Aquifer - Radiology Exam (2024-2025) Questions With
ANSWERS
What are the surgical options for an investigating or treating
lung cancers? - <<<Answers>>>Lung biopsy/surgery options:
Surgical lumpectomy (wedge resection) - either open or
video-assisted through a mini-thoracotomy or VATS
procedure
Needle biopsy performed using fluoroscopy interventional
radiology
Needle biopsy performed using CT for guidance
Lobectomy
Pneumonectomy
Bronchoscopy
List the surgical procedures for lung removal on the basis of
size (smallest to largest) - <<<Answers>>>Wedge resection
(bite) < Segmentectomy (smallest true anatomical division
that can be removed) < Lobectomy (can be multiple lobes - bi
/ tri lobectomy) < Pneumonectomy (entire lung L or R
removed)
Have to assess how much lung function they have to start w/
to decide which is even possible.
, Aquifer - Radiology Exam (2024-2025) Questions With
ANSWERS
What are the contraindications to CT guided (percutaneous)
lung biopsy? - <<<Answers>>>Relative contraindications:
Bleeding diathesis
Pulmonary hypertension
Severe emphysema
Ventilated patient
Central lesions
Explain a V/Q scan - <<<Answers>>>The perfusion is
performed by injecting technetium-labeled macroaggregated
albumin particles intravenously. These "stick" in the smaller
pulmonary capillaries as they are larger than the capillaries,
and remain there for several hours until phagocytosed. The
particles only occlude a small percentage of precapillary
arterioles and capillaries (we certainly don't want to occlude
them all!), but the distribution of the particles provides us
with a perfusion map of the lungs.
The ventilation study can be performed in various ways, most
commonly by the patient inhaling another Tc-99m labeled
tracer (DPTA), which is aerosolized with a nebulizer or
radioactive xenon gas.
When is a V/Q scan indicated? - <<<Answers>>>When
looking for a pulmonary embolism but the patients kidney's
, Aquifer - Radiology Exam (2024-2025) Questions With
ANSWERS
cant handle the contrast needed for a CTA (CT angiography /
helical CT)
What is the "weakness" of a V/Q scan? - <<<Answers>>>IF
the lungs are already abnormal - eg. BAD emphysema or
COPD -then the scan is going to look very confusing
Intermediate probability scans basically tell you NOTHING
(probability of a PE is 20-79%)
these ARE good for a rule out though - if totally normal then
you nearly are CERTAIN theres no PE
What features you looking for on a V/Q scan? -
<<<Answers>>>"Matched Defects" - where there is a
matched decrease in both ventilation and perfusion (as in
PNA or emphysema)
or
"Mismatched Defects" - only 1 flow is decreased as in PE
where the blood isnt flowing despite good ventilation
What is Visipaque™ ? - <<<Answers>>>Visipaque™ is a
non-ionic iso-osmolar iodinated contrast that may have less
renal toxicity (although this is controversial and this contrast
agent still has nephrotoxic potential in high-risk patients).
, Aquifer - Radiology Exam (2024-2025) Questions With
ANSWERS
When should you be concerned for osteomyelitis associated
with a wound? - <<<Answers>>>Osteomyelitis should be
considered if:
- Deep or extensive ulcer, especially if chronic or over bony
prominence
- Unhealed ulcer after six weeks or more of medical care and
off-loading
- Visible bone
- Bone palpable with a probe
- Foot or toe swelling with history of ulceration
- Unexplained elevated WBC count or other markers of
inflammation
INITIAL imaging to order for suspected osteomyelitis? -
<<<Answers>>>Plain film X-rays
(not a CT)
Findings on X-ray of osteomyelitis? - <<<Answers>>>Early
signs of osteomyelitis on radiographs include:
-Focal loss of the 'white' cortical line
-Subchondral lucency
ANSWERS
What are the surgical options for an investigating or treating
lung cancers? - <<<Answers>>>Lung biopsy/surgery options:
Surgical lumpectomy (wedge resection) - either open or
video-assisted through a mini-thoracotomy or VATS
procedure
Needle biopsy performed using fluoroscopy interventional
radiology
Needle biopsy performed using CT for guidance
Lobectomy
Pneumonectomy
Bronchoscopy
List the surgical procedures for lung removal on the basis of
size (smallest to largest) - <<<Answers>>>Wedge resection
(bite) < Segmentectomy (smallest true anatomical division
that can be removed) < Lobectomy (can be multiple lobes - bi
/ tri lobectomy) < Pneumonectomy (entire lung L or R
removed)
Have to assess how much lung function they have to start w/
to decide which is even possible.
, Aquifer - Radiology Exam (2024-2025) Questions With
ANSWERS
What are the contraindications to CT guided (percutaneous)
lung biopsy? - <<<Answers>>>Relative contraindications:
Bleeding diathesis
Pulmonary hypertension
Severe emphysema
Ventilated patient
Central lesions
Explain a V/Q scan - <<<Answers>>>The perfusion is
performed by injecting technetium-labeled macroaggregated
albumin particles intravenously. These "stick" in the smaller
pulmonary capillaries as they are larger than the capillaries,
and remain there for several hours until phagocytosed. The
particles only occlude a small percentage of precapillary
arterioles and capillaries (we certainly don't want to occlude
them all!), but the distribution of the particles provides us
with a perfusion map of the lungs.
The ventilation study can be performed in various ways, most
commonly by the patient inhaling another Tc-99m labeled
tracer (DPTA), which is aerosolized with a nebulizer or
radioactive xenon gas.
When is a V/Q scan indicated? - <<<Answers>>>When
looking for a pulmonary embolism but the patients kidney's
, Aquifer - Radiology Exam (2024-2025) Questions With
ANSWERS
cant handle the contrast needed for a CTA (CT angiography /
helical CT)
What is the "weakness" of a V/Q scan? - <<<Answers>>>IF
the lungs are already abnormal - eg. BAD emphysema or
COPD -then the scan is going to look very confusing
Intermediate probability scans basically tell you NOTHING
(probability of a PE is 20-79%)
these ARE good for a rule out though - if totally normal then
you nearly are CERTAIN theres no PE
What features you looking for on a V/Q scan? -
<<<Answers>>>"Matched Defects" - where there is a
matched decrease in both ventilation and perfusion (as in
PNA or emphysema)
or
"Mismatched Defects" - only 1 flow is decreased as in PE
where the blood isnt flowing despite good ventilation
What is Visipaque™ ? - <<<Answers>>>Visipaque™ is a
non-ionic iso-osmolar iodinated contrast that may have less
renal toxicity (although this is controversial and this contrast
agent still has nephrotoxic potential in high-risk patients).
, Aquifer - Radiology Exam (2024-2025) Questions With
ANSWERS
When should you be concerned for osteomyelitis associated
with a wound? - <<<Answers>>>Osteomyelitis should be
considered if:
- Deep or extensive ulcer, especially if chronic or over bony
prominence
- Unhealed ulcer after six weeks or more of medical care and
off-loading
- Visible bone
- Bone palpable with a probe
- Foot or toe swelling with history of ulceration
- Unexplained elevated WBC count or other markers of
inflammation
INITIAL imaging to order for suspected osteomyelitis? -
<<<Answers>>>Plain film X-rays
(not a CT)
Findings on X-ray of osteomyelitis? - <<<Answers>>>Early
signs of osteomyelitis on radiographs include:
-Focal loss of the 'white' cortical line
-Subchondral lucency
