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A program of continuing medical education based on readings from Computerized tomography
GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE Office of Continuing Education Announces
A PROGRAM OF CONTINUING MEDICAL EDUCATION BASED ON READINGS FROM
Computerized Tomography
Earn 8 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, provided that it is completed as designed. How the Program
Works
I. 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 $20.00, which covers Georgetown University’s expenses for processing your answers to all issues of Volume 5, 1981. For this issue and the three other issues of the volume, answer the questions of your choice for four articles in each issue, returning the enclosed answer sheets to: Georgetown University School of Medicine Office of Continuing Medical Education First Floor Hospital 3900 Reservoir Road, NW Washington, DC 20007, USA Unless you have paid previously, your check for $20.00 should accompany the answer sheets, made payable to the Office of Continuing Medical Education, Georgetown University School of Medicine. Additional answer sheets are available from the above address.
3. If you have not yet subscribed, or need back issues of Volume 5, please contact the Journals Dept., 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 issue of Volume 4 are correct, you will receive the maximum of 8 hours of CME credit, which wiil be on record at the Georgetown Office of CME. All studying is accomplished through readings in Computerized Tomography at your leisure. Unlike most continuing education programs, there are no costly materials to buy nor travel and housing expenses to incur.
111
Continuing Medical Education Questions
-Computerized
Tomography, Vol. 5, No. 3, 1981
“The Value of Computed Tomography in the Follow-up Study of Lung Cancer and Mediastinal Tumors” Kono et al. pp. 169-189 1. Which of the following can not be visualized even by CT? a. Pretracheal lymph nodes b. Paraaortic lymph nodes c. Botallo’s lymph nodes d. Subcarinal lymph nodes e. Hilar lymph nodes 2. CT is of value for observation of mass lesions except those: a. Obscured in the shadow of obstructive pneumonia b. Present in the chest wall c. Sunken into pleural effusion d. Present in the vicinity of main stem bronchi and aorta 3. The significance of contrast enhancement in CT in lung cancer and mediastinal tumors is: a. To deepen the shadow of large vessels and esophagus so that tumors can be separated from them b. To deepen and demarcate tumor shadows c. To differentiate between lung field mass lesions and blood vessels d. Negated “Direct Visualization of Intracranial Aneurysms by Computed Tomography” Weisberg, pp. 191-199 4. The characteristic CT findings in a non-thrombosed aneuyrsm include: a. Isodense region on plain scan b. Dense intraluminal homogeneous post-contrast enhancement c. Minimal mass effect d. All of the above 5. The CT findings in a partially thrombosed aneurysm include: a. Thin rim of peripheral calcification with rim enhancement b. Hyperdense lesion with homogeneous enhancement c. Hypodense lesion with peripheral rim enhancement d. Isodense lesion with peripheral rim enhancement 6. The CT findings in completely thrombosed aneurysms include: a. Marked intraluminal enhancement b. Evidence of hematoma formation c. Hypodense lesion d. Peripheral calcification with peripheral rim enhancement but no intraluminal enhancement “The Computed Tomography of Normal Long Bone Anatomy and Its Simulation of Disease” Paling, pp. 201-213 7. Discontinuity of the cortex of a bone as imaged on CT may be caused by: a. The partial volume effect b. A bony apophysis c. Curvature of the bone d. All of the above 8. Permeation of the medullary cavity is seen as a feature of the bony CT image in: a. Degenerative joint disease b. Malignant bone tumors c. Bony trauma d. Muscular attachments to bone iv
9. A soft tissue mass accompanying cortical irregularity of bone on CT imaging is commonly caused by: a. Primary malignant bone tumors b. Degenerative joint disease c. Muscular attachments to bone d. The partial volume effect
“Computed Tomography Localizer” Russell et al., pp. 215-220 10. Computer localization systems have not been developed for or adapted to second generation CT scanners because: a. They are too bulky b. They necessitate increasing the scan time c. Their existing detectors are relatively few, and they must scan while moving longitudinally d. They are too expensive e. Their scan times are too slow 11. The markers described in this article are advantageous because: a. They can substitute for computer localization systems b. They are inexpensive c. They can indicate the location of the site to be scanned within 0.5 cm -1 cm d. They cause no artifacts and require no calculations e. All of the above 12. Further improvement in localization might possibly be accomplished in conjunction with the localizer described: a. By attaching a tunnel-like film tray to the localizer to accommodate a pre-scan radiographic film, and exposing that film b. By having the patient hold his breath c. By shortening the scan time d. By changing the densities of the localizer devices e. None of the above
“Femoral and Obturator Neuropathy Secondary to Retroperitoneal Hemorrhage: The Value of the CT Scan” Lazaro et al., pp. 221-224 13. All but one will help defer emergency myelography in a patient developing lower extremity weakness while receiving anticoagulant. a. Absence of long tract signs b. Absence of perithecal abnormality in the CT scan c. Presence of sensory level and urinary retention d. Unilateral or discrete sensorimotor deficit 14. An alert elderly patient developed an acute onset of gait difficulty while receiving anticoagulant treatment. One of the following is the preferred treatment. a. Stop anticoagulant, perform lumbar puncture immediately, and proceed to CT scan b. Continue anticoagulant, proceed to CT scan, refer to surgical consultant c. Stop anticoagulant, order IVP, angiogram, barium enema; and observe d. Stop anticoagulant, replace blood loss, proceed to CT scan e. Stop anticoagulant, give protomine or Vitamin K, order STAT EMG 15. Signs of femoral nerve entrapment include all the following except: a. Absent knee jerk b. Sensory loss on the anterior aspect of the thigh C. Abnormal EMG potentials in the adductor muscles d. Abnormal EMG potentials in the vastus medialis muscle e. Dysesthesia over the medial aspect of the leg
“Computed Tomography in Peptic Ulcer: A Preliminary Report” Coin et al., pp. 225-230 16. Gastrointestinal CT uniquely provides a means of visualization of: a. Gastric motility b. Thickness of gastric wall c. Erosive gastritis 17. There is apparent enhancement a. Peptic ulcer b . Submucosal leiomyoma c. Gastroesophageal reflux
on CT with intravenous contrast in:
18. Gastrointestinal motility, a serious problem in CT quality may be favorably influenced by: a. Medication b. Faster scan time c. Both a and b “Computed Tomography in Opportunistic Cerebral Toxoplasmosis Report of Two Cases” Alenghat et al., pp. 231-237 19. Toxoplasma gondii is a: a. Bacterium b. Fungus c. Protozoan d. Rickettsia e. Virus 20. Toxoplasma encephalitis occurs in: a. Children exposed to cats b. Farm workers c. Elderly patients d. Immunosuppressed patients e. Foreign travellers 21. In a. b. c. d. e.
an immunosuppressed patient, abnormal low density in brain on CT may be due to: Cerebral involvement by the underlying neoplasm Bacterial and fungal infections Toxoplasma encephalitis Progressive multifocal leukoencephalopathy (PML) All of the above
vi
A PROGRAM OF CONTINUING MEDICAL EDUCATION BASED ON READINGS FROM
Computerized Tomography
Earn 8 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, provided that it is completed as designed. How the Program
Works
I. 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 $20.00, which covers Georgetown University’s expenses for processing your answers to all issues of Volume 5, 1981. For this issue and the three other issues of the volume, answer the questions of your choice for four articles in each issue, returning the enclosed answer sheets to: Georgetown University School of Medicine Office of Continuing Medical Education First Floor Hospital 3900 Reservoir Road, NW Washington, DC 20007, USA Unless you have paid previously, your check for $20.00 should accompany the answer sheets, made payable to the Office of Continuing Medical Education, Georgetown University School of Medicine. Additional answer sheets are available from the above address.
3. If you have not yet subscribed, or need back issues of Volume 5, please contact the Journals Dept., 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 issue of Volume 4 are correct, you will receive the maximum of 8 hours of CME credit, which wiil be on record at the Georgetown Office of CME. All studying is accomplished through readings in Computerized Tomography at your leisure. Unlike most continuing education programs, there are no costly materials to buy nor travel and housing expenses to incur.
111
Continuing Medical Education Questions
-Computerized
Tomography, Vol. 5, No. 3, 1981
“The Value of Computed Tomography in the Follow-up Study of Lung Cancer and Mediastinal Tumors” Kono et al. pp. 169-189 1. Which of the following can not be visualized even by CT? a. Pretracheal lymph nodes b. Paraaortic lymph nodes c. Botallo’s lymph nodes d. Subcarinal lymph nodes e. Hilar lymph nodes 2. CT is of value for observation of mass lesions except those: a. Obscured in the shadow of obstructive pneumonia b. Present in the chest wall c. Sunken into pleural effusion d. Present in the vicinity of main stem bronchi and aorta 3. The significance of contrast enhancement in CT in lung cancer and mediastinal tumors is: a. To deepen the shadow of large vessels and esophagus so that tumors can be separated from them b. To deepen and demarcate tumor shadows c. To differentiate between lung field mass lesions and blood vessels d. Negated “Direct Visualization of Intracranial Aneurysms by Computed Tomography” Weisberg, pp. 191-199 4. The characteristic CT findings in a non-thrombosed aneuyrsm include: a. Isodense region on plain scan b. Dense intraluminal homogeneous post-contrast enhancement c. Minimal mass effect d. All of the above 5. The CT findings in a partially thrombosed aneurysm include: a. Thin rim of peripheral calcification with rim enhancement b. Hyperdense lesion with homogeneous enhancement c. Hypodense lesion with peripheral rim enhancement d. Isodense lesion with peripheral rim enhancement 6. The CT findings in completely thrombosed aneurysms include: a. Marked intraluminal enhancement b. Evidence of hematoma formation c. Hypodense lesion d. Peripheral calcification with peripheral rim enhancement but no intraluminal enhancement “The Computed Tomography of Normal Long Bone Anatomy and Its Simulation of Disease” Paling, pp. 201-213 7. Discontinuity of the cortex of a bone as imaged on CT may be caused by: a. The partial volume effect b. A bony apophysis c. Curvature of the bone d. All of the above 8. Permeation of the medullary cavity is seen as a feature of the bony CT image in: a. Degenerative joint disease b. Malignant bone tumors c. Bony trauma d. Muscular attachments to bone iv
9. A soft tissue mass accompanying cortical irregularity of bone on CT imaging is commonly caused by: a. Primary malignant bone tumors b. Degenerative joint disease c. Muscular attachments to bone d. The partial volume effect
“Computed Tomography Localizer” Russell et al., pp. 215-220 10. Computer localization systems have not been developed for or adapted to second generation CT scanners because: a. They are too bulky b. They necessitate increasing the scan time c. Their existing detectors are relatively few, and they must scan while moving longitudinally d. They are too expensive e. Their scan times are too slow 11. The markers described in this article are advantageous because: a. They can substitute for computer localization systems b. They are inexpensive c. They can indicate the location of the site to be scanned within 0.5 cm -1 cm d. They cause no artifacts and require no calculations e. All of the above 12. Further improvement in localization might possibly be accomplished in conjunction with the localizer described: a. By attaching a tunnel-like film tray to the localizer to accommodate a pre-scan radiographic film, and exposing that film b. By having the patient hold his breath c. By shortening the scan time d. By changing the densities of the localizer devices e. None of the above
“Femoral and Obturator Neuropathy Secondary to Retroperitoneal Hemorrhage: The Value of the CT Scan” Lazaro et al., pp. 221-224 13. All but one will help defer emergency myelography in a patient developing lower extremity weakness while receiving anticoagulant. a. Absence of long tract signs b. Absence of perithecal abnormality in the CT scan c. Presence of sensory level and urinary retention d. Unilateral or discrete sensorimotor deficit 14. An alert elderly patient developed an acute onset of gait difficulty while receiving anticoagulant treatment. One of the following is the preferred treatment. a. Stop anticoagulant, perform lumbar puncture immediately, and proceed to CT scan b. Continue anticoagulant, proceed to CT scan, refer to surgical consultant c. Stop anticoagulant, order IVP, angiogram, barium enema; and observe d. Stop anticoagulant, replace blood loss, proceed to CT scan e. Stop anticoagulant, give protomine or Vitamin K, order STAT EMG 15. Signs of femoral nerve entrapment include all the following except: a. Absent knee jerk b. Sensory loss on the anterior aspect of the thigh C. Abnormal EMG potentials in the adductor muscles d. Abnormal EMG potentials in the vastus medialis muscle e. Dysesthesia over the medial aspect of the leg
“Computed Tomography in Peptic Ulcer: A Preliminary Report” Coin et al., pp. 225-230 16. Gastrointestinal CT uniquely provides a means of visualization of: a. Gastric motility b. Thickness of gastric wall c. Erosive gastritis 17. There is apparent enhancement a. Peptic ulcer b . Submucosal leiomyoma c. Gastroesophageal reflux
on CT with intravenous contrast in:
18. Gastrointestinal motility, a serious problem in CT quality may be favorably influenced by: a. Medication b. Faster scan time c. Both a and b “Computed Tomography in Opportunistic Cerebral Toxoplasmosis Report of Two Cases” Alenghat et al., pp. 231-237 19. Toxoplasma gondii is a: a. Bacterium b. Fungus c. Protozoan d. Rickettsia e. Virus 20. Toxoplasma encephalitis occurs in: a. Children exposed to cats b. Farm workers c. Elderly patients d. Immunosuppressed patients e. Foreign travellers 21. In a. b. c. d. e.
an immunosuppressed patient, abnormal low density in brain on CT may be due to: Cerebral involvement by the underlying neoplasm Bacterial and fungal infections Toxoplasma encephalitis Progressive multifocal leukoencephalopathy (PML) All of the above
vi