This document provides rationales for questions on the 2005 American College of Radiology Diagnostic In-Training Examination for interventional radiology residents. It includes the questions, images associated with some questions, findings for each image, and rationales for the correct answers. The questions cover topics such as locations of dialysis catheters, diagnoses for angiograms, standards for uterine artery embolization, and indications for percutaneous nephrostomy.
This document provides rationales for questions on the 28th Annual In-Training Examination for Diagnostic Radiology Residents. It includes explanations for answers to 5 multiple choice questions related to pediatric radiology cases. The questions cover topics such as autosomal recessive polycystic kidney disease, everting ureterocele, necrotizing enterocolitis, non-accidental trauma, and vein of Galen aneurysm. The rationales discuss the findings in the images and explain why each answer choice is right or wrong based on those findings and typical presentations of the diseases.
This document appears to be a series of questions and answers from a diagnostic radiology in-training examination. The questions cover topics in genitourinary tract radiology and ask examinees to identify diagnoses, classifications, or characteristics based on provided radiographic images and clinical scenarios. Rationales are given for each answer that provide additional radiologic and clinical details.
This document contains 3 figures and associated questions from a diagnostic radiology in-training examination. Figure 1 shows images from an F-18 FDG PET study in a man with abdominal pain. Figure 2 shows a posterior Tc-99m bone scintigram in a man with back pain. Figure 3 shows an anterior whole body Tc-99m bone scan in a woman with head and neck pain and a history of thyroid cancer. The questions assess the examinee's ability to interpret the images and select the most likely diagnosis.
- Echogenic intracardiac focus is most commonly seen as a normal variant on prenatal ultrasound but should prompt careful examination for other abnormalities.
- While it represents a normal variant, echogenic intracardiac focus has been associated with trisomy 13 and 21 but not trisomy 18.
- The majority (90%) of echogenic intracardiac foci are located in the left ventricle, not the right ventricle as stated in one response option.
The document appears to be excerpts from an examination for diagnostic radiology residents, including four multiple choice questions and associated images regarding musculoskeletal diagnoses. Question #202 asks about a lateral tibial lesion in a child and provides images. The most likely diagnosis is osteofibrous dysplasia, characterized by a lobulated lucency in the anterior cortex associated with anterior bowing of the tibia.
This document contains a multiple choice question and rationales from a pediatric radiology exam. The question shows MRI images of a 22-week fetus and asks for the most likely diagnosis. The rationales eliminate the other answer choices of posterior urethral valves, multicystic dysplastic kidneys, and bilateral ureteropelvic junction obstruction. The correct answer is Autosomal Recessive Polycystic Kidney Disease, as the images show enlarged, fluid-intensity kidneys without urine production, typical of this condition.
Gallium-67 citrate scintigraphy is preferred over In-111 leukocyte scintigraphy for the detection of disk space infection. While both agents are sensitive for osteomyelitis, gallium-67 has been shown to be more sensitive for disc space infection compared to In-111 leukocyte imaging. This is due to potentially confusing normal bowel activity seen on gallium-67 scans that could obscure abdominal pathology. In-111 leukocyte imaging is generally preferred for evaluating other infectious/inflammatory conditions like abdominal abscesses and infected joint prostheses due to less potential for false positives from normal biodistribution.
The document provides rationales for questions on a diagnostic radiology exam. Question 29 asks about an image showing changes in the small bowel. The most likely diagnosis is graft versus host disease based on the classic "ribbon bowel" appearance seen in the image. Graft versus host disease produces a total absence of mucosal folds in the small bowel, typically seen in the ileum rather than jejunum as seen in the image. This appearance is distinct from other potential diagnoses that may also cause small bowel abnormalities.
This document provides rationales for questions on the 28th Annual In-Training Examination for Diagnostic Radiology Residents. It includes explanations for answers to 5 multiple choice questions related to pediatric radiology cases. The questions cover topics such as autosomal recessive polycystic kidney disease, everting ureterocele, necrotizing enterocolitis, non-accidental trauma, and vein of Galen aneurysm. The rationales discuss the findings in the images and explain why each answer choice is right or wrong based on those findings and typical presentations of the diseases.
This document appears to be a series of questions and answers from a diagnostic radiology in-training examination. The questions cover topics in genitourinary tract radiology and ask examinees to identify diagnoses, classifications, or characteristics based on provided radiographic images and clinical scenarios. Rationales are given for each answer that provide additional radiologic and clinical details.
This document contains 3 figures and associated questions from a diagnostic radiology in-training examination. Figure 1 shows images from an F-18 FDG PET study in a man with abdominal pain. Figure 2 shows a posterior Tc-99m bone scintigram in a man with back pain. Figure 3 shows an anterior whole body Tc-99m bone scan in a woman with head and neck pain and a history of thyroid cancer. The questions assess the examinee's ability to interpret the images and select the most likely diagnosis.
- Echogenic intracardiac focus is most commonly seen as a normal variant on prenatal ultrasound but should prompt careful examination for other abnormalities.
- While it represents a normal variant, echogenic intracardiac focus has been associated with trisomy 13 and 21 but not trisomy 18.
- The majority (90%) of echogenic intracardiac foci are located in the left ventricle, not the right ventricle as stated in one response option.
The document appears to be excerpts from an examination for diagnostic radiology residents, including four multiple choice questions and associated images regarding musculoskeletal diagnoses. Question #202 asks about a lateral tibial lesion in a child and provides images. The most likely diagnosis is osteofibrous dysplasia, characterized by a lobulated lucency in the anterior cortex associated with anterior bowing of the tibia.
This document contains a multiple choice question and rationales from a pediatric radiology exam. The question shows MRI images of a 22-week fetus and asks for the most likely diagnosis. The rationales eliminate the other answer choices of posterior urethral valves, multicystic dysplastic kidneys, and bilateral ureteropelvic junction obstruction. The correct answer is Autosomal Recessive Polycystic Kidney Disease, as the images show enlarged, fluid-intensity kidneys without urine production, typical of this condition.
Gallium-67 citrate scintigraphy is preferred over In-111 leukocyte scintigraphy for the detection of disk space infection. While both agents are sensitive for osteomyelitis, gallium-67 has been shown to be more sensitive for disc space infection compared to In-111 leukocyte imaging. This is due to potentially confusing normal bowel activity seen on gallium-67 scans that could obscure abdominal pathology. In-111 leukocyte imaging is generally preferred for evaluating other infectious/inflammatory conditions like abdominal abscesses and infected joint prostheses due to less potential for false positives from normal biodistribution.
The document provides rationales for questions on a diagnostic radiology exam. Question 29 asks about an image showing changes in the small bowel. The most likely diagnosis is graft versus host disease based on the classic "ribbon bowel" appearance seen in the image. Graft versus host disease produces a total absence of mucosal folds in the small bowel, typically seen in the ileum rather than jejunum as seen in the image. This appearance is distinct from other potential diagnoses that may also cause small bowel abnormalities.
This document provides rationales for questions from the 2007 ACR Diagnostic Radiology In-Training Exam related to ultrasound imaging. It discusses the correct answers and rationales for questions regarding various pathologies seen on ultrasound of the uterus, testes, kidneys, abdomen and fetal anatomy. Key details include identifying a cornual pregnancy based on its location, tubular ectasia of the rete testis in an older male, medullary nephrocalcinosis seen as echogenic renal pyramids, the left renal vein in the transverse abdominal image, and measuring fetal head circumference at the level of the thalami and cavum septi pellucidi.
This document provides rationales for answers on a diagnostic radiology exam related to musculoskeletal radiology. The case presented involves radiographs and MRI images of various musculoskeletal injuries and conditions. The correct diagnosis for each case is provided along with explanations for why the other answer choices are incorrect. Key details that help distinguish between similar conditions are emphasized, such as findings that are more or less typical for a given diagnosis. A variety of musculoskeletal injuries, abnormalities, and diseases are discussed.
This document contains rationales for questions on the 2007 ACR Diagnostic Radiology In-Training Exam related to breast radiology. The rationales discuss the correct answers and explain why the other answer options are incorrect based on imaging findings and characteristics of different breast diseases. Invasive lobular carcinoma is identified as the most likely diagnosis for one case based on its appearance on mammography of being seen best on one view only or at least.
The document discusses rationales for questions on the 2007 ACR Diagnostic Radiology In-Training Exam related to nuclear radiology. It provides details and images from various nuclear medicine studies, including thyroid scintigraphy, bone scintigraphy, renal scintigraphy, CNS shunt study, pulmonary perfusion scan, PET imaging, and radioimmunotherapy. For each question, it discusses the correct answer and explains why the other answer options are incorrect based on the findings and characteristics of the studies.
- The document discusses a chest radiograph and CT images of a 51-year-old man with shortness of breath. It shows bilateral perihilar opacities on chest radiograph and thin-walled cysts, ground glass opacities, and reticular opacities on CT.
- The most likely diagnosis is Pneumocystis carinii pneumonia. Findings are consistent with PCP including bilateral often perihilar reticular and ground glass opacification that may become confluent and cysts that are commonly multiple and have predilection for upper lobes.
- Other choices such as pulmonary alveolar proteinosis, cardiogenic pulmonary edema, idiopathic pulmonary fibrosis are
A 23-year-old woman presented with hearing loss. CT showed a soft tissue mass in the left middle ear cavity eroding the scutum and demineralizing the ossicles. The most likely diagnosis is cholesteatoma, a common middle ear soft tissue mass.
A 68-year-old woman presented with left eye pain and proptosis. Angiography showed early filling of both cavernous sinuses and ophthalmic veins, indicating a carotid-cavernous fistula.
MR of a 6-month-old boy with vomiting showed a large enhancing mass in the left lateral ventricle with flow voids. The most likely diagnosis is a choroid plexus
The document describes 3 radiology case studies involving the gastrointestinal system:
1) A case of scleroderma diagnosed based on an x-ray showing dilation of the small bowel with closely spaced folds.
2) A case of appendicitis diagnosed on CT showing an enlarged appendix with periappendiceal inflammation and an appendicolith.
3) A case of a gastric leiomyoma diagnosed on barium study and CT showing a rounded filling defect in the stomach with central ulceration arising from the gastric wall.
A 15-year-old female volleyball player presented with low back pain without trauma. Bone scan showed increased uptake in the left L5 lamina. SPECT localized this to the pars interarticularis. Radiographs were normal. This is most consistent with a stress fracture of the left L5 pars interarticularis, a common injury in young athletes.
The document discusses images from radiology exams of the pelvis and genitourinary system. Figure 1 shows a sagittal MRI of the pelvis showing diffuse thickening of the junctional zone, consistent with adenomyosis. Figures 2A and 2B show an intratesticular mass on ultrasound, indicating seminoma. Figures 3A-C show an ovarian teratoma on ultrasound and MRI of the pelvis in a pregnant patient. Figure 4 shows a bladder tumor on CT scan in a patient with hematuria. Figure 5 shows a hysterosalpingogram indicating Asherman's syndrome. Figures 6A-C show renal cell carcinoma extending into the renal vein, stage IIIA by
Previous year question on bone cyst based on neet pg, usmle, plab and fmge or...Medico Apps
- Aneurysmal bone cyst cannot be diagnosed using fine needle aspiration cytology (FNAC) according to the document.
- FNAC of aneurysmal bone cyst shows only red blood cells and is inconclusive for diagnosis.
- Cystic lesions such as aneurysmal bone cyst, unicameral bone cyst, and some telangiectatic osteosarcomas yield specimens containing predominantly blood or fluid with little diagnostic cellular content making diagnosis via FNAC difficult.
The document is the rationales section from an in-training examination for diagnostic radiology residents sponsored by the American College of Radiology. It contains multiple choice questions in physics related to topics like radiation dose, CT, MRI, fluoroscopy, and radiography. For each question, the correct answer is identified and supported by a short explanation citing relevant references.
The document discusses several radiology cases involving the genitourinary system. Case 1 involves color and Doppler ultrasound images of a transplant patient with elevated creatinine, showing an arteriovenous fistula is most likely. Case 2 shows a contrast-enhanced CT of a motor vehicle accident patient with bilateral non-enhancing kidneys, indicating bilateral renal arterial injury. Case 3 involves a contrast-enhanced CT pelvis image of a prostate cancer patient showing a bulbous contrast-filled structure at the uretero-vesical junction, consistent with a simple ureterocele.
The document describes an ultrasound examination of a 25-year-old female with a palpable right adnexal mass. Longitudinal and transverse endovaginal images show a 4 cm predominantly cystic mass with a heterogeneous echotexture arising from the right ovary. This is most consistent with a dermoid cyst, as dermoids can appear cystic with an echogenic mural nodule or "dermoid plug".
This document contains 5 radiology case studies with images and descriptions of findings. It tests the ability to diagnose common genitourinary conditions based on imaging features. The cases include:
1) A CT showing infundibular strictures in the kidney collecting system, most consistent with renal tuberculosis.
2) A non-contrast CT of a right adrenal hemorrhage seen as a mixed attenuation mass with surrounding stranding.
3) A renal arteriogram showing early venous filling, consistent with a congenital renal arteriovenous fistula.
4) A CT of a renal abscess seen as a fluid attenuation mass with a single air bubble.
5) An excretory
The document discusses breast radiology questions from an exam. Question 188 describes a case where a fibroadenoma was found on biopsy initially and a follow up mammogram 6 months later. The most likely diagnosis is a phyllodes tumor based on the description of phyllodes tumors typically appearing mammographically. Question 189 describes mammogram images and the most likely clinical presentation is peau d'orange skin in the left breast, indicative of inflammatory breast cancer. Question 190 involves calcifications on a mammogram and ductal carcinoma in situ is considered the most likely diagnosis.
Ewing sarcoma and osteosarcoma are two of the most common primary bone cancers in children and adolescents. Ewing sarcoma accounts for about 2% of childhood cancers and most often affects bones of the pelvis, femur, and ribs in the second decade of life. The most frequent genetic abnormality in Ewing sarcoma is a translocation between chromosomes 11 and 22. Osteosarcoma is the most common primary bone tumor in children and makes up about 4% of childhood cancers, typically affecting the distal femur, proximal tibia, and proximal humerus. Both cancers commonly present with pain and swelling and can metastasize to the lungs. Treatment involves chemotherapy, surgery, and sometimes radiation.
Presentation1, pet ct, functional mri and ct angiography in bone tumour.Abdellah Nazeer
This document discusses the use of PET/CT, functional MRI, and CT angiography in evaluating bone tumors. It provides the following key points:
1) PET/CT uses radioactive tracers like FDG to detect cancer cells through their increased glucose metabolism, allowing detection of tumors at early stages. The degree of FDG uptake does not necessarily correlate with a bone tumor's malignant potential.
2) Functional MRI techniques like diffusion weighted imaging and magnetic resonance spectroscopy provide additional tumor characterization by revealing water mobility and choline metabolites related to cellularity.
3) CT angiography is useful for determining a tumor's relationship to major blood vessels, though its role is now limited due to the capabilities of other modalities
Ultrasound of Vascular anomalies by Oscar M. NavarroDr. Naveed Quetta
Ultrasound is the primary imaging modality for evaluating soft tissue vascular anomalies. It can distinguish between vascular tumors like infantile hemangioma and vascular malformations. Hemangiomas appear as well-defined, hypoechoic masses that are highly vascular on Doppler. Vascular malformations like venous malformations appear as poorly marginated, hypoechoic lesions containing venous flow. Lymphatic malformations contain cystic spaces of varying sizes. Understanding the ISSVA classification system for vascular anomalies aids in diagnosis and communication between specialties.
Ewing sarcoma is a rare cancer that develops in bone or soft tissue. It is most common in children and young adults between ages 10-20. The cancer cells are small, round cells and are usually found in the bones of the legs, pelvis, ribs, or spine. Ewing sarcoma is treated with a combination of chemotherapy, radiation therapy, and surgery. Prognosis depends on factors like tumor size, location, and whether the cancer has spread. With current multi-agent chemotherapy regimens, long-term survival rates are around 60-70%.
1. Osteosarcoma is a malignant bone tumor derived from primitive mesenchymal cells. It most commonly occurs in the metaphysis of long bones in children and young adults.
2. Conventional intramedullary osteosarcoma is the most common subtype. It is an aggressive tumor characterized by the production of osteoid matrix. Treatment involves neoadjuvant chemotherapy, surgical resection with wide margins, and adjuvant chemotherapy.
3. Other subtypes include telangiectatic, surface/juxtacortical, and intracortical osteosarcomas, which have varying presentations, imaging characteristics, histology, and clinical behaviors. Accurate diagnosis and subtyping is important for
FRAND (Fair, Reasonable, and Non-Discriminatory terms) can benefit receiving companies through commercially applicable standards and reduced concerns about open source endeavors. However, FRAND may be less successful for granting companies and market innovation. For standards development organizations, clearly defining FRAND terms with reciprocal impact is important, but such definitions risk overwhelming commercial organizations. While FRAND aims to regulate standards for long-term stability, it must also gain commercial acceptance to be effective.
Computer security protects information and property from threats while keeping it accessible to authorized users. There are three main categories of computer insecurity: vulnerabilities, exploits, and payloads. Vulnerabilities are weaknesses that allow attacks, exploits take advantage of vulnerabilities, and payloads are the harmful effects caused, such as deleting files or installing backdoors. Common security measures include usernames/passwords, firewalls, antivirus software, and encryption.
This document provides rationales for questions from the 2007 ACR Diagnostic Radiology In-Training Exam related to ultrasound imaging. It discusses the correct answers and rationales for questions regarding various pathologies seen on ultrasound of the uterus, testes, kidneys, abdomen and fetal anatomy. Key details include identifying a cornual pregnancy based on its location, tubular ectasia of the rete testis in an older male, medullary nephrocalcinosis seen as echogenic renal pyramids, the left renal vein in the transverse abdominal image, and measuring fetal head circumference at the level of the thalami and cavum septi pellucidi.
This document provides rationales for answers on a diagnostic radiology exam related to musculoskeletal radiology. The case presented involves radiographs and MRI images of various musculoskeletal injuries and conditions. The correct diagnosis for each case is provided along with explanations for why the other answer choices are incorrect. Key details that help distinguish between similar conditions are emphasized, such as findings that are more or less typical for a given diagnosis. A variety of musculoskeletal injuries, abnormalities, and diseases are discussed.
This document contains rationales for questions on the 2007 ACR Diagnostic Radiology In-Training Exam related to breast radiology. The rationales discuss the correct answers and explain why the other answer options are incorrect based on imaging findings and characteristics of different breast diseases. Invasive lobular carcinoma is identified as the most likely diagnosis for one case based on its appearance on mammography of being seen best on one view only or at least.
The document discusses rationales for questions on the 2007 ACR Diagnostic Radiology In-Training Exam related to nuclear radiology. It provides details and images from various nuclear medicine studies, including thyroid scintigraphy, bone scintigraphy, renal scintigraphy, CNS shunt study, pulmonary perfusion scan, PET imaging, and radioimmunotherapy. For each question, it discusses the correct answer and explains why the other answer options are incorrect based on the findings and characteristics of the studies.
- The document discusses a chest radiograph and CT images of a 51-year-old man with shortness of breath. It shows bilateral perihilar opacities on chest radiograph and thin-walled cysts, ground glass opacities, and reticular opacities on CT.
- The most likely diagnosis is Pneumocystis carinii pneumonia. Findings are consistent with PCP including bilateral often perihilar reticular and ground glass opacification that may become confluent and cysts that are commonly multiple and have predilection for upper lobes.
- Other choices such as pulmonary alveolar proteinosis, cardiogenic pulmonary edema, idiopathic pulmonary fibrosis are
A 23-year-old woman presented with hearing loss. CT showed a soft tissue mass in the left middle ear cavity eroding the scutum and demineralizing the ossicles. The most likely diagnosis is cholesteatoma, a common middle ear soft tissue mass.
A 68-year-old woman presented with left eye pain and proptosis. Angiography showed early filling of both cavernous sinuses and ophthalmic veins, indicating a carotid-cavernous fistula.
MR of a 6-month-old boy with vomiting showed a large enhancing mass in the left lateral ventricle with flow voids. The most likely diagnosis is a choroid plexus
The document describes 3 radiology case studies involving the gastrointestinal system:
1) A case of scleroderma diagnosed based on an x-ray showing dilation of the small bowel with closely spaced folds.
2) A case of appendicitis diagnosed on CT showing an enlarged appendix with periappendiceal inflammation and an appendicolith.
3) A case of a gastric leiomyoma diagnosed on barium study and CT showing a rounded filling defect in the stomach with central ulceration arising from the gastric wall.
A 15-year-old female volleyball player presented with low back pain without trauma. Bone scan showed increased uptake in the left L5 lamina. SPECT localized this to the pars interarticularis. Radiographs were normal. This is most consistent with a stress fracture of the left L5 pars interarticularis, a common injury in young athletes.
The document discusses images from radiology exams of the pelvis and genitourinary system. Figure 1 shows a sagittal MRI of the pelvis showing diffuse thickening of the junctional zone, consistent with adenomyosis. Figures 2A and 2B show an intratesticular mass on ultrasound, indicating seminoma. Figures 3A-C show an ovarian teratoma on ultrasound and MRI of the pelvis in a pregnant patient. Figure 4 shows a bladder tumor on CT scan in a patient with hematuria. Figure 5 shows a hysterosalpingogram indicating Asherman's syndrome. Figures 6A-C show renal cell carcinoma extending into the renal vein, stage IIIA by
Previous year question on bone cyst based on neet pg, usmle, plab and fmge or...Medico Apps
- Aneurysmal bone cyst cannot be diagnosed using fine needle aspiration cytology (FNAC) according to the document.
- FNAC of aneurysmal bone cyst shows only red blood cells and is inconclusive for diagnosis.
- Cystic lesions such as aneurysmal bone cyst, unicameral bone cyst, and some telangiectatic osteosarcomas yield specimens containing predominantly blood or fluid with little diagnostic cellular content making diagnosis via FNAC difficult.
The document is the rationales section from an in-training examination for diagnostic radiology residents sponsored by the American College of Radiology. It contains multiple choice questions in physics related to topics like radiation dose, CT, MRI, fluoroscopy, and radiography. For each question, the correct answer is identified and supported by a short explanation citing relevant references.
The document discusses several radiology cases involving the genitourinary system. Case 1 involves color and Doppler ultrasound images of a transplant patient with elevated creatinine, showing an arteriovenous fistula is most likely. Case 2 shows a contrast-enhanced CT of a motor vehicle accident patient with bilateral non-enhancing kidneys, indicating bilateral renal arterial injury. Case 3 involves a contrast-enhanced CT pelvis image of a prostate cancer patient showing a bulbous contrast-filled structure at the uretero-vesical junction, consistent with a simple ureterocele.
The document describes an ultrasound examination of a 25-year-old female with a palpable right adnexal mass. Longitudinal and transverse endovaginal images show a 4 cm predominantly cystic mass with a heterogeneous echotexture arising from the right ovary. This is most consistent with a dermoid cyst, as dermoids can appear cystic with an echogenic mural nodule or "dermoid plug".
This document contains 5 radiology case studies with images and descriptions of findings. It tests the ability to diagnose common genitourinary conditions based on imaging features. The cases include:
1) A CT showing infundibular strictures in the kidney collecting system, most consistent with renal tuberculosis.
2) A non-contrast CT of a right adrenal hemorrhage seen as a mixed attenuation mass with surrounding stranding.
3) A renal arteriogram showing early venous filling, consistent with a congenital renal arteriovenous fistula.
4) A CT of a renal abscess seen as a fluid attenuation mass with a single air bubble.
5) An excretory
The document discusses breast radiology questions from an exam. Question 188 describes a case where a fibroadenoma was found on biopsy initially and a follow up mammogram 6 months later. The most likely diagnosis is a phyllodes tumor based on the description of phyllodes tumors typically appearing mammographically. Question 189 describes mammogram images and the most likely clinical presentation is peau d'orange skin in the left breast, indicative of inflammatory breast cancer. Question 190 involves calcifications on a mammogram and ductal carcinoma in situ is considered the most likely diagnosis.
Ewing sarcoma and osteosarcoma are two of the most common primary bone cancers in children and adolescents. Ewing sarcoma accounts for about 2% of childhood cancers and most often affects bones of the pelvis, femur, and ribs in the second decade of life. The most frequent genetic abnormality in Ewing sarcoma is a translocation between chromosomes 11 and 22. Osteosarcoma is the most common primary bone tumor in children and makes up about 4% of childhood cancers, typically affecting the distal femur, proximal tibia, and proximal humerus. Both cancers commonly present with pain and swelling and can metastasize to the lungs. Treatment involves chemotherapy, surgery, and sometimes radiation.
Presentation1, pet ct, functional mri and ct angiography in bone tumour.Abdellah Nazeer
This document discusses the use of PET/CT, functional MRI, and CT angiography in evaluating bone tumors. It provides the following key points:
1) PET/CT uses radioactive tracers like FDG to detect cancer cells through their increased glucose metabolism, allowing detection of tumors at early stages. The degree of FDG uptake does not necessarily correlate with a bone tumor's malignant potential.
2) Functional MRI techniques like diffusion weighted imaging and magnetic resonance spectroscopy provide additional tumor characterization by revealing water mobility and choline metabolites related to cellularity.
3) CT angiography is useful for determining a tumor's relationship to major blood vessels, though its role is now limited due to the capabilities of other modalities
Ultrasound of Vascular anomalies by Oscar M. NavarroDr. Naveed Quetta
Ultrasound is the primary imaging modality for evaluating soft tissue vascular anomalies. It can distinguish between vascular tumors like infantile hemangioma and vascular malformations. Hemangiomas appear as well-defined, hypoechoic masses that are highly vascular on Doppler. Vascular malformations like venous malformations appear as poorly marginated, hypoechoic lesions containing venous flow. Lymphatic malformations contain cystic spaces of varying sizes. Understanding the ISSVA classification system for vascular anomalies aids in diagnosis and communication between specialties.
Ewing sarcoma is a rare cancer that develops in bone or soft tissue. It is most common in children and young adults between ages 10-20. The cancer cells are small, round cells and are usually found in the bones of the legs, pelvis, ribs, or spine. Ewing sarcoma is treated with a combination of chemotherapy, radiation therapy, and surgery. Prognosis depends on factors like tumor size, location, and whether the cancer has spread. With current multi-agent chemotherapy regimens, long-term survival rates are around 60-70%.
1. Osteosarcoma is a malignant bone tumor derived from primitive mesenchymal cells. It most commonly occurs in the metaphysis of long bones in children and young adults.
2. Conventional intramedullary osteosarcoma is the most common subtype. It is an aggressive tumor characterized by the production of osteoid matrix. Treatment involves neoadjuvant chemotherapy, surgical resection with wide margins, and adjuvant chemotherapy.
3. Other subtypes include telangiectatic, surface/juxtacortical, and intracortical osteosarcomas, which have varying presentations, imaging characteristics, histology, and clinical behaviors. Accurate diagnosis and subtyping is important for
FRAND (Fair, Reasonable, and Non-Discriminatory terms) can benefit receiving companies through commercially applicable standards and reduced concerns about open source endeavors. However, FRAND may be less successful for granting companies and market innovation. For standards development organizations, clearly defining FRAND terms with reciprocal impact is important, but such definitions risk overwhelming commercial organizations. While FRAND aims to regulate standards for long-term stability, it must also gain commercial acceptance to be effective.
Computer security protects information and property from threats while keeping it accessible to authorized users. There are three main categories of computer insecurity: vulnerabilities, exploits, and payloads. Vulnerabilities are weaknesses that allow attacks, exploits take advantage of vulnerabilities, and payloads are the harmful effects caused, such as deleting files or installing backdoors. Common security measures include usernames/passwords, firewalls, antivirus software, and encryption.
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This document discusses accounting principles and financial reporting for governments. It notes that most governments account on a cash basis rather than maintaining balance sheets, and do not systematically record assets and liabilities. As a result, solutions to fiscal crises may be built on fragile foundations and could collapse. The document argues that governments should adopt accounting standards similar to GAAP or IFRS to provide more robust financial reporting and make decisions with proper regard to financial consequences. It also discusses how reporting deficits based only on cash flows can be misleading as it does not capture assets, liabilities, or long-term obligations.
Presentation and workshop notes from session on how to apply the Researcher Development Framework to library and information service provision for research/e support
Uses case studies of different types of researchers.
Workshop notes integrated into the presentation
This presentation describes coordination of federal biometric and identity management activities, and was given at the 2008 Biometric Consortium Conference.
The document discusses two projects - the ICT4eTwinners Project and the SMILE Project. It provides links to the projects and summarizes their objectives. The SMILE Project, funded by Facebook, consisted of an online learning laboratory for 100 teachers to investigate educational uses of social media. It included research on trends and best practices and dissemination of results. The document also lists some top tools for developing a personal learning network, including Glogster Edu, Symbaloo, Scoop.it, Pinterest, Learnist and Mightybell.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise causes chemical changes in the brain that may help protect against developing mental illness and improve symptoms for those who already suffer from conditions like anxiety and depression.
The document discusses piecewise defined functions. It defines a piecewise function as one where the function definition changes depending on the interval of x-values. It provides examples of sketching piecewise functions and finding their domains and ranges. Specifically, it gives the examples of the functions y=-2, f(x)=2x for -2<=x<=3, and g(x)=-(3/2)x+1. It also defines a piecewise function as having different expressions on various intervals.
This document discusses face recognition technology and biometrics. It summarizes the results of tests on face recognition systems, distinguishing between verification, watchlist, and identification tasks. Key metrics for each task are defined such as false accept rate, detection rate, and rank-n identification. The document urges using standardized tests and proper terminology to evaluate biometrics systems.
Lighthouse Inc. has been working on a new youth development program over the last 3 years. This summer, they launched two new initiatives - character education classes at a local high school and one-on-one tutoring for struggling students. They also expanded their basketball program and renovated locker rooms at a community center. These projects mark a significant step towards their new vision. They hired two new staff members and received donations of office furniture and supplies to set up their new office space. Overall, it was a busy summer of preparation and partnership building to strengthen educational and character development programs for youth in the community.
Data logging refers to collecting data over time using sensors. Sensors measure a property and send an analog signal to be converted into digital data by an analog-to-digital converter (ADC) for computer processing. Data logging systems are used for scientific experiments, weather stations, and environmental monitoring to gather data regularly about factors like temperature, rainfall, pollution levels, and more. The sensors take measurements that are converted and sent to a data logger for storage and later transmission to a computer for analysis and presentation.
This document discusses 8 key points about educating children with Jesus. It emphasizes teaching children about God's love, spending quality time with them, setting a good example, disciplining them with patience and understanding, and praying for their spiritual growth so they can develop faith and make their own relationship with God.
Termokimia mempelajari perubahan haba dalam reaksi kimia. Terdapat dua jenis reaksi, eksotermik yang melepaskan haba dan endotermik yang menyerap haba. Besaran entalpi digunakan untuk menyatakan kuantiti haba reaksi.
This document discusses using screen capture and recording tools like Jing and Voicethreads for teaching, training, tutoring, and assessing. It provides an overview of Jing, demonstrating how to use it to create simple video tutorials. Examples are given of how Jing has been used to create tutorials on inserting a Voki into Moodle and uploading a PDF file. Voicethreads is introduced as an asynchronous and engaging digital conversation tool, with examples of projects using pictures and collaborative writing. Resources for both Jing and Voicethreads are provided.
The document describes a case involving a chest x-ray and pulmonary angiogram findings in a 57-year-old female patient who presented with chest pain two weeks following a hemorrhagic stroke. The pulmonary angiogram shows multiple filling defects in the left main pulmonary artery and its branches, consistent with pulmonary embolism. While anticoagulation is usually the standard therapy for pulmonary embolism, it is contraindicated in this patient due to her recent stroke. Therefore, the best management option is placement of an inferior vena cava filter to prevent further pulmonary emboli while existing clots dissolve, as anticoagulation cannot be used due to her recent hemorrhagic stroke.
The document provides rationales for questions on an interventional radiology exam. It includes descriptions of imaging findings and the correct answers for 7 multiple choice questions. For each question, it summarizes the key imaging findings and explains why the correct answer is right and the other options are wrong based on those findings and published references. The questions cover topics like cholangiocarcinoma, splenic artery occlusion, pneumothorax management, mesenteric ischemia, Eustachian valve, gonadal vein reflux, and popliteal artery entrapment syndrome.
A post-menopausal woman presented with an asymptomatic 3.0 cm simple ovarian cyst. Of the following statements, the one that is TRUE is that the cyst should be removed if the patient has an increased serum CA-125 level. A simple cyst under 5.0 cm in diameter in a post-menopausal woman has a very low risk of malignancy and can be followed with serial ultrasounds without surgery. The most common neoplasm found on surgical removal of these cysts is a serous cystadenoma, not a fibrothecoma.
This document contains a series of chest radiograph and CT images along with questions about cardiac findings.
Image 1 shows calcification of the aortic valve on a lateral chest x-ray, consistent with aortic stenosis.
Image 2 shows calcifications in the wall of the left atrium on a non-contrast CT, related to prior endocarditis from rheumatic heart disease.
Image 3 demonstrates enlargement of the central pulmonary arteries and diminished peripheral vasculature on chest x-ray, characteristic of pulmonary hypertension due to emphysema (cor pulmonale).
Image 4 shows a defect in the superolateral aspect of the atrial septum on CT, consistent with a sinus
This document contains rationales for questions on the 2007 ACR Diagnostic Radiology In-Training Exam related to cardiac radiology. Question 102 asks which statement about cardiomyopathies is true. The correct answer is that cyclosporine immunosuppressive therapy can cause left ventricular hypertrophy. Cyclosporine is used after cardiac transplantation and can result in left ventricular hypertrophy as a side effect.
Coronary Aneurysms: What Every Radiologist Should KnowGarry Choy MD MBA
1) Coronary artery aneurysms can be caused by atherosclerosis, Kawasaki disease, connective tissue diseases, cocaine use, trauma, and infections.
2) Imaging such as coronary CTA or angiography is important to establish the diagnosis and characterize the aneurysms.
3) Treatment depends on the underlying cause but may include anticoagulation, antiplatelet drugs, surgery such as bypass or stenting, to prevent complications like thrombosis.
The document discusses rationales for exam questions related to chest radiology. Question 202 discusses a CT scan showing a smooth, round upper lobe mass with eccentric calcifications and air-trapping. The most likely diagnosis is a carcinoid tumor. Question 203 shows chest radiographs of a man with cough, demonstrating a classic right upper lobe collapse with a "Reverse S of Golden" suggestive of a central mass. Question 204 involves a CT scan showing post-intubation tracheal narrowing below the thoracic inlet.
This document contains 5 clinical case scenarios involving interventional radiology procedures (questions 265-269). Each case is accompanied by an image and 4 possible answers. The correct answer is identified and a brief rationale is provided for each case. Question 270-279 continue testing knowledge of interventional radiology with additional multiple choice questions related to procedures, techniques, and disease processes.
1) A 24-year-old man was diagnosed with Loeys–Dietz syndrome type 1 based on genetic analysis showing a mutation that puts him at high risk for aortic dissection.
2) A 59-year-old man with a history of carotid stenting presented with visual changes and was found to have retinal cholesterol emboli due to ongoing embolism after stenting.
3) An 83-year-old woman with atrial fibrillation and pacemaker presented with heart failure and was discharged on medical management.
This document presents two medical case studies involving imaging findings and diagnoses. The first case involves a woman with cough and dyspnea, and imaging shows a normal left lung but small right pulmonary artery and hypoplastic right lung. The most likely diagnosis is Swyer James Syndrome. The second case involves a woman with IV drug abuse presenting with fevers and leg pain, and imaging shows a filling defect across the iliac arteries. The most likely diagnosis is an embolism.
This document contains a radiology case study with 4 images (Figures 1-4) and accompanying questions. Figure 1 shows a lateral cervical spine x-ray. The diagnosis is ankylosing spondylitis based on diffuse bony ankylosis throughout the cervical spine. Figure 2 shows MRI images of the knee with a diagnosis of discoid meniscus due to excessive meniscal tissue. Figure 3 shows x-rays of the leg with a diagnosis of Brodie's abscess, seen as an elongated lytic lesion in the tibia. Figure 4 shows knee images of a 13-year-old boy with a diagnosis of chondroblastoma, seen as a well-defined lesion in the proximal tib
The CT images show a high-attenuation collection displacing the heart to the right, indicating hemopericardium or blood in the pericardial sac. Figure 3B further shows a brightly enhancing structure near a surgical clip on the distal posterior descending coronary artery, consistent with a pseudoaneurysm causing the hemorrhage. The findings are most consistent with hemopericardium developing several days after coronary bypass surgery.
This document contains rationales for questions from the 2007 ACR Diagnostic Radiology In-Training Exam related to pediatric radiology. It provides the correct answer and an explanation for each question, referencing imaging findings and typical presentations of various pediatric conditions like congenital cystic adenomatoid malformation, hematometrocolpos, pulmonary sling, Hirschsprung's disease and more. Key anatomic and imaging features are discussed in the rationales to explain why each answer choice is right or wrong.
The patient presented with neck pain and left arm weakness. Imaging showed an intramedullary mass in the cervical spinal cord. Further imaging found additional masses in the cerebellum and eye. Biopsy of the spinal cord mass revealed a hemangioblastoma. The patient was diagnosed with von Hippel-Lindau syndrome based on multiple hemangioblastomas and cysts in the pancreas. The patient underwent surgery to remove the spinal cord mass and experienced post-operative weakness but subsequent improvement.
A 24-year-old man was hospitalized for evaluation of a dilated aorta and was diagnosed with Loeys-Dietz syndrome type 1 based on genetic analysis showing a mutation. An 83-year-old woman with atrial fibrillation and pacemaker presented with heart failure symptoms. Mortality rates after first hospitalization for heart failure are higher in men and increase with age.
Fibroelastomas and rhabdomyomas are the most common benign cardiac tumors after myxomas. Myxomas typically originate in the left atrium and can cause obstruction of blood flow, embolic events, or valve dysfunction. Symptoms include dyspnea, palpitations, and constitutional symptoms. Diagnosis is made using echocardiography, CT, or MRI. Surgical excision is the treatment of choice and prognosis is generally good with low mortality rates.
The document discusses gastrointestinal radiology and contains questions and answers about various gastrointestinal conditions and imaging findings. Question 226 asks which finding on helical CT with dynamic bolus contrast enhancement is the best prognostic indicator of acute pancreatitis. The correct answer is the presence of pancreatic necrosis.
This case report describes a rare complication of percutaneous coronary intervention (PCI) through the radial artery approach. A 61-year old female presented with pain in her right wrist and hand three months after undergoing PCI through her right radial artery. Examination and ultrasound revealed an arteriovenous fistula (AVF) between the distal radial artery and an adjacent vein. The AVF was surgically excised and the radial artery was primarily reanastomosed. AVFs are abnormal connections between arteries and veins that can result from trauma or erosion. They are a rare complication following radial PCI, with only a few previous cases reported. This case highlights the importance of considering AVFs in patients with pain after radial PCI.
This document contains information about the 28th Annual In-Training Examination for Diagnostic Radiology Residents, including sample test questions and rationales. The test is sponsored by the Commission on Education and Committee on Residency Training in Diagnostic Radiology of the American College of Radiology. Sample multiple choice questions are provided about various neuroradiology topics, such as diagnoses for different brain and spine imaging findings. Rationales are given for each answer choice.
This document contains rationales for exam questions related to neuroradiology. Question 70 describes images showing increased T2 signal in the dorsal columns of the cervical spinal cord. The most likely diagnosis is subacute combined degeneration, which is caused by vitamin B12 deficiency and commonly presents with numbness in the hands. Question 71 concerns images of a child with seizures and developmental delay, showing features of holoprosencephaly. Question 72 discusses images of a man with seizures, showing a punctate calcification with ring enhancement, most consistent with cysticercosis given the patient's Hispanic ethnicity.
This document contains rationales for questions from the 2007 ACR Diagnostic Radiology In-Training Exam. The rationales provide explanations for the correct answers to multiple choice questions related to diagnostic radiology topics including test sensitivity and predictive values, medical ethics, and radiation safety. Specifically, one rationale discusses how the positive predictive value of a diagnostic test increases as the prevalence of a disease increases in a population. Another rationale examines the ethical requirement for physicians to be honest with patients about medical errors or complications. A third rationale identifies radon exposure as contributing the most to background radiation levels in the US.
The document discusses several radiology cases involving the brain and spine. Question 291 presents CT scans of a woman with headaches and asks for the most likely diagnosis of a fat-containing extraconal orbital mass. Question 292 shows MR images of a woman with extremity weakness and asks for the most likely diagnosis of multiple brain and spine lesions. Question 293 presents MR images of a man with back pain and asks for the diagnosis of a posterior spinal mass seen on the images.
The document discusses randomized controlled trials and which statements about them are true. It states that option C, "Randomization reduces the risk of an imbalance in factors which could influence the clinical course of the patients," is true. Randomization helps balance both known and unknown prognostic factors between treatment groups in a randomized controlled trial.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
Giloy in Ayurveda - Classical Categorization and SynonymsPlanet Ayurveda
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
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Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
Pictorial and detailed description of patellar instability with sign and symptoms and how to diagnose , what investigations you should go with and how to approach with treatment options . I have presented this slide in my 2nd year junior residency in orthopedics at LLRM medical college Meerut and got good reviews for it
After getting it read you will definitely understand the topic.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
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The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Nano-gold for Cancer Therapy chemistry investigatory project
23204964
1. 28th Annual
In-Training Examination
for Diagnostic
Radiology Residents
Rationales
Sponsored by:
Commission on Education
Committee on Residency Training in Diagnostic Radiology
February 3, 2005
The American College of Radiology www.acr.org
2. Section IV – Interventional Radiology
Figure 1
95. You are shown a chest radiograph (Figure 1) obtained after the placement of a temporary
hemodialysis catheter. Where is the catheter located?
A. Superior intercostal vein
B. Descending aorta
C. Hemiazygous vein
D. Duplicated SVC
American College of Radiology
3. Section IV – Interventional Radiology
Question #95
Findings:
There are pacing electrodes entering the heart normally via a right-sided superior vena cava. On the left,
taking a parallel course, is an Ash-type dialysis access catheter.
Rationales:
A. Incorrect.
B. Incorrect.
C. Incorrect.
D. Correct. In less than 1% of normal patients—patients without congenital heart disease—the left
brachiocephalic vein does not cross the midline to join the right brachiocephalic vein, but rather drains
into the coronary sinus as a second left-sided superior vena cava.
Citations:
Kaufman JA, Lee MJ. Vascular and Interventional Radiology: The Requisites. St. Louis, Mo: Mosby; 2004.
Diagnostic In-Training Exam 2005
4. Section IV – Interventional Radiology
Figure 2
96. A patient with a history of renal carcinoma presents with a painful pelvic mass six weeks following a
percutaneous lymph node biopsy. What does the pelvic arteriogram (Figure 2) show?
A. Acquired arteriovenous fistula
B. Congenital arteriovenous malformation
C. Vascular metastasis
D. Hemodialysis access graft
American College of Radiology
5. Section IV – Interventional Radiology
Question #96
Findings:
Just above the left hip joint there is a saccular dilation of the external iliac artery with communication to and
early opacification of the left iliac vein and vena cava.
Rationales:
A. Correct. Arteriovenous fistulas are point-to-point communications between an artery and a vein. Acquired
conditions, the most common etiology in a hospital setting, is iatrogenic.
B. Incorrect. Arteriovenous malformations are high-flow congenital lesions. The distinguishing feature from
acquired arteriovenous fistulas is the central tangle of communicating arterioles and venules termed “the
nidus.”
C. Incorrect. Metastases from renal cell carcinoma can be very vascular with arteriovenous shunting, but there
is no vascular metastasis present here to be seen.
D. Incorrect. Grafts are placed usually below the hip joint and the synthetic material connecting the artery and
vein is recognizable.
Citations:
Kaufman JA, Lee MJ. Vascular and Interventional Radiology: The Requisites. St. Louis, Mo: Mosby; 2004.
Diagnostic In-Training Exam 2005
6. Section IV – Interventional Radiology
Figure 3
97. A 67-year-old man presents with acute onset of back pain. You are shown a thoracic aortogram
(Figure 3). What is the MOST likely diagnosis?
A. Intraluminal thrombus
B. Traumatic laceration
C. Dissecting hematoma
D. Mycotic aneurysm
American College of Radiology
7. Section IV – Interventional Radiology
Question #97
Findings:
Arising just distal to the left subclavian artery, there is a double-barrel descending thoracic aorta with dense
filling of the compressed true lumen, a less densely opacified false lumen, and an intimal flap between.
Rationales:
A. Incorrect.
B. Incorrect.
C. Correct. Aortic dissection is the separation of the intima from the adventia by blood within the medial
layer of the artery.
D. Incorrect.
Citations:
Kaufman JA, Lee MJ. Vascular and Interventional Radiology: The Requisites. St. Louis, Mo: Mosby; 2004.
Diagnostic In-Training Exam 2005
8. Section IV – Interventional Radiology
Figure 4
98. A 52-year-old construction worker had bluish discoloration and numbness of the fifth finger of his
right hand. You are shown an arteriogram (Figure 4) of the right hand and wrist. The proximal
arteries were intact. What is the MOST likely diagnosis?
A. Paget-Schroetter syndrome
B. Giant cell arteritis
C. Scleroderma
D. Hypothenar hammer syndrome
American College of Radiology
9. Section IV – Interventional Radiology
Question #98
Findings:
There is disruption of the ulnar artery at the wrist.
Rationales:
A. Incorrect. All 4 possible answers are associated with occlusions of upper extremity blood vessels. However,
Paget-Schroetter is a syndrome of venous occlusion at the thoracic outlet.
B. Incorrect. Giant cell arteritis is associated with long strictures of the subclavian and axillary arteries.
C. Incorrect. Scleroderma does cause small vessel occlusions of the arteries of the hand and wrist and should be
seriously considered in the differential diagnosis, but the patient is a male construction worker, and it is the
ulnar artery that is occluded.
D. Correct. Finger ischemia resulting from repetitive trauma to the ulnar artery, often the result of occupational
exposure, is hypothenar hammer syndrome.
Citations:
Taylor LM. Hypothenar hammer syndrome. J Vasc Surg. 2003;37:697.
Valji K. Vascular and Interventional Radiology. Philadelphia, Pa: W.B. Saunders; 1999.
Vedantham S, Gould J. Case Review Vascular and Interventional Imaging. St. Louis, Mo: Mosby; 2004.
Diagnostic In-Training Exam 2005
10. Section IV – Interventional Radiology
Figure 5
99. A 74-year-old man has had right-sided claudication for the past 4 weeks. You are shown an
arteriogram (Figure 5) at the level of the patient’s knees. What is the MOST likely diagnosis?
A. Thrombosed popliteal artery aneurysm
B. Diabetic atherosclerotic occlusive disease
C. Popliteal artery entrapment
D. Adventitial cystic disease
American College of Radiology
11. Section IV – Interventional Radiology
Question #99
Findings:
On the right side, the popliteal artery is obstructed. On the left side there is opacification of a long fusiform
popliteal artery aneurysm.
Rationales:
A. Correct. All 4 possible answers are associated with occlusions of the popliteal artery. Popliteal artery
aneurysms are bilateral in the majority of cases and much more frequent in men than woman. Arterial
occlusive symptoms result either from thrombosis of the aneurysm, as in this case, or from distal
embolization.
B. Incorrect. Diabetes is a common condition, certainly associated with arterial occlusive disease, but is not
the best choice in the face of the contralateral aneurysm.
C. Incorrect. Typically popliteal artery entrapment presents in young athletes with a pathognonomic finding
of medial deviation of the popliteal artery. Although aneurysms may rarely develop, they would be an
unusual complication of an unusual condition.
D. Incorrect. Adventitial cystic disease is a rare condition characterized by the extrinsic compression of the
popliteal artery by a mucinous filled cyst.
Citations:
Kaufman JA, Lee MJ. Vascular and Interventional Radiology: The Requisites. St. Louis, Mo: Mosby; 2004.
LaBerge JM. Interventional Radiology Essentials. Baltimore, Md: Lippincott, Williams & Wilkins; 2000.
Diagnostic In-Training Exam 2005
12. Section IV – Interventional Radiology
100. Concerning acute gastrointestinal hemorrhage, which statement is TRUE?
A. Radionuclide scanning should not be performed.
B. Bright red blood per rectum excludes an upper gastrointestinal bleed.
C. The angiographic diagnosis is based upon the visualization of contrast extravasation into the
bowel lumen.
D. Bleeding from Mallory-Weiss tears may be diagnosed upon injection of either the superior or
inferior mesenteric arteries.
Question #100
Rationales:
A. Incorrect. Radionuclide scanning is more sensitive than arteriography in detecting gastrointestinal
hemorrhage and can be helpful in localizing the bleed.
B. Incorrect. About 10% of patients with brisk upper gastrointestinal hemorrhage, bleeding proximal to the
ligament of Treitz, will have bright red blood per rectum.
C. Correct. The hallmark of gastrointestinal hemorrhage is extravasation of contrast material into the bowel.
D. Incorrect. Mallory-Weiss tears occur at the gastroesophageal junction, not in the distribution of either the
superior or inferior mesenteric arteries.
Citations:
Kaufman JA, Lee MJ. Vascular and Interventional Radiology: The Requisites. St. Louis, Mo: Mosby; 2004.
Valji K. Vascular and Interventional Radiology. Philadelphia, Pa: W.B. Saunders; 1999.
American College of Radiology
13. Section IV – Interventional Radiology
101. Concerning inferior vena cava filters, which statement is TRUE?
A. Removable filters are not available.
B. The ideal location for filter placement is at the iliac vein confluence.
C. Current filters require surgical cut down for placement.
D. Current filters can be placed from femoral or jugular venous approach.
Question #101
Rationales:
A. Incorrect. Removable filters are now commercially available.
B. Incorrect. The ideal location is just below the renal veins.
C. Incorrect. Most devices are placed percutaneously.
D. Correct. Current devices can be placed via a transfemoral or transjugular access.
Citations:
Kinney TB. Update on inferior vena cava filters. J Vasc Interv Radiol. 2003;14:425-440.
Diagnostic In-Training Exam 2005
14. Section IV – Interventional Radiology
102. Regarding standards of practice in uterine artery embolization for leiomyomata, which statement is
FALSE?
A. A viable pregnancy is an absolute contraindication to uterine artery embolization.
B. Ultrasonography or magnetic resonance imaging should be performed prior to embolization.
C. Coil occlusion of the uterine artery is preferred.
D. Post procedure analgesia is necessary.
Question #102
Rationales:
A. Incorrect. True. Res ipsa loquitur.
B. Incorrect. True. The purpose of the imaging is to confirm the diagnosis of leiomyomata, exclude other pelvic
pathology and provide baseline measurements to assess the effects of treatment.
C. Correct. False. Successful treatment of uterine leiomyomata requires distal occlusion of all branches feeding
the uterine leiomyomata. Proximal occlusion of larger arteries with coils would not be expected to provide
clinical success.
D. Incorrect. True. A pain management strategy is required for all patients.
Citations:
Andrews RT, Spies JB, Sacks D, et al. Patient care and uterine artery embolization for leiomyomata. J Vasc Interv
Radiol 2004;15:115-120.
American College of Radiology
15. Section IV – Interventional Radiology
103. Concerning indications for percutaneous nephrostomy, ALL of the following are true EXCEPT:
A. Urinary tract obstruction
B. Pyonephrosis
C. Life threatening hyperkalemia
D. Access for endoscopic urinary tract procedures
Question #103
Rationales:
A. Incorrect. Urinary tract obstruction is the most frequent indication for percutaneous nephrostomy.
B. Incorrect. These patients are at high risk for gram-negative sepsis. Emergency drainage is indicated.
C. Correct. Life threatening hyperkalemia is NOT an indication for nephrostomy. It is true that patients
in renal failure will elevate their potassium and that percutaneous nephrostomies will reverse renal failure
when the cause is urinary tract obstruction. However, severe hyperkalemia is actually a contraindication to
percutaneous nephrostomy because of the risk of cardiac arrest. The emergency treatment is hemodialysis.
D. Incorrect. Access for stone removal is one example of an indicated endoscopic procedure that requires a
preliminary percutaneous nephrostomy.
Citations:
Ramchandani P, Cardella JF, Grassi CJ, et al. Quality improvement guidelines for percutaneous nephrostomy.
J Vasc Interv Radiol. 2003;14:S277-S281.
Valji K. Vascular and Interventional Radiology. Philadelphia, Pa: W.B. Saunders; 1999.
Diagnostic In-Training Exam 2005
16. Section IV – Interventional Radiology
104. What is the diameter of an 18 French catheter?
A. 3 mm
B. 6 mm
C. 12 mm
D. 18 mm
Question #104
Rationales:
A. Incorrect.
B. Correct. French is a scale used for denoting the size of catheters and other tubular instruments.
Each unit is roughly equivalent to .33 mm; 18 French indicates a diameter of 6 mm.
C. Incorrect.
D. Incorrect.
Citations:
Dorland Newman WA. Dorland’s Illustrated Medical Dictionary. 27th ed. Philadelphia, Pa: W.B. Saunders;
1988.
American College of Radiology