Veterinary Radiology (3Rd Year) - Spring 2011 - Set #2

Front 1

If you see whispy looking radioopacity in the retroperitoneal space, what are 3 possibilities of what it could be?

Back 1

(1) Rodenticide poisoning
(2) Fat replaced with soft tissue
(3) Urine leaking into the retroperitoneal space (urethral rupture)

Front 2

What are the circular mineral looking opacities ventral to L4-L5 in the retroperitoneal space?

Back 2

Circumflex arteries

Front 3

What are two common fluid types seen in the retroperitoneal space?

Back 3

Urine
Blood

Front 4

What are 4 causes of loss of detail in the retroperitoneal space?

Back 4

(1) Young animal with minimal body fat
(2) Emaciated animal
(3) Free fluid in the space
(4) Mass in the space

Front 5

Where is the right kidney located on the dog (between what vertebrae)? Cat?

Back 5

T13-L1 DOG
L1-L4 CAT

Front 6

Where is the left kidney located on the dog (between what vertebrae)?

Back 6

L2-L4 DOG
L2-L5 CAT

Front 7

How big should a dog's kidney be on a VD view (the only view used to measure kidneys)?

Back 7

2.5-3.5 times the length of L2

Front 8

How big should a cat's kidney be on a VD view (the only view used to measure kidneys)?

Back 8

2.4-3.0 times the length of L2

Front 9

T/F It is perfectly safe to do an intravenous pylogram on a patient with renal disease.

Back 9

False. Can't do one on a renal patient (material can't be excreted properly).

Front 10

What is a suitable alternative to an intravenous pylogram for a patient with renal disease?

Back 10

Nuclear Scintigraphy

Front 11

Is it better to use ionic or non-ionic contrast when performing an intravenous pylogram? What are the side effects (of the one you shouldn't use)?

Back 11

Non-ionic - very few side effects, costs the same as ionic.

Side effects: seizures, meningitis, death if it gets into the CNS/brain when used with myelograms

Front 12

At what times (after contrast is give IV) should you take films for an intravenous pylogram?

Back 12

5, 10, 20, and 40 minutes
Both lateral and VD views

Front 13

In which species (cat or dog) are kidneys easier to ID?

Back 13

Kidneys are easier to ID in the cat

Front 14

For the following time frames, fill in what type of "-gram" you would likely see when performing a Intravenous pylogram:

-Immediately
-Within 20 seconds
-3-5 minutes post injection
-Contrast cleared into lower urinary tract

Back 14

-Immediately: arteriogram
-Within 20 seconds: nephrogram
-3-5 minutes post injection: pyelogram
-Contrast cleared into lower urinary tract: cystogram

Front 15

What is the most common complication of an intravenous pylogram?

Back 15

Vomiting - the more quickly you give the contrast, the quicker they vomit

Can also get hives or bronchoconstriction. Good to have some epi around.

Front 16

How big should the following structures be on a intravenous pyelogram:

-Renal pelvis
-Recesses
-Proximal ureters

Back 16

-Renal pelvis: <2mm wide
-Recesses: <1mm wide
-Proximal ureters: <2.5mm

Front 17

What should you look for if you suspect contrast induced renal failure? What should you do if you see this?

Back 17

Opacification of kidneys that persists or becomes more intense over time. May see contrast in the gall bladder, liver, or GI as these are alternative routes of excretion.

Should put patient on IV fluids right away.

Front 18

What are 4 DDX for small irregularly shaped kidneys?

Back 18

(1) End-stage kidney
(2) Infarcts
(3) Chronic pyelonephritis
(4) Chronic nephritis

Front 19

What are 8 DDX for large regularly shaped kidneys?

Back 19

-Acute pyelonephritis/nephritis
-Hydronephrosis
-Lymphoma
-Large parenchymal cyst or perirenal pseudocyst
-FIP
-Amyloidosis
-Compensatory hypertrophy

Front 20

What two breeds of cats get polycystic renal disease?

What other organs may also have cysts on them with this disease?

Back 20

Persians and Himalayans

Liver and pancreas

Front 21

T/F Perirenal pseudocysts are outside the renal parenchyma and may be within the capsule or outside the capsule.

Back 21

True. More common in older male cats.

Front 22

Which specific renal neoplasm do dogs get typically? Cats?

Back 22

Dogs - Renal adenocarcinoma
Cats - Lymphosarcoma, can occur in dogs also. Generally bilateral.

Front 23

What is the number one tumor seen in the bladder?

Back 23

Transitional cell carcinoma

Front 24

T/F Ureters are normally not seen on survey films.

Back 24

True.

Front 25

T/F Hydroureter is best documented with contrast-IVP.

Back 25

True.

Front 26

What are two causes of hydroureter?

Back 26

Bladder trigone mass
Ectopic ureters

Front 27

T/F The deep circumflex arteries will look like small calculi (urethral calculi).

Back 27

True.

Front 28

What special view can be done to see ectopic ureters when doing an EU vaginocystourethrogram?

Back 28

Oblique views

Front 29

If a Lab puppy is brought in that has been "piddlin since he was brand new," what DDX would be at the top of your list?

Back 29

Ectopic ureter

Front 30

What are 5 indications for radiography of the bladder?

Back 30

-Dysuria
-Hematuria
-Pyuria
-Stranguria
-Incontinence

Front 31

What are the 3 divisions of the urethra in the male?

Back 31

-Prostatic
-Membranous
-Penile

Front 32

T/F The urethra tunnels through the os penis.

Back 32

True.

Front 33

T/F Cat bladders are always seen in the abdomen (vs the pelvic canal).

Back 33

True.

Front 34

Which two urolith types are invisible on radiographs?

Back 34

Cysteine and urate are invisible
“I can’t C U”

Front 35

What two places do urethral obstructions commonly occur?

Back 35

Ischium
Base of os penis

Front 36

What radiographic view would you need to do in order to see urethral obstruction at the ischium or base of the os penis?

Back 36

Butt shot

Front 37

T/F Cats usually get sandy stuff that can form plugs instead of big stones in the bladder.

Back 37

True.

Front 38

T/F Smaller bladder stones are less of a concern than big ones.

Back 38

False. Small ones are more of a concern.

Front 39

Where did Dr. Pack have a delicious steak in Las Vegas?

Back 39

Craftsteak

Front 40

Why did Dr. Pack like the MGM Grand hotel so much when she was in Las Vegas?

Back 40

Because it lit up green

Front 41

What are 3 indications for cystography?

Back 41

-Lower urinary signs
-Suspect bladder/urethral rupture/laceration**
-Caudal abdominal mass(es)

Front 42

When performing a cystogram, which side should you put the patient on to avoid air embolism?

Back 42

Left lateral, use CO2

Front 43

T/F Filling defects on a cystogram can include: mucosal filling defects (like tumors), clots, uroliths, and bubbles.

Back 43

True.

Front 44

What radiographic changes (when performing a cystogram) can you see with cystitis?

Back 44

-Thick bladder wall (esp. cranioventral)
-Irregular mucosal margin

Front 45

What are 4 complications of doing a cystogram?

Back 45

-Bladder rupture
-Catheter knot
-Bladder/urethral trauma
-Air embolism

Front 46

T/F When doing a pneumo and double contrast cystogram, the patient should always be left lateral recumbency.

Back 46

True. To avoid air embolism.

Front 47

What results might you see on an abdominal radiograph of a ruptured bladder?

Back 47

-Ascites and absent/obscured bladder
-Positive cystogram

Front 48

T/F Urethrography is required to see a urethral rupture.

Back 48

True.

Front 49

T/F Normal adrenal glands are typically seen on routine radiographs.

Back 49

False. Not seen.

Front 50

Where are adrenal glands located in relation to the kidneys?

Back 50

Cranial and medial to the kidney.

Front 51

T/F Opacity in the adrenal glands can occur with both benign and neoplastic processes.

Back 51

True. Mineralization can be a normal variant.

Front 52

What three views are usually done for the stifle joint in the horse?

Back 52

CdCr
Lateromedial
Caudolateral-to-craniomedial

Front 53

R or L markers are ALWAYS placed ________, or in the case of the lateral view, _________ in equine radiology.

Back 53

R or L markers are ALWAYS placed LATERALLY, or in the case of the lateral view, DORSALLY.

Front 54

What are the 7 common equine musculoskeletal diseases listed in our notes?

Back 54

-Fractures (chip, slab, stress, regular types)
-Infection (abscess, osteomyelitis, septic arthritis)
-Degenerative Joint Disease (osteophytes, entheseophytes)
-Osteochondrosis (joint mice, cyst-like lucencies)
-Laminitis
-Navicular disease
-Angular limb deformities

Front 55

T/F Rads may be normal in a lame horse.

Back 55

True*** Radiographs don't always correlate with disease and vice versa.

Front 56

What are the two standard view used for the distal phalanx of the horse (pedal or coffin bone, P3)?

Back 56

Lateral
45 degree DP

Front 57

What is the structure that Dr. Pack liked to point out in the distal phalanx of the horse using a 45 degree DP view?

Back 57

Crena

Front 58

Lateral and medial obliques of the distal phalanx are good for visualizing what condition in P3 of the horse?

Back 58

Fractures of P3, especially the sides

Front 59

What are two specific conditions that are seen best with a horizontal DP view in the horse?

Back 59

Poor trimming jobs
Ulcers

Front 60

What two radiographic features are seen in a 45 degree DP view of a horses's distal phalanx?

Back 60

-Irregular solar margin of P3 due to resorption
-Enlarged vascular channels

Front 61

T/F There is usually no periosteal reaction in infectious or septic osteitis in the distal phalanx of the horse.

Back 61

True.

Front 62

What are the two progressive changes seen with laminitis in the horse?

Back 62

Sinking of P3 relative to the hoof
Rotation of P3

Front 63

T/F Gas between sensitive (dermal) and insensitive (epidermal) laminae may be seen with rotation of P3 (relative to the hoof wall).

Back 63

True.

Front 64

“Ski-tipped” remodeling to dorsodistal P3 in the horse indicates (ACUTE/CHRONIC) changes.

Back 64

CHRONIC changes

Front 65

Match the equine P3 fracture type with the description of the fracture:

(1) Type I
(2) Type II
(3) Type III
(4) Type IV
(5) Type V
(6) Type VI

(A) Comminuted fx
(B) Solar margin only
(C) Articular fxs from DIJ to solar margin
(D) Non-articular of Palmar process
(E) Articular midsagittal fx
(F) Extensor Process fx

Back 65

(1) D
(2) C
(3) E
(4) F
(5) A
(6) B

Front 66

Mineralization of the collateral cartilages (side bone) are seen in what kind of horses?

Back 66

Draft horses

Front 67

What is a keratoma?

Back 67

Mass in the hoof wall that causes pressure necrosis. Lysis in P3 is seen.

Front 68

You see a subchondral bone cyst (or could be OCD) on one side of a horse's tarsus. What should you do next?

Back 68

Radiograph the other tarsus!

Front 69

T/F Mineralization of the collateral cartilages (side bones) are a common cause of lameness in the horse.

Back 69

False. Are not routinely the cause of lameness.

Front 70

What are the 4 surfaces of the navicular bone (of the horse) seen on a lateral radiograph?

Back 70

Clockwise starting at 12:
-Proximal surface
-Flexor surface
-Distal border
-Articular surface

Front 71

When taking a skyline view, where is the x-ray beam angled?

Back 71

Along the back of distal pastern

Front 72

How many synovial fossa are too many in the navicular bone?

Back 72

5 or if they look like grains of rice

Front 73

What is the prognosis for navicular bone fractures?

Back 73

Usually poor

Front 74

Which joint is involved with low ringbone in the horse?

Back 74

Distal interphalangeal joint (coffin joint)

Front 75

Which joint is involved with high ringbone in the horse?

Back 75

Proximal interphalangeal joint (pastern joint)

Front 76

What surfaces are seen on a DLPMO view?

Back 76

Lateral and palmar surfaces

Front 77

What surfaces are seen on a DMPLO?

Back 77

Medial and palmar surfaces.

Front 78

Which proximal sesamoid bone in the horse has a rounder top on it?

Back 78

Medial proximal sesamoid bone, the lateral proximal sesamoid bone is more pointed at the apical margin.

Front 79

What are 5 radiographic features of degenerative joint disease in the horse?

Back 79

-Osteophytes
-Entheseophytes
-Subchondral sclerosis
-Joint space narrowing
-Soft tissue swelling

Front 80

Where is osteochondrosis seen in the fetlock joint?

Back 80

Dorsoproximal 1/3 of the saggital ridge. May see flattening, +/- fragments. Best seen on a flexed lateral view.

Front 81

What is the underlying cause of physitis of the distal MC III physis in foals?

Back 81

Rapid growth, people feeding too much grain to make them huge.

Front 82

What are the 5 possible proximal sesamoid fractures in the horse?

Back 82

Apical
Midbody
Basilar
Abaxial
Sagittal

Front 83

What are "Bucked shins?"

Back 83

Microfractures of middle/distal third dorsal MC III cortex as a result of cyclic loading of MC III.

Front 84

What are "splints" in the horse?

Back 84

Damage to the interosseous ligament.
-Between MC II and III in front, between MC IV and III in rear
-Proximal third of bones affected

Front 85

T/F MC (MT) III is very prone to sequestration.

Back 85

True.