VIQ - Genitourinary, Adrenal, Obstetrics & Gynaecology and Breast - Warm Up

Question 1

@# 1. Regarding percutaneous nephrostomy:
a) It is best to target an upper pole calyx
b) A 5-French drain is adequate for an infected system
c) Ideally the guidewire should be passed into the ureter
d) The tract should be dilated to 2-French larger than that of the drainage catheter
e) A straight Amplatz wire should be used

Answer 1

1.
a) False - mid + lower pole calyces. This has lower risk of pneumothorax
b) False - 6-French uninfected, 8-French for infected
c) True
d) False - 1-French larger
e) False - J wire to avoid perforation of pelvis

Question 2

@# 4. The following cause bladder wall calcification:
a) Transitional cell carcinoma
b) Cytotoxin cystitis
c) Sarcoidosis
d) Osteogenic sarcoma metastases
e) Scleroderma

Answer 2

4.
a) True
b) True
c) False
d) True
e) False

Question 3

@# 7. The following renal calculi are radiopaque:
a) Cystine
b) Struvite
c) Calcium oxalate
d) Xanthine
e) Urate

Answer 3

7.
a) True - mildly radiopaque
b) True
c) True
d) False
e) False

Question 4

@# 9. Phaeochromocytoma:
a) Is associated with tuberous sclerosis
b) Affects the bladder
c) Is bilateral in 20-40% of cases
d) Is extra-adrenal in 20-30% of cases
e) Is associated with gastric haemorrhage

Answer 4

a) True
b) True - in 1 % of cases
c) False - 10%
d) False-10%
e) True - Carney syndrome; triad of extradrenal phaeochromo- cytoma, gastric
leiomyosarcoma and pulmonary chondromas

Question 5

@# 11. The following are causes of adrenal calcification:
a) Tuberculosis
b) Phaeochromocytoma
c) Adrenal myelolipoma
d) Histoplasmosis
e) Wolman’s disease

Answer 5

11.
a) True
b) True
c) True - calcification present in 20%
d) True
e) True - rare autosomal recessive lipid disorder associated with enlarged calcified adrenal
glands, hepatomegaly and splenomegaly

Question 6

@# 14. The following decrease noise in CT scanning:
a) Zoom enlargement of the display
b) Using a narrower window
c) Increasing slice thickness
d) Decreasing the pitch
e) Decreasing the scan time

Answer 6

14.
a) False - increases noise
b) False - increases noise as each grey level covers a smaller range of CT numbers
c) True
d) True
e) False

Question 7

@# 16. The following are true concerning testicular tumours:
a) 10% of germ cell tumours are bilateral
c) On ultrasound, seminoma is typically seen as a homogenous hyperechoic lesion
c) Embryonal cell carcinoma is normally homogenous on ultrasound
d) Pancreatic adenocarcinoma can metastasise to the testis
e) In 55-60% of cases, seminoma completely replaces the testicular tissue

Answer 7

16.
a) True
b) False - homogenous hypoechoic lesion sharply delineated from the normal testicular tissue
c) False - heterogenous. More aggressive than seminoma
d) True
e) False - not in the majority

Question 8

@# 18. Meta-iodo-benzyl-guanidine (MIBG) imaging is used to detect the following:
a) Colonic adenocarcinoma
b) Follicular thyroid carcinoma
c) Carcinoid tumour
d) Phaeochromocytoma
e) Neuroblastoma

Answer 8

18.
a) False
b) False - medullary thyroid carcinoma
c) True
d) True
e) True

Question 9

@# 20. Concerning renal cell carcinoma:
a) It is bilateral in 10-15% of cases
b) Metastases are present at diagnosis in 40%
c) Stranding densities in the perirenal fat are consistent with tumour spread
d) The staging accuracy of MRI is much better than CT
e) Growth into the renal vein occurs in 5-10%

Answer 9

20.
a) False - 2%
b) True
c) False - usually attributable to oedema or fibrosis from previous inflammation
d) False - they are about equal
e) False - 30%

Question 10

@# 22. Raised alpha-fetoprotein is caused by the following:
a) Twins
b) Encephalocoele
c) Renal agenesis
d) Gastroschisis
e) Omphalocoele

Answer 10

22.
a) True
b) True
c) True
d) True
e) True

Question 11

@# 25. Krukenberg tumour is caused by:
a) Gastric adenocarcinoma
b) Colonic adenocarcinoma
c) Renal cell carcinoma
d) Pancreatic adenocarcinoma
e) Malignant melanoma

Answer 11

25.
a) True
b) True
c) False
d) True
e) False

Question 12

@# 26. The following may cause megaureter:
a) Posterior urethral valves
b) Retroperitoneal fibrosis
c) Beckwith-Wiedemann syndrome
d) Diabetes insipidus
e) Ectopic ureter

Answer 12

26.
a) True
b) True
c) False
d) True
e) True

Question 13

@# 27. Concerning congenital uterine anomalies:
a) 75% of women with congenital uterine anomalies have fertility problems
b) They are associated with urinary tract anomalies in 80-90%
c) In uterine didelphys there is duplication of the vagina
d) Bicornuate uterus is the commonest anomaly
e) Vaginal atresia may present with hydronephrosis

Answer 13

27.
a) False - 25%
b) False - 20-50%
c) True
d) False - septate uterus
e) True - due to a haematocolpos

Question 14

@# 31. The following are true concerning MRI artefacts:
a) Truncation artefact is avoided by decreasing the voxel size
b) Susceptibility artefacts are seen around metal implants
c) Susceptibility artefacts are reduced by using gradient-echo rather than spin-echo sequences
d) Aliasing is reduced by increasing the field of view
e) Aliasing is reduced by using a larger surface coil

Answer 14

31.
a) True
b) True
c) False - the opposite is true
d) True
e) False - smaller surface coil

Question 15

@# 32. Regarding pyeloureteritis cystica:
a) It is most commonly seen in young adults
b) The most common causative organism is Proteus mirabilis
c) Diabetics are predisposed
d) There is a good response to antibiotic therapy
e) There is a risk of malignancy

Answer 15

32.
a) False - 6th decade
b) False - Escherichia coli
c) True
d) False
e) True - increased incidence of transitional cell carcinoma of bladder

Question 16

@# 35. Gallium-67 citrate is taken up by the following:
a) Lymphoma
b) Bronchial carcinoma
c) Normal bone marrow
d) Haemangioma
e) Simple renal cysts

Answer 16

35.
a) True
b) True
c) True
d) False
e) False