Clinical Medicine 216 - Imaging (final)

Helpfulness: 0
Set Details Share
created 3 years ago by Dizzy
22 views
show moreless
Page to share:
Embed this setcancel
COPY
code changes based on your size selection
Size:
X
Show:
1

_________ uses X-ray examination of the breasts for detection of tumours.

Mammography

2

Mammography takes around _________ minutes.

30 to 45

3

Powder, lotion, perfume, or deodorant can produce _________ on the mammogram.

Shadows

4

_________ is typically used for further evaluation of masses found on mammography or palpable masses not seen on mammograms.

Ultrasound

5

_________ is useful to evaluate questionable findings and for pre-surgical evaluation in patients with known breast cancer to detect additional lesions that might change the surgical approach. For example, breast-conserving lumpectomy to mastectomy.

MRI

6

Screening mammography is not routinely recommended for women under age ________ , it may have a role for selected individuals in the high risk category.

40

7

Where there is a family history of a first degree relative with pre-menopausal breast cancer, referral for mammography may be advised at an age _________ years younger than the age of the relative’s diagnosis.

5 to 10

8

_________ are involved in the performance, supervision, and interpretation of mammography.

Radiologists

9

Under the supervision of the radiologist, the __________ will have the responsibility for image acquisition and day to day quality control.

Medical radiation technologist

10

_________ takes the responsibility for the initial testing, and for conducting and overseeing quality control testing of the mammographic unit such as collimation assessment, focal spot size, resolution measurements, and beam quality assessment.

Medical physicist

11

_________ responsibilities include ensuring confidentiality, understanding policies and the requirements for an information systems quality assurance program.

Information systems specialist

12

Elective mammography should not be performed during _________ because of increased sensitivity to radiation damage in the proliferating breast.

Pregnancy or lactation

13

_________ is not recommended for use in pregnancy, therefore, enhanced MRI should not be performed in pregnancy unless assessment with MRI is critical to acute patient care and cannot be avoided.

Gadolinium contrast

14

MRI can be performed for suspected malignancy during _________ .

Lactation

15

It is not necessary to suspend ________ after iodinated contrast or gadolinium administration.

Breastfeeding

16

Females under the age of __________ with a palpable abnormality or significant symptoms should undergo targeted ultrasound. Thereafter, mammography should be performed if there is suspicion of malignancy.

30

17

Mammography has high sensitivity in this type of breast:

Fatty breast

18

The sensitivity of mammography in this type of breast is limited:

Extremely dense breast

19

Radiologists look for ________ ?

Skin thickening, micro-calcifications, and dominant masses

20

Always ________ suspicious calcifications.

Biopsy

21

_________ of all malignant tumours are discovered by mammography because of the presence of suspicious calcifications.

50%

22

Short-term follow-up of less than ________ months is almost never useful.

6

23

For women with very dense breasts, some breast tumors may be difficult to detect with mammography, with ________ percent being false negative .

10

24

An estimated _________ percent of cancers are missed by mammography.

10 to 30

25

Treatment options for _________ include mastectomy, lumpectomy with breast irradiation, or, for patients with small lesions (<1-2 cm) of low-grade DCIS, lumpectomy alone.

Ductal carcinoma in situ (DCIS)

26

_________ is a new kind of test. It takes multiple x-rays in an ark of each breast from many angles. It uses less pressure, and takes 11 images in 7-seconds. (aka. 3D mammography)

Digital tomosynthesis

27

Digital tomosynthesis ________ .

Improves dense breast imaging

28

The radiation dose for digital tomosynthesis is ________ than that of a single conventional mammography image.

Slightly higher

29

Ultrasonography (US) in breast imaging is used to differentiate _________ lesions. Also US cannot detect most small calcifications.

Solid from cystic

30

Abscess and hematoma may mimic a ________ .

Solid mass

31

Ultrasonography (US) of a markedly hypoechoic (appears dark) mass of the breast is suggestive of ________ .

Breast carcinoma

32

MRI in breast imaging is _________ sensitive to small abnormalities. It is used to image implants and ruptures, and it is also effective for dense breast imaging.

Highly

33

An MRI takes around ________ minutes, and requires the use of injected contrast, and often cannot distinguish between cancerous and noncancerous tumours.

30 to 60

34

_________ is offered as a for-profit service, using a heat-sensitive infrared camera to take images of the body and detect blood flow pattern, and some breast thermography clinics claim the service they provide can detect breast cancer.

Thermography

35

The gold standard for diagnosis of endometriosis is direct visualization by ________ and histologic study.

Laparoscopy

36

Ultrasonography is the ________ investigational tool for suspected endometriosis. It allows detection of ovarian cysts and other pelvic disorders such as uterine fibroids.

First-line

37

Ultrasound is predominantly used to evaluate the ovaries and to assess the pelvis in the workup for _________.

Pelvic pain or infertility

38

Ultrasound is most commonly used imaging of the uterus, and either ________ .

Transvaginal or transabdominal

39

MRI has a greater specificity for the diagnosis of ________ than the other non-invasive imaging techniques.

Endometrioma

40

What is the condition in which the endometrium breaks through the myometrium? It may present with menorrhagia and dysmenorrhoea. Ultrasound and MRI are imaging modalities that may show characteristic findings.

Adenomyosis

41

________ is usually the first and often the only imaging modality employed to investigate menorrhagia and dysmenorrhoea.

Pelvic ultrasound

42

A type of x-ray taken of a woman's reproductive tract after a dye is injected, and is part of a basic fertility evaluation. May result in a 'fill and spill' phenomenon.

Hysterosalpingography (HSG)

43

Hysterosalpingography (HSG) is usually performed under ________ and takes about 15-20 minutes.

Fluoroscopy

44

What are the contraindications to a Hysterosalpingogram?

The presence of an infection of the genital tract; recent or active bleeding; suspected intrauterine pregnancy; and allergy to iodinated contrast material.

45

CT is unable to diagnose adenomyosis, but may suggest its presence when uterine ________ is present.

Enlargement

46

_________ is the modality of choice to diagnose and characterize adenomyosis.

Pelvic MRI

47

_________ are caused by endometriosis, pelvic inflammatory disease, neoplasms, and surgical trauma.

Pelvic adhesions

48

Ultrasound often only demonstrates ________ in the peritoneal cavity or non-specific thickening and increased vascularity of the endometrium.

Ascitic fluid

49

________ usually arises as a complication of Chlamydia or Gonorrhoeae infection that rises from the vagina or cervix to the fallopian tubes.

Tubo-ovarian abscess (TOA)

50

A corpus luteum may seal and fill with fluid or blood, forming a corpus luteum cyst. The characteristic circular Doppler appearance is called the _________ ?

Ring of fire

51

When a Graafian follicle or follicular cyst bleeds, a ________ is formed.

Complex hemorrhagic ovarian cyst (HOC)

52

The Poly-Cystic Ovary Syndrome (PCOS) is also known as Stein-Leventhal syndrome, with 10 or more peripheral simple cysts usually characteristic __________ appearance.

String-of-pearls

53

Residual ovary syndrome or ovarian remnant syndrome is a condition that occurs when ovarian tissue is left behind following _________ , causing development of a pelvic mass, pelvic pain, and occasionally dyspareunia.

Oophorectomy

54

__________ is a condition that results from retrograde flow through incompetent valves in ovarian veins. The diagnosis is established by the demonstration of multiple dilated, tortuous parauterine veins.

Pelvic congestion syndrome

55

What is the most common benign neoplasm of the uterus arising from smooth muscle, often with no symptoms? Ultrasound is the usual diagnostic tool.

Uterine Fibroids

56

Fibroids on x-ray are only visualized if ________. X-ray is NOT the modality to use to diagnose fibroids.

Calcified

57

Ultrasonography has been used to image the developing fetus for decades without any concrete evidence of ________ . Because MRI is so new, a thorough investigation of its biologic effects on the developing fetus has not been done.

Harmful effects

58

The most common cause of ________ is urinary tract infection.

Dysuria

59

The most common cause of recurring urinary tract infection in men is chronic _________ .

Bacterial prostatitis

60

Imaging of the _________ uses CT urography: for evaluation of structural abnormalities and possible abscess formation; MRI could be considered if the patient has an allergy to contrast.

Lower urinary tract

61

Imaging of the _________ uses CT abdomen with contrast (or without); and MRI abdomen: for patients with contrast allergies and pregnant patients.

Upper urinary tract

62

CT is the most sensitive modality for diagnosis and assessment of _________ complications, but it does have a significant radiation exposure and should be used sparingly, especially in young patients.

Acute pyelonephritis

63

Pyelonephritis and renal abscess can mimic ________ .

Tumours

64

In acute pyelonephritis, _________ shows areas of decreased uptake in the upper and lower poles of the right kidney, consistent with pyelonephritis.

Nuclear scintigraphy

65

________ is a type of infection of the bladder wall by gas-forming bacteria or fungi. The most frequent offending organism is E. coli, X-ray and CT usually is diagnostic with gas in the bladder wall.

Emphysematous cystitis

66

________ reveals a segment of irregular, beaded narrowing in the distal bulbous urethra in Gonococcal urethral stricture.

Retrograde urethrogram

67

Contrast-enhanced CT is the best imaging tool if abscess suspected and will demonstrate a diffusely enlarged, edematous gland in _________ .

Prostatitis

68

Infection of the testicle and epididymis is called _________. Ultrasound is the gold standard of diagnosis, and it classically appears as hypoechoic enlargement of the testicle and epididymis with increased flow on doppler colour imaging.

Epididymo-orchitis

69

Benign prostatic hyperplasia is the most common cause of urinary complaints in men, and ultrasound remains the _________ for diagnosis and staging.

Gold standard

70

Dysuria may be the earliest symptom of the irritative changes caused by _________ of the bladder.

Carcinoma in situ

71

For renal cell cancer, ________ is frequently used to both diagnose and stage renal cell carcinomas.

CT

72

__________ is the most common primary neoplasm of the urinary bladder, and also the entire urinary system. MRI is superior to other modalities in locally staging the tumour.

Transitional cell carcinoma (TCC)

73

A ________ is an X-ray test that takes pictures of your bladder and urethra while your bladder is full and while you are urinating. Contrast material is injected into your bladder through your urethra.

Cystourethrogram

74

_________ is the gold standard imaging modality for stones in the urinary system.

CT-KUB

75

With a CT, almost all stones are opaque but vary considerably in density. ________ of renal tract calculi are visible on a non-contrast CT. One of the commonest sites for a stone to become lodged is at the vesicoureteric junction.

99%

76

An infection ________ an obstructing stone is often an emergency. The body has difficulty clearing these infections and because antibiotics often cannot reach adequate levels due to the decreased blood supply and urine flow that occurs whenever a stone causes obstruction.

Behind

77

The normal epidermis head is _________ and the epidydimal body and tail is _______ to the testis.

Isoechoic; hypoechoic

78

________ is a surgical emergency, and can result in cutting of the blood supply to the spermatic cord.

Testicular torsion

79

In testicular torsion, ________ diagnosis and surgical management are critical if the testis is to be salvaged. Doppler ultrasound has become widely accepted as a sole modality for diagnosis.

Expedient

80

________ identifies the absence of blood flow typically found in a twisted testicle, which distinguishes the condition from epididymitis. Epididymitis shows increased flow.

Color Doppler sonography

81

The ________ sign of the spermatic cord on imaging may indicate acute torsion.

Whirlpool

82

Torsion of the appendix testis is the most common cause of an acute painful _________ a child

Hemiscrotumin

83

Ultrasound is used to distinguish between intratesticular masses, which are more commonly malignant, and extratesticular masses, which are more commonly benign in _________ .

Imaging of testicular cancers

84

Ultrasound can also be used to accurately differentiate intratesticular solid masses, which are often _________ , from cystic lesions, which are usually ________ .

Malignant; benign

85

MRI imaging showed a 100% sensitivity and an 88% specificity for differentiation of benign from malignant intratesticular lesions. The initial staging workup usually includes CT or MR imaging of the ________ .

Chest, abdomen, and pelvis

86

The most common sites of solid organ metastatic disease are the __________. Testicular metastases to bone may also occur.

Lungs, liver, and brain

87

In ________ , ultrasound is the gold standard investigation. Characteristic findings include: hypoechogenicity, hypervascularity, swelling and scrotal wall thickening.

Orchitis

88

MRI is the best cross-sectional modality to assess ________ replacing CT.

Cryptorchidism (absence of a testis in the scrotal sac)

89

_________ happens when part of the large or small intestine becomes stuck in the groin or scrotum and cannot go back into the abdomen.

Incarcerated inguinal hernia

90

_________ is a sac filled with fluid that forms around a testicle and most common in babies.

Hydrocele

91

Ultrasound is the first modality usually used to evaluate hydrocele. It presents as a simple fluid collection. It is ________ on Doppler evaluation. It may contain septations, calcifications or cholesterol.

Avascular

92

________ is the dilatation of the plexus of veins, found in the spermatic cord, where ultrasound is the diagnostic modality of choice.

Varicocoele

93

An MRI is effective at imaging bone and bone marrow disorders that can cause ________ . It can also help assess iron concentration in various organs such as the heart and liver

Anemia

94

________ is a genetically determined disorders of hemoglobin synthesis with decreased production of polypeptide chains of hemoglobin molecules.

Thalassemic syndrome

95

Radiographically, the skeletal response to marrow proliferation consists of ________ of the medulla, _______ of cortical bone, and ________ of cancellous bone, which results in a generalized loss of bone density.

Expansion; thinning; resorption

96

________ is a chronic hemoglobinopathy resulting from the presence of a mutated form of hemoglobin.

Sickle cell disease (SCD)

97

MRI is the best method for detecting early signs of changes in bone marrow due to acute and chronic _________ .

Bone marrow infarction, marrow hyperplasia, osteomyelitis, and osteonecrosis

98

________ may manifest with neurological features or megaloblastic anemia evident with MRI. Clinical signs of dorsal column involvement (loss of position and vibration sense and ataxia), lateral column involvement (spasticity, hyperreflexia and positive Babinski sign) and spinothalamic tracts involvement (sensory level).

Vitamin B12 deficiency

99

_________ is a cancer of plasma cells. Often, no symptoms are noticed initially. When advanced; bone pain, bleeding, frequent infections, and anemia may occur.

Multiple myeloma

100

Multiple myeloma is the most common primary malignant ________ in adults.

Bone neoplasm

101

_________ is a rare disease in which the bone marrow and the hematopoietic stem cells that reside there are damaged. This causes a deficiency of all three blood cell types (pancytopenia): red blood cells (anemia), white blood cells (leukopenia), and platelets (thrombocytopenia).

Aplastic anemia

102

________ is characterized by recurrent upper airway obstruction occurring at the level of the pharynx during sleep. CT and magnetic resonance imaging are used.

Obstructive sleep apnea (OSA)

103

_________ Bone Forming Tumours; ________ Bone Destroying Tumours; ________ lytic & blastic pattern

Osteoblastic; osteolytic; mixed

104

Patterns of bone destruction: _________ Benign; _________ Malignant or Infection; _________ Aggressive Malignant.

Geographic; moth-eaten; permeative

105

________ loss of bone density is necessary before detectable on radiographs.

30-50%

106

What type of pattern of bone destruction has separate chambers producing a soap bubble appearance?

Geographic

107

What type of pattern of bone destruction is defined as an ill-defined zone of multiple small radiolucencies that may coalesce?

Moth-eaten

108

What type of pattern of bone destruction has numerous, tiny pinhole lesions, which are usually seen in the most rapidly aggressive malignant bone tumours.

Permeative

109

On bone imaging, if the cortex is _______ it is usually a good sign; if the cortex is _________ it can either be benign or malignant; if the cortex is ________ it usually indicates an infection or a malignant tumour.

Intact; expanded or bulging; destroyed, eroded, or penetrated

110

There are three basic periosteal patterns of new bone formation:

Solid, lamellated, and spiculated

111

A _________ periosteal response is continuous layer of new bone that attaches to the outer cortical surface, and may create an elliptical appearance. It is typically benign due to a slow form of irritation such as a stress fracture or venous stasis.

Solid

112

On bone imaging an alternating layer pattern of lucent and opaque densities is know as ________ response.

Lamellated

113

What response gives a hair-on-end appearance in bone imaging that can be perpendicular, brushed whiskers, or sunburst, and is Indicative of an aggressive bone tumour, usually osteosarcoma?

Spiculated

114

________ of periosteal is new bone at the peripheral lesion-cortex junction as a result of the sub-periosteal extension of the lesion.

Codman's triangle

115

Margination or zone of transition is the _________ between a tumour and normal bone.

Interface

116

The ________ zone of transition is usually benign, and the margins of the lesion are sharp, definite, and sclerotic. Usually slow growing and commonly seen fibrous dysplasia and simple bone cysts.

Short

117

The ________ zone of transition has imperceptible margination or hazy, ill-defined or a wide zone of transition, with no distinct line, and usually indicates aggressive bone destruction seen in malignant tumors and infections.

Long

118

If the process began in the soft tissue; then the soft tissue destruction is greater than in the neighbouring bone (gout, soft tissue neoplasms). If the pathologic process began in bone then the boney destruction is usually greater than the soft tissue involvement

Outside-In vs. Inside-Out Principle

119

What is the dominant internal extracellular substance of a lesion?

Matrix

120

________: Cannot be suggested on plain films; ________: Frequently calcifies (Stippled, flocculent); ________: Demonstrate varying degrees of density from diffuse to hazy or dense/ivory (osteosarcoma); ________ :Smokey, hazy internal density, “ground glass” (fibrous dysplasia)

Fat; cartilage; osseous; Fibrous

121

Conditions of multiple tumours and tumour-like conditions:

Metastasis, multiple myeloma, Paget’s disease, fibrous dysplasia, haemophelia, Brown Tumours of hyperparathyroidism

122

________ almost always do not cross joints, but _________ do.

Tumours; infections

123

The two most common sources of joint contamination are ________ from a distant site and ________ . Secondary septic arthritis can be a complication of joint replacement therapy.

Bloodborne; traumatic implantation

124

Drug abusers are prone to infections of _________ joints.

Spine, sacroiliac, sternoclavicular, and symphysis pubis

125

For suppurative/pyogenic osteomyelitis ________ scans are the earliest means of diagnosis.

Bone

126

________ is usually a single joint involvement from hematogenous or direct implantation. The knee and hip are the most common sites.

Septic arthritis

127

Earliest signs are of a destructive lytic lesion of the anterior corner of the vertebral endplate with loss of disc space. Displaced paraspinal line on an AP view from abscess formation especially in T-spine (because of contrasting lung). May involve Psoas which can develop a snowflake type of calcification. Osteolytic vertebral body destruction with collapse causing a wedging of the vertebrae with angular kyphosis leading to a Gibbus deformity.

Radiologic features of TB

128

________ frequently progresses to abscess formation and thus often has a mass like appearance on MR images. The hallmark of muscle infection is fluid collections present inside the muscle.

Bacterial myositis

129

In chronic muscular dystrophy, the muscle has been entirely replaced by _______ .

Fat

130

________ is a relatively common acquired chronic relapsing demyelinating disease involving the central nervous system. MRI is the preferred imaging modality for diagnosis and follow up.

Multiple sclerosis (MS)

131

This test should not be performed in women who are pregnant or breastfeeding. If you are hyperthyroid a hot nodule is seen that is producing excess thyroid hormone.If the uptake is very low because of hypothyroidism, nodules will appear “cold” as in thyroiditis (inflammation of the thyroid gland).

Radioactive iodine

132

With radioactive iodine and if you are hyperthyroid, a ________nodule is seen that is producing excess thyroid hormone. If the uptake is very low because of hypothyroidism, nodules will appear ________ as in thyroiditis (inflammation of the thyroid gland).

Hot; cold

133

________ is a generalized reduction in bone mass that is less severe than that resulting from osteoporosis, caused by the resorption of bone at a rate that exceeds bone synthesis.

Osteopenia

134

_________ is a reduction in bone quantity, while _________ is a reduction in bone quality.

Osteoporosis; Osteomalacia

135

________ is the least sensitive method for assessing bone quantity and quality.

Plain Film Radiography

136

Subperiosteal bone resorption is a radiographic hallmark of ________ producing an irregular lace-like frayed appearance of the external/subperiosteal bone.

Hyperparathyroidism

137

In the spine the effects of hyperparathyroidism can have a ________ pattern: alternating dense-lucent-dense pattern seen in vertebral bodies.

Rugger Jersey Spine

138

Hyperparathyroidism can present with ________ (osteoclastoma): distinct geographical radiolucenicies, may mimic a destructive neoplasm, and a ________ look with imaging of the skull.

Brown tumours; salt and pepper

139

For bone density assessment, _________ are diagnostic measure of choice for osteoporosis.

DEXA scans (Dual Energy X-ray Absorptiometry)

140

A _________ is the number of standard deviations away from the mean. The mean is derived from the age of peak bone mass (20 – 35 years). -2.5 or worse constitutes osteoporosis.

T-score

141

What body parts should be imaged when measuring bone density?

Hip, lumbar spine, calcaneus, and radius

142

__________ is a form of endometriosis characterized by the invasive, usually benign growth of tissue into smooth muscle such as the uterus.

Adenomyosis