect of radiation

A

Likelihood that effect/cancer will occur in long term, there is no threshold (not dose dependent)
More time dependent

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6
Q

Define the deterministic effect of radiation

A

Effects vary with dose, there is a threshold below which the effect does not occur (dose dependent)
Eg skin cancer occur from dose 2-5 Gy, not below that.

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7
Q

Name 1o uses ultrasound

A

Trauma:
• fast: free fluid in abdomen, pericardium, haemothorax, pneumothorax
• Doppler: vascular injury

Paediatrics
• solid abdominal organ exam

Neonates
• hip dislocation
• intracranial haemorrhage!

• General exam: gallstones, kidney stones, liver disease, thyroid, testicular torsion
• obstetrics: intrauterine foetus development and other complications eg abruptio
• Heart echo: ejection fraction, pericardial effusion
• MSK: tendon rupture/tear
• breast: lesions, biopsies

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8
Q

What is fluoroscopy and what is it used for (4)

A

Uses x ray to view anatomy as it functions in real time.
• gastrointestinal: barium swallow and meal, barium enema
• genitourinary: vesicoureterogram vcug (inject urographin contraSt in bladder), intravenous pyelogram IVP (inject ultraVist contrast iv )
• Arthrogram’s: joint space
• hysterOgrams: uterus and fallopian tubes

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9
Q

Name 3 considerations before giving patient Ct contrast

A

• Iodine allergy
• penicillin allergy
• if patient has taken glucophage - if given with contrast → lactic acidosis

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10
Q

Name 6 uses MRI

A

Best for soft tissue
. Brain: tumours, stroke, abscesses, nerve compression
• chest: heart, valves, coronary blood vessels
• Blood vessel magnetic resonance angiography MRA: aneurysm, stricture, dissection
• abdomen, pelvis: liver, gallbladder, pancreas, kidneys, prostates bladder; blockage, ambiguous genitalia, tumours, bleeding, infection
• bones and joints: bone marrow, bone tumours, cartilage, torn ligaments or tendons, infection
. Spine: discs, nerves for spinal stenosis, disc bulge, spine tumour

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11
Q

Nb name 2 contraindications MRI

A

• Pacemakers, metal implants, metal chips or clips
• claustrophobia

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12
Q

How can physician reduce radiation doses (5)

A

• Order appropriate investigation for relevant clinical presentation
• do not unnecessarily repeat
• always check previous imaging before order new
• have all pre-ct scan pre-requisites checked before request investigation eg have relevant blood results ready in case of post contrasted imaging or angiography
• check if allergy to iodine, penicillin, opioids

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13
Q

How much radiation can pregnant woman receive

A

<50 mGy (5 rads)

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14
Q

How can irradiation in unknown early pregnancy be prevented

A

Ten day rule:
Women of childbearing age: non-urgent diagnostic radiography of abdo should be confined to pre-ovulatory phase of menstrual cycle ie 10 days following first day of last period

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15
Q

First choice study for head trauma?

A

Ct brain

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16
Q

First choice study for long bone fracture??

A

Xray

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17
Q

First choice study for symptoms cholecystitis?

A

Ultrasound

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18
Q

First choice study for chronically ill with metastasis presenting with confusion, slurred speech, herriparesis?

A

Only pre and contrast Ct brain
Not staging Ct

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19
Q

First choice study for trauma to exclude tension pneumo, widened mediastinum, location ETT and ICD?

A

Ap chest radiograph

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20
Q

First choice study for suspected vascular injury in trauma?

21
Q

First choice study for evidence vascular injury in trauma?

22
Q

Imaging Approach to widened mediastinum? (3)

A

• Chest xray ideally with head up, NGT
. If abnormal, Ct scan with contrast
. If abnormal or equivocal, angiography

23
Q

First choice study for suspected intracranial bleed adult?

A

Pre contrast Ct

24
Q

First choice study for suspected intracranial bleed neonate?

A

Ultrasound

25
Q

First choice study for suspected Gallstones adult?

A

Ultrasound

26
Q

First choice study for suspected intracranial aneurysm?

27
Q

First choice study for sudden paraparesis and incontinence?

28
Q

First choice study for suspected interstitial lung disease?

A

High resolution Ct chest

29
Q

First choice study for suspected neonate hip dislocation?

A

Ultrasound

30
Q

First choice study for suspected intra peritoneal abscesses adult?

A

Contrasted Ct scan

31
Q

First choice study for suspected hyperacute infarct with normal Ct?

A

MRI hyper acute sequence

32
Q

First choice study for suspected brain abscess or metastasis with known renal failure?

A

MRI special sequence not needing contrast

33
Q

First choice study for suspected diverticulitis adult?

A

Barium enema

34
Q

First choice study for adult fell and present with suspected knee dislocation and cold limb?

A

Doppler then xray
If absent pulses and stable: Ct Angio lower limb to plan surgery

35
Q

First choice study for unstable hypotensive with abdominal and head injures?

A

Ultrasound abdomen
Ct abdo, Ct brain

36
Q

First choice study for blunt abdo trauma with suspected haemorrhage from pelvic #?

A

Ct angio abdo and pelvis

37
Q

First choice study for suspected appendicitis adult?

A

Contrasted Ct abdomen
Ultrasound if obese

38
Q

What does pneumoperitoneum indicate?

A

• Bowel perforation
• surgical emergency

39
Q

Name 2 causes pneumoperitoneum

A

. Gastric ulcer perforation
• colonic diverticulitis perforation
Not seen in perforated appendicitis

40
Q

Symptoms ruptured aneurysm?

A

Triad:
• hypotension
• pulsating mass
• back pain

41
Q

Most common site ruptured aneurysm?

A

Left retroperitoneum

42
Q

Name 2 git complications ruptured aneurysm

A

• Sigmoid diverticulitis
• renal colic
Due to impingements haematoma on adjacent structure

43
Q

First choice study for suspected ruptured aneurysm in stable patient?-

A

Ct angiogram

44
Q

First choice study for suspected ruptured aneurysm in unstable patient?-

A

Ultrasound

45
Q

Name 2 uses plain abdominal radiograph in acute abdomen

A

• Kidney stone detection
• pneumoperitorium detection

(If don’t find these, do more investigations )

46
Q

Define positive fast in RUQ

A

Fluid in morrison’s pouch between liver and kidney

47
Q

Top 3 scans for chest emergency?

A

. CXR first
• then ultrasound
• then Ct if still in doubt

48
Q

First choice study for suspected bladder injury?-

A

Ct cystogram

49
Q

First choice study for suspected pancreatitis?-

A

Ultrasound
If in doubt, Ct (fat stranding)

Chemical Pathology (23 decks)

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