Case of the Week 17 Created on November 15, 2023 Case of the Week 15 Nov 2023 1 / 2 What diagnosis best fits the above images? Metastatic carcinoid tumor. Small bowel obstruction due to intussusception. Colon carcinoma with colonic obstruction. Impacted fecal matter and stercoral colitis. 2 / 2 All the following are true except In small bowel obstruction, abdominal pain is described as intermittent and colicky but improves with vomiting, while the pain associated with LBO is continuous. The vomiting in small bowel obstruction tends to be more frequent, in larger volumes, and bilious, which is in contrast to vomiting during an large bowel obstruction, which typically presents as intermittent and feculent when present. Abdominal distention is marked in large bowel obstruction with obstipation more commonly present Large bowel obstruction will mimic small bowel obstruction if the ileocecal valve is competent. Your score is The average score is 53% LinkedIn Facebook Twitter 0% Restart quiz Previous week cases 6 Created on October 16, 2023 Case of the Week 16 Oct 2023 1 / 2 Which is the most likely etiology based on the reformatted image? Ureterocele. Retroaortic left renal vein Bladder Neoplasm Trauma 2 / 2 What is the most likely diagnosis for the renal finding? Left pyelonephritis. Obstructed left ureter Left renal vein thrombosis Left renal artery stenosis Your score is The average score is 8% LinkedIn Facebook Twitter 0% Restart quiz 20 Created on September 25, 2023 Case of the week 25 Sept 2023 1 / 2 What is the diagnosis?  TORCH infection AVM Sturge weber syndrome Healed cortical infarct 2 / 2 Which of the following is not CT findings in sturge weber syndrome subcortical calcification (seen at an earlier age than plain film) and associated parenchymal volume loss Tram-track sign of cortical and subcortical calcification ipsilateral choroid plexus may be enlarged Ventriculomegaly Your score is The average score is 70% LinkedIn Facebook Twitter 0% Restart quiz 24 Created on September 19, 2023 Case of the Week 19 Sept 2023 1 / 2 What is the diagnosis? Retroperitoneal rhabdomyosarcoma Retroperitoneal extramedullary hematopoiesis Retroperitoneal fibrosis Abdominal aorta thrombosed aneurysm 2 / 2 Which of the following is a false statement regarding retroperitoneal fibrosis? Which of the following is a false statement regarding retroperitoneal fibrosis? It causes medial deviation of the middle third of the ureters. It develops around the renal hila and spreads downwards where it can envelop the aortic bifurcation.  On MRI, the soft tissue mass is usually dark on T1W and T2W unless there is an active inflammation whereby the T2W images can be hyperintense.  Your score is The average score is 69% LinkedIn Facebook Twitter 0% Restart quiz 50 Created on September 04, 2023 Case of the Week 4 September 2023 1 / 2 In this patient with head trauma the most likely diagnosis is Epidural hematoma Subdural hematoma Diffuse Axonal Injury Duret Hemorrhage 2 / 2 Features of DAI include all except The mechanism is commonly a shear injury The neurologic manifestations are disproportionate to the imaging findings Hemorrhages commonly involve the grey-white interface and corpus callosum CT is superior to MRI in evaluation Your score is The average score is 67% LinkedIn Facebook Twitter 0% Restart quiz 30 Created on August 29, 2023 Case of the Week 28th August 2023 1 / 2 What is the diagnosis?  Lacunar infarcts Prominent Virchow Robin space Carbon monoxide poisoning Neurogenic cyst 2 / 2 Which of the following is a false statement regarding carbon monoxide poisoning? arbon monoxide poisoning may result in an anoxic-ischemic encephalopathy, with acute as well as delayed effects. Carbon monoxide strongly binds to hemoglobin and the resultant carboxyhemoglobin in the bloodstream can cause profound hypoxic/anoxic injury Treatment consists of administering 100% oxygen which accelerates the elimination of carboxyhemoglobin 9. CT is considered the most sensitive and specific imaging modality for diagnosis.  Your score is The average score is 62% LinkedIn Facebook Twitter 0% Restart quiz 27 Created on August 09, 2023 Case of the week 7 August 2023 1 / 2 The most likely diagnosis in this patient with uncontrolled hypertension and headache is Multiple sclerosis Leukodystrophy PRES Cerebral infarct 2 / 2 All of the following are true about PRES except It can present with visual disturbance Risk factors include pre-eclampsia/eclampsia, renal failure and cytotoxic agents Treatment is supportive and involves correcting the underlying cause Prognosis is poor and the minority of patients recover Your score is The average score is 70% LinkedIn Facebook Twitter 0% Restart quiz 18 Created on July 31, 2023 Case of the Week 31 July 2023 1 / 2 What is the finding seen in given images? portal vein thrombosis superior mesenteric vein thrombosis inferior mesenteric vein thrombosis left gonadal vein thrombosis 2 / 2 What is the pathology usually associated with this finding? appendicitis diverticulitis epiploic appendagitis gastritis Your score is The average score is 61% LinkedIn Facebook Twitter 0% Restart quiz 31 Created on July 24, 2023 Case of the Week 24 July 2023 1 / 2 The most likely diagnosis on this noncontrast head CT is Brainstem glioma CP angle meningioma Vertebral artery aneurysm AV malformation 2 / 2 Vertebral artery aneurysm can present with Subarachnoid hemorrhage Medullary compression Cranial neuropathy All of the above Your score is The average score is 77% LinkedIn Facebook Twitter 0% Restart quiz 22 Created on July 17, 2023 Case of the Week 17 July 2023 1 / 2 The type of hernia demonstrated is a/an Inguinal hernia Femoral hernia Obturator hernia Ventral hernia 2 / 2 CT features of an incarcerated hernia typically include all except Dilated bowel with transition at the hernia neck Mesenteric vascular congestion in the hernia Fluid in the hernia sac Retroperitoneal hemorrhage Your score is The average score is 64% LinkedIn Facebook Twitter 0% Restart quiz 18 Created on July 10, 2023 Case of the Week 10 July 2023 1 / 2 The most likely diagnosis in this patient with right lower quadrant pain is Appendicitis Transverse colon diverticulitis Meckel’s diverticulitis Salpingitis 2 / 2 The most common location for diverticulitis is Ascending colon Transverse colon Descending colon Sigmoid colon Your score is The average score is 56% LinkedIn Facebook Twitter 0% Restart quiz 24 Created on July 03, 2023 Case of the Week 3 July 2023 1 / 2 The pattern of hemorrhages seen in the head CT indicate a mechanism of Shear injury Venous infarct Ruptured aneurysm Cerebral amyloidosis 2 / 2 All of these statements are true about Diffuse Axonal Injury except It is caused by shear forces (sudden deceleration injury) The pattern consists of multiple small hemorrhages at the grey white interface, corpus callosum and brainstem Post-traumatic coma may last a considerable time CT is more sensitive than MRI Your score is The average score is 52% LinkedIn Facebook Twitter 0% Restart quiz 27 Created on June 26, 2023 Case of the Week 26 June 2023 1 / 2 What are the findings in the above image? Hemothorax Mediastinal shift to the left Small focus of active hemorrhage in the intercostal region All of the above. 2 / 2 What are the complication of hemothorax Hypotension/shock Empyema Chronic fibrothorax All of the above. Your score is The average score is 78% LinkedIn Facebook Twitter 0% Restart quiz 49 Created on June 19, 2023 Case of the Week 19 June 2023 1 / 2 What are the CT findings seen in this unresponsive patient, post cardiac arrest? Diffuse sulcal effacement Loss of grey-white differentiation Pseudosubarachnoid hemorrhage All of the above. 2 / 2 What is the diagnosis? Hypoxic ischemic encephalopathy Posterior Reversible Encephalopathy Syndrome (PRES) Creutzfeldt Jakob Disease Status Epilepticus Your score is The average score is 68% LinkedIn Facebook Twitter 0% Restart quiz 33 Created on June 12, 2023 Case of the Week 12 June 2023 1 / 2 What is the diagnosis on this contrast CT image of the abdomen and pelvis? Rectus Sheath Hematoma with active contrast extravasation Desmoid Tumor of abdominal wall Spindle cell tumor Cesarean scar Endometriosis. 2 / 2 Rectus sheath hematoma develops due to which of the following causes? Tearing of fibres of the rectus abdominis muscle Direct blunt abdominal trauma. Rupture of epigastric arteries All of the above. Your score is The average score is 88% LinkedIn Facebook Twitter 0% Restart quiz 29 Created on June 05, 2023 Case of the Week 5 June 2023 1 / 2 What is the diagnosis? Gallbladder mucocele Liver abscess Emphysematous cholecystitis Acute acalculous cholecystitis 2 / 2 Which of the following is a false statement regarding emphysematous cholecystitis? Vascular compromise of the cystic artery is thought to play a significant role in causing emphysematous cholecystitis. Women are affected twice as commonly as men. It is a surgical emergency and treatment is emergent surgical intervention. CT is considered the most sensitive and specific imaging modality for identifying gas within the gallbladder lumen or wall. Your score is The average score is 60% LinkedIn Facebook Twitter 0% Restart quiz 28 Created on May 29, 2023 Case of the Week 29 May 2023 1 / 2 What is the diagnosis? Sinding-Larsen-Johansson disease Osgood-Schlatter disease Jumper’s knee Infrapatellar bursitis 2 / 2 Which of these is not an MRI finding of Osgood-Schlatter disease? Thickening and edema of the distal patellar tendon Bone marrow edema at the tibial tuberosity Prepatellar bursitis Deep infrapatellar bursitis Your score is The average score is 52% LinkedIn Facebook Twitter 0% Restart quiz 39 Created on May 22, 2023 Case of the Week 22 May 2023 1 / 2 What is the finding seen in the given CT images Pancreatic pseudocyst Gastric outlet obstruction with pneumatosis of gastric wall Toxic megacolon with pneumatosis coli Bezoar 2 / 2 Causes of gastric wall pneumatosis may include Ingestion of corrosives Gastric outlet obstruction Gastric volvulus All of the above Your score is The average score is 91% LinkedIn Facebook Twitter 0% Restart quiz 29 Created on May 15, 2023 Case of the Week 15 May 2023 1 / 2 The maxillofacial CT scan demonstrates Orbital floor blowout fracture Lamina papyracea blowout fracture Tripod fracture Hemosinus 2 / 2 Complications of this injury may include Extraocular muscle entrapment Enopthalmos Hypoglobus All of the above Your score is The average score is 76% LinkedIn Facebook Twitter 0% Restart quiz 32 Created on May 08, 2023 Case of the Week 8 May 2023 1 / 2 In the above given frontal and lateral wrist radiograph, identify the fracture Normal radiograph. No fracture identified. Torus fracture involving distal radial metaphysis. Greenstick fracture involving the distal radial metaphysis. Salter Harris type V involving the distal radial epiphysis. 2 / 2 Which among the following is true regarding above depicted fracture. Also known as buckle fractures, are incomplete fractures of shaft of long bones better characterized by bulging of the cortex. They result from trabecular compression due to an axial loading forces along the long axis of the bone. Usually seen in children, frequently involving the distal radial metaphysis. All of the above Your score is The average score is 64% LinkedIn Facebook Twitter 0% Restart quiz 28 Created on April 24, 2023 Case of the Week 24 April 2023 1 / 2 What is the complete diagnosis? Occlusion of the right common carotid artery Occlusion of the right internal carotid artery Occlusion of the right vertebral artery Segmental occlusion of both vertebral arteries 2 / 2 Which of these is false about the vertebral artery? PICA is a paired artery originating from V4 segment of the vertebral artery Most common cause of vertebral artery thrombosis is vertebral artery dissection Vertebral artery dissection is encountered in older patients than internal carotid artery dissection Rotational vertebral artery occlusion syndrome (bow hunter's syndrome) is a rare form of vertebrobasilar insufficiency secondary to dynamic compression of the usually dominant vertebral artery. Your score is The average score is 45% LinkedIn Facebook Twitter 0% Restart quiz 45 Created on April 17, 2023 Case of the Week 17 April 2023 1 / 2 What is the diagnosis? Non-ketotic hyperglycaemic hemichorea (NHH)/ hemichorea - hemiballismus syndrome Hypertensive hemorrhages Basal ganglia calcifications Tuberous sclerosis. 2 / 2 Which of these is false about non-ketotic hyperglycaemic hemichorea Non-ketotic hyperglycaemic hemichorea is always bilateral CT brain initially is normal, but later can demonstrate hyperdensity in the Caudate nuclei and Putamen. MRI brain is the diagnostic modality of choice Findings tend to be contralateral to the body side affected by hemiballistic, hemichoreic movements. Symptoms and imaging findings resolve upon normalization of glucose levels. Your score is The average score is 62% LinkedIn Facebook Twitter 0% Restart quiz 56 Created on April 10, 2023 Case of the Week 10 April 2023 1 / 2 What is the diagnosis? Pneumatosis intestinalis Emphysematous cholecystitis. Hepatic abscess. Pneumatosis coli. 2 / 2 What is the major complication leading to a high mortality rate? Pancreatitis Pericholecystic abscess. Perforation Cystic duct obstruction Your score is The average score is 80% LinkedIn Facebook Twitter 0% Restart quiz 53 Created on April 03, 2023 Case of the Week 03 April 2023 1 / 2 What is the diagnosis? Aspiration pneumonia Aspiration pneumonia secondary to esophageal dilatation esophageal dilatation secondary to neoplasm at the GE junction and aspiration pneumonia Impacted food bolus at the gastroesophageal junction with esophageal obstruction and aspiration pneumonia 2 / 2 Which of these is FALSE about impacted food bolus? Cannot be identified at all on plain radiograph Depending on the ingested content, the bolus may be visible on plain radiograph. CT helps in identifying the site of impaction and complications Treatment less invasive than endoscopy includes effervescent crystals, carbonated drinks, glucagon and muscle relaxant. Your score is The average score is 52% LinkedIn Facebook Twitter 0% Restart quiz 35 Created on March 27, 2023 Case of the Week 27 March 2023 1 / 2 What is the vascular abnormality seen in above images? Aortic aneurysm Aberrant right subclavian artery Aberrant left subclavian artery Double aortic arch 2 / 2 What is the most common course of aberrant right subclavian artery? Retro tracheal Pre tracheal Retro esophageal Retro sternal Your score is The average score is 57% LinkedIn Facebook Twitter 0% Restart quiz 39 Created on March 20, 2023 Case of the Week 20 March 2023 1 / 2 What is the diagnosis? small bowel obstruction,due to adhesions small bowel obstruction, due to volvulus small bowel obstruction, due to internal hernia small bowel obstruction, due to jejunojejunal intussusception 2 / 2 Which of these is false about intussusception? Intussusception without a lead point tends to be transient. An intussusception without a lead point does not generally cause proximal bowel obstruction Small bowel intusssuception without a lead point is more common than intussusception with a lead point A lead point intussusception involving the small bowel is more commonly related to a primary or secondary malignant neoplasm Your score is The average score is 46% LinkedIn Facebook Twitter 0% Restart quiz 38 Created on March 13, 2023 Case of the Week 13 March 2023 1 / 2 What is the diagnosis in a patient with sepsis? Cellulitis Vaginitis emphysematosa Pyoderma gangrenosum Fournier’s gangrene 2 / 2 Which of these is false about Fournier’s gangrene? The mortality rate for patients with Fournier’s gangrene is nearly 50%. Fascial air, muscle or fascial edema are the most common findings on CT. Management options include: radical surgical debridement of necrotic tissue, i/v antibiotics and hyperbaric oxygen therapy The most commonly affected regions are the pretibial regions. Your score is The average score is 76% LinkedIn Facebook Twitter 0% Restart quiz 37 Created on March 06, 2023 Case of the Week 06 Mar 2023 1 / 2 What is the diagnosis? Lateral patellar impingement syndrome Iliotibial band syndrome Lateral patellar dislocation Osteoarthritis 2 / 2 Which is the strongest restraint to lateral patellar displacement. Medial patellar retinaculum Lateral patellar retinaculum Medial patellofemoral ligament Vastus medialis oblique Your score is The average score is 49% LinkedIn Facebook Twitter 0% Restart quiz 31 Created on February 27, 2023 Case of the Week 27 Feb 2023 1 / 2 What is the most likely diagnosis based on the given axial and coronal CT images. Right renal forniceal or calyceal rupture (perinephric urinoma) Right perinephric abscess Right subcapsular and perirenal hematoma Right retroperitoneal lymphangiomatosis 2 / 2 Which among the following is true of this pathology? The renal fornix is the most susceptible part of the renal collecting system to rupture from increased pressure. The renal pelvis is the most susceptible part of the renal collecting system to rupture from increased pressure. The most common cause of the renal calyceal rupture is ureteral stricture. On arterial phase imaging urinary contrast will accumulate outside of the collecting system within the urinoma Your score is The average score is 65% LinkedIn Facebook Twitter 0% Restart quiz