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Continuing medical education questions
GEORGETOWN UNMB!SITY 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 1 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 forfour 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. All 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. 8, No. 4, 1984 0 Radiology of Anterior Cerebral Artery Infarction Nabeedy et al., pp. 183-192 1.
What is the most common clinical finding in infarction of the territory of the anterior cerebral artery? a. Contralateral leg weakness b. Contralateral face weakness c. Expressive aphasia
2.
What is the most common cause of bilateral anterior cerebral artery territory infarction? a. Embolic process b. Arteritis c. Bleed and spasm from rupture of anterior communicating artery aneurysm d. Hypertension
3.
Which test is more sensitive in detection of infarction in the territory of the anterior cerebral artery during the first week? a. Conventional angiography b. Intravenous digital subtraction angiography c. Computed tomography d. Radionuclide brain scanning
?? An Overview of C.T. Based Stereotactic Systems for the Localization of Intracranial Lesions Alker and Kelly, pp. 193-196 4.
Currently available CT based stereotactic systems permit three-dimensional a. External landmarks such as pins b. Reformatting of images in the coronal and sagittal plane c. Use of special contrast material
5.
Accuracy of the newest CT based stereotactic systems is: a. 1.0 cm b. 0.5 cm c. 1.0 mm d. 0.5 mm
6.
CT based sterotactic systems require: a. A dedicated CT scanner in the operating room b. Extensive hardware modifications of commercially available CT units c. Relatively minor hardware modifications and specially written software
localization with the use of:
?? Traumatic Jktradural Hematomas with Delayed Deveiopment Fukamachi et al., pp. 197-201 7.
Delayed traumatic extradural hematomas: a. Are believed to be uncommon b. Are not reported in the literature at all c. Will be found more commonly then believed if sequential CT examinations can be performed in early stage of trauma more frequently d. All of the above e. a and c
8.
Clinical features of the delayed traumatic extradural hematomas collected from the literature: a. All of the patients had skull fractures b. In a large number of cases, the delayed extradural hematomas were preceded by removals of other intracranial hematomas c. In all the cases, rents of the middle meningeal arteries were bleeding sources d. All of the above
9.
As protective mechanisms preventing a rapid formation of the extradural hematoma, the following are listed: a. Bulging edematous brain especially in cases with low-pressure sources of bleeding b. Strength of dura mater-bone attachment c. Traumatic fistulous communication between the meningeal artery and its accompanying veins d. Presence of other more rapidly formed intracranial hematomas e. All of the above
1-IDouble Pituitary Glands with Partial Duplication of Facial and Forebrain Structures with Hydrocephaius Bagherian
et al., pp. 203-210
10. Duplication of the forebrain structure may be associated with these CT scan abnormalities: a. Hydrocephalus b. Agenesis of corpus callosum c. Open sagittal sutures d. Hypertelorism e. All of the above 11. Duplication of forebrain structures may be related to: a. A chromosomal anomaly b. Incomplete twinning c. Incompetent neural induction d. a and b e. b and c 12. Agenesis of the corpus callosum is associated with: a. Midline craniofacial anomalies b. A sex-link recession trait c. Hydrocephalus d. Epilepsy e. All of the above
0 Computerized Tomography of the Temporo-mandibular Joint Avrahami
et al., pp. 211-216
13. The most useful procedure in the diagnosis of a high condylar mandibular a. A combination of axial CT scan and conventional tomography b. Axial CT scan combined with panoramic view c. Coronal CT slices d. CT slices in two directions (axial and coronal) e. None of the above
fracture is:
14. The following could be said about the X-ray evaluation of the temporo-mandibular joint: a. The examination can be completed with 2-3 coronal CT slices b. The conventional X-ray studies are not necessary c. The patient receives more radiation in a conventional X-ray study than in a CT examination d. All of the above e. a and b 1.5. Which of the following statements is right? a. Fractures of the mandibular condyle cannot be missed by conventional AP and lateral tomography b. The fractures and the dislocations of the mandibular condyle are always bilateral c. The CT diagnosis of the temporo-mandibular joint is of a high medico-legal importance d. All of the above e. None of the above
0 Differential Diagnosis of Anterior Upper Mediastinal Expansion by Contrast Enhanced Computed Tomography Salonen et al., pp. 217-222 16. One would expect lymphomas seen on a CT scan to show: a. More homogeneous tissues than thyroids and thymus glands b. Contrast enhancement significantly more than thyroids and thymus tissues c. Differences between Mb. Hodgkin and other lymphomas d. a and c e. All of the above 17. One would expect mediastinal thyroids seen on a CT scan to show: a. Occasional cystic lesions b. Usually poor contrast enhancement c. More heterogeneous tissues than thymic tissues d. a and b e. bandc 18. A a. b. c. d. e.
malignant thymoma seen on a CT scan: Is usually easy to distinguish from a benign thymoma Usually affects the mediastinum Is typically infiltrative in nature All of the above aandc
0 CT Findings in Renal Ischemia and Infarction Chawla et al., pp. 223-227 19. IVP changes in renal &hernia and infarction: a. Are diagnostic of renal ischemia infarction b. May be normal in small peripheral infarcts c. Prolonged nephrographic phase in severe infarction and ischemia d. a and b e. bandc 20. CT findings in renal ischemia and infarction are: a. Classical wedge shaped infarction seen b. Area of decreased attenuation seen c. Cortical ream enhancement noted d. a and b e. band c 21. Most informative study for renal infarct and ischemia is: a. IVP b. Ultrasound c . Angiography d. CAT scan e. Renal scan
0 Computed Tomography of Iliopsoas Muscle Tumors Wechsler and Nino-Murcia, pp. 229-235 22. The following anatomical statement about the iliopsoas muscle as seen on CT scan is correct: a. The iliopsoas muscle inserts on the lesser trochanter of the femur b. Below the level of renal hila, the ureters and the gonadal vessels lie on the ventral aspect of the psoas muscle c. The femoral nerve lies in the groove between the psoas and iliacus muscle at the level of the sacrosciatic foramen d. The proximity of the psoas muscle to the abdominal and retroperitoneal organs is responsible for the frequent spread of disease into the psoas muscle e. All of the above 23. The following statement about primary psoas muscle tumors is false: a. Primary psoas muscle tumors are not uncommon b. Myosarcomas can occur in adults c. Liposarcomas can be of water density d. Calcification can occur in malignant fibrohistiocytomas 24. Metastatic tumors are: a. Not as common as primary retroperitoneal tumors b. Can be easily separated from hematomas and abscesses c. Often secondary to associated soft tissue mass extending from the spine d. Never occurs in the breast and lung carcinoma 0 Computed Tomography in Localization of Foreign Bodies Lodged in the Extremities Firooznia et al., pp. 237-239 25. Foreign objects retained in the body may (Choose the most appropriate answer): a. Be asymptomatic b. Cause pain, swelling and infection c. Both d. Neither 26. A a. b. c. d.
low-density foreign object: May not be detectable on roentgenograms May be detectable on CT Both Neither
27. CT is helpful in management of patients with suspected foreign bodies, because: a. It may detect low-density objects b. It is only helpful in detection of radio-opaque objects c. aandb d. None of the above
vii
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 1 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 forfour 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. All 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. 8, No. 4, 1984 0 Radiology of Anterior Cerebral Artery Infarction Nabeedy et al., pp. 183-192 1.
What is the most common clinical finding in infarction of the territory of the anterior cerebral artery? a. Contralateral leg weakness b. Contralateral face weakness c. Expressive aphasia
2.
What is the most common cause of bilateral anterior cerebral artery territory infarction? a. Embolic process b. Arteritis c. Bleed and spasm from rupture of anterior communicating artery aneurysm d. Hypertension
3.
Which test is more sensitive in detection of infarction in the territory of the anterior cerebral artery during the first week? a. Conventional angiography b. Intravenous digital subtraction angiography c. Computed tomography d. Radionuclide brain scanning
?? An Overview of C.T. Based Stereotactic Systems for the Localization of Intracranial Lesions Alker and Kelly, pp. 193-196 4.
Currently available CT based stereotactic systems permit three-dimensional a. External landmarks such as pins b. Reformatting of images in the coronal and sagittal plane c. Use of special contrast material
5.
Accuracy of the newest CT based stereotactic systems is: a. 1.0 cm b. 0.5 cm c. 1.0 mm d. 0.5 mm
6.
CT based sterotactic systems require: a. A dedicated CT scanner in the operating room b. Extensive hardware modifications of commercially available CT units c. Relatively minor hardware modifications and specially written software
localization with the use of:
?? Traumatic Jktradural Hematomas with Delayed Deveiopment Fukamachi et al., pp. 197-201 7.
Delayed traumatic extradural hematomas: a. Are believed to be uncommon b. Are not reported in the literature at all c. Will be found more commonly then believed if sequential CT examinations can be performed in early stage of trauma more frequently d. All of the above e. a and c
8.
Clinical features of the delayed traumatic extradural hematomas collected from the literature: a. All of the patients had skull fractures b. In a large number of cases, the delayed extradural hematomas were preceded by removals of other intracranial hematomas c. In all the cases, rents of the middle meningeal arteries were bleeding sources d. All of the above
9.
As protective mechanisms preventing a rapid formation of the extradural hematoma, the following are listed: a. Bulging edematous brain especially in cases with low-pressure sources of bleeding b. Strength of dura mater-bone attachment c. Traumatic fistulous communication between the meningeal artery and its accompanying veins d. Presence of other more rapidly formed intracranial hematomas e. All of the above
1-IDouble Pituitary Glands with Partial Duplication of Facial and Forebrain Structures with Hydrocephaius Bagherian
et al., pp. 203-210
10. Duplication of the forebrain structure may be associated with these CT scan abnormalities: a. Hydrocephalus b. Agenesis of corpus callosum c. Open sagittal sutures d. Hypertelorism e. All of the above 11. Duplication of forebrain structures may be related to: a. A chromosomal anomaly b. Incomplete twinning c. Incompetent neural induction d. a and b e. b and c 12. Agenesis of the corpus callosum is associated with: a. Midline craniofacial anomalies b. A sex-link recession trait c. Hydrocephalus d. Epilepsy e. All of the above
0 Computerized Tomography of the Temporo-mandibular Joint Avrahami
et al., pp. 211-216
13. The most useful procedure in the diagnosis of a high condylar mandibular a. A combination of axial CT scan and conventional tomography b. Axial CT scan combined with panoramic view c. Coronal CT slices d. CT slices in two directions (axial and coronal) e. None of the above
fracture is:
14. The following could be said about the X-ray evaluation of the temporo-mandibular joint: a. The examination can be completed with 2-3 coronal CT slices b. The conventional X-ray studies are not necessary c. The patient receives more radiation in a conventional X-ray study than in a CT examination d. All of the above e. a and b 1.5. Which of the following statements is right? a. Fractures of the mandibular condyle cannot be missed by conventional AP and lateral tomography b. The fractures and the dislocations of the mandibular condyle are always bilateral c. The CT diagnosis of the temporo-mandibular joint is of a high medico-legal importance d. All of the above e. None of the above
0 Differential Diagnosis of Anterior Upper Mediastinal Expansion by Contrast Enhanced Computed Tomography Salonen et al., pp. 217-222 16. One would expect lymphomas seen on a CT scan to show: a. More homogeneous tissues than thyroids and thymus glands b. Contrast enhancement significantly more than thyroids and thymus tissues c. Differences between Mb. Hodgkin and other lymphomas d. a and c e. All of the above 17. One would expect mediastinal thyroids seen on a CT scan to show: a. Occasional cystic lesions b. Usually poor contrast enhancement c. More heterogeneous tissues than thymic tissues d. a and b e. bandc 18. A a. b. c. d. e.
malignant thymoma seen on a CT scan: Is usually easy to distinguish from a benign thymoma Usually affects the mediastinum Is typically infiltrative in nature All of the above aandc
0 CT Findings in Renal Ischemia and Infarction Chawla et al., pp. 223-227 19. IVP changes in renal &hernia and infarction: a. Are diagnostic of renal ischemia infarction b. May be normal in small peripheral infarcts c. Prolonged nephrographic phase in severe infarction and ischemia d. a and b e. bandc 20. CT findings in renal ischemia and infarction are: a. Classical wedge shaped infarction seen b. Area of decreased attenuation seen c. Cortical ream enhancement noted d. a and b e. band c 21. Most informative study for renal infarct and ischemia is: a. IVP b. Ultrasound c . Angiography d. CAT scan e. Renal scan
0 Computed Tomography of Iliopsoas Muscle Tumors Wechsler and Nino-Murcia, pp. 229-235 22. The following anatomical statement about the iliopsoas muscle as seen on CT scan is correct: a. The iliopsoas muscle inserts on the lesser trochanter of the femur b. Below the level of renal hila, the ureters and the gonadal vessels lie on the ventral aspect of the psoas muscle c. The femoral nerve lies in the groove between the psoas and iliacus muscle at the level of the sacrosciatic foramen d. The proximity of the psoas muscle to the abdominal and retroperitoneal organs is responsible for the frequent spread of disease into the psoas muscle e. All of the above 23. The following statement about primary psoas muscle tumors is false: a. Primary psoas muscle tumors are not uncommon b. Myosarcomas can occur in adults c. Liposarcomas can be of water density d. Calcification can occur in malignant fibrohistiocytomas 24. Metastatic tumors are: a. Not as common as primary retroperitoneal tumors b. Can be easily separated from hematomas and abscesses c. Often secondary to associated soft tissue mass extending from the spine d. Never occurs in the breast and lung carcinoma 0 Computed Tomography in Localization of Foreign Bodies Lodged in the Extremities Firooznia et al., pp. 237-239 25. Foreign objects retained in the body may (Choose the most appropriate answer): a. Be asymptomatic b. Cause pain, swelling and infection c. Both d. Neither 26. A a. b. c. d.
low-density foreign object: May not be detectable on roentgenograms May be detectable on CT Both Neither
27. CT is helpful in management of patients with suspected foreign bodies, because: a. It may detect low-density objects b. It is only helpful in detection of radio-opaque objects c. aandb d. None of the above
vii