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Radiology USMLE Step 3 > Section 2: Radiological facts > Flashcards

Section 2: Radiological facts Flashcards

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USMLE® Step 1 flashcards
1
Q

When is CT of the head the best answer on the test?

  1. Noncontrast head CT
  2. Contrast head CT
A
  1. This is the best initial test to rule out hemorrhage when the case describes trauma or acute neurological change.
  2. This is appropriate when you want to evaluate for AV malformations or primary or metastatic tumors

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 14986-15009). Kaplan Publishing. Kindle Edition.

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2
Q

When is CT of the abdomen/pelvic the best answer on the test?

A

This is the best test to evaluate

  • Retroperitoneal structures
  • Pancreatitis or pancreatic masses
  • Nodal metastasis from colon, prostate, testicular, or renal malignancies.

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 14986-15009). Kaplan Publishing. Kindle Edition.

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3
Q

When is high resolution CT of the chest best answer on the test?

A

This is the test of choice to evaluate parenchymal lung disease (interstitial fibrosis).

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 14986-15009). Kaplan Publishing. Kindle Edition.

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4
Q

True or False

CT is the best test to evaluate bony structures

A

True

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 14986-15009). Kaplan Publishing. Kindle Edition.

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5
Q

List the contraindications to CT scan

A
  1. Renal insufficinecy (creatinine ≥ 1.5). •
  2. Do not give IV contrast in patients with multiple myeloma.
  3. Always discontinue metformin before doing a CT scan with IV contrast and only resume metformin 48 hours after the scan, when renal failure has been ruled out
  4. Do not order MRI with contrast in patients with renal disease (creatinine ≥ 1.5) due to the risk of nephrogenic systemic fibrosis

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 14986-15009). Kaplan Publishing. Kindle Edition.

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6
Q

When is MRI the best answer on the test?

A
  1. For evaluating demyelinating diseases (e.g., multiple sclerosis and some dementias).
  2. It is the best test to evaluate the posterior fossa, base of the skull, and the orbit.
  3. It is the best test to evaluate acoustic neuromas, pituitary tumors, and small intraparenchymal brain tumors.
  4. It is the test of choice for bone tumors, bone and soft tissue infections (e.g., osteomyelitis), joint spaces, and aseptic necrosis of femoral head.
  5. It is the test of choice for evaluating disease of the spinal cord and spinal column (e.g., herniated discs, degenerative disc disease, and spinal tumors).

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 15009-15029). Kaplan Publishing. Kindle Edition.

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7
Q

HIDA (hepatobiliary) scan is a nuclear scan. When is HIDA the best test?

A

For evaluating biliary obstruction versus acute cholecystitis

For evaluation of biliary leaks postoperatively

It is also the test of choice to evaluate congenital abnormalities of the biliary tract, including biliary atresia

It is not the test of choice for evaluating gallbladder stones.

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 15009-15029). Kaplan Publishing. Kindle Edition.

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8
Q

When is a bone (nuclear) scan the best test?

A

This is used for evaluating

  • metastatic bone lesions (prostate, breast, kidney, thyroid, lung)
  • delayed fractures
  • osteomyelitis
  • avascular necrosis of the femoral head

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 15009-15029). Kaplan Publishing. Kindle Edition.

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9
Q

When is an adrenal (nuclear) scan the best test?

A

This is the test of choice to localize pheochromocytoma when a MRI/ CT scan is nondiagnostic

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 15009-15029). Kaplan Publishing. Kindle Edition.

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10
Q

When is a V/Q scan the best answer in the test?

  • What does a normal test imply?
  • What is the next step following an intermediate scan?
  • What does a perfusion defect with normal ventilation indicates?
  • When not to order a V/Q scan
A

This is the initial test of choice to evaluate for pulmonary embolism (PE).

  • A normal study rules out PE
  • Requires further workup with CT angiogram
  • Quite probably indicates PE
  • In a patient with COPD or extensive lung disease.

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 15009-15029). Kaplan Publishing. Kindle Edition.

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11
Q

When is gallium scan the best answer?

A

Test of choice for localizing abscesses, staging lymphomas, and melanomas.

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 15029-15041). Kaplan Publishing. Kindle Edition.

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12
Q

True or False:

  1. Bone scan is not useful in purely lytic metastatic lesions
  2. Is the best initial radiological test of choice in multiple myeloma
A
  1. True
  2. False

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 15029-15041). Kaplan Publishing. Kindle Edition.

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13
Q

When is Ultrasound the best test?

A
  1. It is the best initial test to evaluate the gallbladder for stones when a patient presents with right upper-quadrant pain.
  2. It is the best initial test for assessing the uterus, adnexa, and ovaries (with the exception of cervical carcinoma).
  3. It is the best initial test to evaluate the prostate; it also aids in obtaining biopsy.
  4. It is the best test to evaluate for deep venous thrombosis (DVT).

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 15029-15041). Kaplan Publishing. Kindle Edition.

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14
Q

List the differentials for lytic bone lesions on x-ray films

A
  • Multiple myeloma
  • Primary bone tumor
  • Metastasis (most common: lung, renal or thyroid, breast)

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 15055-15096). Kaplan Publishing. Kindle Edition.

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15
Q

List the differentials for blastic bone lesions on x-ray films

A
  • Metastasis (most common: breast, prostate, lymphoma)
  • Paget’s disease
  • Medulloblastoma in pediatrics

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 15055-15096). Kaplan Publishing. Kindle Edition.

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16
Q

List the differentials for large mediastinum on chest x-ray films

A
  • Aortic aneurysm
  • Lymphadenopathy

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 15055-15096). Kaplan Publishing. Kindle Edition.

17
Q

List the differentials for infiltrated lungs with effusion on x-ray films

A
  • Staphylococcus pneumoniae
  • Streptococcus pneumoniae
  • Lung infarct
  • Tuberculosis

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 15055-15096). Kaplan Publishing. Kindle Edition.

18
Q

List the differentials for small bowel obstruction on x-ray films

A
  • Adhesions
  • Hernia
  • Intussusception (pediatrics)
  • Gallstone ileus
  • Carcinoma

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 15055-15096). Kaplan Publishing. Kindle Edition.

19
Q

List the differentials for large bowel obstruction on x-ray films

A
  • Carcinoma
  • Hernia
  • Diverticulitis
  • Intussusceptions (pediatrics)

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 15055-15096). Kaplan Publishing. Kindle Edition.

20
Q

List the differentials for gas in the biliary system on radiological imaging

A
  • Gallstone ileus
  • Gas forming infection
  • Instrumentation

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 15055-15096). Kaplan Publishing. Kindle Edition.

21
Q

List the differentials for small kidney(s) on radiological imaging

A
  • Renal artery disease
  • Chronic hydronephrosis
  • Chronic glomerulonephritis
  • Chronic pyelonephritis

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 15055-15096). Kaplan Publishing. Kindle Edition.

22
Q

List the differentials for large kidney(s) on radiological imaging

A
  • Acute pyelonephritis
  • Acute glomerulonephritis
  • Renal vein thrombosis
  • Carcinoma (unilateral)
  • Wilms’ tumor (pediatrics)

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 15096-15119). Kaplan Publishing. Kindle Edition.

23
Q

List the differentials for ring enhancing lesions in the brain in an immunocompetent patient on CT scan

A
  • Metastatic tumors
  • Demyelinating disease
  • Pyogenic abscess

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 15096-15119). Kaplan Publishing. Kindle Edition.

24
Q

List the differentials for ring enhancing lesions in the brain in an immunocompromised patient on CT scan

A
  • Toxoplasma encephalitis (T. gondii)
  • Primary CNS lymphoma (Epstein-Barr virus)
  • Tuberculosis (in endemic areas)

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 15096-15119). Kaplan Publishing. Kindle Edition.

25
Q

List the differentials for hemorrhage into the basal ganglia, cerebellum, or pons on radiological imaging

A

Hypertensive brain hemorrhage

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 15096-15119). Kaplan Publishing. Kindle Edition.

26
Q

List the differentials for hemorrhage into the cerebral hemisphere on radiological imaging

A
  • Arteriovenous malformation
  • Aneurysm
  • Trauma
  • Metastatic lesions
  • Other causes: vasculitis, cocaine, coagulation abnormalities

Fischer, Conrad (2012-09-22). Master the Boards: USMLE Step 3 (Kaplan Medical Usmle Master the Boards Step 3) (Kindle Locations 15096-15119). Kaplan Publishing. Kindle Edition.

Radiology USMLE Step 3 (2 decks)

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