Case of the week

25

Created on May 16, 2022

Case of the Week

16 May 2022

1 / 2

The CT images demonstrate findings of all except

1. Spondylitis

2. Discitis

3. Psoas phlegmon

4. Compression fracture

2 / 2

All of the following are true about spinal infection except

a) Accounts for less than 5% of osteomyelitis overall

b) Fever is a common presenting symptom

c) Vertebral endplates are more commonly involved because of their abundant vascular supply

d) The thoracolumbar junction is the most commonly affected segment of the spine involved in tuberculous infection

Your score is
The average score is 48%
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Previous week cases

Created on May 09, 2022

Case of the Week

09 May 2022

1 / 2

The delayed contrast CT images show

a) Rectal perforation

b) Intraperitoneal bladder rupture

c) Extraperitoneal bladder rupture

d) Hemoperitoneum

2 / 2

The following are true about extraperitoneal bladder rupture except

a) It is the least common type of bladder injury, accounting for 10 % of cases.

b) It is usually the result of pelvic fractures or penetrating trauma.

c) The site of injury is usually at the bladder base anterolaterally

d) It is represented by the molar tooth sign

Your score is

The average score is 36%

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32

Created on May 02, 2022

Case of the Week

02 May 2022

1 / 2

The pelvic radiograph shows

a) AVN of the left hip

b) AVN of the right hip

c) Left pubic ramus fracture

d) Right femoral neck fracture

2 / 2

Risk factors for this entity include all except

a) Femoral neck fracture or dislocation

b) Chronic steroid use

c) Abstinence from alcohol

d) Sickle cell disease

Your score is
The average score is 63%
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26

Created on April 25, 2022

Case of the week

25 April 2022

1 / 2

The appropriate term for the injury seen on this CT scan is

a) Chance fracture

b) Chopart fracture

c) Choice fracture

d) Torus fracture

2 / 2

All are true of this injury except

a) These are flexion-distraction type injuries of the spine that extend to involve all three spinal columns

b) high association with visceral injuries

c) Often result from seat-belt injury

d) Patients with neurologic symptoms should be managed conservatively

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The average score is 58%
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249

Case of the week

18 April 2022

1 / 2

The most likely diagnosis on this contrast CT of the abdomen and pelvis is

a) Mesenteric volvulus

b) Acute appendicitis

c) Gallstone pancreatitis

d) Perforated diverticulitis

2 / 2

All are true about this entity except

a) In the Western world, gallstones are the leading cause of acute pancreatitis, causing up to 40% of cases

b) Larger size of the stones increases the risk for biliary pancreatitis.

c) For patients with gallstones, the risk of biliary pancreatitis is up to 7% on long term follow-up

d) ERCP is indicated for ascending cholangitis

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Your score is

The average score is 60%

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Case of the week

11 April 2022

1 / 4

Findings are characteristic of

Trauma

Posterior reversible encephalopathy syndrome (PRES)

Cysticercosis

Pick’s Disease

2 / 4

The lesions are in the

Parietal lobes, grey matter

Frontal lobes, white matter

Temporal lobes, grey matter

Occipital lobes, white matter

3 / 4

The most likely diagnosis on this contrast CT scan is

a) Appendicitis

b) Intususception

c) Abdominal aortic aneurysm

d) Internal hernia

4 / 4

The following facts about this entity are correct except

a) Bariatric surgery predisposes to this condition

b) The foramen of Winslow is the most common location

c) Often presents with obstruction of bowel

d) CT is the modality of choice for its evaluation

Your score is

The average score is 74%

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114

Case of the Week

4 April 2022

1 / 2

The sign (lipohydrohemarthrosis) demonstrated on this CT of the knee joint is also eponymously called (based on its resemblance to a French pastry)

Perfect sign

Parfait sign

Prospect sign

Prescott sign

2 / 2

The etiology of this finding is

Patellar fracture

Tibial plateau fracture

Femoral condyle fracture

Tibial spine fracture

Your score is

The average score is 64%

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221

Case of the Week

16 March 2022

1 / 2

Radiologic signs of mesenteric ischemia visible on this image include all of the following except

Small bowel wall thickening

Mesenteric vascular gas

Mesenteric hyperemia

SMA occlusion

2 / 2

Of the following, the most specific sign of mesenteric ischemia is

Fluid levels in the bowel

Bowel wall thickening

Pneumatosis of the bowel wall

Free intraperitoneal air

Your score is
The average score is 57%
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149

Case of the Week

07 March 2022

1 / 2

History: 13/y male with pain in right hip and walking difficulty.

What is the diagnosis?

Perthes disease

Slipped capital femoral epiphysis

Tuberculous arthritis

Juvenile rheumatoid arthritis

2 / 2

What is the main role of MRI in assessment of disease?

Early diagnosis

Cartilaginous involvement

Assessment of joint congruence and containment

All of the above

Your score is

The average score is 75%

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Case of the week

28 February 2022

1 / 2

The CT scan of the neck shows

Peritonsillar abscess

Ludwigs Angina

Retropharyngeal abscess

Submandibular sialadenitis

2 / 2

All are true about retropharyngeal abscess except

Half of the retropharyngeal abscesses are believed to be attributed to antecedent upper respiratory tract infection

the number one cause of death in patients with retropharyngeal abscess is upper airway occlusion

Retropharyngeal abscesses are often polymicrobial infections.

Oral antibiotics are generally sufficient to treat this infection.

Your score is

The average score is 55%

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Case of the week

21 February 2022

1 / 2

The images in this patient with acute onset of chest pain show

Aortic intramural hematoma

Hemopericardium

Potential cardiac tamponade

All of the above

2 / 2

The sign on the noncontrast CT that indicates this diagnosis is

Hyperdense crescent sign

Doughnut sign

Terry Thomas sign

Drooping lily sign

Your score is

The average score is 82%

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Case of the week

14 February 2022

1 / 2

The CT images demonstrate findings of all except

Spondylitis

Discitis

Psoas phlegmon

Compression fracture

2 / 2

All of the following are true about spinal infection except

Accounts for less than 5% of osteomyelitis overall

Fever is a common presenting symptom

Vertebral endplates are more commonly involved because of their abundant vascular supply

The thoracolumbar junction is the most commonly affected segment of the spine involved in tuberculous infection

Your score is

The average score is 62%

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Case of the Week

07 February 2022

1 / 2

In a patient with bloody diarrhea, the CT findings include

Colonic wall edema

Pneumatosis coli

Portal venous gas

All of the above

2 / 2

The diagnosis is most likely

Ulcerative colitis

Ischemic colitis

Amebic colitis

None of the above

Your score is

The average score is 75%

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Case of the week

11 April 2022

1 / 4

Findings are characteristic of

Trauma

Posterior reversible encephalopathy syndrome (PRES)

Cysticercosis

Pick’s Disease

2 / 4

The lesions are in the

Parietal lobes, grey matter

Frontal lobes, white matter

Temporal lobes, grey matter

Occipital lobes, white matter

3 / 4

The most likely diagnosis on this contrast CT scan is

a) Appendicitis

b) Intususception

c) Abdominal aortic aneurysm

d) Internal hernia

4 / 4

The following facts about this entity are correct except

a) Bariatric surgery predisposes to this condition

b) The foramen of Winslow is the most common location

c) Often presents with obstruction of bowel

d) CT is the modality of choice for its evaluation

Your score is

The average score is 74%

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Case of the Week

10 January 2022

1 / 2

The noncontrast CT in this patient who is post cardiac arrest (left image current, right image prior for comparison) shows all the following signs except:

Effacement of sulci, ventricles and basal cisterns

Loss of gray-white matter differentiation

Pontine hemorrhage

Pseudo Subarachnoid hemorrhage sign

2 / 2

The physiologic basis for these changes in the given setting includes

Ruptured aneurysm resulting in Subarachnoid hemorrhage

Hypoxic injury resulting in cerebral edema

Vascular occlusion resulting in cerebral infarct

Dehydration resulting in Dural sinus thrombosis

Your score is

The average score is 62%

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Case of the Week

3 January 2022

1 / 2

In a young female with right pelvic pain the findings most likely represent

Hydrosalpinx

Appendicitis

Ovarian torsion

Diverticular abscess

2 / 2

The common organisms involved in PID are all except

Chlamydia

Gardnerella

Neisseria

Meningococcus

Your score is

The average score is 65%

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Case of the Week

27 December 2021

1 / 3

The location of the hemorrhage is the

Falx

Pons

Midbrain

Cerebellum

2 / 3

Risk factors for brainstem hemorrhage include

Hypertension

Vascular malformation

Bleeding diathesis

All of the above

3 / 3

The following are true about midbrain hemorrhage

The majority present with acute symptoms

Common presenting symptoms are alteration of consciousness and headache

Most patients deteriorate rapidly

In approximately 1/3 no cause is apparent

Your score is

The average score is 66%

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Case of the Week

20 December 2021

1 / 2

The CT images demonstrate a

Gastric volvulus

Small bowel volvulus

Cecal volvulus

Sigmoid volvulus

2 / 2

All are true except

Approximately 60% of intestinal volvulus involves the sigmoid colon

Sigmoid volvulus is more common in younger patients

Bird beak sign is a radiologic feature of sigmoid volvulus

Endoscopic detorsion in the initial treatment of choice

Your score is

The average score is 46%

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Case of the Week

24 January 2022

1 / 2

All of the following are correct except:

Cecal volvulus accounts for approximately 50% of all intestinal volvulus

Cecal volvulus generally occurs in somewhat younger patients than with a sigmoid volvulus.

In the absence of bowel wall ischemia, the treatment can be performed endoscopically

If unrecognized and untreated, it can result in bowel perforation and fecal peritonitis.

2 / 2

In a patient presenting with sudden onset of abdominal pain, the findings above are most suggestive of a

Sigmoid volvulus

Cecal volvulus

Gastric volvulus

Intusussception

Your score is

The average score is 45%

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115

Case of the Week

13 December 2021

1 / 2

The significant finding is

Pneumobilia

Pneumatosis

Pneumothorax

Pneumoperitoneum

2 / 2

Other causes of this finding include

toxic caustic ingestion

scleroderma

steroids

lymphangioleiomyomatosis

Your score is

The average score is 47%

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112

Case of the Week

6 December 2021

1 / 2

The significant abnormality is in the

Pituitary gland

Falx

Pineal gland

Septum pellucidum

2 / 2

The following are true about pituitary apoplexy except

An existing pituitary macroadenoma is usually present

Pregnancy is a predisposing factor

It may result in oculomotor palsy

Hypopituitarism is an uncommon sequelae

Your score is

The average score is 36%

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117

Case of the Week

29 November 2021

1 / 2

Hemorrhage is seen in all except

Right thalamus

Right lateral ventricle

Left lateral ventricle

Right frontal convexity

2 / 2

The pattern of hemorrhage is suggestive of a

Bleed from vascular malformation

Bleed from tumor

Hypertensive bleed

Ruptured aneurysm

Your score is

The average score is 71%

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115

Case of the Week

22 November 2021

1 / 2

The image shows

Bartholin cyst

Perianal abscess

Urethral diverticulum

Vulvar abscess

2 / 2

All of the following facts are true about this entity except

much more common in females

usually appears in early adolescence

its size does not correlate with symptoms

causes recurrent urinary infections

Your score is

The average score is 31%

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121

Case of the Week

15 November 2021

1 / 2

The radiograph shows

Right AC joint subluxation

Sternal fracture

Left clavicle fracture

Pneumothorax

2 / 2

All the following except ___________ can be better diagnosed on a lateral radiograph

Vertebral compression fracture

Sternal fracture

Retropharyngeal abscess

Widening of the carinal angle

Your score is

The average score is 64%

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Case of the Week

9 November 2021

1 / 2

The finding on this contrast CT of the neck is

Peritonsillar abscess

Thyroid mass

Left internal carotid artery occlusion

Parotid abscess

2 / 2

Predisposing factors include

Hashimoto’s disease

Sjogren syndrome

Hypercholesterolemia

Tonsillitis

Your score is

The average score is 56%

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Case of the Week

25 October 2021

1 / 2

In a patient with history of gastric sleeve surgery the hepatic finding seen on the CT images above most likely represents

Thrombosed hepatic vein

Thrombosed portal vein

Dilated bile duct

Hepatic laceration

2 / 2

All of the following statements are correct except

Portal vein thrombosis is a common complication of laparoscopic bariatric surgery

Portal venous flow is affected by increased intraabdominal pressure with carbon dioxide pneumoperitoneum

Treatment of PVT is guided by the acuity of the disease and the underlying cause, if known

Clinical presentation may be subtle and requires a high index of suspicion

Your score is

The average score is 31%

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Case of the Week

18 October 2021

1 / 2

The CT angiogram of the brain demonstrates all the findings except

Left transverse sinus thrombosis

Left sigmoid sinus thrombosis

Left internal jugular vein thrombosis

Basilar artery thrombosis

2 / 2

Risk factors for the above would include

Heparin overdose

Hemophilia

Thrombocytopenia

COVID-19 infection

Your score is

The average score is 55%

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Case of the Week

11 October 2021

1 / 2

In a patient experiencing abdominal pain following a motor accident the findings most likely represent

Rectal perforation

Small bowel perforation

Urinary Bladder trauma

Iliac vessel injury

2 / 2

The follow up delayed rescan confirms

Intraperitoneal bladder rupture

Extraperitoneal bladder rupture

Malpositioned Foley Catheter

Bowel rupture

Your score is

The average score is 65%

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Case of the Week

4 October 2021

1 / 2

In a patient with a recent drop in hemoglobin, the significant finding on this CT scan is

Iliopsoas hematoma

Gluteal hematoma

Rectus sheath hematoma

Hemoperitoneum

2 / 2

All are true about this condition except

Generally self-limiting

More common in males

Contrast CT can demonstrate active hemorrhage

Anticoagulation is a risk factor

Your score is

The average score is 59%

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