Rapid Fire Flashcards
1
Q
When say ‘Subglottic Hemangioma
A
You Say PHACES Syndrome
2
Q
When say ‘PH ACES Syndrome
A
You say Cutaneous Hemangioma
3
Q
When say ‘Ropy Appearance
A
You say Meconium Aspiration
4
Q
When say ‘Post Term Delivery
A
You Say Meconium Aspiration
5
Q
When say ‘Fluid in the Fissures
A
You say Transient Tachypnea
6
Q
When say ‘History of c-scction
A
You say Transient Tachypnea
7
Q
When say ‘Maternal sedation”,
A
You say Transient Tachypnea
8
Q
When say ‘Granular Opacities + Premature
A
You say RDS
9
Q
When say ‘Granular Opacities + Term + High Lung Volume
A
You say Pneumonia
10
Q
When say “Granular Opacities + Term + Low Lung Volume
A
You say B-Hemolytic Strep
11
Q
When say ‘Band Like Opacities
A
You say Chronic Lung Disease (BPD)
12
Q
When say ‘Linear Lucencies
A
You say Pulmonary Interstitial Emphysema
13
Q
When say ‘Pulmonary Hypoplasia
A
You say diaphragmatic hernia
14
Q
When say ‘Lung Cysts and Nodules
A
You Say LCH or Papillomatosis
15
Q
When say ‘Lower lobe bronchiectasis
A
You Say Primary Ciliary Dyskinesia
16
Q
When say ‘Upper lobe bronchiectasis
A
You Say CF
17
Q
When say ‘Posterior mediastinal mass (under 2),”
A
You Say Neuroblastoma
18
Q
When say ‘No air in the stomach
A
You say Esophageal Atresia
19
Q
When say ‘Excessive air in the stomach
A
You say “H” Type TE fistula
20
Q
When say ‘Anterior Esophageal Impression
A
You say pulmonary sling
21
Q
When say ‘Pulmonary Sling,
A
You say tracheal stenosis.
22
Q
When say ‘Single Bubble
A
You say Gastric (antral or pyloric) atresia
23
Q
When say ‘Double Bubble
A
You say duodenal atresia
24
Q
When say ‘Duodenal Atresia
A
You say Downs
25
When say ‘Single Bubble with Distal Gas
You say maybe Mid Gut Volvulus
26
When say ‘Non-bilious vomiting”,
You say Hypertrophic Pyloric Stenosis
27
When say ‘Paradoxial aciduria”
You say Hypertrophic Pyloric Stenosis
28
When say ‘Bilious vomiting - in an infant
You say Mid Gut Volvulus
29
When say ‘Corkscrew Duodenum
You say Mid Gut Volvulus
30
When say ‘Reversed SMA and SMV
You say Malrotation
31
When say ‘Absent Gallbladder
You say biliary atresia
32
When say ‘Triangle Cord Sign
You say biliary atresia
33
When say ‘Asplenia
You say “cyanotic heart disease”
34
When say ‘Infarcted Spleen
You say Sickle Cell
35
When say ‘Gall Stones
You say Sickle Cell
36
When say ‘Short Microcolon
You say Colonic Atresia
37
When say ‘Long Microcolon
You say Meconium ileus or distal ileal atresia
38
When say ‘Saw tooth colon
You say Hirschsprung
39
When say ‘Calcified mass in the mid abdomen o f a newborn
you say Meconium Peritonitis
40
When say ‘Meconium ileus equivalent
you say Distal Intestinal Obstruction Syndrome (CF)
41
When say ‘Abrupt caliber change o f the aorta below the celiac axis”
You say Hepatic
| Hemangioendothelioma,
42
When 1 say “Cystic mass in the liver o f a newborn,”
you say Mesenchymal Hamartoma
43
When say Elevated AFP, with mass in the liver o f a newborn
you say Flepatoblastoma
44
When say Common Bile Duct measures more than 10 mm
You say Choledochal Cyst
45
When say Lipomatous pseudohypertrophy of the pancreas
You say CF
46
When say Unilateral Renal Agenesis
You say unicomuate uterus
47
When say Neonatal Renal Vein Thrombosis
You say maternal diabetes
48
When say Neonatal Renal Artery Thrombosis
You say Misplaced Umbilical Artery Catheter
49
When say Flydro on Fetal MRI
You say Posterior Urethral Valve
50
When say Urachus
You say bladder Adenocarcinoma
51
When say Nephroblastomatosis with necrosis
you say Wilms
52
When say Solid Renal Tumor o f Infancy,”
you say Mesoblastic Nephroma
53
When say Solid Renal Tumor o f Childhood
you say Wilms
54
When say Midline pelvic mass, in a female
you say Hydrometrocolpos
55
When say Right sided varicocele
you say abdominal pathology
56
When say Blue Dot Sign
you say Torsion of the Testicular Appendage
57
When say Hand or Foot Pain / Swelling in an Infant
You say - sickle cell with hand foot syndrome.
58
When say ixtratesticular scrotal mass
you say embryonal rhabdomyosarcoma
59
When say Narrowing o f the interpedicular distance
you say Achondroplasia
60
When say Platyspondyly (flat vertebral bodies),”
you say Thanatophoric
61
When say Absent Tonsils after 6 months
You say “Immune Deficiency”
62
When say Enlarged Tonsils well after childhood (like 12-15)”
You say “Cancer” ... probably
| lymphatic
63
When say Mystery Liver Abscess in Kid
You say “Chronic Granulomatous Disease”
64
When say narrowed B Ring
You say Schatzki (Schat”B ”ki Ring)
65
When say esophageal concentric rings
You say Eosinophilic Esophagitis
66
When say shaggy” or “plaque like” esophagus
You say Candidiasis
67
When say looks like Candida, but an asymptomatic old lady
you say Glycogen Acanthosis
68
When say reticular mucosal pattern
you say Barretts
69
When say high stricture with an associated hiatal hernia
you say Barretts
70
When say abrupt shoulders,
you say cancer
71
When say Killian Dehiscence
you say Zenker Diverticulum
72
When say transient, fine transverse folds across the esophagus
you say Feline Esophagus.
73
When say bird’s beak
you say achalasia
74
When say solitary esophageal ulcer
you say CMV or AIDS
75
When say ulcers at the level o f the arch or distal esophagus
you say Medication induced
76
When say Breast Cancer + Bowel Hamartomas
you say Cowdens
77
When say Desmoid Tumors + Bowel Polyps
you say Gardners
78
When say Brain Tumors + Bowel Polyps
you say Turcots
79
When say enlarged left supraclavicular node
you say Virchow Node (GI Cancer)
80
When say crosses the pylorus
you say Gastric Lymphoma
81
When say isolated gastric varices
you say splenic vein thrombus
82
When say multiple gastric ulcers
you say Chronic Aspirin Therapy.
83
When say multiple duodenal (or jejunal) ulcers
you say Zollinger-Ellsion
84
When say pancreatitis after Billroth 2,
you say Afferent Loop Syndrome
85
When say Weight gain years after Roux-en-Y
you say Gastro-Gastro Fistula
86
When say Clover Leaf Sign - Duodenum
you say healed peptic ulcer.
87
When say ‘Sand Like Nodules in the Jejunum
you say Whipples
88
When say Sand Like Nodules in the Jejunum + CD4 <100
you say MAI
89
When say Ribbon-like bowel
you say graft vs host
90
When say Ribbon like Jejunum,
you say Long Standing Celiac
91
When say Moulage Pattern,
you say Celiac (moulage = loss o f jejunal folds)
92
When say Fold Reversal - of jejunum and ileum
you say Celiac
93
When say Cavitary (low density) Lymph nodes
you say Celiac
94
When say hide bound” or “Stack or coins
you say Scleroderma
95
When say Megaduodenum
you say Scleroderma
96
When say Duodenal obstruction, with recent weight loss
you say SMA Syndrome
97
When say Coned shaped cecum
you say Amebiasis
98
When say Lead Pipe
you say Ulcerative Colitis
99
When say String Sign
you say Crohns
100
When say Massive circumferential thickening, without obstruction
you say Lymphoma
101
When say Multiple small bowel target signs
you say Melanoma
102
When say Obstructing Old Lady Hernia
you say Femoral Hernia
103
When say sac of bowel
you say Paraduodenal hernia.
104
When say scalloped appearance of the liver
you say Pseudomyxoma Peritonei
105
When say HCC without cirrhosis
you say Hepatitis B (or Fibrolamellar HCC)
106
When say Capsular retraction
you say Cholangiocarcinoma
107
When say Periportal hypoechoic infiltration + AIDS
you say Kaposi’s
108
When say sparing o f the caudate lobe
you say Budd Chiari
109
When say large T2 bright nodes + Budd Chiari
you say Hyperplastic nodules
110
When say liver high signal in phase, low signal out phase
you say fatty liver
111
When say liver low signal in phase, and high signal out phase
you say hemochromatosis
112
When say multifocal intrahepatic and extrahepatic biliary stricture
you say PSC
113
When say multifocal intrahepatic and extrahepatic biliary strictures + papillary stenosis
you say AIDS
| Cholangiopathy.
114
When say bile ducts full of stones
you say Recurrent Pyogenic Cholangitis
115
When say Gallbladder Comet Tail Artifact
ou say Adcnomyomatosis
116
When say lipomatous pseudohypertrophy of the pancreas
you say CF
117
When say sausage shaped pancreas
you say autoimmune pancreatitis
118
When say autoimmune pancreatitis
you say IgG4
119
When say lgG4”
you say RP Fibrosis, Sclerosing Cholangitis, Fibrosing Mediastinitis, Inflammatory Pseudotumor
120
When say Wide duodenal sweep
you say Pancreatic Cancer
121
When say Grandmother Pancreatic Cyst”
you say Serous Cystadenoma
122
When say Mother Pancreatic Cyst
you say Mucinous
123
When say Daughter Pancreatic Cyst
you say Solid Pseudopapillary
124
When say bladder stones,”
you say neurogenic bladder
125
When say pine cone appearance
you say neurogenic bladder
126
When say urethra cancer
you say squamous cell CA
127
When say urethra cancer - prostatic portion
you say transitional cell CA
128
When say urethra cancer - in a diverticulum,”
you say adenocarcinoma
129
When say long term supra-pubic catheter
you say squamous Bladder CA
130
When say e-coli infection
you say Malakoplakia
131
When say vas deferens calcifications
you say diabetes
132
When I say “calcifications in a fatty renal mass
you say RCC
133
When 1 say “protrude into the renal pelvis
you say Multilocular cystic nephroma
134
When I say “no functional renal tissue,”
you say Multicystic Dysplastic Kidney
135
When 1 say “Multicystic Dysplastic Kidney
you say contralateral renal issues (50%)
136
When I say “Emphysematous Pyelonephritis
you say diabetic
137
When I say “Xanthogranulomatous Pyelonephritis
you say staghom stone
138
When I say “Papillary Necrosis
you say diabetes
139
When I say “shrunken calcified kidney,”
you say TB (“putty kidney”)
140
When 1 say “bilateral medulla nephrocalcinosis
you say Medullary Sponge Kidney
141
When I say “big bright kidney with decreased renal function
you say HIV
142
When I say “history of lithotripsy
you say Page Kidney
143
When I say “cortical rim sign
you say subacute renal infarct
144
When I say “history of renal biopsy
you say AVF
145
When 1 say “reversed diastolic flow
you say renal vein thrombosis
146
When 1 say “sickle cell trait
you say medullary RCC
147
When 1 say “Young Adult, Renal Mass, + Severe HTN
you say Juxtaglomerular Cell Tumor
148
When 1 say “squamous cell bladder CA
you say Schistosomiasis
149
When 1 say “entire bladder calcified
you say Schistosomiasis
150
When 1 say “urachus
you say adenocarcinoma o f the bladder
151
When I say “long stricture in urethra
you say Gonococcal
152
When 1 say “short stricture in urethra,”
you say Straddle Injury
153
When 1 say “Unicomuate Uterus
you say Look at the kidneys
154
When 1 say “T-Shaped Uterus
you say DES related or Vaginal Clear Cell CA
155
When I say “Marked enlargement o f the uterus
you say Adenomyosis
156
When 1 say “Adenomyosis,
you say thickening o f the junctional zone (> 12 mm)
157
When 1 say “Wolffian duct remnant
you say Gartner Duct Cyst
158
When I say “Theca Lutein Cysts,”
you say moles and multiple gestations
159
When I say “Theca Lutein Cysts + Pleural Effusions,”
you say - Hyperstimulation Syndrome (patient on
| fertility meds).
160
When I say “Low level internal echoes
you say Endometrioma
161
When I say “T2 Shortening,
you say - Endometrioma - “Shading Sign”
162
When 1 say “Fishnet appearance
you say Hemorrhagic Cyst
163
When I say “Ovarian Fibroma + Pleural Effusion
you say Meigs Syndrome
164
When I say “Snow Storm Uterus
you say Complete Mole - 1st Trimester
165
When I say “Serum (3-hCG levels that rise in the 8 to 10 weeks following evacuation o f molar pregnancy
you say Choriocarcinoma
166
When I say “midline cystic structure near the back of the bladder o f a man
you say Prostatic Utricle
167
When 1 say “lateral cystic structure near the back o f the bladder of a man
you say Seminal Vesicle Cyst
168
When I say “isolated orchitis
you say mumps
169
When 1 say “onion skin appearance
you say epidermoid cyst
170
When I say “multiple hypoechoic masses in the testicle
you say lymphoma
171
When I say “cystic elements and macro-calcifications in the testicle
you say Mixed Germ Cell Tumor
172
When 1 say “homogenous and microcalcifications
you say seminoma
173
When 1 say “gynecomastia + testicular tumor
you say Sertoli Leydig
174
When 1 say “fetal macrosomia,
you say Maternal Diabetes
175
When I say “one artery adjacent to the bladder,”
you say two vessel cord
176
Pulmonary Interstitial Emphysema (PIE)
put the bad side down
177
Bronchial Foreign Body
put the lucency side down (if it stays that way, it’s positive)
178
Papillomatosis has a small (2%) risk o
scc
179
Pulmonary sling is the only variant that goes
between the esophagus and the trachea. This is associated
| with trachea stenosis.
180
Thymic Rebound
Seen after stress (chemotherapy) - Can be PET-Avid
181
Lymphoma - Most common mediastinal mass
in child (over 10)
182
Anterior Mediastinal Mass with Calcification
Either treated lymphoma, or Thymic Lesion (lymphoma
| doesn’t calcify unless treated).
183
Neuroblastoma is the most common
posterior mediastinal mass in child under 2 (primary thoracic does
better than abd)
184
Hypertrophic Pyloric Stenosis
NOT at birth, NOT after 3 months (3 weeks to 3 months )
185
Criteria for HPS
4 mm and 14 mm (4mm single wall, 14mm length).
186
Annular Pancreas presents as
duodenal obstruction in children and pancreatitis in adults
187
Most common cause o f bowel obstruction in child over 4
Appendicitis
188
ntussusception
3 months to 3 years is ok, earlier or younger think lead point
189
Gastroschisis is ALWAYS
on the right side
190
Omphalocele has
associated anomalies (gastroschisis does not).
191
Physiologic Gut Hernia normal at
6-8 weeks
192
AFP is elevated with
hepatoblastoma
193
Endothelial growth factor is elevated with
Hemangioendothelioma
194
Most Common cause o f pancreatitis in a kid
trauma (seatbelt)
195
Weigert Meyer Rule
Duplicated ureter on top inserts inferior and medial
196
Most common tumor o f the fetus or infant
Sacrococcygeal Teratoma
197
Most common cause o f idiopathic scrotal edema
HSP
198
Most common cause o f acute scrotal pain age 7-14
Torsion o f Testicular Appendages
199
Bell Clapper Deformity is the etiology for
testicular torsion
200
SCFE is a
Salter Harris Type 1
201
Physiologic Periostitis o f the Newborn doesn’t occur in a newborn
seen around 3 months
202
Acetabular Angle should be
< 30, and Alpha angle should be more than 60
203
Most Common benign mucosal lesion o f the esophagus
papilloma
204
Esophageal Webs have increased risk for
cancer, and Plummer-Vinson Syndrome (anemia T web)
205
Dysphagia Lusoria is from
compression by a right subclavian artery (most patients with aberrant rights
don’t have symptoms).
206
Achalasia has an increased risk of
squamous cell cancer (20 years later)
207
Most common mesenchymal tumor o f the G1 tract
GIST
208
Most common location for GIST
Stomach
209
Abscesses are almost exclusively seen in
Crohns (rather than UC)
210
Nodes + UC
Common in the setting o f active disease
211
Nodes (larger than 1 cm) + Crohns
Cancer
212
Diverticulosis + Nodes
Cancer (maybe) -> next step endoscopy
213
Krukenberg Tumor
Stomach (GI) met to the ovary
214
Menetrier’s involves
fundus and spares the antrum
215
The stomach is the most common location for
sarcoid (in the Gl tract)
216
Gastric Remnants have an increased risk o f cancer years after
Billroth
217
Most common internal hernia
Left sided paraduodenal
218
Most common site o f peritoneal carcinomatosis
retrovesical space
219
An injury to the bare area o f the liver can cause a
retroperitoneal bleed
220
Primary Sclerosing Cholangitis associated with
UC
221
Extrahepatic ducts are normal with
Primary Biliary Cirrhosis
222
Anti-mitochondrial Antibodies
positive with primary biliary cirrhosis
223
Mirizzi Syndrome
the stone in the cystic duct obstructs the CBD
224
Mirizzi has a 5x increased risk of
GB cancer
225
Dorsal pancreatic agenesis
associated with diabetes and polysplenia
226
Hereditary and Tropical Pancreatitis
early age o f onset, increased risk o f cancer
227
Felty’s Syndrome
Big Spleen, RA, and Neutropenia
228
Splenic Artery Aneurysm
- more common in women, and more likely to rupture in pregnant women.
229
Insulinoma is the most common
islet cell tumor
230
Gastrinoma is the most common
islet cell tumor with MEN
231
Ulcerative Colitis has an increased risk o f colon cancer
(if it involves colon past the splenic flexure). UC involving the rectum only does not increase risk o f CA.
232
Calcifications in a renal CA
are associated with an improved survival
233
RCC bone mets are “always”
lytic
234
There is an increased risk o f malignancy with
dialysis
235
Horseshoe kidneys are more susceptible to
trauma
236
Most common location for TCC is the
bladder
237
Second most common location for TCC is the
upper urinary tract
238
Upper Tract TCC is more commonly
multifocal (12%) - as opposed to bladder (4%)
239
The cysts in acquired renal cystic disease improve after renal transplant, although the risk o f renal CA in
the native kidney remains elevated.
In fact, the cancers tend to be more aggressive because o f the
immunosuppressive therapy needed to not reject a transplant.
240
Weigert Meyer Rule
Upper Pole inserts medial and inferior
241
Ectopic Ureters are associated with
incontinence in women (not men)
242
Leukoplakia is
pre-malignant
243
malakoplakia is not
pre-malignant
244
Extraperitoneal bladder rupture
is more common, and managed medically
245
Intraperitoneal bladder rupture
is less common, and managed surgically
246
Indinavir (HIV medication) stones are the only ones
not seen on CT
247
Uric Acid stones are not seen
plain film
248
Endometrial tissue in a rudimentary horn (even one that does NOT communicate) increases the risk o f
miscarriage
249
Arcuate Uterus does NOT have an increased risk o f
infertility (it’s a normal variant)
250
Fibroids with higher T2 signal respond better to
UAE
251
Hyaline Fibroid Degeneration
is the most common subtype
252
Adenomyosis
favors the posterior wall, spares the cervix
253
Hereditary Non-Polyposis Colon Cancer (HNPCC)
a 30-50x increased risk o f endometrial
| cancer
254
Tamoxifen increases the risk o f
endometrial cancer, and endometrial polyps
255
Cervical Cancer that has parametrial involvement (2B)
is treated with chemo/radiation. Cervical
| Cancer without parametrial involvement (2A) - is treated with surgery
256
Vaginal cancer in adults is usually
squamous cell
257
Vaginal Rhabdomyosarcoma occurs in
children / teenagers
258
remenopausal ovaries can be hot on PET (depending on the phase o f cycle). Post menopausal ovaries
should Never be hot on PET.
259
Transformation subtypes
Endometrioma = Clear Cell, Dermoid = Squamous
260
Postpartum fever can be from
ovarian vein thrombophlebitis
261
Fractured penis
rupture o f the corpus cavemosum and the surrounding tunica albuginea
262
Prostate Cancer is most commonly in the
peripheral zone, - ADC dark
263
BPH nodules are in the
central zone
264
Hypospadias is the most common association with
prostatic utricle
265
Seminal Vesicle cysts are associated with
renal agenesis, and ectopic ureters
266
Cryptorchidism increases the risk o f
cancer (in both testicles), and the risk is not reduced by orchiopexy
267
Immunosuppressed patients can get
testicular lymphoma -hiding behind blood testes barrier
268
Most common cause o f correctable infertility in a man is a
varicocele
269
Undescended testicles are more common in
premies
270
Membranes disrupted before 10 weeks, increased risk for
amniotic bands
271
The earliest visualization o f the embryo is the
double bleb sign
272
Hematoma greater than 2/3 the circumference o f the chorion has a
2x increased risk o f abortion.
273
Biparietal Diameter
Biparietal Diameter - Recorded at the level o f the thalamus from the outermost edge o f the near skull to the inner table o f the far skull.
274
Abdominal Circumference
does not include the subcutaneous soft tissues
275
Abdominal Circumference is recorded at the the level o f the
junction o f the umbilical vein and left
| portal vein
276
Abdominal Circumference is the parameter classically involved with
asymmetric IUGR
277
Femur Length does NOT include
the epiphysis
278
Umbilical Artery Systolic / Diastolic Ratio should NOT
exceed 3 at 34 weeks - makes you think preeclampsia and IUGR
279
A full bladder can mimic a
placenta previa
280
Nuchal lucency is measured between
12 weeks, and should be < 3 mm. More than 3mm is associated with Downs.
281
Lemon sign will disappear after
24 weeks
282
Aquaductal Stenosis is the most common cause
of non-communicating hydrocephalus in a neonate
283
The tricuspid valve is the most
anterior
284
The pulmonic valve is the most
superior
285
There are 10 lung segments on the
right
286
8 lung segments on the
left
287
If it goes above the clavicles, it’s in the
osterior mediastinum (cervicothoracic sign)
288
Azygos Lobe has
4 layers o f pleura
289
Most common pulmonary vein variant is
a separate vein draining the right middle lobe
290
Most common cause o f pneumonia in AIDS patient
Strep Pneumonia
291
Most common opportunistic infection in AIDS
PCP
292
Aspergilloma is seen in a
normal immune patient
293
Invasive Aspergillus is seen in an
immune compromised patient
294
Fleischner Society Recommendations do NOT apply to
patient’s with known cancers
295
Eccentric calcifications in a solitary pulmonary nodule pattern is considered
the most suspicious
296
A part solid nodule with a ground glass component is the most
suspicious morphology you can have
297
Most common early presentation o f lung CA
is a solitary nodule (right upper lobe)
298
Lung Fibrosis patients (UIP, e tc ...) more commonly have
lower lobe CA
299
Stage 3B lung CA is
unresectable (contralateral nodal in v o lv emen t; ipsilateral or contralateral
scalene or supraclavicular nodal involvement, tumor in different lobes).
300
The most common cause o f unilateral lymphangitic carcinomatosis
is bronchogenic carcinoma lung
| cancer invading the lymphatics
301
There is a 20 year latency between initial exposure and
development o f lung cancer or pleural mesothelioma
302
Pleural effusion is the earliest and most common finding with
asbestosis exposure
303
Silicosis actually raises your risk o
by about 3 fold.
304
Nitrogen Dioxide exposure is
“Silo Filler’s Disease,” gives you a pulmonary edema pattern.
305
Reticular pattern in the posterior costophrenic angle
is supposedly the first finding o f UIP on CXR
306
Sarcoidosis is the most common recurrent primary disease after
lung transplant
307
Pleural plaque o f asbestosis typically
spares the costophrenic angles
308
Pleural effusion is the most common manifestation
of mets to the pleura
309
There is an association with mature teratomas and
klinefelter syndrome
310
Injury close to the carina is going to cause a
pneumomediastinum rather than a pneumothorax
311
Hodgkin Lymphoma spreads in a contiguous fashion from the
mediastinum and is most often unilateral.
312
Non-Hodgkin Lymphoma is typically
bilateral with associated abdominal lymphadenopathy
313
MRI is superior for assessing
superior sulcus tumors because you need to look at the brachial plexus.
314
Leiomyoma is the most common
benign esophageal tumor (most common in the distal third).
315
Esophageal Leiomyomatosis may be associated with
alports syndrome
316
Bronchial / Tracheal injury must be evaluated with
bronchoscopy
317
If you say COP also say
eosinophiic pneumonia
318
If you say BAC also say
lymphoma
319
Bronchial Atresia is classically in the
LUL
320
Pericardial cysts MUST be
simple, Bronchogenic cysts don’t have to be simple
321
PAP follows a rule o f 1 /3s post treatment
1/3 gets better, 1/3 doesn’t, 1/3 progresses to fibrosis
322
Dysphagia Lusoria presents
later in life as atherosclerosis develops
323
Carcinoid is COLD on
PET
324
Wegener’s is now called
Granulomatosis with Polyangiitis
325
The right atrium is defined by the
IVC
326
The right ventricle is defined by the
moderator band
327
The tricuspid papillary muscles insert
on the septum (mitral ones do not).
328
Lipomatous Hypertrophy o f the Intra-Atrial Septum - can be
PET Avid (it’s brown fat)
329
LAD gives o ff
diagonals
330
RCA gives off
acute marginals
331
LCX give off
obtuse marginals
332
RCA perfuses
SA and AV nodes most of the time
333
Dominance is decided by which vessel gives o ff the
posterior descending - it’s the right 85%
334
LCA from the Right Coronary Cusp
always gets repaired
335
RCA from the Left Coronary Cusp
repaired if symptoms
336
Most common location o f myocardial bridging
is in the mid portion o f the LAD.
337
Coronary Artery Aneurysm - most common cause in adult
atherosclerosis
338
Coronary Artery Aneurysm - most common cause in child
kawasaki
339
Left Sided SVC empties into the
coronary sinus
340
Rheumatic heart disease is the most common cause
of mitral stenosis
341
Pulmonary Arterial Hypertension is the most common cause of
tricuspid atresia
342
Most common vascular ring is the
double aortic artch
343
Most common congenital heart disease is a
VSD
344
Most common ASD is
the secundum
345
Infracardiac TAPVR classically shown with
pulmonary edema in a newborn
346
“L” Transposition type is
congenitally corrected (they are “L”ucky).
347
“D” Transposition type is
doomed
348
Truncus is associated with
CATCH-22 (DiGeorge)
349
Rib Notching from coarctation spares the
1st and 2nd Ribs
350
Infarct with > 50% involvement is
unlikely to recover function
351
Microvascular Obstruction is NOT seen in
chronic infarct
352
Amyloid is the most common cause o f
restricted cariomyopathy
353
Primary amyloid can be seen in
multiple myeloma
354
Most common neoplasm to involve the cardiac valves
fibroelastoma
355
Most commonly the congenital absence o f the pericardium
is partial and involves the pericardium
over the left atrium and adjacent pulmonary artery (the left atrial appendage is the most at risk to
become strangulated).
356
Glenn shunt
SVC to pulmonary artery (vein to artery)
357
Blalock-Taussig Shunt
Subclavian Artery to Pulmonary Artery (artery - artery)
358
Ross Procedure
Replaces aortic valve with pulmonic, and pulmonic with a graft (done for kids).
359
Aliasing is common with Cardiac MRI. You can fix it by:
(1) opening your FOV, (2) oversampling
| the frequency encoding direction, or (3) switching phase and frequency encoding directions.
360
Giant Coronary Artery Aneurysms
(> 8mm) d o n ’t regress, and are associated with Mis.
361
Wet Beriberi
(thiamine def) can cause a dilated cardiomyopathy
362
Most common primary cardiac tumor in children
rhabdomyoma
363
2nd most common primary cardiac tumor in children
Fibroma
364
Most common complication o f MI is
myocardial remodeling
365
Unroofed coronary sinus is associated with
persistent left SVC
366
Most common source o f cardiac mets
Lung Cancer (lymphoma #2).
367
A-Fib is most commonly associated with
left atrial enlargement
368
Most common cause o f tricuspid insufficiency is
RVH (usually from pulmonary HTN / cor
| pulmonale).
369
Artery o f Adamkiewicz comes o ff
on the left side (70%) between T8-L1 (90%)
370
Arch o f Riolan
middle colic branch o f the SMA with the left colic o f the IMA
371
Most common hepatic vascular variant
right hepatic artery replaced o ff the SMA
372
The proper right hepatic artery is
anterior the right portal vein, whereas the replaced right hepatic artery is
posterior to the main portal vein.
373
Accessory right inferior hepatic vein
most common hepatic venous variant
374
Anterior tibialis is the
first branch o ff the popliteal
375
Common Femoral Artery (CFA): Begins at the level o f
inguinal ligament
376
Superficial Femoral Artery (SFA): Begins once the
CFA gives o ff the profunda femoris
377
Popliteal Artery: Begins as the
SFA exits the adductor canal
378
Popliteal Artery terminates as the
anterior tibial artery and the tibioperoneal trunk
379
Axillary Artery: Begins at
the first rib
380
Brachial Artery: Begins as it crosses
teres major
381
Brachial Artery: Bifurcates to the
ulnar and radial artery
382
lntraosseous Branch: Typically arises from the
ulnar artery
383
Superficial Arch = From the
ulna
384
Deep Arch = From the
radius
385
The “coronary vein,” is the
left gastric vein
386
Enlarged splenorenal shunts are associated with
hepatic encephalopathy
387
Aortic Dissection, and intramural hematoma are caused by
HTN (70%)
388
Penetrating Ulcer is from
atherosclerosis
389
Strongest predictor o f progression o f dissection in intramural hematoma
Maximum aortic diameter >
| 5cm.
390
Leriche Syndrome Triad
Claudication, Absent/ Decreased femoral pulses, Impotence.
391
Most common associated defect with aortic coarctation
bicuspid aorta (80%)
392
Neurogenic compression is the most common subtype of
thoracic outlet syndrome
393
Splenic artery aneurysm
More common in pregnancy, more likely to rupture in pregnancy.
394
Median Arcuate Compression
worse with expiration
395
Colonic Angiodysplasia is associated with
aortic stenosis
396
Popliteal Aneurysm
30-50% have AAA, 10% o f patient with AAA have popliteal aneurysm, 50-70% of
popliteal aneurysms are bilateral.
397
Medial deviation o f the popliteal artery by the medial head o f the gastrocnemius
popliteal entrapment
398
Type 3 Takayasu is the
most common (arch + abdominal aorta)
399
Most common vasculitis in a kid
HSP (Henoch-Schonlein Purpura)
400
Tardus Parvus infers stenosis
proximal to that vessel
401
1CA Peak Systolic Velocity < 125
“No Significant Stenosis” or < 50%
402
1CA Peak Systolic Velocity 125-230
50-69% Stenosis or “Moderate”
403
ICA Peak Systolic Velocity > 230
70% Stenosis or “ Severe”
404
18G needle will accept a
0.038 inch guidewire,
405
19G needle will allow a
0.035 inch guidewire
406
Notice that 0.039, 0.035, 0.018 wires are in
inches
407
3 French
1mm
408
French size is the (what) of the catheter and sheath
French size is the OUTSIDE o f a catheter and the INSIDE o f a sheath
409
End Hole Only Catheters
hand injection only
410
Side Hole + End Hole
Power Injection OK, Coils NOT ok
411
Double Flush Technique
For Neuro IR — no bubbles ever
412
“Significant lesion”
A systolic pressure gradient > 10 mm Hg at rest
413
Things to NOT stick a drain in:
Tumors, Acute Hematoma, and those associated with acute bowel rupture and peritonitis
414
Renal Artery Stenting for renal failure
tends to not work if the Cr is > 3.
415
Persistent sciatic artery is
prone to aneurysm
416
Even if the cholecystostomy tube instantly resolves all symptoms, you need to leave the tube in for
2-6 weeks (until the tract matures), otherwise you are going to get a bile leak.
417
MELD scores greater than
24 are at risk o f early death with TIPS
418
The target gradient post TIPS (for esophageal bleeding) is between
9 and 11
419
Absolute contraindication for TIPS
Heart Failure, Severe Hepatic Failure
420
Most common side effect o f BRTO is
gross hematuria
421
Sensitivity = GI Bleed Scan
0. lmL/min
422
Sensitivity Angiography
1.0 mL/min
423
For Gl Bleed - after performing an embolization o f the GDA (for duodenal ulcer),
you need to do a run o f the SMA to look at the inferior pancreaticoduodenal
424
Most common cause o f lower Gl bleed is
diverticulosis
425
TACE will prolong survival better than
systemic chemo
426
TACE: Portal Vein Thrombosis is considered
```
a contraindication (sometimes) because o f the risk o f
infarcting the liver.
```
427
Left Bundle Branch Block needs
a pacer before a Thoracic Angiogram
428
Never inject contrast through a
Swan Ganz catheter for a thoracic angiogram
429
You treat pulmonary AVMs at
3 mm
430
Hemoptysis - Active extravasation is
NOT typically seen with the active bleed
431
UAE - Gonadotropin-releasing medications (often prescribed for fibroids) should be
stopped for 3
| months prior to the case
432
The general rule for transgluteal is to
avoid the sciatic nerves and gluteal arteries by access through the
sacrospinous ligament medially (close to the sacrum, inferior to the piriformis).
433
When to pull an abscess catheter; As a general rule
when the patient is better (no fever, WBC
| normal), and output is < 20 cc over 24 hours.
434
If the thyroid biopsy is non-diagnostic
you have to wait 3 months before you re-biopsy
435
Posterior lateral approach is the move fo
perc nephrostomy
436
You can typically pull a sheath with an ACT
< 150-180
437
Artery calcifications (common in diabetics)
make compression difficult, and can lead to a false
| elevation o f the AB1.
438
Type 2 endoleaks are the
most common
439
Type 1 and Type 3 endoleaks are
high pressure and need to be fixed stat
440
Venous rupture during a fistula intervention can ofter be treated with
```
prolonged angioplasty (always leave
the balloon on the wire).
```
441
Phlegmasia alba
massive DVT, without ischemia and preserved collateral veins
442
Phlegmasia cerulea dolens
massive DVT, complete thrombosis o f the deep venous system, including the
collateral circulation.
443
You are more likely to develop Venous Thromboembolism if you are
paraplegic vs tetraplegic
444
Circumaortic left renal vein
the anterior one is superior, the posterior one is inferior, and the filter should be below the lowest one.
445
Risk o f DVT is increased with
IVC filters
446
Filter with clot > 1cm3 o f clot
Filter stays in
447
Acute Budd Chiari with fulminant liver failure
needs a TIPS
448
Pseudoaneurysm o f the pancreaticoduodenal artery
Sandwich technique” - distal and proximal
| segments o f the artery feeding o ff the artery must be embolized
449
Median Arcuate Ligament Syndrome - First line is
surgical release of the ligament
450
Massive Hemoptysis =
Bronchial artery - Particles bigger than 325 micrometers
451
Acalculous Cholecystitis
Percutaneous Cholecystostomy
452
Hepatic encephalopathy after TIPS
You can either (1) place a new covered stent constricted in the
middle by a loop o f suture - deployed in the pre-existing TIPS, (2) place two new stents - parallel to each
other (one covered self expandable, one uncovered balloon expandable).
453
Recurrent variceal bleeding after placement o f a constricted stent
balloon dilation o f the constricted stent
454
Appendiceal Abscess
Drain placement * just remember that a drain should be used for a mature (walled
off) abscess and no frank pertioneal symptoms
455
Inadvertent catheterization o f the colon (after trying to place a drain in an abscess)
wait 4 weeks for the
| tract to mature - verify by over the wire tractogram, and then remove tube.
456
DVT with severe symptoms and no response to systemic anticoagulation
Catheter Directed
| Thrombolysis
457
Geiger Mueller
maximum dose it can handle is about lOOmR/h
458
Activity level greater than 100 mCi o f Tc-99m is considered
a major spill
459
Activity level greater than 100 mCi o f Tl-201 is considered
a major spill
460
Activity level greater than 10 mCi o f In-111, is considered to represent
a major spill
461
Activity level greater than 10 mCi o f Ga-67, is considered
a major spill
462
An activity level greater than 1 mCi o f 1-131 is considered to constitute
a major spill
463
Annual Dose limit o f 100 mrem to
the public
464
Not greater than 2 mrem per hour - in an
unrestricted area
465
Total Body Dose per Year
5 rem
466
Total equivalent organ dose (skin is also an organ) per year
50 rem
467
Total equivalent extremity dose per year
50 rem (500mSv)
468
Total Dose to Embryo/fetus over entire 9 months
0.5 rem
469
NRC allows no more than 0.15 micro Ci o f Mo per
1 mili Ci o f Tc, at the time o f administration
470
Chemical purity (Al in Tc) is done with
PH paper
471
The allowable amount o f Al is
< 10 micrograms
472
Radiochemical purity (looking for Free Tc) is done with
thin layer chromatography
473
Free Tc occurs from
lack o f stannous ions or accidental air injection (which oxidizes)
474
Prostate Cancer bone mets are uncommon with a PSA less than
10 mg/ml
475
Flair Phenomenon occurs 2 weeks - 3 months
after therapy
476
Skeletal Survey is superior (more sensitive) for
lytic mets
477
AVN - Early and Late is
COLD, Middle (repairing) is Hot.
478
Particle size for VQ scan is
10-100 micrometers
479
Xenon is done first during
the VQ scan
480
Amiodarone - classic
thyroid uptake blocker
481
Hashimotos increases risk for
lymphoma
482
Hot nodule on Tc, shouldn’t be considered benign until you show that it’s also hot
on I123. This is the
| concept o f the discordant nodule.
483
History o f methimazole treatment (even years prior) makes 1-131 treatment
more difficult
484
Methimazole side effect is
neutropenia
485
In pregnancy PTU is
the blocker of choice
486
Sestamibi in the parathyroid depends on
blood flow and mitochoncria
487
You want to image with PET - following therapy at interval of
2-3 weeks for chemotherapy, and 8-12
weeks for radiation is the way to go. This avoids “ stunning” - false negatives, and inflammatory
induced false positive.
488
111 In Pentetreotide is the most commonly used agent for
somatostatin receptor imaging. The classic
| use is for carcinoid tumors
489
Meningiomas take up
octreotide
490
In 111 binds to
neutrophils, lymphocytes, monocytes and even RBCs and platelets
491
Tc99m HMPAO binds to
neutrophils
492
WBCs may accumulate at post op surgical sites for
2-3 weeks
493
Prior to MIBG you should
block the thyroid with Lugols Iodine or Perchlorate
494
Scrotal Scintigraphy
The typical agent is Tc-99m Pertechnetate. This agent is used as both a flow
agent and a pool agent.
495
Left bundle branch block can cause a
false positive defect in the ventricular septum (spares the apex)
496
Pulmonary uptake o f Thallium is an indication o f
LV dysfunction
497
MIBG mechanism is that o f an Analog o
Norepinephrine - actively transported and stored in the neurosecretory granules
498
MDP mechanism is that o f a
Phosphate analog - which works via Chemisorption
499
Sulfur Colloid mechanism
Particles are Phagocytized by RES
500
The order o f tumor prevalence in NF2 is the same as the mnemonic
MSME (schwannoma >
| meningioma > ependymoma).
501
Maldeveloped draining veins is the etiology o f
sturge weber
502
All phakomatosis (NF 1, NF -2, TS, and VHL) EXCEPT Sturge Weber are
autosomal dominant
503
Most Common Primary Brain Tumor in Adult
astrocytoma
504
“Calcifies 90% o f the time”
oligodendroglioma
505
Restricted Diffusion in Ventricle
Watch out for Choroid Plexus Xanthogranuloma (not a brain
| tumor, a benign normal variant)
506
Pituitary - T1 Big and Bright =
pituitary apoplexy
507
Pituitary - Normal T1 Bright =
```
Posterior Part (because o f storage o f Vasopressin , and other storage
proteins)
```
508
Pituitary - T2 Bright =
rathke cleft cyst
509
Pituitary - Calcified =
craniopharyngioma
510
CP Angle - Invades Internal Auditory Canal =
schwannoma
511
CP Angle - Invades Both Internal Auditory Canals =
schwannoma with NF2
512
CP Angle - Restricts on Diffusion =
epidermoid
513
Peds - Arising from Vermis =
medulloblastoma
514
Peds - “tooth paste” out o f 4th ventricle =
ependymoma
515
Adult myelination pattern
T 1 at 1 year, T2 at 2 years
516
Brainstem and posterior limb o f the internal capsule are
are myelinated at birth.
517
CN2 and CNV3 are not in the
cavernous sinus
518
Persistent trigeminal artery (basilar to carotid) increases
the risk of aneurysm
519
Subfalcine herniation can lead to
ACA infarct
520
ADEM lesions
will NOT involve the calloso-septal interface.
521
Marchiafava-Bignami progresses from
body -> genu -> splenium
522
Post Radiation changes don’t start for
2 months (there is a latent period).
523
Hippocampal atrophy is first with
alheimer dementia
524
Beaked Tectum =
chiari 2
525
Beaker Anterior Inferior LI =
Hurlers
526
Sometimes Beaked Pons =
multi system atrophy
527
Most common TORCH is
CMV
528
Toxo abscess does NOT
restrict diffusion
529
Small cortical tumors can be occult without
IV contrast
530
JPA and Ganglioglioma can
enhance and are low grade
531
Nasal Bone is the
most common fx
532
Zygomaticomaxillary Complex Fracture (Tripod)
is the most common fracture pattern and involves
| the zygoma, inferior orbit, and lateral orbit.
533
Supplemental oxygen can mimic
SAH on FLAIR
534
Putamen is the most common location for
hypertensive hemorrhage
535
Restricted diffusion without bright signal on FLAIR should make you think
hyperacute (< 6 hours)
| stroke.
536
Enhancement o f a stroke: Rule o f 3s
starts at day 3, peaks at 3 weeks, gone at 3 months
537
PAN is the Most Common systemic vasculitis
to involve the CNS
538
Scaphocephaly is the most common type o f
scaphocephaly
539
Piriform aperture stenosis is associated with
hypothalamic pituitary adrenal axis issues.
540
Cholesterol Granuloma is the most common
primary petrous apex lesion
541
Large vestibular aqueduct syndrome has
absence o f the bony modiolus in 90% o f cases
542
Octreotide scan will be positive for
esthesioneuroblastoma
543
The main vascular supply to the posterior nose is the
```
sphenopalatine artery (terminal internal
maxillary artery).
```
544
Warthins tumors take up
pertechnetate
545
Sjogrens gets salivary gland
lymphoma
546
Most common intra-occular lesion in an adult
melanoma
547
Enhancement o f nerve roots for 6 weeks after spine surgery
is normal. After that it’s arachnoiditis
548
Hemorrhage in the cord is the most important factor for
outcome in a traumatic cord injury
549
Currarino Triad
Anterior Sacral Meningocele, Anorectal malformation, Sarcococcygeal osseous defect
550
Type 1 Spinal AVF (dural AVF)
is by far the more common.
551
Herpes spares the
basal ganglia (MCA infarcts do not)
552
Most common malignant lacrimal gland tumor
adenoid cystic adenocarcinoma
553
Arthritis at the radioscaphoid compartment is the first sign o f
SNAC or SLAC wrist
554
SLAC wrist has a
DISI deformity
555
Pull o f the Abductor pollucis longus tendon is what causes
the dorsolateral dislocation in the Bennett Fx
556
Carpal tunnel syndrome has an association with
dialysis
557
Degree o f femoral head displacement predicts risk of
AVN
558
Proximal pole o f the scaphoid is at risk fo
AVN with FX
559
Most common cause o f sacral insufficiency fracture
osteoporosis in old lady
560
Patella dislocation is nearly always
lateral
561
Tibial plateau fracture is way more common
laterally
562
SONK favors
medial knee (are of maximum weight bearing)
563
Normal SI joints excludes
ankylosing spondylitis
564
Looser Zones are a type o f
insufficiency fx
565
T score o f -2.5 marks
osteoporosis
566
First extensor compartment
de Quervains
567
First and Second compartment
intersection syndrome
568
Sixth extensor compartment
early RA
569
Flexor pollicis longus goes through
the carpal tunnel, flexor pollicis brevis does not
570
The pisiform recess and radiocarpal joint
normally communicate
571
The periosteum is intact with both
Perthes and ALPSA lesions. In a true bankart it is disrupted.
572
Absent anterior/superior labrum, + thickened middle glenohumeral ligament
buford complex
573
Medial meniscus is thicker
posteriorly
574
TB in the spine
spares the disc space (so can brucellosis).
575
Scoliosis curvature points away from the
osteoid osteoma
576
Osteochondroma is the only benign skeletal tumor associated with
radiation
577
Mixed Connective Tissue Disease requires
serology (Ribonucleoprotein) for Dx
578
Medullary Bone Infarct will
have fat in the middle
579
Bucket Handle Meniscal tears are
longitudinal tears
580
No grid on
mag views
581
BR-3 =
< 2% chance o f cancer
582
BR-5
> 95% chance o f cancer
583
Nipple enhancement can be
normal on post contrast MRI - don’t call it Pagets.
584
Upper outer quadrant has the highest density o f breast tissue,
and therefore the most breast cancers
585
Majority o f blood (60%) is via the
internal mammary
586
Majority o f lymph (97%) is to
axilla
587
The stemalis muscle can only be seen on
CC view
588
Most common location for ectopic breast tissue is in the
axilla
589
The follicular phase (day 7-14) is the best time to have
a mammogram (and MRI).
590
Breast Tenderness is max around day
27-30
591
Tyrer Cuzick is the most
comprehensive risk model, but does not include breast density.
592
If you had more than 20Gy o f chest radiation as a child
you can get a screening MRI
593
BRCA 2 (more than 1) is seen with
male brease cancer
594
BRCA 1 is more in
younger patients
595
BRCA 2 is more in
post menopausal
596
BRCA 1 is more often a
triple negative CA
597
Use the LMO for
kyphosis, pectus excavatum, and to avoid a pacemaker / line
598
Use the ML to help catch
milk of calcium layering
599
Fine pleomorphic morphology to calcification has the
highest suspicion for malignancy
600
Intramammary lymph nodes are NOT
in the fibroglandular tissue
601
Surgical scars should get lighter, if they get denser
think about recurrent cancer.
602
You CAN have isolated
intracapsular rupture
603
You CAN NOT have isolated
extra (it’s always with intra).
604
If you see silicone in a lymph node, you need to recommend
MRI to evaluate for extracapsular rupture
605
The number one risk factor for implant rupture is
the age of the implant
606
Tamoxifen causes
a decrease in parenchymal uptake, then a rebound
607
T2 Bright things
these are usually benign. Don't forget colloid cancer is T2 bright
