Random_14

Question 1

Black turbinate sign

Answer 1

Black turbinate sign

• non-enhancement of the mucosa
• due to angioinvasion by fungus and infarction
• mucormyocosis or aspergillosus
• in diabetic and neutropenic patients

Question 2

Isolated lateral rectus muscle involvement?

Answer 2

Orbital pseudotumor

Question 3

Summary of Dysmyelination

• Metachromatic leukodystrophy
• Canavan disease
• Alexander disease
• Adrenoleukodystrophy
• CACH - childhood onset ataxia with CNS hypomyelination
• Megalencephalic leukoencephalopathy - Van der Knaap syndrome
• Sudanophilic leukodystrophy - Pelizaeus-Merzbacher disease
• Krabbe disease

Answer 3

• Metachromatic leukodystrophy
  
  • Arylsulfatase
  • 6mo - 2yo
  • Tigroid pattern
  • U fibers spared
• Canavan disease
  
  • first 6mo
  • macrocephaly
  • increased NAA
  • U fibers affected
• Alexander disease
  
  • 6mo - 2yo
  • macrocephaly
  • frontal predilection
  • basal ganglia
  • lactate elevated
  • U fibers affected
• Adrenoleukodystrophy
  
  • adrenal insufficiency
  • hearing and vision affected
  • posterior predilection
  • enhancing advancing edge
• CACH (childhood onset ataxia with CNS hypomyelination)
  
  • > 3yo
  • ataxia
  • optic atrophy
  • vanishing white matter converting to CF
  • lactate on MRS
• Megalencephalic leukoencephalopathy - Van der Knaap syndrome
  
  • < 6mo
  • macrocephaly
  • ataxia
  • cysts at temporal tips
  • spares U fibers
• Sundanophilic leukodystrophy - Pelizaeus-Merzbacher disease
  
  • < 6mo
  • abnormal eye movements
  • tigroid stripes
• Krabbe disease
  
  • 6mo - 2yo
  • hypertonia
  • psychomotor arrest
  • basal ganglia density changes
  • spares U fibers
  • involves corticospinal tracts
  • enhanced nerve roots (optic nerve)

Question 4

Jersey finger

Answer 4

• FDP injury at its attachment to distal phalanx
• American football or rugby
• player grabs the jersey of another player while that player is running away
• hyperextension of DIP with PIP in flexion

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Question 7

Answer 7

Finger tenosynovitis

• uncomplicated
  
  • increased fluid in the tendon sheath
  • mild enhancement
• septic
  
  • more intense enhancement
  • adjacent abscess, septic joint, or osteomyelitis
• stenosing (trigger finger)
  
  • tendon sheath fluid stenosis
  • may have thick pulleys
• rheumatoid
  
  • marked enhancement of tendon sheath
  • synovitis of adjacent joints

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Hypertrophic Olivary Degeneration

• pathway disrupted - Guillian-Mollaret triangle
• most common symptom - palatal myoclonus

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Question 26

Most important predictor for twin pregnancy?

Answer 26

Chorionicity

Question 27

Risks associated monochorionic twin pregnancy

Answer 27

* TTTS - twin twin transfusion syndrome (10-20% pregnancies) * TRAP (1% of monochorionic twins) * acardiac monster * Consequence of demise * Cord entanglement in monoamniotic twins

Question 28

Multiple gestations - the first person to scan the patient MUST determine chorionicity and amnionicity

Answer 28

Multiple gestations - the first person to scan the patient MUST determine chorionicity and amnionicity

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Question 31

Dysplastic Cerebellar Gangliocytoma Lhermitte-Duclos Disease

Answer 31

* WHO grade 1 tumor * characteristic MR alternating signal striations * T1 hypo, T2 hyper, no enhancement * expansion of the granular layer by large neurons creating widened folia * FDG-18 avid * most common symptoms * mass effect on 4th ventricle * hydrocephalus * associated with Cowden syndrome (autosomal dominant lesion - PTEN gene) * mucocutaneous lesions * GI polyps * hamartomas * thyroid and breast cancers

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Subchondral insufficiency fracture vs AVN/ON

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NF-1

Answer 54

NF-1

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NF-1

Answer 55

NF-1

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Approach to sagittal peds brain MR Sweep the MIdline

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Approach to axial peds brain MR

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Question 67

What enzyme/gene is implicated in all of the 3 cancers? pheochromocytoma paraganglioma renal cell carcinoma

Answer 67

Succinate Dehydrogenase

Question 68

NF-1 Malignant/sarcomatous degeneration

Answer 68

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NF-1 Bony abnormalities

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Question 78

Asymmetric RUL involvement vs Asymmetric LUL involvement

Answer 78

* Asymmetric RUL involvement - Mitral regurg * Asymmetric LUL involvement - Pulmonary stenosis

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Question 80

Microcarcinoid Tumorlets Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia DIPNECH

Answer 80

Microcarcinoid Tumorlets Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia DIPNECH HRCT * mosaic attenuation due to air trapping * nodular bronchial wall thickening * bronchiectasis * mucus plugging b/c of airway obstruction

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Dysplasia Epiphysealis Hemimelica aka Trevor Disease * extremely rare * male children predominant * osteochondroma arising from the epiphysis * distal femur/knee most common site * an irregular mass with focal ossification arising from one side of the affected epiphysis

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