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IPAP > Radiology Block 1 > Flashcards

Radiology Block 1 Flashcards

1
Q

What is the sequence from highest to lowest wavelength/strength for ionizing radiation?

A 
Gamma: Shorter, higher freq/energy
Xray
UV
Visible
Infrared
Microwave
Radio: longer, lower freq/energy
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2
Q

Define Scintigraphy

A

Radioactive tracer used for imaging organ function

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3
Q

What is the use for radionuclide Tc-99m?

A

Numerous

Most frequently for bone scans

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4
Q

What is the use for radionuclide Ga-67?

A

Inflammation

Infection

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5
Q

What is the use for radionuclide In-111?

A

Infection

Tumors

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6
Q

What is the use for radionuclide Ti-201?

A

Cardiac Perfusion

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7
Q

What are 7 variations of nuclear medicine imaging?

A 
Bone scan
Myocardial perfusion
HIDA
V/Q
Thyroid scan
PET
SPECT
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8
Q

Define Sclerotic

A

Unhealthy hardeing/thickening of bone

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9
Q

Define Lytic

A

Destruction of area of bone by disease/cancerous cells

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10
Q

Define Osteomalacia

A

Bone softening due to insufficient mineralization

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11
Q

What are the Generalized reasons for Inc/Dec bone density?

A

Inc- Diffuse osteoblastic metastases, osteopetrosis

Dec- Osteoperosis, Hyperparathyroidism, Rickets/osteomalacia

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12
Q

What are the Focal reasons for Inc/Dec bone density?

A

Inc- Localized osteoblastic metastases, Avascular necrosis, Paget Disease
Dec- Localized Osteolytic metastases, Multiple Myeloma, Osteomyelitis

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13
Q

What are 3 pitfalls to recognizing Fx?

A

Sesamoids
Accessory ossicles
Unhealed Fx

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14
Q

What are the two types of Comminuted Fx?

A

Butterfly

Segmental

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15
Q

What are 5 types of healing fractures?

A 
Periosteal reaction
Delayed union
Nonunion
Malunion
Pseudoarthrosis
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16
Q

What are the 3 classifications of arthritis?

A

Hypertrophic
Erosive
Infectious

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17
Q

What are the types of Hypertrophic arthritis?

A 
Primary
Secondary
Erosive
Charcot
Ca Pyrophosphate Deposition Disease
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18
Q

How how many Hounsfield units have air, bone, fat, water and soft tissue been assigned?

A 
Air: -1000 HU
Bone: 400-600 HU
Fat: -40 -  -100
Water: 0
Soft tissue: 20 - 100
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19
Q

Radiation causes biological effects at a cellular level in what two ways?

A

Direct damage

Indirectly forming radicals

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20
Q

What are 4 examples of testing done by CT that are beneficial for provider and PT?

A 
Virtual colon/bronchoscopy
Fx
Coronary angiography
Abdominal pathology
Trauma
Cardiac calcium
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21
Q

What is a preferred imaging form for women of childbearing age and during pregnancy?

A

US

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22
Q

What is the imaging study of choice for imaging female pelvis and pediatric PTs?

A

US

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23
Q

What form of imaging can differentiate cystic verse solid lesions in PTs of all ages?

A

US

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24
Q

US is the image of choice for what types of PT populations?

A 
Female pelvis
Pediatrics
Cystic vs solid lesions
Non-invasive vasculature
Fetal/placental
Real-time fluid aspiration and biopsy
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25
Q

What are 4 common evaluation images US is used for?

A

Cystic vs solid breast masses
Thyroid nodules
Tendons
Newborn spine/brain/hips

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26
Q

What type of imaging are MRIs widely used for?

A

Neurological
Soft tissue
Masses
Female pelvis

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27
Q

What are 3 uses of interventional radiology?

A

Iodine contrast used to view anatomy, pathology or position of implants

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28
Q

How are radioisotopes artificially produced?

A

Neuron enrichment in nuclear reactor or cyclotron

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29
Q

What are two examples of naturally occurring radioisotopes?

A

Uranium

Thorium

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30
Q

Define SPECT

A

Single-photon Emission Computed Tomography

Gamma camera rotates around PT capturing 2D images from numerous angles and formed into 3D images by computer

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31
Q

What type of nuclear injection is used during PET scans?

A

Positron (positive electron) isotope attached to pharmaceutical

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32
Q

When is PET scanning most often used?

A

Diagnosis and treatment f/u of cancer
Locate hidden metastases
Detect recurrence

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33
Q

Define Flat Plate

A

Plain film of abdomen w/ PT lying supine

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34
Q

What is the systematic approach to reading abdominal scans?

A

1- gas pattern
2- etraluminal air
3- abnormal abdominal calcifications
4- soft tissue masses

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35
Q

What is the difference between distended and dilation when reading abdominal CT scans?

A

Distended- bowel filled w/ normal amounts of air, normal

Dilated- bowel filled with beyond normal amounts of air, abnormal

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36
Q

Why would an increase number of air-fluid levels be seen in a PTs colon?

A

Recent enema
Anti-cholinergic meds
Anti-peristaltic meds

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37
Q

What is being looked for with a supine abdomen view?

A

Bowel gas patterns
Masses
Calcifications

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38
Q

What is being looked for with a prone abdomen view?

A

Gas in retrosigmoid colon

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39
Q

What is being looked for with a upright abdomen view?

A

Air/fluid levels in bowel

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40
Q

What is being looked for with a upright chest view?

A

Air/effusions

Pneumonia

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41
Q

Supine view is AKA ?

A

Scout film

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42
Q

Define Organomegaly

A

Evaluation of soft tissue structures in abdomen

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43
Q

Define Riedel lobe

A

Right lobe of liver extending to iliac crest in women

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44
Q

Define FAST

A

Focused Abdominal Sonogram for Trauma

Portable US for unstable PTs to look for free peritoneal fluid

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45
Q

What is a FAST exam used in place of?

A

Peritoneal lavage

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46
Q

What are the most commonly injured solid organs from blunt trauma?

A

Spleen
Liver
Kidney
Bladder

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47
Q

What is the most frequently injured organ from blunt and penetrating trauma?
What is the preferred imaging technique to locate it?

A

Right lobe of liver

CT w/ contrast

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48
Q

Spleens are usually injured from what mechanism of injury?

What is the imagine method of choice to screen?

A

Deceleration of unrestrained passengers

CT due to the fact the spleen is the most highly vascular organ

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49
Q

What are the most common causes of kidney injuries?

What is the imaging method of choice?

A

Motor vehicle accidents

CT w/ contrast

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50
Q

What causes shock bowel injuries?

A

Blunt abdominal trauma w/ hypovolemia or hypotension

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51
Q

What is the MOA for bladder injuries?

What is the preferred imaging method to detect it?

A

Pelvic Fx

CT cystogram

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52
Q

What is the MOA of urethral injuries?

What is the imaging method of choice?

A

Pelvic/blunt trauma in males

Retrograde Urethrography RUG

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53
Q

What is the difference between luminal and mural?

A

Luminal- arise from mucosa, polyp/carcinoma

Mural- arise from wall, leiomyomas/lipoma

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54
Q

Loops of the GI system have to be in what position for accurate/effective examination?

A

Fully distended

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55
Q

What is the study of choice for diagnosing aspiration?

A

Esophagography

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56
Q

Lumen of the stomach is studied through what form of imaging?
Wall thickness and structures outside of the stomach are examined by?

A

Endoscopy

CT w/ contrast

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57
Q

What do the different colors on US mean?

A

Echogenic- bright/white

Sonolucent- dark/black

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58
Q

What is the direction orientation of images produced by US?

A

Sagital/longitudinal

Transverse

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59
Q

What effect is used by US to determine if fluids are heading towards or away from the transducer?

A

Doppler effect

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60
Q

US is the study of first choice for what abnormailities?

A

Biliary system

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61
Q

How can gallstones and biliary sludge be differentiated on an US?

A

Sludge doesn’t produce acoustical shadowing

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62
Q

PT undergoing HIDA exams will show what images if cystic duct is obstructed or if the common bile duct is obstructed?

A

Cystic- tracer won’t appear in gallbladder

Common bile- tracer won’t appear in small intestine

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63
Q

What is the screening study of choice for asymptomatic, pulsatile abdominal masses?

A

US

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64
Q

What is the imaging study of choice for evaluating pelvic masses and pelvic pain in female PTs?

A

US

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65
Q

What is the imaging study of choice for evaluating uterine fibroids?

A

US- transabdominal or transvaginal

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66
Q

When/why are MRIs used to evaluate uterine fibroids?

A

Complicated surgical case planning

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67
Q

What is the imaging study of choice for evaluating ovaries?

A

US

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68
Q

What form of imaging is used to identify the best location to perform a paracentesis to remove ascitic fluid?

A

US

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69
Q

What form of imaging is the best at identifying the presence of an intrauterine pregnancy?

A

US

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70
Q

Define Duplex Sonography

A

Vascular US with Doppler spectral waveform

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71
Q

What is the highest yielding sonographic exam for DVTs examination?

A

US of symptomatic PT w/ symptoms above the knee

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72
Q

MRI imaging is better than CT scans for what two purposes?

A

Soft tissue abnormalities

Changes in tissue over time

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73
Q

What form of imaging is preferred to study bone marrow components?

A

MRI

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74
Q

What is the prototype for generalized increase in bone density?

A

Carcinoma of prostate

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75
Q

Sclerotic lesions that affect the cortex usually cause what abnormality?
Sclerotic lesions that affect the medullary cause what abnormality?

A

Cortex- periosteal new bone formation

Medulla- punctate, amorphous lesions

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76
Q

What is the imaging method of choice for studying skeletal metastases?

A

Radionuclide bone scan

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77
Q

What is the imaging method of choice for detecting avascular necrosis?

A

MRI

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78
Q

How is Paget’s Disease diagnosed?

A

Conventional radiograph

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79
Q

What are the imaging hallmarks of Paget’s Disease?

A

Thickened cortex
Accentuation of trabecular pattern
Increased bone size

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80
Q

What is the imaging method of choice for bone mass density tests?

A

Dual energy x-ray absorptiometry DEXA

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81
Q

What is the most common primary malignancy of bone in adults?

A

Multiple myeloma

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82
Q

The most common cause of osteomyelitis is what microbe?

A

Staph Aureus

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83
Q

What is the difference between a simple and comminuted fracture?

A

SImple- two fragments

More than 2= comminuted

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84
Q

What is the most common form of arthritis and where does it show?

A

Primary OA

Hips, knees, hands

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85
Q

What is the imaging hallmark of Primary Osteoarthritis?

A

Marginal osteophyte formation, subchondral sclerosis, subchondral cysts, narrowing of the joint space

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86
Q

What bone abnormality is seen on all forms of arthritis?

A

Narrowing of joint space

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87
Q

Where is erosive osteoarthritis most common?

A

Proximal and distal interphalangeal joints

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88
Q

What is the most common cause of Charcot arthropathy and where is it seen?

A

Diabetes

Feet and ankles

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89
Q

Charcot arthropathy can mimic what other bone disorder?

A

Osteomyelitis

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90
Q

Where is CPPD commonly found in the body?

A

Wrists cartilage
Menisci of knee
Hook shaped formations at metacarpal heads

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91
Q

What are the 4 types of erosive arthritis?

A

RA
Gout
Psoriatic arthritis
Ankylosing spondylitis

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92
Q

What is the imaging hallmark for RA?

A

Metacarpal radial deviation

Phalangeal ulnal deviation

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93
Q

What type of arthritis has atlantoaxial subluxation

A

RA

Proximal joints

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94
Q

Gout is a formation of what type of crystal?

A

Calcium urate

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95
Q

Define Tophi

A

Skin manifestation from gout

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96
Q

PT presents w/ olecranon bursitis, what is first diagnosis?

A

Gout

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97
Q

What form of arthritis presents with “pencil-cup” deformity

A

Psoriatic arthritis

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98
Q

Where is psoriatic arthritis found?

A

Distal interphalangeal joints

99
Q

What are the 3 types of infectious arthritis?

A

Hematogenous- infection located elsewhere
Pyogenic
Non-pyogenic

100
Q

What is the most common cause of pyogenic arthritis?

A

Staph Aureus

101
Q

What is the most common cause of non-pyogenic arthritis??

A

TB in the thoracic spine

102
Q

What are the two types of pyogenic arthritis and what type of damage does it cause?

A

Indirect- from blood
Direct- local infection outside of joint
Destroys articular cartilage and adjacent articular cortex

103
Q

Where does non-pyogenic arthritis appear in kids and adults?

A

Kids- spine

Adults- knee

104
Q

What is the most common skull fracture?

What is the most serious?

A

Linear

Basilar

105
Q

What is the imaging study of choice for skull fractures?

A

Unenhanced CT

106
Q

True AP and Lateral shoulder joint x-rays are AKA?

A

Y-view

107
Q

Where are Bankheart Lesions located?

Where are Hillsack lesions found?

A

Glenoid

Humoral

108
Q

“Sail Sign” in an elbow is indicative of what?

A

Hemarthrosis

109
Q

What PT population is a slipped capital femoral epiphyses found in?

A

Sedentary obese children

110
Q

Define a Mortise view?

A

Ankle series AP view w/ slight intentional rotation

111
Q

What does the term “conventional radiograph” mean?

A

Plain film w/out contrast

112
Q

CT numbers can be assigned within what range and means what?

A

-1000 to 1000

Measures how much x-ray bean is absorbed by tissues

113
Q

What are two consequences of scattered radiation?

A

Degrades image quality

Radiates bystanders

114
Q

Radiation can cause damage in what two ways?

A

Direct molecular damage

Free radical creation

115
Q

Radiation can cause biological damage effects in what ways?

A

Deterministic- nonrandom when a threshold is met

Stochastic- random w/out meeting a threshold

116
Q

What tissues have a low and high sensitivity for radiation?

A

Slowly dividing/mature= low

Rapidly dividing/differentiated- high

117
Q

What are 5 uses of x-rays?

A 
FAT CD
Fx
Abdomen air/obstruction
Trauma
Chest tube
Debris
118
Q

What are the risks of iodine contrast?

A 
Lactic acidosis
Asthma
Diabetes
Renal failure
Dehydration
119
Q

Define Contrast Induced Nephropathy

A

Serum Cr increases x 25% from baseline or, inc .5mg/dL 2-7 days post imaging

120
Q

Define Spatial Lattice Relaxation

A

H+ proton realignment, relaxation process emits energy for image

121
Q

Define Nephrogenic Systemic Fibrosis

A

MRI contrast agent side effect on renal system

122
Q

What is the radioisotope used for cancer scans?

A

Fluorodeoxyglucose

123
Q

What is the study of choice for dysphagia?

A

Barium esophagram

124
Q

What is the imaging study of choice for examining the stomach lumen?

A

Endoscopy

125
Q

What is the imaging preference for diagnosing gastric carcinomas?

A

Double contrast UGI and CT

126
Q

What is the imaging preference for diagnosing duodenal ulcers?

A

Double contrast UGI

127
Q

What is the imaging choice for examining the aorta?

A

CT w/ oral contrast

128
Q

What is the imaging method of choice for diagnosing diverticulitis?

A

CT

129
Q

What is the imaging preference for diagnosing appendicitis?

A

CT

130
Q

What is the imaging method for diagnosing pancreatitis?

A

CT

131
Q

What is the first form of imaging used for jaundice PTs?

A

US

132
Q

Imaging method of choice for female pelvis or renal masses is?

A

US

133
Q

Define Acoustical Impedance?

A

How much sound is transmitted vs how much is reflected back

134
Q

What do a large or small acoustic impedance mean?

A

Large- greater sound reflection (gas/bone)

Small- greater transmission (fluid)

135
Q

Define Echogenic

A

Hyperechoic

Tissue that reflects many echoes (white)

136
Q

Define Sonoluscent

A

Hypoechoic/anechoeic

Tissues w/ few/no echoes (dark/black)

137
Q

What is the provider/PT orientation for sonography?

A

PT head to left

Head up

138
Q

What does US low and high frequency mean?

A

Low- object is moving away from transducer (Blue)

High- object is moving towards transducer (red)

139
Q

What is the first image choice for biliary system abnormalities?

A

US

140
Q

What form of imaging has a decreased sensitivity for detecting gallstones?

A

CT

141
Q

What is the difference in imaging of biliary sludge and gallstones?

A

Sludge- shadows

Stones- no shadows

142
Q

Define Murphy’s Sign

A

Positive sonogram w/ pain upon compression

143
Q

What is the preferred imaging for acute T1titis?

A

HIDA

144
Q

What imaging is used for examination of the intra/extrahepatic ducts and pancreatic duct?

A

US

145
Q

What imaging is used to detect the presence of hydronephrosis?

A

US

146
Q

How is renal disease progression seen on US?

A

Parechyma has increased echogenic than liver/kidney

147
Q

When is a full bladder used as an acoustic window?

A

Transabdominal

Transvaginal= empty bladder

148
Q

Any male PT w/ acute scrotal symptoms receives what imaging?

A

Color Doppler US

149
Q

What is the image of choice for PTs with asymptomatic pulsatile abdominal masses?

A

US

150
Q

What image is used for detecting uterine fibroids?

A

US

151
Q

Transudate will have a ____ US appearance while exudate will have _____

A

Sonoluscent

Echo

152
Q

What is the earliest sonographic finding in pregnancy?

A

Gestational sac

Embryo is the first structure seen in a gestational sac

153
Q

What is used for noninvasive assessments of extracranial atherosclerosis?

A

Carotid US

154
Q

When is US best for detecting DVTs?

A

Pt s/ pain above the knee

155
Q

Where does osteromyelitis tend to occur in children?

A

At metaphysis

156
Q

What are 2 examples of incomplete fractures in children?

A

Greenstick- part of cortex involvement

Torus- compression of cortex

157
Q

There are almost always sesamoid bones in what locations?

A

Thumb
Posterolateral knee- fabella
Great toe

158
Q

Where are accessory ossicles almost always found?

A

Foot

159
Q

Fractures are described using what 4 major parameters?

A

Number of fragments
Direction of fracture
Relationship of fragments to each other
Open or closed

160
Q

What are the 4 parameters for describing the relationship of fracture fragments?

A

Displacement
Angulation
Shortening
Rotation

161
Q

What is the sequence of images for diagnosing stress fractures?

A

Radiograph

Bone scan

162
Q

What is the most common fracture of the elbow in an adult?

What is the most common fracture of the elbow in a child?

A

Radial head

Distal humerus

163
Q

Hip fractures in older adults are common and frequently related to what other disease?

A

Osteoporosis

164
Q

What findings would be seen on imaging of primary osteoarthritis?

A

Marginal osteophytes
Subchondral sclerosis/cyst
Narrowed joint space

165
Q

Radiologists report says PT is showing signs of juxtaarticular erosion and bony proliferation at tendon insertions, what does the PT have?

A

Psoriatic arthritis

166
Q

What form of pyogenic arthritis is monoarticular?

A

Non-pyogenic

167
Q

What is the study of first choice for studying the brain and spine?
What is the compromise?

A

MRI

Brain anatomy is easier w/ CT

168
Q

What fissure separates the temporal from the frontal/parietal lobes?

A

Sylvian

169
Q

What is the most superior portion of the ventricular system?

A

Bodies of lateral ventricles

170
Q

What structure separates the cerebral hemispheres and can be seen as calcified in adults?

A

Falx Cerebri

171
Q

What are some calcified structures that could be seen on CT but are non-pathologic?

A

Pineal gland
Basal ganglia
Choroid plexus
Falx and tentorium

172
Q

What are some brain structures that can enhance after IV iodine contrast?

A

Venous sinuses
Choroid plexus
Pituitary gland and stalk

173
Q

What causes streak artifacts on CT?

A

Dental fillings
Aneurysm clips
Bullets

174
Q

What is the study of choice for intracranial and spinal cord abnormalities?

A

MRi

175
Q

Why is MRI more sensitive than a CT for brain/neurological studies?

A

Increased contrast and soft tissue resolution

176
Q

What is an MRI less sensitive at detecting when compared to a CT?

A

Lesion calcification

Cortical bone

177
Q

What is the study of choice for acute head trauma?

What are the first two things to be evaluated?

A

Unenhanced CT to rule out mass effect and blood

178
Q

Fractures of the cranial vault or most likely to occur at what skull bones?

A

Temporal

Parietal

179
Q

Why are basilar skull fractures the most serious?

A

Tears of dura matter and CSF leaks

180
Q

What is the imaging method of choice for facial fractures?

A

CT

181
Q

What is the most common orbital fracture?

A

Blow out fracture

182
Q

Define Diffuse Axonal Injury

A

Prolonged coma after head trauma

Head injury w/ poorest prognosis

183
Q

What is the study of choice for identifying Diffuse Axonal Injuries?

A

MRI

184
Q

How are most acute stroked initially imaged?

A

Noncontrast enhance CT

185
Q

How are most acute, nonhemorrhagic strokes found?

A

CT

186
Q

How are aneurysms detected?

A

CT angiography

MR angiography

187
Q

What is the imaging method of choice for identifying vestibular schwannomas?

A

Contrast enhanced MRi

188
Q

What is the image of choice for identifying MS?

A

MRI

189
Q

Unstable isotopes attempt to reach stability through what processes?

A

Fission
Emit particles- A/B
Energy- gamma

190
Q

What is the difference between Gamma Ray and X-ray?

A

Gamma originate from nucleus

X-ray originates from outside of nucleus

191
Q

What is the most widely used radioisotope?

A

Tc99m

192
Q

What studies can be performed with a SPECT?

A

ANY

Especially myocardial perfusion, bone imaging, functional brain imaging

193
Q

What is the downfall of nuclear medicine scanning capabilities?

A

Can not detect lesions less than 1cm

Resolution= 1cm

194
Q

What is the screening method of choice for detection of osseous metastatic diseases and diagnosing fractures before they’re visible?

A

Bone scans

195
Q

Metastatic bone diseases usually present with a pattern of multiple asymmetric focal areas/hot spots of increased uptake with what important exception?

A

Multiple myeloma

196
Q

What imaging is done to differentiate between cellulitis and osteomyelitis?

A

Triple phase bone scan

197
Q

What risk factor is often associated with PEs?

A

Immobilization after surgery

198
Q

What is the modality of choice for diagnosing PEs?

A

CT-PA have replaced V/Q scans

VQ performed if PT is allergic to iodine or impaired renal function

199
Q

What is seen on a V/Q scan if a PE is present?

A

Ventilation is maintained

Perfusion is absent

200
Q

What is the most frequently used nuclear medicine liver study?

A

HIDA

201
Q

What nuclear med test exposes a PT to ionizing radiation?

A

PET Scan

202
Q

What are the hallmark imaging signs for avascular necrosis?

A

Crescent sign- femur

Snow capping- humerus

203
Q

What form of imaging is most sensitive for osteoporosis?

A

Dexa scan

204
Q

What form of imaging is most specific for pyogenic arthritis?

A

MRI

205
Q

What form of arthritis shows up as a “Gull Sign” on images?

A

Erosive osteoarthritis

206
Q

What bone disease has “rat bite” appearance?

A

Gout

207
Q

What bone disease has a “Rocker Bottom Foot” appearance on imaging?

A

Charcot

208
Q

What form of bone disease is not found on bone scan?

A

Multiple myeloma

X-ray

209
Q

What are 3 scenarios that oral contrast is NOT given?

A

Trauma
Rock search study
Vascular study

210
Q

What dictates surgical approaches to liver lesions?

A

Liver vasculature

211
Q

Define Vicarious Excretion of contrast?

A

Kidneys can’t process/keep up with elimination so contrast is eliminated through alternate pathways

212
Q

US computer measures what 3 pieces of info?

A

Time
Frequency
Magnitude/amplitude

213
Q

Posterior acoustic shadow means ?

Posterior acoustic enhancement means?

A

Stone

Cyst

214
Q

Increased frequency has what impact on the penetration?

A

Decreased

215
Q

______ are echogenic and have an acoustic shadow

A

Gallstones

216
Q

Where would osteoblastic lesions from osteoblastic metastases be found?

A 
Vertebrae
Ribs
Pelvis
Humerus
Femur
217
Q

What bone is most often involved w/ Paget Disease?

A

Pelvis

218
Q

What is the difference between postmenopausal osteoporosis and age-related bone loss

A

Postmenopausal osteoporosis is characterized by increased bone resporption due to osteoclastic activity. Age-related bone loss begins around age 45 to 55 and is characterized by a loss of total bone mass

219
Q

What are some of the findings of hyperparathyroidism on conventional radiographs?

A

Overall decrease in bone density, subperiosteal bone resorption (especially on the radial side of the middle phalanges of the index and middle finger), erosion of the distal clavicles, well-circumscribed lytic lesions in the long bones called Brown tumors

220
Q

Osteolytic metastatic disease can produce focal destruction of bone. These lesions are most often produced by _______

A

Focal infiltration of bone by cells other than osteocytes

221
Q

What is the image modality of choice for viewing the medullary canal?

A

MRI

222
Q

On conventional radiographs, what are the classical findings of osteolytic metastases?

A

Irregularly shaped, lucent bone lesions (single or multiple. Geographic, mottled, or permeative, in order of decresing size of the most discrete lesion visible). Destruction of pedicles in the spine.

223
Q

Findings of multiple myeloma on conventional radiographs includes:

A

The most common early manifestation is diffuse and usually severe osteoporosis. Plasmacytomas appear as expansile septated lesions frequently with associated soft-tissue masses. Later in its disseminated form, multiple small sharply circumscribed (described as punched-out) lytic lesions of approximately the same size are present, usually without any accompanying sclerotic reaction around them

224
Q

What imaging modalities are frequently used for earlier diagnosis of osteomyelitis?

A

Conventional radiographs can take up to 10 days to display the first findings of osteomyelities so that other imaging modalities, such as MRI and nuclear medicine studies are frequently used for earlier diagnosis

225
Q

Which three types of arthritis are usually diagnosed clinically instead of radiologically?

A

Septic (pyogenic) arthritis, psoriatic arthritis, GoutHemophilia

226
Q

What is the study of first choice in evaluating for the presence of arthritis?

A

Conventional radiographs. They will demonstrate abnormalities of the articular cortex and the subchondral bone and will provide late, indirect evidence of the integrity of the articular cartilage. MRI is more sensitive in directly visualizing the soft tissues in and around a joint

227
Q

Hypertrophic arthritis is characterized by bone formation, either _______ or _______

A

Subchondral sclerosis or osteophytes

228
Q

Erosive osteoarthritis is a type of primary OA characterized by more severe _______ and by the development of erosive joint changes. It occurs most often in _______ women

A

Inflammation. Perimenopausal

229
Q

Calcium pyrophosphate deposition disease results from the deposition of calcium pyrophosphate dihydrate crystals in and around joints, mostly in _______. This is especially common in the _______ and the menisci of the knee

A

Hyaline cartilage and fibrocartilage. Triangular fibrocartilage of the wrist.

230
Q

Chondrocalcinosis can occur in CPPD, hyperparathyroidism, and _______

A

Hemochromatosis

231
Q

What are the imaging hallmarks of psoriatic arthritis?

A

Juxtaarticular erosions, especially of the DIP joints of the hands. Bony proliferations at the sites of tendon insertions (enthesophytes). Periosteal reaction along the shafts of the bone. Resorption of the terminal phalanges (or the DIP joints with telescoping of one phalanx into another: pen-in-cup deformity)

232
Q

Desiccation of the disk can lead to release of nitrogen from tissues surrounding the disk resulting in the appearance of air density in the disk space. What is this known as?

A

Vacuum-disk phenomenon

233
Q

What is an uncovertebral joint (or joints of Luschka)?

A

Small joint-like strucutres at the lateral edges of C3 to T1

234
Q

Compression fractures of the spine typically occur secondary to _______

A

Osteoporosis

235
Q

Osteoporotic compression fractures usually involve the anterior and superior aspect of the vertebral body, leading to a _______ deformity (the so-called Dowager’s hump)

A

Wedge-shaped

236
Q

In the spine, metastases may lead to _______. They tend to destroy the _______, including and especially the posterior aspect of the pedicles (differentiate this from osteoporotic compression fractures)

A

“Compression fractures. Vertebral body.
This is different because in osteoporotic compression fractures, the posterior vertebral body and pedicles usually remain in tact”

237
Q

What is the prototype example of a primary malignancy that produces osteoblastic metastases, for men and for women?

A

Prostate cancer, breast cancer

238
Q

What scan is used for spinal cord metastases?

A

T99m Bone scan

239
Q

Infection of the disk (diskitis) is almost always associated with _______ of the adjacent vertebrae and it almost alsways spreads hematogenously from infection in another organ . The lumbar region is most commonly involved, and _______ is most often the pathogen

A

Osteomyelitis. Staph aureus

240
Q

_______ should be considered any time there are abnormalities of the disk space and destruction of the adjacent vertebral body end plates

A

Diskitis

Osteomyelitis

241
Q

How do internal endosteal healing and external periosteal healing differ?

A

Internal- indistinctness of the fracture line leading to eventual obliteration of the fracture line. External- external callus formation eventually leading to bridging of the fracture site

242
Q

In what kind of bone do pathological fractures occur?

A

Bone with a preexisting abnormality

243
Q

What is the gold standard for evaluating the structural intergrity of silicone breast implants?

A

MRI

244
Q

For a cyst in the breast to meet the definition of benign by ultrasound, it must have what criteria?

A

Anechoic (echo-free)
Enhanced through transmission,
Thin back wall

IPAP (212 decks)

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