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Flashcards in FINAL Summer 2012 Deck (81)
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1
Q

Signs of paranasal sinusitis on upright Waters’ or upright coronal CT are:

A. Opacification with air-fluid level
B. Hyperaeration
C. Mixed opacification and air density
D. Rounded, well-defined, soft-tissue density

A

A. Opacification with air-fluid level

2
Q

The most common neoplasm to produce a paraneoplastic syndrome such as HPT, Cushing’s syndrome or acromegalgy and produce mediastinal widening:

A. Squamous cell
B. Small Cell
C. Large cell
D. Carcinoid

A

B. Small Cell

3
Q

On this view the right ventricle is non-border forming

A. PA
B. Lateral
C. LAO
D. RAO

A

A. PA

4
Q

Small bowel obstruction (mechanical ileus) produces ___ on the plain film upright radiograph

A. Multiple water filled loops of bowel
B. Distended gas filled loops/air-fluid levels
C. Distended gas filled loops/no air-fluid levels
D. Fluid/fluid levels due to fat and fluid separation

A

B. Distended gas filled loops/air-fluid levels

5
Q

All of the following are causes of large bowel obstruction (mechanical ileus). Which is the most common?

A. Intususception, adhesions
B. Colon cancer, diverticulitis
C. Ovarian mets, volvulus
D. Bowel hernia, distended bladder

A

B. Colon cancer, diverticulitis

6
Q

Lymphangitic carcinomatosis/pulmonary lymphatic mets, causes reduced-lymph absorption edema, is most commonly related to primaries of the stomach, pancreas, prostate and breast and will show all of the following findings except:

A. Kerley lines
B. Hilar LAN
C. Reticulonodular pattern
D. 3-5mm nodules

A

D. 3-5mm nodules

7
Q

Descending order of incidence for aortic aneurysm location is:

A. Aortic arch, thoracic, ascending, abdominal
B. Thoracic, ascending, abdominal, arch
C. Ascending, arch, thoracic, abdominal
D. Abdominal, arch, thoracic, ascending

A

D. Abdominal, arch, thoracic, ascending

8
Q

Marfan’s syndrome would cause a ___ aneurysm

A. Stanford A
B. Stanford B

A

A. Stanford A

Type II

9
Q

A common posterior mediastinal mass:

A. Bronchogenic cyst
B. IVF Schwannoma
C. Aortic aneurysm
D. Esophageal achalasia

A

B. IVF Schwannoma

10
Q

HEALED, END STAGE (not active) secondary/post primary TB usually produces radiographic upper lung ___ which may lead to ___

A. Air space consolidation, cavitation
B. fibrotic nodules, conglomerate masses
C. nodular densities, multiple calcific nodules
D. fibrosis, cicatrix atelectasis

A

D. fibrosis, cicatrix atelectasis

11
Q

Probably the most common potentially life-threatening disorder encountered in patients presenting with back pain:

A. Infectious discitis
B. Multiple myeloma
C. Emphysematous cholecystitis
D. AAA

A

D. AAA

12
Q

Which of the following are characteristic findings of acquired valvular heart disease (usually mitral and aortic) which typically causes valvular stenosis: Pick all correct choices

A. Alteration in cardiac size
B. Valvular calcification may be present
C. Alteration in pulmonary vascularity
D. Alteration in size and shape of specific cardiac chambers

A

A. Alteration in cardiac size
B. Valvular calcification may be present
C. Alteration in pulmonary vascularity
D. Alteration in size and shape of specific cardiac chambers

13
Q

True of both Hodgkin’s and non-Hodgkin’s lymphoma :

A. Anterior mediastinal mass
B. Pleural effusion
C. Interstitial lung pattern
D. Bimodal age distribution

A

A. Anterior mediastinal mass

14
Q

Pancoast tumor is a(n) ____ usually:

A. Bronchogenic carcinoma
B. Carcinosarcoma
C. Alveolar cell carcinoma
D. Bronchial adenoma

A

A. Bronchogenic carcinoma

15
Q

Aortic coarctation classic radiographic finding:

A. Bilateral rib notching
B. Unilateral rib notching
C. Rt. ventricle enlargement
D. Compresses the trachea

A

A. Bilateral rib notching

16
Q

Upright abdominal or lumbar spine plain films would not be helpful in the evaluation of:

A. Free peritoneal air
B. Acute pancreatitis
C. Abnormal calcifications
D. Gas and fluid patterns

A

B. Acute pancreatitis

17
Q

The presence of pulmonary hematogenous mets:

A. Indicates slow primary growth
B. May have no signs & symptoms at discovery
C. Indicates the primary lesion is a carcinoma
D. Indicates the primary lesion is an adenoma

A

B. May have no signs & symptoms at discovery

18
Q

A patient with multiple small cavitating pulmonary nodules without air-fluid levels, nasopharyngeal mass with difficulty nose breathing and renal disease is likely suffering from:

A. Carter’s syndrome
B. Wegener’s disorder
C. Erasmus syndrome
D. Langerhans histocytosis/eosinophilic granuloma

A

B. Wegener’s disorder

19
Q

Where in the human body are air-fluid levels normal? Pick two

A. Maxillary sinus
B. Proximal large bowel
C. Lung
D. Gastric fundus

A

B. Proximal large bowel

D. Gastric fundus

20
Q

A patient with an acute abdomen showing distended loops of small bowel 5 cm in diameter has a(n) ___ small bowel pattern.

A. normal
B. abnormal

A

B. abnormal

21
Q

Which of the following cause pulmonary edema related to PVH? Pick all that apply

A. Mitral stenosis
B. Pulmonary growth
C. CHF
D. Ammonia gas inhalation

A

A. Mitral stenosis

C. CHF

22
Q

Periostitis-diffuse, synovitis and digital clubbing may be a clinical indication of:

A. atelectasis
B. Previous pulmonary tuberculosis
C. Pleuritis
D. pulmonary neoplasm

A

D. pulmonary neoplasm

23
Q

Westermark’s sign and Hampton’s hump are radiographic features of:

A. pneumothorax
B. myocardial infarction
C. pulmonary embolism/infarction
D. pneumococcal pneumonia

A

C. pulmonary embolism/infarction

24
Q

The pancoast syndrome consists of:

A. Localized emphysema, apical pulmonary mass, rib pain
B. arm pain, cervical spine pain, hilar pulmonary mass, Horner’s syndrome
C. Bloody sputum, apical pulmonary mass, arm pain, vertebral destruction
D. Oculosympathetic interference, arm pain, neck pain, apical pulmonary mass

A

D. Oculosympathetic interference, arm pain, neck pain, apical pulmonary mass

25
Q

The end stage findings of empyema (infectious, massive pleural effusion) may result in:

A. Pleural plaque calcification
B. Herniation of ipsilateral lung tissue
C. Tracheal deviation to contralateral side
D. Expanded rib cage on ipsilateral side

A

A. Pleural plaque calcification

26
Q

Eisenmenger physiology results in?

A. Cardiac arrest
B. Great exercise for the right ventricle
C. Left atrial enlargement
D. Increased pulmonary gaseous transmission

A

A. Cardiac arrest

27
Q

Three direct signs of lung collapse, seen on plain film are:

A. increased lung lucency, displaced fissures, and hilar elevation
B. Increased lung opacity, displaced fissures, and vascular or bronchial crowding
C. Unilateral hemidiaphragm elevation, tracheal deviation, displaced fissures
D. Hilar displacement, displaced fissures, hyper lucency of unaffected lung

A

B. Increased lung opacity, displaced fissures, and vascular or bronchial crowding

28
Q

Chiropractic clinicians should be aware that many intrinsic organ disease refer pain. Abdominal visceral disease may refer pain to the musculoskeletal system. Kidneys and ureters may refer pain to the ___

A. lumbar spine; pelvis
B. groin/flank
C. lower thoracic spine
D. sacral region

A

B. groin/ flank

29
Q

Costophrenic angle blunting may indicate pleural scar, low flat diaphragm or ____

A. Free pleural effusion
B. Atelectasis of a lower lobe
C. Basal subsegmental infiltrate
D. Subpulmonic pleural effusion

A

A. Free pleural effusion

30
Q

Next to lymph noes and ectopic thyroid, this might be a third common cause for middle mediastinal masses

A. Trachea
B. Esophagus
C. Aorta
D. Azygous vein enlargement

A

B. Esophagus

31
Q

Best cardiac emanation for chamber wall thickness and volume?

A. Echocardiography
B. Retrograde aortography
C. Coronary arteriography
D. Thallium scan

A

A. Echocardiography

32
Q

300 ml or greater pleural effusion volume is required to be visible on:

A. an upright PA projection
B. the lateral decubitus view
C. a lateral view
D. a cross-table projection

A

A. an upright PA

33
Q

All of the following would be considered true statements regarding pulmonary metastasis except:

A. May have no known primary
B. May have no symptoms at discovery
C. Pleural effusion commonly accompanies
D. Lymph more common than hematogenous

A

D. Lymph more common than hematogenous

34
Q

Hilar mediastinal lymphadenopathy is most often due to ___ in patients >40.

A. lung cancer spread
B. Histoplasmosis
C. Coccidiodomycosis
D. Sarcoidosis

A

A. lung cancer spread

35
Q

Which one of the following is not a finding of pneumothorax:

A. Peripheral hyperlucency/ pleural space air
B. Mediastinal shift to the affected side
C. Visceral pleural line
D. Tracheal deviation to unaffected side

A

B. Mediastinal shift to the affected side

36
Q

Which one of the following is associated with pulmonic stenosis, ASD, and right ventricle hypertrophy:

A. Tetralogy of Fallot
B. Trilogy of Fallot
C. Transposition of great vessels
D. Tricuspid atresia
E. Ebstein's anomaly with cyanosis
A

B. Trilogy of Fallot

37
Q

ASD with mitral stenosis would be expected to produce ___ which will eventually produce ___? Pick 2

A. Left atrial enlargement
B. Fallot physiology
C. Eisenmenger’s
D. High volume left to right shunting

A

C. Eisenmenger’s

D. High volume left to right shunting

38
Q

Which one of the following would not have an ASD?

A. Trilogy of Fallot
B. Truncus arteriosus
C. Tricuspid atresia
D. Pentalogy of Fallot
E. Ebstein's anomaly with cyanosis
A

B. Truncus arteriosus

39
Q

On a recumbent AP chest film, upper and lower lung blood vessels of equal size may indicate pulmonary blood pressure alteration:

A. True
B. False

A

B. False

40
Q

Which one of the following is non-cyanotic?

A. VSD & Eisenmenger's
B. Trilogy of Fallot
C. Ebstein's & ASD
D. Lutembacher's syndrome
E. Pentalogy of Fallot
A

D. Lutembacher’s syndrome

41
Q

Which condition would not be a pre-cursor for left ventricle failure?

A. Emphysema
B. Aortic stenosis
C. Mitral regurgitation
D. Coronary artery disease

A

A. emphyesma

42
Q

Which type of aortic dissection is the most common and has the worst prognosis, using the DeBakey classification?

A. type II
B. type I
C. Type III
D. Type IV

A

B. Type 1

43
Q

Which dissection in the stanford system would have better prognosis?

A. type II
B. type I
C. Type III
D. Type IV

A

C. Type III

44
Q

What is a classic sign of pulmonary arterial hypertension?

A. Small hilar areas
B. Pulmonary edema
C. Constriction of upper lobe blood vessels
D. Large pulmonary artery

A

D. Large pulmonary artery

45
Q

A common finding of mitral stenosis and CHF:

A. Right atrial enlargement
B. Right lung base airbronchogram sign
C. Phantom tumor
D. PVH
E. LVE
A

D. PVH

46
Q

A patient with multiple posterior mediastinal masses and enlarged IVF’s may have?

A. Myasthenia Gravis
B. Neurofibromatosis
C. Multiple sclerosis
D. Muscular dystrophy

A

B. Neurofibromatosis

47
Q

Chamber enlargement at the right ventricle, would be expected with which of the following:

  1. Ebstein’s anomaly
  2. Aortic coarctation
  3. pulmonic stenosis
  4. ASD
  5. VSD
A. 1,2,3
B. 2,3,4
C. 1,2,4
D. 3,4,5
E. 1,3,4
A

D. 3,4,5

  1. pulmonic stenosis
  2. ASD
  3. VSD
48
Q

Which primary malignancy is responsible for 3-5mm metastatic nodules?

A. Osteosarcoma
B. Colon cancer
C. Seminoma
D. Breast cancer

A

C. seminoma

49
Q

Pulmonary vascular obstructive disease secondary to chronic increased pulmonary blood flow can convert a left to right shunt to a right to left shunt

A. True
B. False

A

A. True

50
Q

With regard to tumor staging, all of the following combinations of TNM are stage 3a or b cancers except:

A. T1 N0 M0
B. T2 N2 M0
C. T4 N2 M0
D. T3 N3 M0

A

A. T1 N0 M0

51
Q

Which of the following combinations would involve only ipsilateral lymph node groups on CT examination?

A. T1 N0 M0
B. T2 N1 M0
C. T1 N2 M0
D. T3 N3 M0

A

B. T2 N1 M0

52
Q

Berqvist’s triad is associated with ___,___, and ___

A. Rib fracture
B. Traumatic hernia of the left hemidiaphragm
C. Spine and/or pelvic fracture
D. Traumatic hernia of the right hemidiaphragm

A

A. Rib fracture
B. Traumatic hernia of the left hemidiaphragm
C. Spine and/or pelvic fracture

53
Q

Eisenmenger physiology with VSD would have cyanosis:

A. In the lower extremity only
B. In the upper extremity only
C. In the upper and lower extremity
D. In the peripheral extremity

A

C. In the upper and lower extremity

54
Q

Pulmonary infarction related to DVT and pulmonary embolism:

A. Has no radiographic sign
B. Is seen as a pulmonary mass
C. Seen as a round or oval opacity over the lung hilus
D. Seen as air space consolidation at the lateral lung

A

D. Seen as air space consolidation at the lateral lung

55
Q

Carcinoid tumor of the lung is a ___

A. Bronchiolar carcinoma
B. Bronchial adenoma
C. Carcinosarcoma
D. Bronchogenic carcinoma

A

B. Bronchial adenoma

56
Q

Which of the following would not be a cause of LVE?

A. Mitral stenosis
B. Systemic hypertension
C. Large VSD
D. Aortic Coarctation

A

A. Mitral stenosis

57
Q

Echinococcosis (hydatid disease) is a pulmonary infection:

A. Causing “a water-lolly sign” and bone disease
B. Caused by a parasite found in South Asia
C. That occurs in newborns with inactivated surfactant
D. Complicating comatose or quadriplegic patients

A

A. Causing “a water-lolly sign” and bone disease

58
Q

Which of the following would be causes of proximal aortic enlargement? Pick all the correct choices

A. Coarctation
B. ASD
C. Mitral Stenosis
D. PDA

A

A. Coarctation

59
Q

Which of the following are considered to be the smoking related lung neoplasms?

  1. Squamous cell
  2. Small cell
  3. Carcinoid
  4. Large cell
  5. Bronchiolar carcinoma
A. 1,2,3,4
B. 1,2,3
C. 1,2,4
D. 1,4,5
E. 1,3,4,5
A

C. 1,2,4

  1. Squamous cell
  2. Small cell
  3. Large cell
60
Q

Which cause of atypical pleural effusion is usually rift sided and inter fissure major and minor?

A. Empyema
B. CHF
C. pulmonary infarction
D. SLE
E. pleural metastasis
A

B. CHF

61
Q

All of the following must be considered in the differential diagnosis of thymoma except:

A. Teratoma
B. Substernal thyroid
C. Lymphoma
D. Pericardial cyst

A

D. Pericardial cyst

62
Q

The extra pleural sign (remember what this tells us) helps to differentiate lung lesions from all of the following except:

A. Free pleural effusion
B. Rib mets. or fractures
C. Mediastinal lesions
D. Intercostal lesions

A

A. Free pleural effusion

63
Q

Adynamic or paralytic/non-obstructive ileus may be caused by:

A. Diverticulitis
B. Spinal trauma
C. Tumor
D. Volvulus

A

B. Spinal trauma

  • Obstructive
  • Tumor
  • Diverticulitis
  • Small bowel obstruction
  • Volvulus
64
Q

Gallstone mechanical ileus is caused by:

A. A stone filled, spastic gallbladder
B. A gallstone in the small bowel
C. A gallstone lodged at the biliary duct
D. A gallstone lodged in the pancreatic duct

A

B. A gallstone in the small bowel

65
Q

The percentage of gallstones calcified and visible on plain film:

A. 100%
B. 10-15%
C. 50-60%
D. 80-90%

A

B. 10-15%

66
Q

Diagnostic abdominal ultrasound is the most cost effective imaging for which two

A. Gallbladder
B. Small bowel
C. Stomach
D. Aorta

A

A. Gallbladder

D. Aorta

67
Q

Smooth muscle leiomyoma is a common finding in the female patient in this area:

A. Uterine
B. Spleen
C. Hepatic
D. Adrenals

A

A. Uterine

68
Q

The most common reasons for mediastinal lymph node calcification include:

A. Bronchogenic carcinoma and lymphoma
B. Fungal infections and pneumoconiosis
C. Metastatic chondrosarcoma and neurofibroma
D. Sarcoidosis and metastatic osteosarcoma

A

B. Fungal infections and pneumoconiosis

69
Q

Small cell carcinoma may create a radiologic appearance of:

A. Pulmonary nodules
B. Large pulmonary artery
C. Hilar enlargement
D. Apical mass

A

C. Hilar enlargement

  • Apical mass
  • Squamous cell
70
Q

Interstitial pulmonary edema and normal hilar size and normal upright vascular relationship suggests:

A. PVH
B. Ebstein’s anomaly
C. Pulmonic stenosis
D. Increased capillary permeability

A

D. Increased capillary permeability

71
Q

AAA should be suspected on a lateral lumbar X-ray anytime the calcified vessel wall diameter measures:

A. >2cm
B. >3cm
C. >5cm
D. >3.8cm

A

D. >3.8cm

72
Q

Periostitis, synovitis and digital clubbing:

A. Is associated with atelectasis
B. Is an indication of pleural effusion
C. Related to previous pulmonary TB
D. A paraneoplastic syndrome related to bronchiogenic ca.

A

D. A paraneoplastic syndrome related to bronchiogenic ca.

73
Q

With skeletal metastasis, which should be remembered relative to bronchiogenic carcinoma?

A. Commonly caused mixed mets
B. May spread beyond axial skeleton
C. Causes osteolytic mets.
D. Typically spreads only to the rib cage

A

B. May spread beyond axial skeleton

C. Causes osteolytic mets.

74
Q

The potential seriousness of AAA is directly related to the lumen diameter. The rule in clinical practice, AAA measuring

A

D. 5

75
Q

Multiple cm pulmonary nodules can be seen with all except:

A. Mets.
B. Sarcoidosis
C. Rheumatoid lung
D. Pulmonary infarction

A

D. Pulmonary infarction

76
Q

MATCHING

Teratoma

A. Non-obstructive/paralytic ileus
B. High diabetes association
C. Hemoptysis common
D. Mediastinum near origin of great vessels
E. Bronchiolar carcinoma
AB. Caplans syndrome
AC. LAN+ lung disease
A

D. Mediastinum near origin or great vessels

77
Q

MATCHING

Coal worker’s pn.

A. Non-obstructive/paralytic ileus
B. High diabetes association
C. Hemoptysis common
D. Mediastinum near origin of great vessels
E. Bronchiolar carcinoma
AB. Caplans syndrome
AC. LAN+ lung disease
A

AB. Caplan’s syndrome

78
Q

MATCHING

Acute traumatic spine compression fx

A. Non-obstructive/paralytic ileus
B. High diabetes association
C. Hemoptysis common
D. Mediastinum near origin of great vessels
E. Bronchiolar carcinoma
AB. Caplans syndrome
AC. LAN+ lung disease
A

Non-obstructive/paralytic ileus

79
Q

MATCHING

Sarcoidosis

A. Non-obstructive/paralytic ileus
B. High diabetes association
C. Hemoptysis common
D. Mediastinum near origin of great vessels
E. Bronchiolar carcinoma
AB. Caplans syndrome
AC. LAN+ lung disease
A

AC. LAN + lung disease

80
Q

MATCHING

Vas deferens calcification

A. Non-obstructive/paralytic ileus
B. High diabetes association
C. Hemoptysis common
D. Mediastinum near origin of great vessels
E. Bronchiolar carcinoma
AB. Caplans syndrome
AC. LAN+ lung disease
A

B. High diabetes association

81
Q

The pressure on the wall of an AAA is important. How many times greater is the pressure on the wall of a 6cm AAA compared to a 4cm AAA

A. 1.5
B. 3.0
C. 4.0
D. 5.0

A

D. 5.0