Radiology

Question 1

Define stroke

Answer 1

Sudden onset focal neurological deficit of presumed vascular origin

Question 2

What are the two types of stoke and frequency at which they occur?

Answer 2

Ischaemic (80%)

Haemorrhagic (20%)

Question 3

What is the gold standard imaging for suspected stroke?

Answer 3

Non-contrast CT head

Question 4

Give 3 acute signs (<24hr) of stroke which can be seen on CT

Answer 4

1. Hyperdense vessel sign
2. Loss of insular ribbon
3. Hypoattenuation of tissue and swelling

Question 5

Give 3 examples of focal neurological deficit

Answer 5

Sensation change
Loss of coordination
Dysphagia

Question 6

What is malignant MCA syndrome?

Answer 6

Rapid neurological deterioration due to space-occupying effects of cerebral oedema +/- haemorrhage transformation

Question 7

Define intracranial haemorrhage

Answer 7

An extravascular accumulation of blood within different intracranial spaces

Question 8

Give 2 risks and 2 causes of intracerebral haemorrhage

Answer 8

Risks: HTN and Diabetes

Causes: Trauma and Aneurysm

Question 9

Where do extradural haemorrhages occur?

Answer 9

Between inner surface fo skull and outer layer of dura

Question 10

How does an extradural haemorrhage present with respect to time?

Answer 10

Lucent period before the patient develops symptoms

Question 11

What findings may be seen in the pupils in extradural haemorrhage?

Answer 11

Fixed and dilated on the affected side

Question 12

What usually causes subdural haemorrhage?

Answer 12

Tearing of bridging veins in the subdural space due to shearing forces

Question 13

Give 3 signs/symptoms of a subarachnoid haemorrhage

Answer 13

Thunderclap headache
Reduced GCS
Seizure

Question 14

Give 2 causes of subarachnoid haemorrhage

Answer 14

Spontaneous

Rupture of berry aneurysm

Question 15

What imaging is used to detect pneumoperitoneum?

Answer 15

Erect chest X-ray

Question 16

What is Rigler’s sign and what does it indicate?

Answer 16

Gas inside and out of the bowel lumen which highlights the bowel clearly
Pneumoperitoneum

Question 17

What does coffee bean sign indicate?

Answer 17

Sigmoid volvulus

Question 18

What does thumbprinting on abdominal x-ray indicate?

Answer 18

Bowel wall oedema due to inflammation or infection e.g. colitis

Question 19

Give 3 features of cholecystitis on US

Answer 19

1. Pericholecystic fluid
2. GB wall thickening >3mm
3. Gallstones

Question 20

Give 2 early signs on acute pancreatitis on CT

Answer 20

Pancreatic oedema

Peri-pancreatic fat stranding

Question 21

Give 2 imaging modalities to assess obstructive uropathy

Answer 21

CT KUB
CT urogram (filling defect)

Question 22

Give 3 features of appendicitis which may be seen on US

Answer 22

1. Thickened wall
2. Collection
3. Pelvic free fluid

Question 23

Where should the tip of an ET tube end up?

Answer 23

5-7cm above carina

Question 24

Where should a tracheostomy tube be positioned?

Answer 24

Tip halfway between stoma and carina at T3

Question 25

What is the correct positioning of an NG tube?

Answer 25

Below left hemidiaphragm 10cm distal to GOJ

Question 26

Where does a central venous catheter go to and from?

Answer 26

L/R subclavian into jugular vein

Question 27

Where should the tip of a central venous catheter end up?

Answer 27

SVC or Cavo-atrial junction

Question 28

Where should the tip of a PICC line end up?

Answer 28

Cavo-atrial junction

Question 29

What 3 arterial pathologies can be treated using interventional radiology?

Answer 29

Narrowing of arteries
Expansion of arteries
Bleeding

Question 30

What 2 venous pathologies can be treated using interventional radiology

Answer 30

Blood clots

Dilated veins

Question 31

Name 2 non-vascular procedures which can be done using interventional radiology

Answer 31

Nephrostomy

Gastrostomy

Question 32

Give 2 ways interventional oncology can be achieved

Answer 32

Ablation of tumour

Chemoembolization