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SUMRAD > Special Population > Flashcards

Special Population Flashcards

1
Q

What is tool used to screen, diagnose lump or symptoms in breast?

A

Mammography

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2
Q

What is the BI-RADs score in mammography?

A

5-6 not ideal further eval d/t concern for malignancy, get MRI or biopsy.
Use CAD-computer aided detection software with reporting database

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3
Q

What is seen on Mammography that is normal?

A

High density ducts- white.

Fibrous breast/thick will be hard to see mass.

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4
Q

What are views of Mammography?

A

Cranial-caudal. Medial and Lateral-side smush

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5
Q

Describe mass shapes?

A 
Round, 
Oval. 
Lobulated-scalloped, 
Irregular, 
Architectural Distortion-creates indentation externally
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6
Q

Describe mass shapes?

A 
Circumcised-pick up,
Obscured- less edge, 
Microlobulated- many scallops, 
Ill defined- very irregular. 
Spiculated- crab like spikes coming out everywhere
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7
Q

Which margin and shape carry high suspicion on mammography?

A 
Asymmetric density,
 Lobulated, 
irregular, 
architectural distortion 
microlobulated, 
ill defined, 
spiculated, 
grouped micro-calcifications
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8
Q

What are benin patho on mammography?

A 
Fibroadenomas, 
cysts, 
abscess, 
hematoma, 
intraductal papilloma,
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9
Q

What are indication for Breast US?

A

Not indicated for cancer screening
Indication = diagnostic?
CANNOT see Microcalcifications
ONLY for cystic or solid

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10
Q

What will indicate a cyst on Breast US? What is follow up ?

A

Cyst are Anechoic-black fluid, thin walls.

F/U is MRI or biopsy bc cyst MOST of time are benign BUT NOT ALWAYS

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11
Q

What is reason for Breast MRI?

A

Indications

  1. visibility-extent of tumor
  2. Breast implant rupture
  3. Young pt’s, high risk -dense tissue
  4. abnormality that can be felt but not seen on mammogram or ULS
  5. Mammogram & ULS indeterminate/unsure
  6. After surgery or radiation - recurrence
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12
Q

What is seen on MRI that is often malignant?

A

Ring enhanced tumors

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13
Q

What is next step after suspicious mammogram and MRI?

A

PET SCANS!

  1. Cancer staging
  2. Recurrent breast CA
  3. Best- Large, aggressive tumors
  4. Looking for mets
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14
Q

What is 1st choice for male breast?

A

Ultrasound

2nd Mammography- challenging

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15
Q

What’re the imaging options for testicles?

A

-power Doppler (vascular flow) ultrasound is the procedure of choice
-nuclear medicine scan
-MRI
NEVER CT
INDICATIONS
-torsion -trauma -epididymitis -orchitis -tumors -hernia -hydrocele -abscess

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16
Q

Is a power Doppler the same as the simple color flow?

A

NOOOOOO! It’s more advanced

17
Q

What’s the normal appearance for a testicle on ULS?

A
  • fine, homogeneous echo texture

- should have good flow signals on power flow Doppler

18
Q

Who gets testicular torsion?

A

Kids and young men
spermatic cord twists and leads to low flow/infarct.
ischemia causes severe pain.

19
Q

How will testicular torsion appear on ULS?

A
  • heterogenous with hypoechoic areas
  • testicular enlarged
  • low or no flow signals on Doppler -NO FLOW = SURGICAL EMERGENCY
20
Q

What’re indications for prostate imaging?

A
  • malignancy
  • urinary retention
  • strictures
21
Q

What’re imaging modalities for prostate imaging?

A
  • US bladder for post-void residual
  • transrectal US
  • CT/MRI
  • retrograde urethrogram (good for strictures)
22
Q

When would we US the bladder vs transrectal?

A

Bladder: post residual volume, evaluate urinary retention Transrectal: abnormal digital exam, high PSA, masses, calcifications

23
Q

When is a CT/MRI of the prostate indicated?

A
  • evaluate masses or malignancy
  • extent, characteristics of masses
  • calcifications
  • relationship to adjacent structures
24
Q

If you see a long bone fracture in an infant/toddler, is that relatively normal?

A

NO! Long bone fractures require high force and are very uncommon especially if the pt is non-ambulatory
<1yo from fall of bed ABN

25
Q

What is radiographic evidence of potential past abuse?

A
  • periosteal reaction

- multiple healing sites with callous formation (5-14 callous begins)

26
Q

What’re suggestive radiologic findings of non-accidental trauma in infants and toddlers?

A
  • healing fractures in various stages w/ periosteal rxs
  • posterior rib fractures
  • fxs at edges of the metaphysis of long bones
  • humeral shaft fx (above the supracondylar area)
  • compression fractures of vertbral bodies
  • femur, hand, foot fxs if non-ambulatory
  • sternum, sternoclavicular joint, acromion, scapula
27
Q

What is a skeletal survey?

A
  • best is they are < 2 yo
  • done down for legal
  • 2 views of the skull
  • lateral vertical, thoracolumbar spine
  • AP views of upper and lower extremities -AP chest, oblique view of ribs
  • AP pelvis
28
Q

Is a bone scan useful in assessing non-accidental trauma?

A

They are sensitive, but not specific

29
Q

When would we utilize a head CT w/o contrast for suspected non-accidental trauma in kiddos?

A

If they present w/ ALOC,
seizure,
retinal hemorrhage

30
Q

What’s a common mechanism of posterior rib fractures in kiddos?

A

From squeezing of the chest, grasping, shaking of the lil one

31
Q

If a 2 yo presents and has a metaphysical corner fracture, what should we be suspicious of?

A

Highly suggestive for child abuse from shaking, twisting, or pulling Seen in the knees, ankles, elbows or wrists

32
Q

What’re kid specific conditions to remember?

A
  • toddler’s fracture
  • osteogenesis imperfecta
  • salter Harris classification
  • elbow/wrist ossification
  • is osgood-schlatter dz
  • slipped capital femoral epiphysis
  • legg-calve-perthes disease
33
Q

What is a toddlers fracture?

A
  • occurs from 1-3 yrs of age
  • from a fall running or foot gets caught
  • KIDDO WILL NOT WALK
  • non-displaced, oblique or spiral fox of distal tibia
  • can be very, very subtle
34
Q

Will an x-ray show a toddlers fracture?

A

Not always! It may be negative initially, but a callous will form **this is not abuse usually

35
Q

What is osteogenesis imperfecta?

A
  • failure to form normal collagen
  • bone fragility, multiple, frequent fractures
  • angulation of long bones and deformities
36
Q

What’re the characteristics of osteogenesis imperfecta?

A
  1. Short stature
  2. Blue sclera
  3. Deafness
  4. Brittle teeth

SUMRAD (13 decks)

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