Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OSCEs > Radiology > Flashcards

Radiology Flashcards

1
Q

CXR - pneumothorax

A

region of lucency around the edge of the lung (with a visible lung edge)

lucency of the entire hemithorax
+ mass effect (mediastinal shift/depression of diaphragm) + rib# !! tension !!
*one way flap valve - MS compresses vessels and heart
Rx: A to E, decompress with large bore cannula in safe triangle – insert chest drain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

CXR - lobar pneumonia

A

patchy opacification (with air bronchograms)
+/- pleural collection
+/- cavitation

+ loss of heart border and hemi-diaphragm

most likely a lobar pneumonia - usually CAP (S. pneumo, H. Influenzae)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

CXR - lobar collapse

A

dense shadow in x
+ mediastinal shift/tracheal deviation towards
+/- raised horizontal fissure

Causes - foreign body, asthma (mucus plug), cancer

if RUL = density in the RUZ, raised horizontal fissure, loss of right heart border
if LLL = triangular opacity in the LLZ, obscured left hemidiaphragm

+/- bloods, CT, bronchoscopy
retrieval of foreign body or chest physio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

CXR - acute pulmonary oedema

A 
upper lobe diversion
inc heart size
pleural effusions
peri-hilar opacification +/- air bronchograms
septal lines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

CXR - pleural effusion

A

blunting of the costophrenic angle with a visible meniscus

I would ideally review a lateral view

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

DDx for opacification on CXR

A

fluid (pulm oedema)
pus (pneumonia)
blood (pulm haemorrhage)
cells (malignancy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

DDx for bilateral hilar lymphadenopathy

A

inf, inflam, malignancy

tb, sarcoid, lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

CXR - NG tube

A
  1. descend in the midline
  2. intersect the carina
  3. travel through the gastro-oesophageal junction
  4. tip visible 10cm below the diaphragm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

CT head - subdural

A

peripheral hyperdense crescent-shaped collection (central hypodensity represents active bleeding)
hyperdense > isodense > hypodense
not limited by sutures, may fill dural reflections

+/- mass effect

acute ? head injury
subacute/chronic = confusion/vague neurology
~ tearing of bridging veins
Rx: correct any clotting abnormalities, repeat CT, get neurosurgical opinion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

CT head - extradural

A

peripheral hyperdense lens-shaped collection
(well-demarcated haemorrhage between brain and skull)
acute: hyperdense
bound by skull sutures

+/- associated injuries, e.g. fracture,
+/- mass effect and midline shift

high impact trauma, young patients ~ middle meningeal artery
= headache, focal neurology, LOC
Rx: urgent consideration of neurosurgical intervention - burr hole (smaller bleeds - conservative Rx)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

CT head - stroke

A

post-infarction - hypodense region
acute haemorrhage/clot in vessel - hyperdensity

= sudden neuro deficit, Sx depends on vascular territories
Rx: depends on time of onset but can include thrombolysis (excluded haemorrhagic and no CIs), thrombectomy (for proximal circulation), aspirin > long term clopi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

CT head - mass

A

variety of appearances ~
hypo- or hyperdense, irregular, well-defined, peripheral or deep lesions

+/- mass effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

CT head - subarachnoid

A

hyperdensity in the cisterns and sulci suggestive of blood

older middle-age
~ rupture of berry aneurysm, or trauma
= headache, meningism, confusion/low GCS
Ix: LP?
Rx: cause, neurosurgical opinion (coil/clip aneurysms), high fluid intake, CCB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

AXR - Sigmoid volvulus

A

large dilated loop of colon which arises in the pelvis (LLQ), extends towards the RUQ, forming a coffee bean sign.
ahaustral

+/- ascending, transverse and descending colon may be dilated

~ chronic constipation
Rx: endoscopic decompression with sigmoidoscope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

AXR - Caecal volvulus

A

twisting of the large bowel which appears to arise in the pelvis RIF and extends towards epigastrium or LUQ
haustral pattern is maintained

+/- distended small bowel

= colicky abdominal pain, vomiting, and abdominal distension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

AXR - small bowel obstruction

A

multiple loops of dilated bowel in the central abdomen, with lines across them suggesting valvulae conniventes

~ adhesions, herniae.
Rx: decompression (NG) and IV fluids
\+/- surgery
* ischaemia,
perforation
17
Q

AXR - large bowel obstruction

A

dilated bowel in the abdominal peripheries, with haustral markings suggesting a large bowel obstruction

mechanical (neoplasm, diverticular stricture, volvulus) or non-mechanical (pseudo-obstruction - air in bowel)

18
Q

AXR - colorectal cancer

A

•Apple-core stricture with shouldered margins
+/- obstruction, perforation

RFs: dec fibre, IBD, familial, smoking
Sx: CBH, PR mass, obstruction, PR bleed, FLAWS

Rx: Duke’s staging, MDT, colonoscopy for biopsy (grade)
Radical excision

19
Q

CXR - perforation

A

•Air under the diaphragm aka pneumoperitoneum – forms crescent beneath diaphragm.
*if shown an abdominal x-ray (double wall sign), you should request to see the erect x-ray.

Causes:
•Spontaneous perforation i.e. ulcer
•Iatrogenic: laparoscopy insufflation.
•Traumatic

Rx: drip and suck, NBM, fluids, analgesia, Abx

20
Q

Barium swallow - oesophagus (cancer)

A

•Irregular, shouldered stricture of the oesophagus – an ‘apple-core’ lesion.
•Where?
*Distal third – adenocarcinoma (more common ~ GORD - Barrett’s).
*Proximal third – squamous cell carcinoma (~smoking/ETOH).

Sx: prog dysphagia, wt loss, if upper - hoarseness, cough

Ix: OGD + biopsy.
•Staging: CT, EUS, laparoscopy, mediastinoscopy.

Management:
•MDT.
•Oesophagectomy: 25% (Ivor-Lewis 2 stage, McKeown 3 stage)
•Palliation: 75% of patients (stenting, analgesia)

21
Q

Barium swallow - oesophagus (achalasia)

A

•Proximal dilatation of the oesophagus with smooth distal tapering towards the GEJ – the bird’s beak appearance.
+/- aspiration pneumonia

Focal motility disorder of the oesophagus caused by degeneration of the myenteric plexus = disrupted oesophageal peristalsis causing impaired relaxation of the lower oesophageal sphincter

Sx: dysphagia to liquids then solids, cramps, regurg, wt loss

Rx: CCB, botox injection, balloon dilation, myotomy

22
Q

CXR - causes of white out

A

Complete white out of the left hemithorax
? massive effusion - trachea away
? collapse - trachea towards
? pneumonectomy - trachea towards
? pneumonia/oedema/mesothelioma - same position

Bilateral - ARDS - pneumonia, sepsis, drowning

23
Q

CXR - causes of cavitating lesion

A

Infection - S aureus, TB
Inflammation - granuloma, rheumatoid
Malignancy - SCC

24
Q

CXR - lung metastases

A

peripheral, round lesions of variable size, scattered throughout both lungs
~ metastases

breast carcinoma
colorectal carcinoma
renal cell carcinoma
uterine leiomyosarcoma
head and neck squamous cell carcinoma
25
Q

Digital subtraction angiogram

A
  • Vessel stenosis.
  • Distal filling by collaterals.

Presentation:
Acute: 6Ps = pain, pallor, pulseless, perishingly cold, paraesthesia, paralysis.
Chronic: asymptomatic, intermittent claudication, rest pain, ulceration and gangrene, Leriche Syndrome (ED + buttock claudication).

26
Q

XR - colles fracture

A

Extra-articular # of the distal radius.
Dorsal displacement and angulation of distal fragment.

FOOSH + osteoporosis

  • Resuscitate + manage life-threating injuries.
  • Assess NV injury: median nerve + radial artery.
  • Reduction + fixation:
    o Bier’s block (with prilocaine) – allows analgesia.
    o Dorsal backslab with 3-point pressure.
  • Fracture clinic appointment for orthopaedic assessment
27
Q

Describe this fracture on XR

A

“This is a plain radiograph of the upper/lower of x patient. Ideally, I’d have another view and compare to any previous imaging”

PADS
Pattern- “There is a complete/incomplete, transverse/olique/spiral’ fracture”
Anatomy- “of the distal/mid/proximal 1/3rd of the left/right x bone”
Deformity- “with anterior/posterior, medial/lateral, dorsal/volar” translation or angulation
Soft tissues, joint involvement, ?impaction

“I’d ideally assess for soft tissue injury, if the fracture is open/closed and the neurovascular status of the limb”

Complications
There are general complications associated with surgery and immobility and specific. Specific complications can be immediate, early or late. Immediate includes damage to NV or adjacent soft tissue, bleeding and pain. Early includes compartment syndrome, VTE/PE, infection.
Late includes malunion or non-union, AVN, joint disease and neuropathic pain.
General - surgery = ABD, BPI, immobility = 5Ws

OSCEs (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions