RD MCQ 2013 september recalls - NSW: Formatted Flashcards
- Which type of Non Hodkins lymphoma is PET not useful for
a. T cell
b. lymphocyte rich
c. nodular sclerosing
d. mycosis fungoides
e. diffuse large B cell
*LW:
d. mycosis fungoides (also known as cutaneous T cell lymphoma, NHL type),
- this is my favoured answer as although FDG PET results are positive in most T cell lymphomas, except indolent cutaneous T cell lymphoma.
PRevious answer:
a. T cell
- Which type of Non Hodkins lymphoma is PET not useful for
a. T cell
b. lymphocyte rich
c. nodular sclerosing
d. mycosis fungoides (also known as cutaneous T cell lymphoma, NHL type),
- this is my favoured answer as although FDG PET results are positive in most T cell lymphomas, except indolent cutaneous T cell lymphoma.
e. diffuse large B cell: TRUE
- A patient how has previously been treated for prostate cancer now has lower leg weakness and can’t walk. MRI no structural abnormality.(repeat)
a. Transverse myelitis
b. Post radiotherapy
c. Leptomeningeal recurrence
*LW:
Post radiation thereapy can occur short term and long term.
Transverse myelitis is possible, as can occur in setting of malignancy, favours anterior cord.
b. Post radiotherapy although depends on time course (could be transverse myelitis if acute)
- Which is not an associated drug reaction?
a. Methotrexate and lung mass
b. Cyclosporin and pneumatocoele
c. Amiodarone and pulmonary fibrosis
d. Phenytoin and pleural effusion
b. Cyclosporin and pneumatocoele
methotrexate can get fibrosis -> conglomeration which may probably produce mass like appearance
- Technitium is useful in medical imaging. Which is true?
a. half life of 90 min
b. its daughter, molybdenum is not radioactive
c. produces gamma and beta radiation
d. produces energy from 5 keV to 5000 keV, which suits the detectors well
c. produces gamma and beta radiation
**LJS - Tc-99m (metastable) to Tc-99 gamma decay to ground state, releasing 140keV gamma photon, plus a little bit of internal conversion (also releasing gamma photon)
i.e. no beta emission.
Check of my physics notes and googling confirms this. But maybe someone who’s more of a physics buff understands this better?
Poor recall? Unrecalled option correct?
If there were beta emission wouldn’t radiation dose be high, and hence not as clinically useful as it is?
However, other answers all false:
a. half life of 90 min - no, 6 hours
b. its daughter, molybdenum is not radioactive - Mo is the parent, not the daughter. 99Mo decays by beta emission to 99mTc
d. produces energy from 5 keV to 5000 keV, which suits the detectors well - produces 140 keV gamma photon
- Which is true regarding diffuse axonal injury?
a. Usually non-haemorrhagic
b. Most common in the subcortical white matter of the frontal and temporallobes
c. Susceptability weighted imaging is not helpful
d. Diffusion weighted imaging is diagnostic
a. Usually non-haemorrhagic 80% non-haemorrhagic.
77. Which is true regarding diffuse axonal injury?
a. Usually non-haemorrhagic 80% non-haemorrhagic.
b. Most common in the subcortical white matter of the frontal and temporal lobes
c. Susceptability weighted imaging is not helpful
e. Diffusion weighted imaging is diagnostic kind of true although I guess other pathologies could simulate findings. Probably a better
- Which is least associated?
a. Caroli’s disease and medullary sponge kidney
b. NEC and maternal diabetes
c. Hypercalcaemia and supravalvular aortic stenosis
d. Typhlitis and haematological malignancy
- LW:
b. NEC and maternal diabetes
- Which is least associated?
a. Caroli’s disease and medullary sponge kidney: True
b. NEC and maternal diabetes: not associated.
c. Hypercalcaemia and supravalvular aortic stenosis: technically true, supra valvular AS is very rare and is associated with Williams syndrome which includes hyper calcaemia.
d. Typhlitis and haematological malignancy: true.
- In regards to second trimester screening
a. An echogenic intracardiac focus can be related to non-chromosomal cardiacdefects
b. Echogenic bowel is not pathological if there are no chromosomal anomalies
c. An isolated single umbilical artery is associated with cardiac anomalies
d. Choroid plexus cysts without any other abnormality are a strong indicatior ofchromosomal abnormalities
- LW: All answers false - likely incomplete recall.
82. In regards to second trimester screening
a. An echogenic intracardiac focus can be related to non-chromosomal cardiac defects:
- False: no recognised direct association with congenital heart disease for an EIF on its own
b. Echogenic bowel is not pathological if there are no chromosomal anomalies:
- False:
- can be normal variant / isolated findings in up to 70% cases, however can be associated with intra amniotic haemorrhage, T21, (and less commonly T13, T18, XO), CMV infection, CF, IUGR, meconium peritonitis.
c. An isolated single umbilical artery is associated with cardiac anomalies:
- False.
- 65% occurs in isolation.
- Associations in 35% of cases and include, lesser umbilical coils, umbilical arterial aneursym, TRAPS, IUGR.
- If other abnormalities present, associations include trisomy, renal anomalies.
d. Choroid plexus cysts without any other abnormality are a strong indicatior ofchromosomal abnormalities
- False
- Soft marker, as majority occur with no other associated abnormalities.
- Associations include: T18, T21, Klinefelter, Aicardi syndrome.
Previous answers:
82. In regards to second trimester screening
a. An echogenic intracardiac focus can be related to non-chromosomal cardiac defects not according to RP.
b. Echogenic bowel is not pathological if there are no chromosomal anomalies 70% normal, trisomies as well as TORCH, CF, IUGR, intra-amniotic haemorrhage
c. An isolated single umbilical artery is associated with cardiac anomalies not isolated.
d. Choroid plexus cysts without any other abnormality are a strong indicator of chromosomal abnormalities soft marker
- In regards to lower limb angiography
a. The popliteal artery is best seen in lateral view if there is a total kneereplacement
b. The profunda femoris artery origin is best visualised in external rotation(can’t remember whether external or internal)
a. The popliteal artery is best seen in lateral view if there is a total knee replacement
- A young patient has left atrial enlargement, thickened interlobular septa,widespread dense pulmonary nodules and small pleural effusions. Which is most likely?
a. Sarcoidosis
b. Metastases
c. Pulmonary haemosiderosis
d. Talcosis
c. Pulmonary haemosiderosis