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Continuing medical education questions Computerized radiology, vol. 9, no. 1, 1985
GEDRGEI’OWN UNIWWSITY
SCHOOL OF MEDICINE Office of Continuing Education Announces
A PROGRAM OF CONTINUING MEDICAL EDUCATION BASED ON READINGS FROM
Computerized Radiology
Earn up to 12 credit hours in Category I of the Physician’s Recognition Award of the American Medical Association. This comprehensive reader/study program is available to all radiologists and technologists within the medical imaging field. As an organization accredited for continuing medical education, the Office of Continuing Medical Education, Georgetown University School of Medicine certifies that this continuing medical education activity meets the criteria for up to 2 credit hours (per issue) in Category I of the Physician’s Recognition Award of the American Medical Association and ACCME Category I, provided that it is completed as designed.
How the Program Works
1. Select articles of particular interest to you and answer the questions pertaining to your selected articles at the end of the issue. 2. The cost of the program is $5.00 per issue which covers Georgetown University’s expenses for processing your answers. For this issue and the five other issues of the volume, answer the questions of your choice for four articles in each issue, returning the enclosed answer sheet and your check in the amount of $5.00 made payable to: Georgetown University School of Medicine Office of Continuing Medical Education First Floor Hospital 3800 Reservoir Road, NW Washington, DC 20007, USA
3. If you have not yet subscribed, or need back issues of the journal, please contact the Journals Department, Pergamon Press, Fairview Park, Elmsford, NY 10523; or Headington Hill Hall, Oxford OX3 OBW, England. 4. If at least 80% of your answers to the questions in each of the six issues of Volume 8, 1984 are correct, you will receive the maximum of 12 hours of CME credit, which will be on record at the Georgetown Office of CME. Ail studying is accomplished through readings in Computerized Radiology at your leisure. Unlike most continuing education programs, there are no costly materials to buy nor travel and housing expenses to incur.
Continuing Medical Education Questions Computerized Radiology, Vol. 9, No. 1, 1985 0 Computed Tomographic Evaluation of Ocular ‘Ikauma Cobb et al., pp. 140 1. The least likely to be detected using CT is: a. Vitreous hemorrhage b. Retrobulbar hematoma c. Conjunctival hemorrhage d. Hyphema 2.
Regarding the normal optic nerve, which of the following is true: a. Is thickest at the orbital apex b. Measures 3-4. mm in width c. Avulsion usually occurs at the orbital apex d. Ultrasound can usually demonstrate the entire nerve to the optic canal e. a and c
3.
Advantages of CT over ultrasound in ocular trauma include all of the following except: a. Entire orbital extent of optic nerve can be visualized b. More sensative for detection of intra-ocular foreign bodies c. Requires no ocular manipulation d. Better demonstrates associated injuries e. Not hampered by organized intra-ocular clot or air
0 A Tomographic Analysis of the Anatomy and Pathological Conditions of the Posterior Third Ventricular
Region Weisberg,
pp. ll-1!3
4.
The pineal has the following characteristics: a. It is located posterior to the third ventricle b. It is usually c:alcified in adults c. It appears anterior to the quadrigeminal cistern d. All of the above
5.
Intracranial germinomas have the following characteristics: a. They are located in superior vermis b. They originate in the sella turcica c. They are usually located in the posterior third ventricular region and may extend to the periventricular anterior third ventricular region d. They may contain teeth, bone and cartilage
6.
Thalamic hypertensive hemorrhages have the following common characteristics: a. They extend into the third ventricle b. They extend into the quadrigeminal and interpeduncular cistern c. They extend into the fourth ventricle d. They appear as hypodense round lesions
• J A Metastatic Ovarian ‘Ibmor Involving the Dura: Seen on Myelography and CT Newmark and Ong, pp. 21-23 7.
CT can make a lspecific diagnosis of which intradural lesion? a. Lipoma b. Ependymoma c. Dermoid d. a and c e. a, b and c
8.
Intradural metastases can occur from: a. Lung tumors b. Colon tumor:; c. Breast tumors d. Kidney tumors e. All of the above
and
9.
Which of the following can cause an intradural lesion? a. Neurofibroma b. Meningioma c. Astrocytoma d. a and b e. a, b and c
0 Primary Yolk Sac Tumor of the Neck Metastasizing to the Spine: Seen on CT Newmark and Kant, pp. 25-27 10. Endodermal sinus tumors can arise from the: a. Vagina b. Anterior mediastinum c. Liver d. a and b e. a, b and c 11.’What is/are true of yolk sac tumors? a. Usually elevated alpha-fetoprotein b. Have poor prognosis c. Usually found in young patients d. Common in the neck e. a, b and c 12. Endodermal sinus tumors can arise from: a. Ovarian tissue b. Testicular tissues c. Caudate nucleus d. a and b e. a, b and c 0 Applications of Dynamic CT, or Angio CT in Neuroradiology: A Disappointing Experience Leonardi et al., pp. 29-36 13. Dynamic CT a. Automatic b. Automatic c. Automatic d. Automatic e. a, b and d
or angio CT special software must offer: analysis of the region of interest cut off of tube cooling time hysodensities hystograms exposition program with tube temperature evaluation
14. Dynamic CT of blood flow offers: a. Quantitative analysis of blood flow b. Relative to controlateral blood flow evaluation c. Recognition of vascular structures such as aneurysms, AVM, arteries, veins, etc. d. Identification of regions suffering from T.I.A. 15. Dynamic CT of brain tumors allows: a. Hystological identifications b. Recognition of tumor vascularity c. Evaluation of blood brain barrier modifications d. Differential diagnosis from vascular lesions e. Neither 0 CT Diagnosis sf Emphysematow Pyelonepbitis Vas et al., pp. 37-39 16. Emphysematous pyelonephritis is an unusual condition seen usually in: a. Diabetics b. Patients with kidney obstruction c. Both d. Neither 17. Clinical features of emphysematous a. Fever, vomiting and back pain b. Palpable flank mass c. Both d. Neither
pyelonephritis include the following findings:
vi
18. Treatment consists of: a. Antibiotic therapy b. Surgical drainage and/or nephrectomy c. Neither d. Both 0 Computed Tomography Demonstration of Obstruction of the Inferior Vena Cava Caused by Hepatocellular
Carcinoma Abaskaron
et al., pp. 41-43
19. Computed tomographic signs of obstruction of the hepatic portion of the IVC are: a. Nonvisualization of the hepatic portion of IVC b. Dilatation of the infrahepatic IVC c. Paravertebral venous collaterals d. Changes in the diameter of IVC with valsalva maneuver e. All of the above 20. The most common cause of obstruction a. Thrombosis b. Tumor c. Retroperitoneal fibrosis d. Aortic aneursym
of the upper portion of the WC:
21. Carcinoma of the liver with obstruction a. 50 - 75% b. 25 - 50% c. 10 - 29% d. Less then !i%
of the IVC
0 Cervical Diastematomyelia: Unocmmon Presentation of a Rare Congenital Disorder Anand et al., pp. 45-49 22. Diastematomyelia is most commonly seen in which region of the spine? a. Cervical b. Cervico-th,oracic c. Thoroaco-lumbar d. Lumbar 23. Onset of symlptoms is most commonly seen during: a. Infancy b. Adolescence c. Puberty 11.Adulthood 24. Associated other anomalies with diastematomyelia a. Spina bifida b. Soft tissue c. Skin d. Lipomas e. All of these
include:
0 Computed Tomographic Detection of Gas within Spontaneously Necrotic Tissue Silverman et al., pp. 51-55 25. The most common CT appearance of an intra-abdominal a. Multiple bubbles of air within a soft tissue mass b. Multiple bubbles of air within a collection of fluid c. A near water density mass d. A poorly defined soft tissue mass
abscess is:
26. Abnormal flu:id collections which can simulate abscess of CT include: a. Urinoma b. Lymphocelle c. Bile collection d. Necrotic neoplasm e. All of the arbove 27. The most spec:ific finding of an intra-abdominal a. Focal fluid collections b. Air within fluid density mass c. Poorly defined soft tissue mass d. None of the above
vii
abcess is:
Cl Intra-abdominal Ovarian Pathology: A Potential Pitfall in CT Diagnosis Brodey and Tolentino,
pp. 57-59
28. The preferred method of examination of the ovaries is ultrasound a. Lack of radiation exposure b. Ability to differentiate cystic from solid lesions c. Ability to separate uterine from ovarian masses d. Inability of CT to identify the ovaries consistently e. All of the above
because of the:
29. An ovarian cyst can be suggested as the etiology to a mass by the following CT characteristics: a. Multiplicity b. Septations c. Fat and calcifications d. Gravity-dependent layering e. All of the above 30. Limitations to evaluation of ovarian masses by ultrasound a. Intestinal gas b. Obesity c. Limited bladder capacity d. All of the above e. None of the above
include:
0 CT Measurements of the Anterior Portions of the Diaphragm with Illustrative Abnormal Cases Patterson and Teates, pp. 61-65 31. The anterior leaflet of the diaphragm can be measured on computerized tomographic images: a. Equally well on the right and left sides b. In 80% of patients on the left side and less then 15% of patients on the right c. In less than 20% of patients on either side of the abdomen 32. Measurements of the thickness of the anterior portion of the diaphragm leaflets on CT images: a. Have a wide range of thickness, up to nearly 3 cm on either side b. The normal range of thickness is wide due to folding and the oblique course in relation to routine transaxial images c. Measurements may be less important than an evaluation of the shape of apparent diaphragm thickenings on sequential images d. All of the above 33. Neoplastic implants on the anterior portions of the diaphragm: a. May be associated with little or no measurable thickening of the diaphragm b. May show calcification c. Have a rounded appearance or a rectangular shape, in contradistinction to the “pointed” appearance of folded areas in the diaphragm d. Cannot be identified on CT images e. a, b and c
..
Vlll
SCHOOL OF MEDICINE Office of Continuing Education Announces
A PROGRAM OF CONTINUING MEDICAL EDUCATION BASED ON READINGS FROM
Computerized Radiology
Earn up to 12 credit hours in Category I of the Physician’s Recognition Award of the American Medical Association. This comprehensive reader/study program is available to all radiologists and technologists within the medical imaging field. As an organization accredited for continuing medical education, the Office of Continuing Medical Education, Georgetown University School of Medicine certifies that this continuing medical education activity meets the criteria for up to 2 credit hours (per issue) in Category I of the Physician’s Recognition Award of the American Medical Association and ACCME Category I, provided that it is completed as designed.
How the Program Works
1. Select articles of particular interest to you and answer the questions pertaining to your selected articles at the end of the issue. 2. The cost of the program is $5.00 per issue which covers Georgetown University’s expenses for processing your answers. For this issue and the five other issues of the volume, answer the questions of your choice for four articles in each issue, returning the enclosed answer sheet and your check in the amount of $5.00 made payable to: Georgetown University School of Medicine Office of Continuing Medical Education First Floor Hospital 3800 Reservoir Road, NW Washington, DC 20007, USA
3. If you have not yet subscribed, or need back issues of the journal, please contact the Journals Department, Pergamon Press, Fairview Park, Elmsford, NY 10523; or Headington Hill Hall, Oxford OX3 OBW, England. 4. If at least 80% of your answers to the questions in each of the six issues of Volume 8, 1984 are correct, you will receive the maximum of 12 hours of CME credit, which will be on record at the Georgetown Office of CME. Ail studying is accomplished through readings in Computerized Radiology at your leisure. Unlike most continuing education programs, there are no costly materials to buy nor travel and housing expenses to incur.
Continuing Medical Education Questions Computerized Radiology, Vol. 9, No. 1, 1985 0 Computed Tomographic Evaluation of Ocular ‘Ikauma Cobb et al., pp. 140 1. The least likely to be detected using CT is: a. Vitreous hemorrhage b. Retrobulbar hematoma c. Conjunctival hemorrhage d. Hyphema 2.
Regarding the normal optic nerve, which of the following is true: a. Is thickest at the orbital apex b. Measures 3-4. mm in width c. Avulsion usually occurs at the orbital apex d. Ultrasound can usually demonstrate the entire nerve to the optic canal e. a and c
3.
Advantages of CT over ultrasound in ocular trauma include all of the following except: a. Entire orbital extent of optic nerve can be visualized b. More sensative for detection of intra-ocular foreign bodies c. Requires no ocular manipulation d. Better demonstrates associated injuries e. Not hampered by organized intra-ocular clot or air
0 A Tomographic Analysis of the Anatomy and Pathological Conditions of the Posterior Third Ventricular
Region Weisberg,
pp. ll-1!3
4.
The pineal has the following characteristics: a. It is located posterior to the third ventricle b. It is usually c:alcified in adults c. It appears anterior to the quadrigeminal cistern d. All of the above
5.
Intracranial germinomas have the following characteristics: a. They are located in superior vermis b. They originate in the sella turcica c. They are usually located in the posterior third ventricular region and may extend to the periventricular anterior third ventricular region d. They may contain teeth, bone and cartilage
6.
Thalamic hypertensive hemorrhages have the following common characteristics: a. They extend into the third ventricle b. They extend into the quadrigeminal and interpeduncular cistern c. They extend into the fourth ventricle d. They appear as hypodense round lesions
• J A Metastatic Ovarian ‘Ibmor Involving the Dura: Seen on Myelography and CT Newmark and Ong, pp. 21-23 7.
CT can make a lspecific diagnosis of which intradural lesion? a. Lipoma b. Ependymoma c. Dermoid d. a and c e. a, b and c
8.
Intradural metastases can occur from: a. Lung tumors b. Colon tumor:; c. Breast tumors d. Kidney tumors e. All of the above
and
9.
Which of the following can cause an intradural lesion? a. Neurofibroma b. Meningioma c. Astrocytoma d. a and b e. a, b and c
0 Primary Yolk Sac Tumor of the Neck Metastasizing to the Spine: Seen on CT Newmark and Kant, pp. 25-27 10. Endodermal sinus tumors can arise from the: a. Vagina b. Anterior mediastinum c. Liver d. a and b e. a, b and c 11.’What is/are true of yolk sac tumors? a. Usually elevated alpha-fetoprotein b. Have poor prognosis c. Usually found in young patients d. Common in the neck e. a, b and c 12. Endodermal sinus tumors can arise from: a. Ovarian tissue b. Testicular tissues c. Caudate nucleus d. a and b e. a, b and c 0 Applications of Dynamic CT, or Angio CT in Neuroradiology: A Disappointing Experience Leonardi et al., pp. 29-36 13. Dynamic CT a. Automatic b. Automatic c. Automatic d. Automatic e. a, b and d
or angio CT special software must offer: analysis of the region of interest cut off of tube cooling time hysodensities hystograms exposition program with tube temperature evaluation
14. Dynamic CT of blood flow offers: a. Quantitative analysis of blood flow b. Relative to controlateral blood flow evaluation c. Recognition of vascular structures such as aneurysms, AVM, arteries, veins, etc. d. Identification of regions suffering from T.I.A. 15. Dynamic CT of brain tumors allows: a. Hystological identifications b. Recognition of tumor vascularity c. Evaluation of blood brain barrier modifications d. Differential diagnosis from vascular lesions e. Neither 0 CT Diagnosis sf Emphysematow Pyelonepbitis Vas et al., pp. 37-39 16. Emphysematous pyelonephritis is an unusual condition seen usually in: a. Diabetics b. Patients with kidney obstruction c. Both d. Neither 17. Clinical features of emphysematous a. Fever, vomiting and back pain b. Palpable flank mass c. Both d. Neither
pyelonephritis include the following findings:
vi
18. Treatment consists of: a. Antibiotic therapy b. Surgical drainage and/or nephrectomy c. Neither d. Both 0 Computed Tomography Demonstration of Obstruction of the Inferior Vena Cava Caused by Hepatocellular
Carcinoma Abaskaron
et al., pp. 41-43
19. Computed tomographic signs of obstruction of the hepatic portion of the IVC are: a. Nonvisualization of the hepatic portion of IVC b. Dilatation of the infrahepatic IVC c. Paravertebral venous collaterals d. Changes in the diameter of IVC with valsalva maneuver e. All of the above 20. The most common cause of obstruction a. Thrombosis b. Tumor c. Retroperitoneal fibrosis d. Aortic aneursym
of the upper portion of the WC:
21. Carcinoma of the liver with obstruction a. 50 - 75% b. 25 - 50% c. 10 - 29% d. Less then !i%
of the IVC
0 Cervical Diastematomyelia: Unocmmon Presentation of a Rare Congenital Disorder Anand et al., pp. 45-49 22. Diastematomyelia is most commonly seen in which region of the spine? a. Cervical b. Cervico-th,oracic c. Thoroaco-lumbar d. Lumbar 23. Onset of symlptoms is most commonly seen during: a. Infancy b. Adolescence c. Puberty 11.Adulthood 24. Associated other anomalies with diastematomyelia a. Spina bifida b. Soft tissue c. Skin d. Lipomas e. All of these
include:
0 Computed Tomographic Detection of Gas within Spontaneously Necrotic Tissue Silverman et al., pp. 51-55 25. The most common CT appearance of an intra-abdominal a. Multiple bubbles of air within a soft tissue mass b. Multiple bubbles of air within a collection of fluid c. A near water density mass d. A poorly defined soft tissue mass
abscess is:
26. Abnormal flu:id collections which can simulate abscess of CT include: a. Urinoma b. Lymphocelle c. Bile collection d. Necrotic neoplasm e. All of the arbove 27. The most spec:ific finding of an intra-abdominal a. Focal fluid collections b. Air within fluid density mass c. Poorly defined soft tissue mass d. None of the above
vii
abcess is:
Cl Intra-abdominal Ovarian Pathology: A Potential Pitfall in CT Diagnosis Brodey and Tolentino,
pp. 57-59
28. The preferred method of examination of the ovaries is ultrasound a. Lack of radiation exposure b. Ability to differentiate cystic from solid lesions c. Ability to separate uterine from ovarian masses d. Inability of CT to identify the ovaries consistently e. All of the above
because of the:
29. An ovarian cyst can be suggested as the etiology to a mass by the following CT characteristics: a. Multiplicity b. Septations c. Fat and calcifications d. Gravity-dependent layering e. All of the above 30. Limitations to evaluation of ovarian masses by ultrasound a. Intestinal gas b. Obesity c. Limited bladder capacity d. All of the above e. None of the above
include:
0 CT Measurements of the Anterior Portions of the Diaphragm with Illustrative Abnormal Cases Patterson and Teates, pp. 61-65 31. The anterior leaflet of the diaphragm can be measured on computerized tomographic images: a. Equally well on the right and left sides b. In 80% of patients on the left side and less then 15% of patients on the right c. In less than 20% of patients on either side of the abdomen 32. Measurements of the thickness of the anterior portion of the diaphragm leaflets on CT images: a. Have a wide range of thickness, up to nearly 3 cm on either side b. The normal range of thickness is wide due to folding and the oblique course in relation to routine transaxial images c. Measurements may be less important than an evaluation of the shape of apparent diaphragm thickenings on sequential images d. All of the above 33. Neoplastic implants on the anterior portions of the diaphragm: a. May be associated with little or no measurable thickening of the diaphragm b. May show calcification c. Have a rounded appearance or a rectangular shape, in contradistinction to the “pointed” appearance of folded areas in the diaphragm d. Cannot be identified on CT images e. a, b and c
..
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