September EVMS (unoficial) quiz answers

Great Job everybody that participated - Dr. Dey, Dr. Trace, Dr. Bonney and Dr. Vosburg each scoring high marks!

1. Right atrium, right ventricle, coronary sinus. 3 pts

2. Swan Ganz Catheter - it is in a branch of the right pulmonary artery. It should be retracted. 2 pts

3. NG tube in a right lower lobe bronchus. 1 - reposition it. but they should be prepared for pneumothorax and possible need for chest tube placement and get a chest x-ray. 4 pts

4. Notice the right atrial lead is displaced from its position in the second image. So it needs to be resecured. 1 pt

5. Mediport - should have tip in the distal SVC. This is in an internal mammary vein. 2 points

6. Left subclavian line with tip near the coronary sinus in a retained left SVC. 2 points

7. Right mainstem intubation. 1 pt

8. Right sided PICC line with tip going into the neck. It should be in the SVC. 2 pts

9.  C - 1 pt. They are MR unsafe

10. LVAD (several answers acceptable); pericardial - 2 pt

11. Heart transplant (but could be resolution of prior problem). Used as a bridge. 2 pt

12. LA appendage clip (LAA closure device). Used for a. fib so doesn't need anticoagulation. yes; 3 pt

13. c - 1 pt

14. D - 1 pt

15. False - latent has positive lab findings with negative imaging and clinical findings - 1 pt

16.  D - a and b - 1 pt

Bonus - George Ezra

September EVMS (unofficial) Journal Club Quiz

What Time is It? Time for a Quiz! This quiz is based on the articles from September. May the best person win! Remember - EVMS residents - email me. Nonresidents - DM me on Twitter!

This month will be a little more visual based and will have more variable points.

1. Looking at these films - Where are the 3 leads placed?

2. Ignore the pacemaker. What is the other catheter? Is it placed appropriately? Where is it recommended to be?

3. Ignore the pigtail drain and ekg leads. There is an abnormally placed tube. What is it? Where is it? What do you tell the care team to do after removing and/or repositioning (2 things)?

4. Patient is symptomatic. The second image was obtained 1st. The images are separated by hours to a day. What is the finding?

5. What type of catheter is this? Where is it supposed to be? Is it where it is supposed to be?

6. Left Subclavian Line - Where is the tip? Why?

7. Ignore the mediport and EKG leads - What is wrong? What complication is present?

8. What is going on? Where should this line be?

9. Which of the following is false regarding LVAD?

A. Can be used as a bridge to recovery.

B.  Axial flow VADs are associated with nonsurgical bleeds such as GI bleed in avms or acquired von Willebrand disease. 

C. The majority of currently used versions are MR compatible

D. All of the above

10. What kind of device is this? Is the device pericardial or preperitoneal?

11. The next image is the same patient as in 10 several months later. What do you think happened? How do you think the device in 10 was used?

12. What is the marked device? What is it used for? Is it MR compatible?

13. Primary Tuberculosis

a. Thoracentesis of pleural effusions in TB commonly isolates m. tuberculosis

b. Ghon focus is an acute finding in primary TB.

c. Commonly involves right paratracheal and hilar lymph nodes

d. Empyema necessitatis is the result of an enteropleural fistula.

14. Postprimary Tuberculosis

a. Cavitation is rare postprimary tuberculosis.

b. Air-fluid level in a cavitation is almost always a sign of severe tuberculosis

c. Miliary tb is nosocomially spread

d. Poorly marginated opacities in the upper lobes and superior segment lower lobes are common

15. True or false: Latent tuberculosis has negative lab findings with positive imaging and negative clinical findings of tuberculosis. 

16. Tuberculosis

a. Inactive tuberculosis may have fibronodular changes in the upper lung fields but no evidence of active disease

b. Miliary tuberculosis can be seen in primary and postprimary tuberculosis especially in the setting of HIV.

c. Bronchial involvement can happen in primary or postprimary but especially postprimary

d. A and B

e. B and C

Bonus: Which of the following artists was endorsed by Magneto/Dumbledore? The songs are not the answer - but simply examples of the artists in action. I personally like all these artists especially Robert Post for personal reasons even though I should sue for using my name. We are both on instagram but I think mine is better - @robsradiology

A. Kongos Hey I Don't Know

B. George Ezra Shotgun

C. Robert Post Got None

D. Vampire Weekend Giving Up the Gun

E. Dashboard Confessional Hands Down

October EVMS Journal Competition Articles

It is October - Pink Ribbon Month - In honor of this month, let's review some articles in the field of Breast Imaging!

Multimodality Imaging of Single Lumen Silicone Breast Implants

Assessment and Management of Challenging BI-RADS 3 Lesions

What Radiologists Need to Know about Inflammatory Breast Cancer