Radiology

Question 1

preferred imaging studies

Answer 1

ct without contrast: trauma, stroke, acute headache, coma

mr without contrast: chronic headache, dementia

mr without contrast: seizure, infection, cancer

Question 2

facial fractures are commonly caused by ___

Answer 2

blunt or penetrating trauma (vehicle accidents, assaults, falls)

Question 3

types of fractures

Answer 3

• linear (temporal, parietal)
• depressed (due to direct blow to head)
• diastatic (widening suture lines in childhood)
• basilar
• ping pong (infants)

Question 4

most common form of traumatic intraaxial injury

Answer 4

cerebral contusion

- at inferior and polar surfaces of frontal and temporal lobes

Question 5

epidural vs subdural hematoma

Answer 5

read

Question 6

radiographic features of hematomas

Answer 6

acute = hyperdense
subacute = hypo/isodense
chronic = hypodense

Question 7

features of subarachnoid hemorrhage

Answer 7

• ct: hyperdense material in subarachnoid space
• angiography: to see aneurysms (cta, mra, dsa)
• tears of subarachnoid vessels

Question 8

intracerebral hematomas occur in ___

Answer 8

within brain tissue and due to severe head injury

Question 9

causes of stroke

Answer 9

infarction: in situ thrombosis (atherosclerosis or embolism)
hemorrhage: hypertension

Question 10

gold standard imaging for hemorrhage

Answer 10

ct

Question 11

early signs of stroke

Answer 11

• hypoattenuating brain tissue
• obscuration of lentiform nucleus
• dense mca sign
• insular ribbon sign

Question 12

benefits of mri for stroke

Answer 12

• can contrast hemorrhagic and ischemic

- diffusion weighted imaging: most sensitive sequence for stroke imaging

Question 13

screening assessment for head injuries

Answer 13

read (noncontrast ct)

Question 14

imaging of choice for cervical spine injuries

Answer 14

plain films

Question 15

lines that should be parallel and aligned

Answer 15

• ant vertebral bodies
• post vertebral bodies
• spinolaminar lines
• spinous process

Question 16

most common fracture mechanism in cervical injuries

Answer 16

hyperflexion

Question 17

fracture from cervical hyperextension

Answer 17

hangman’s fracture

• best on lateral view
• fractures through pars intercularis
• anterior dislocation of the c2 vertebral body
• prevertebral soft tissue swelling

Question 18

fracture from axial compression

Answer 18

jefferson’s fracture

- axial blow to vertex of head (from diving headfirst)

Question 19

radiographic features of spinal cord compression

Answer 19

• plain film and ct: not for assessment and cause

- mri: gold standard!! to see spinal canal and contents

Question 20

imaging of choice for thorax

Answer 20

cxr

• rib fractrues
• pulmonary contusions/ lacerations
• abnormal collections of air
• abnormal collections of fluid

Question 21

most common blunt chest injury

Answer 21

rib fractures

• 4-9 most common = pneumothorax and contusion
• 1 only = facial fractures
• 1 2 3 = serious trauma, ruptured bronchus
• 10-12 = lacerated liver/spleen

Question 22

what is flail chest

Answer 22

> /=3 contiguous broken ribs in 2 or more places, moves paradoxically with respiration

Question 23

most common pulmonary finding in blunt chest injury

Answer 23

pulmonary contusion

Question 24

pulmonary laceration can result in the formation of a ___

Answer 24

traumatic lung cyst or traumatic lung hematoma

Question 25

pneumothorax secondary to high intrathoracic pressures from ventilation resulting in rupture of pleural bleb

Answer 25

tension pneumothorax | - midline structures are pulled to contralateral side

Question 26

signs of pneumomediastinum

Answer 26

- spinnaker sail sign: elevation of thymic lobes due to pneumomediastinum - continuous diaphragm sign: entire diaphragm is visualized from one side to the other

Question 27

air appears around heart but does not extend above great vessels

Answer 27

pneumopericardium

Question 28

streaky air over lateral chest wall or neck

Answer 28

subcutaneous emphysema - localized: penetrating injury - diffuse: pulmonary interstitial emphysema

Question 29

abnormal collections of fluid from lungs

Answer 29

- hemothorax | - chylothorax (lymph)

Question 30

abdominal radiology tests

Answer 30

- erect cxr - abdominal x-ray (first line) - us abdomen - ct abdomen

Question 31

imaging for pneumoperitoneum

Answer 31

plain radiograph or ct

Question 32

bowel related signs of pneumoperitoneum

Answer 32

- double wall sign or rigler's sign | - telltale triangle sign

Question 33

peritoneal ligament related signs of pneumoperitoneum

Answer 33

- football sign - falciform ligament sign (silver's sign) - lateral umbilical ligament sign (inverted v) - urachus sign

Question 34

right upper quadrant signs of pneumoperitoneum

Answer 34

- lucent liver sign - hepatic edge sign - ligamentum teres sign - morison's pouch sign - cupola sign

Question 35

most common disorder of the urinary tract

Answer 35

renal/ureteric calculi, mostly calcium oxalate

Question 36

imaging modality for acute cholecystitis

Answer 36

uts

Question 37

findings in acute cholecystitis

Answer 37

- cholelithiasis - gb wall thickening >3-5 mm - pericholecystic fluid - positive murphy sign - gb distention

Question 38

most common cause and imaging for peptic ulcer disease

Answer 38

h pylori infection and nsaid use, uses endoscopy or upper gi series

Question 39

imaging for appendicitis

Answer 39

uts or ct scan

Question 40

signs of diverticulitis

Answer 40

- diverticulosis - pericolonic fat inflammation and inc vascularitis in mesocolon - symmetrical mural thickening - phlegmon formation - free fluid

Question 41

diagnostics for mechanical obstruction

Answer 41

- xray, ct, uts, or mri - normal bowels: small bowel <3 cm, large bowl <6 cm, cecum <9 cm - 80% small bowel obs

Question 42

abnormal aaa findings

Answer 42

- > 3cm abdominal aorta - thrombus within aneurysm - calcification

Question 43

types of fractures

Answer 43

read

Question 44

describing fractures by direction of fracture line

Answer 44

- transverse - oblique - spiral - longitudinal

Question 45

describing fractures by relationship of fragments

Answer 45

- displacement - angulation (a/p, m/l) - shortening - rotation - impaction, depression, compression

Question 46

describing fractures by number of fragments

Answer 46

``` 2 = simple >2 = comminuted ``` uncommon: fatigue, insufficiency, secondary to pre-existing abnormality