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79 Cards in this Set
- Front
- Back
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PET F18 NaF is used for what type of mets?
Liver Bone Brain Bowel |
Bone
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Which of the following is most associated with vertebral fractures?
Spondylosis dysplasia Scoliosis C. DISH |
DISH
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Which of the following is associated with periostitis?
a. Idiopathic juvenile arthritis b. SLE c. OA |
IJA
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Epidural lipomatosis most commonly associated with?
A. Addisons disease B. Cushings syndrome C. Pituitary adenoma D. Exogenous steroid use |
B. Cushings syndrome
D. Exogenous steroid use |
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All of the following are MSK complications of hemophilia except:
Expanded appearance of diaphyses. Expanded appearance of radial head. Erosions and cartilage loss. |
Expanded appearance of the diaphyses
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89.What is the rate of pneumothorax in percutaneous lung biopsy?
5% 10% 20% 50% |
20
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All of the following are true regarding ovarian carcinoma except:
CA-125 is a useful tool for diagnosing disease and monitoring for recurrence FDG-PET is less sensitive for detecting purely mucinous ovarian carcinoma Early intraperitoneal spread of disease to peritoneum and omentum is common Germ cell ovarian tumors have worse prognosis than adenocarcinoma of the ovary |
Germ cell ovarian tumors have worse prognosis than adenocarcinoma of the ovary
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92.Which of the following is true regarding the technical difficulty of imaging/diagnosing a cyst in 3D ultrasound?
Reconstruction increases internal noise Reconstruction may make cyst wall appear irregular Increased through transmission may not be appreciated in reconstructed planes Decreased resolution results in non-diagnostic exams |
Increased through transmission may not be appreciated in reconstructed planes
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93.Increased systolic velocity in the internal carotid may be attributed all of the following except:
Obstructive contralateral carotid disease Hyperthyroidism Anemia Aortic stenosis Ipsilateral proximal stenosis |
Aortic stenosis
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During ultrasound evaluation of the carotid, which of the following is true?
Hemodynamically significant lesion is greater than 70% occlusion. Severity of stenosis is measured as reduction in cross-sectional area at site of stenosis Velocities may be artificially elevated in contralateral occlusive carotid disease Critical stenosis (>95%) is associated with post stenotic velocities too high to measure accurately |
Velocities may be artificially elevated in contralateral occlusive carotid disease
Incorrect response N.B: …hemodynamically significant lesion is >50% stenosis; >70% has been demonstrated to benefit from endarterectomy (NASCET study) …stenosis is measured as ratio of cross-sectional diameter of the downstream greatest diameter over the diameter at stenotic lesion (NASCET) …critical stenoses of >95% are associated with paradoxical pseudonormalization of velocities or undetectable flow due to the degree of stenosis Dahnert |
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In nuclear medicine calibrator QA, “constancy” refers to which of the following?
Accurate measurement over a large range of activity levels Accurate measurement over a range of positions in the ionization chamber Reproducibility of measurements over a range of different points in time Spatial resolution within parameters set by the National Bureau of Standards |
Reproducibility of measurements over a range of different points in time
…”A” is the definition of linearity …”B” is the definition of geometry |
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95.Which of the following is not a contraindication for thrombolysis?
CVA or head trauma in last 3 months GI/GU bleed in last 3 months Infected venous thrombosis Thrombocytopenia (<100,000) |
GI/GU bleed in last 3 monts
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Which of the following is true of BOOP?
A. EBV B. Decreased FEV1 more than 20% is suggestive C. Tree-in-bud appearance |
Decreased FEV1
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What attaches the lung to the mediastinum?
Inferior pulmonary ligament |
Inferior pulmonary ligament
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The least amount of time for pretreatment with steroids to have the maximal effect is?
A. 12hrs B. 24hrs C. 6 hrs |
6
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Which does not cause retinal detachment?
Coats Retinoblastoma Diabetes Ocular choroidal melanoma Ocular rhadomyosarcoma |
Ocular rhabdomyosarcoma – retinal detachment very rare with this
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What will you see with hyperextension of the cervical spine?
Decreased disc space Avulsion fractures Rotary subluxation Increased interspinous distance Anterolisthesis |
Avulsion fractures
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What is the treatment of postpericardial syndrome?
Pericardiocentesis NSAIDS Diuretics Narcotics |
NSAIDS
Pericarditis may occur within 2 to 5 days after a heart attack, or it may occur as much as 11 weeks later. The condition is called Dressler's syndrome when it persists for weeks or months after a heart attack. |
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All are associated with IBD except?
A) Uveitis B) PSC C) Osteomas D) Retinitis |
Osteomas
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In crossed fused renal ectopia, which ureter inserts abnormally?
Neither Crossed kidney Non-crossed kidney Both abnormal |
Neither
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Which will have a secondary ossification center in a neonate?
Proximal Femur Distal Femur |
Proximal Femur
There is an ossification center in the greater trochanter that is visible at term birth. The ossification at the lesser trochanter is recognizable at the 19th week on DEXA scans. |
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Portal vein hypertension equals?
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wedge pressure - free hepatic vein pressure
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Gallium negative?
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Kaposis
Kaposi Sarcoma is thallium avid, gallium neg Infection are thallium neg, gallium avid Lymphoma is thallium and gallium avid |
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In osteochondritis dessicans, what determines the stability of the OCD fragment?
Extent of subchondral fx Depth of subchondral fx Integrity of the articular cartilage Time of onset to time of diagnosis |
Extent of subchondral FX
a large lesion >1 cm, Cyst-like lesion beneath the osteochondric lesion, or loose granulation tissue are signs of Unstable Lesion |
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On US of the liver, which structure is responsible for making the caudate lobe appear hypoechoic on routine examination?
Ligamentum teres Intrahepatic fissure Ligamentum venosum |
Ligamentum venosum
The fissure for the ligamentum venosum, containing the remnant of the ductus venosus, is a hyperechoic linear or band like structure separating the cuadate lobe from the lateral left lobe of the liver. |
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Which of the following is true concerning a new MRI sequence evaluating sensitivity and specificity for detecting liver cancer?
Determines accuracy Determines precision Determines positive predictive value Determines negative predictive value |
Determines accuracy
accuracy - sens + spec precision - ppv |
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Which of the following is an expected complication of neonatal septic hip?
Absent femoral head Widened femoral physis Sclerosis of the femoral head and neck Coxa magna |
Absent femoral head
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Treatment of symptomatic neonate with diffuse liver hemangioendotheloma?
A. Chemoembolization B. Embolization with particles C. Hepatic artery coil embolization D. Alcohol E. Gelfoam |
Hepatic artery coil embolization
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The pulmonary changes with fat emboli are due to?
A. Permeability of pulmonary arteries B. Hydrostatic pressure C. Pulmonary infarct |
Permeability of pulmonary arteries
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Status post liver transplant with new biliary dilatation. Need to evaluate:
a. Hepatic artery patency b. Portal vein patency c. Cholangiocarcinoma d. Hepatic vein patency |
Hepatic artery patency
Hepatic artery supplies biliary ducts |
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Most common tumor with aneurysmal dilatation of the small bowel:
a. Melanoma met b. Adenocarcinoma c. Non-Hodgkin's lymphoma d. Hodgkin's lymphoma e. Carcinoid |
Non-Hodgkin’s lymphoma
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Most useful for differentiating between recurrent brain tumor and radiation necrosis (FDG PET not an option):
A. N-13 PET (NH3 PET) B. Tl-201 SPECT C. Tc-99m ECD D. Tc-99m HMPAO E. Contrast-enhanced CT |
Thallium-201 SPECT
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Which is TRUE regarding enlarged vestibular aqueduct system?
a. Occurs in females more than males b. Uncommonly associated with cochlear dysplasia c. Larger size of aqueduct correlates with severity d. Infants born with deafness e. Usually bilateral f. congenital versus acquired |
Usually bilateral (disease is congenital but hearing loss is acquired)
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Elderly patient with back pain and posterolateral extradural mass with increased T2 signal and thin peripheral rim enhancement. Likely diagnosis?
a) Extruded, sequestered herniated disc fragment b) Tarlov cyst c) Arachnoid cyst d) Synovial cyst e) Schwannoma f) Epidermoid |
Synovial cyst
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Which has highest chance of malignant transformation?
a. Multiple hereditary exostoses b. Enchondromatosis c. Melorrheostosis d. Polyostotic fibrous dysplasia e. Cortical desmoids |
Enchondromatosis
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Most characteristic feature of NOF (non-ossifying fibroma):
a. thin sclerotic rim b. wide zone of transition c. laminated periosteal reaction d. epiphyseal location e. permeative pattern |
Thin sclerotic rim
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What results in bright T1 signal in the basal ganglia and thalami of a child?
a. Leigh’s disease b. Hypoxia c. Basilar artery occlusion d. Calcifications |
Hypoxia
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In which space is a glomus vagale tumor located?
a. Masticator b. Parapharyngeal c. Carotid d. Prevertebral |
Carotid
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In utero infection with which of the following will least likely demonstrate periventricular calcifications?
a. Toxoplasmosis b. Herpes simplex Type II c. Rubella d. HIV e. Cytomegalovirus |
HIV
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Which is most characteristic of Brodie’s abscess?
a. Lamellated periosteal reaction b. Fading rim of sclerosis c. Central enhancement on MRI |
Lamellated periosteal reaction
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A woman with biopsy-proven breast carcinoma undergoes excision and treatment. Follow-up mammogram demonstrates irregular mass-like opacity within the region of resection. What is the appropriate BIRADS classification? (repeat)
a. 0 b. 1 c. 2 d. 3 e. 4 f. 5 g. 6 |
BIRADS 3
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Which of the following stones would appear least dense on CT?
a. Cysteine b. Uric acid c. Oxalate d. Matrix |
Matrix (or Indinavir)
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Which is true regarding HCC?
a. Increased AFP is seen with fibrolamellar type b. HCC more commonly invades the hepatic veins than cholangiocarcinoma |
HCC more commonly invades the hepatic veins than cholangiocarcinoma
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Which results in the nephrographic phase?
a. Glomerular filtration and tubular secretion of water b. Glomerular filtration and tubular resorption of water c. Tubular secretion |
Glomerular filtration and tubular resorption of water
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Which is true of L-TGA? (repeat)
a. Atrioventricular discordance and arterioventricular discordance b. Atrioventricular discordance and arterioventricular concordance c. Atrioventricular concordance and arterioventricular discordance d. Atrioventricular concordance and arterioventricular concordance |
atrioventricular discordance (ventricular inversion) with ventriculoarterial discordance
(D –TGA – AV concordance and VA discordance – need PFO, ASD and prostaglandins) |
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Which is not a cause of unilateral rib notching? (repeat)
a. Brachial artery stenosis b. AVM c. Blalock-Taussig shunt d. Aberrant left subclavian with distal aortic stenosis |
Brachial artery stenosis
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Brain MRI of a patient with HIV demonstrates nonenhancing cystic foci within the basal ganglia. What is most likely?
a. Toxoplasmosis b. Cryptococcus c. Lymphoma D CMV |
CMV
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What is correct for MR spectroscopy of the brain?
a. NAA is present in neurons and axons b. Cho peak is stable in most pathologic lesions c. Cr is a marker of cell membrane turnover d. Cho is the most obvious peak for normal brain MRS |
a. NAA is present in neurons and axons
Creatine provides a measure of energy stores. Choline is a measure of increased cellular turnover and is elevated in tumors and inflammatory |
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Which transducer is best to image the patellar tendon?
a. 10 MHz linear b. 10 MHz curved c. 10 MHz phased array d. 5 MHz linear e. 5 MHz curved |
10 MHz linear
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What is not routinely imaged on 2nd trimester sonogram?
a. Cerebellum b. Lateral ventricles c. Kidneys d. Umbilical insertion e. Lips/nose |
Lips/nose
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Which of the following is an expected complication of neonatal septic hip?
A. Absent femoral head B. Widened femoral physis C. Sclerosis of the femoral head and neck D. Coxa magna |
Absent femoral head
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Which of the following MOST often metastasizes to the heart?
a) melanoma b) lymphoma c) breast d) lung (bronchogenic carcinoma) e) RCC |
Bronchogenic carcinoma (Lung)
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Membranous croup is caused by:
a. Staphyloccocus aureus b. Haemophilus flu c. Parainfluenza d. Streptococcus e. Ecoli |
Staphyloccocus aureus
Membranous croup (exudative tracheitis) is caused by a bacterial infection, most commonly Staphylococcus. Viral croup, AKA croup or laryngeotracheobronchitis, is caused by a virus, commonly parainfluenza. |
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Physiologic herniation of bowel occurs at what maternal age?
a. 6-8 wks b. 8-12 wks c. 12-16 wks d. 16-20 wks e. 20-24 wks |
8-12 weeks
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What rotator cuff tendon attaches to the lesser tuberosity
a. Subscapularis b. Supraspinatus c. Teres Minor d. Infraspinatus |
Subscap
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Ulnar collateral ligament of the thumb tears. Pt goes for operative repair. MRI showed ligament fragment was located:
a. under the adductor pollicus b. under the abductor pollicus c. under the flexor pollicus longus d. under the extensor pollicus tendon e. deep or superficial to the adductor pollicus aponeurosis |
E.
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Vascular supply for the AV node is from:
A the conus branch of the RCA B the proximal right coronary artery C the posterior descending artery D distal branch of right coronary artery E branch of the LCX artery |
Distal branch of RCA
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What does NOT cause clockwise rotation of the interventricular septum?
a. Mitral stenosis b. Pulmonary artery hypertension c. Pulmonary stenosis d. Tricuspid stenosis e. Aortic stenosis |
Tricuspid stenosis does not cause RVH.
Clockwise rotation of the septum results from right-sided hypertrophy or small left sidedness. PAH leads to RVH and rotation of the septum away (clockwise). |
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Which of the following is NOT a cause of diffuse uptake of technetium-99m MDP in the bones with no appreciable uptake in the kidneys?
a. hypoparathyroidism b. aggressive osteoporosis c. diffuse osteoblastic bony metastases d. hyperthyroidism e. chronic renal disease |
Hypoparathyroidism (NOT a cause)
Superscan can be seen in all of the following: A. Metabolic 1. Renal osteodystrophy 2. Osteomalacia 3. Hyperparathyroidism 4. Hyperthyroidism |
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Which radiopharmaceutical is most sensitive for demonstrating myocardial viability?
a. FDG PET b. 201Tl c. 99m Tc Sestamibi d. Stress echocardiography |
FDG-PET
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22 year-old male with short stature and cervical spine fusions. Most likely:
a. Juvenile RA b. Spondyloepiphysealis dysplasia c. Turner’s syndrome d. Achondroplasia |
Juvenile RA
Juvenile RA: posterior elements fuse, with short stature. Spondyloepiphyseal dysplasia: dwarves with dysplasia of the spine; thoracolumbar scoliosis, kyphosis, and kyphoscoliosis, are common in these patients, but no fusion. |
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Which is FALSE regarding MUGA scans?
A. the operator hand selects each ROI B. a second derivative edge detection method is used C. arrhythmias lead to distortion in mid 1/3 of cardiac cycle D. widened RR indicates slow sinus rhythm |
Widened RR indicates slow sinus rhythm (FALSE)
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All are associated with SCFE EXCEPT:
a. Obesity b. Hypothyroidism c. Growth hormone d. Spondyloepiphysealis dysplasia e. Renal osteodystrophy |
Spondyloepiphysealis dysplasia (NOT associated)
SCFE is associated with hypothyroidism, panhypopituitaryism, gonadal conditions, renal osteodystrophy, and during growth hormone therapy. |
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Case control study can be assessed with all of the following EXCEPT:
a. Relative risk b. Odds risk/odds ratio c. Confidence interval d. P value |
Relative risk
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Which is NOT a sign of rotator cuff tear on ultrasound? (two answers)
A. Focal nonvisualization of rotator cuff B. Complete nonvisualization of rotator cuff C. A cartilage interface sign D. Convex contour of subacromial/ subdeltoid bursa with transducer compression E. Mixed echogenicity of the rotator cuff F. Subacromial/subdeltoid bursal fluid G. Supraspinatus tendinopathy |
Convex contour of subacromial/ subdeltoid bursa with transducer compression (Not a sign)
Supraspinatus tendinopathy (NOT associated) |
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Cholecystokinin in a HIDA scan does all the following EXCEPT:
a. increase bile flow b. increases sensitivity for chronic cholecystitis c. it shortens time for diagnosis of acute cholecystitis d. increases sensitivity for acute cholecystitis in hyperalimentation |
Shortens time for diagnosis of acute cholecystitis (FALSE)
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Prevalence increases from 5 to 25% Which of the following will NOT change:
a. Pretest probability b. Posttest probability c. Likelihood ratio positive d. PPV |
Likelihood ratio (positive)
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In type A aortic dissection, MR is more useful than angiography for which of the following? (Multiple T/F)
1. Evaluation of false lumen thrombus 2. Pericardial tamponade 3. Relation of dissection to coronary arteries 4. Point of origin of dissection 5. Aortic insufficiency |
1. True. Evaluation of false lumen thrombus – MR can better demonstrate this. Further, a completely thrombosed false lumen (10%) can give a false-negative on angiography.
2. True. Pericardial tamponade – Neither MR nor angio is great, but MR is better because of fluid on T2. 3. False. Relation of dissection to the coronary arteries – Angiography would better demonstrate this relationship. MRI is limited with small vessels. 4. False. Angiography is superior to any other technique in demonstrating entry and reentry points. 5. False. Aortic insufficiency - Even with the cine capability of MR, angiography is still better with real time contrast injection. |
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LEAST likely to have persistent increased uptake on MAG3 renal scan:
A Pyelonephritis B ATN C Obstruction D Renal artery stenosis E Renal vein thrombosis |
Pyelonephritis (LEAST likely)
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All of the following are true regarding MR artifacts EXCEPT:
A. Aliasing is due to something out of FOV B. Chemical shift artifact occurs in the frequency encoding direction C. Pulsation occurs in frequency encode direction D. Chemical shift is more prominent in higher magnetic field E. Chemical shift occurs between fat and water interfaces |
Pulsation occurs in frequency encoding direction (FALSE)
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TRUE regarding upper GI bleeding:
A. 60% of bleeds represent upper GI bleeds B. Angiography can demonstrate bleeds of 0.1cc per minute C. 25% of bleeds are small bowel origin D. Vasopressin is extremely useful in controlling peptic ulcer bleeds E. Intra arterial vasopressin may be used to successfully treat esophageal varices |
60% of bleeds represent upper GI sources
About 25% of the LOWER GI bleed is of small bowel origin. |
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Patient with large breasts has a mammogram with (spot) compression to 8 cm which demonstrates motion unsharpness (blurring). LEAST likely to improve motion unsharpness?
a. Increase mAs b. Increase kVp c. Increase compression (larger paddle) d. Switch from a molybdenum to Rhobidium target e. Change focal spot |
Increase mAs (LEAST likely)
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Which of the following requires a PDA to survive?
a) Hypoplastic left heart syndrome (HLHS) b) Corrected transposition c) Tetralogy of Fallot d) Coarctation e) TAPVR f) Truncus |
HPLHS
a) Shone syndrome = Aortic atresia. See small LV, small LA, small ascd AO. Hemodynamics: RV supplies PA, ductus arteriosis, descending aorta, and ascending aorta/arch via retrograde flow. B) Corrected transposition aka L-trans. C) TOF – PDA masks the neonates’ symptoms, when PDA closes – cyanosis at 3 to 4 months. D) Coarctation – Adult and pedi type exist. Pedi – PDA prevents CHF but not necessary for survival. E) TAPVR – Anamolous connection b/n pulm vessels & systemic veins. Patent foramen ovale necessary for survival. ASD restores oxygenated blood to left side. F) Truncus – Left and right heart already connected at their origin (single outlet of heart). |
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What is most characteristic of three phase bone scanning of shin splints:
A. hot on all three phases B. increased flow with decreased activity on blood pool and delayed images C. no increased flow or blood pool activity but hot on delayed images D. cold on all images E. bone scanning plays no role in its evaluation |
No increased flow or blood pool activity but hot on delayed images
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Regarding percutaneous ultrasound guided liver biopsy, which of the following statements is false:
A. Patients taking daily aspirin can undergo the procedure safely B. Heparin should be stopped 4 – 6 hours prior to the procedure C. PT, PTT and platelet levels should be checked prior to the procedure D. FFP and platelets may need to be given to correct coagulopathy for the procedure |
B - Heparin should be stopped 4-6 hours prior (and A)
Day -7: Stop Aspirin, Obtain INR • Day -5: Stop Warfarin, Check INR • Day -3: Start Low Molecular Weight Heparin q12-24 hours • Day -1: • Stop LMWH 12-24 hours before procedure • Administer Vitamin K 1 mg PO if INR >1.5 |
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What causes increased resistance (RI) in distal CCA:
a. Ipsilateral ICA occlusion b. Ipsilateral ECA occlusion c. subclavian steal d. stenosis of ipsilateral proximal CCA e. intracranial AVM |
Ipsilateral ICA occlusion
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5 year old has a large chest wall mass (with permeative destruction of a single rib). Which is the most likely diagnosis?
A. Metastatic neuroblastoma B. Osteosarcoma C. Eosinophilic granuloma D. Primitive neuroectodermal tumor -PNET E. Leukemia F. Ewing sarcoma G. Neuroblastoma |
Ewing's
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Young man fractured clavicle week ago, now presents with posterior shoulder pain. Which nerve is likely injured?
a) Musculocutaneous b) Axillary nerve c) Ulnar nerve d) Median nerve |
Ulnar
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NOT associated with atlantoaxial dislocation
a. JRA b. Hypothyroidism c. Trauma d. Spondyloepiphyseal dysplasia e. Down’s syndrome |
Hypothyroidism
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