Thursday, January 27, 2022

December Quiz

December Quiz for Unofficial Journal Club

Answers are due on 2/5/2022 at midnight


1. Which acute aortic syndrome (AAS) is the most common? 

a. Acute aortic dissection (AAD). 

b. Intramural hematoma (IMH). 

c. Limited intimal tear (LIT). 

d. Penetrating atherosclerotic ulcer (PAU). 


2. Why are acute type A lesions more dangerous than type B lesions? 

a. They are about twice as common as type B lesions. 

b. They require surgery to meaningfully help the patient. 

c. They have an accelerated rate and number of potentially fatal complications. 

d. They are clinically more sudden in onset. 


3. What is the most important finding in Figure 3a? 

a. A mobile intimal flap, consistent with acute dissection. 

b. Dissection involvement of the ascending aorta. 

c. Adventitial hematoma compressing the pulmonary arteries. 

d. Aneurysmal caliber of the ascending aorta. 


4. Which AAS represents an imaging finding rather than a distinct pathologic condition? 

a. IMH. 

b. LIT. 

c. PAU. 

d. Leaking or ruptured aortic aneurysm. 


5. Why are noncontrast CT images particularly helpful in evaluating AASs? 

a. They help meet the requirement in CT before contrast-enhanced imaging can be performed. 

b. They allow the patient to practice the breath hold needed for contrast-enhanced imaging. 

c. They allow differentiation of calcified plaque from surgical material. 

d. They allow evaluation for acute hemorrhage.


6. What is the most common cause of blunt traumatic aortic injury (BTAI)? 

a. Fall from a significant height. 

b. High-velocity motor vehicle collision. 

c. Pedestrian struck by a motor vehicle. 

d. Nonaccidental trauma. 


7. What is cited as the most commonly involved site of minimal aortic injury (MAI)? 

a. Ascending aorta. 

b. Origin of the right brachiocephalic artery. 

c. Aortic isthmus. 

d. Diaphragmatic crus. 


8. What imaging modality is standard to help diagnose MAI? 

a. Chest radiography. 

b. Multidetector CT angiography. 

c. MRI. 

d. Catheter-based angiography. 


9. In figure 4d, what direct sign of MAI is present? 

a. Intimal flap. 

b. Psuedoaneurysm. 

c. Small periaortic hemorrhage. 

d. Coarctation. 


10. What type of management is currently recommended for the treatment of MAI? 

a. Minimally invasive surgical repair. 

b. Open surgical repair. 

c. Transcatheter endovascular repair (TEVAR). 

d. Nonoperative medical management.


11. What parenchymal injury with its characteristic appearance is depicted on the accompanying axial CT image? 

a. Contusion, with well-defined regions of solid pulmonary consolidation. 

b. Hematoma, with solid pulmonary consolidation that usually extends to pleural margins. 

c. Contusion, with ground-glass parenchymal attenuation with 1–3 mm of subpleural sparing. 

d. Laceration, with linear and branching parenchymal attenuation confined to individual anatomical segments. 


12. On CT images, why might pulmonary hematomas pose a diagnostic dilemma for radiologists? 

a. Chronic hematomas can be mistaken for lung malignancy. 

b. They enhance heterogeneously at arterial phase imaging. 

c. They are difficult to distinguish from pulmonary contusions. 

d. When they occur near the pulmonary hila, they are suggestive of possible pulmonary arterial injury. 


13. Why are extrapleural hematomas important for radiologists to identify correctly? 

a. They can cause local mass effect, which may result in tension physiology. 

b. They do not typically respond to chest tube placement and may require surgical evacuation. 

c. They have a high association with sternal fractures. 

d. They predispose to local pleural scar formation, which may cause breathing difficulties. 


14. Which of the following has been proposed as an explanation for the frequency of right versus left main bronchus injury? 

a. The left main bronchus is more frequently injured because it is longer than the right. 

b. The left main bronchus is more frequently injured because it is shorter than the right. 

c. The right main bronchus is more frequently injured because it is longer than the left. 

d. The right main bronchus is more frequently injured because it is shorter than the left. 


15. What percentage of cases of tracheal injury are occult at CT? 

a. 5%. 

b. 29% 

c. 54%. 

d. 92%.


16. The ____ slip extends over the dorsal aspect of the proximal phalanx to insert at the dorsal aspect of the PIP Joint


17. Mallet finger

a. results from disruption of the tendon at its insertion on the volar aspect of the distal phalanx

b. Typically treated with pinning

c. most manifest with radiographic depicted fractures

d. isolated tendon injuries are best depicted on sagittal MR images


18. Tendon lacerations

a. lacerations of the extensor mechanism often result in proximal tendon retraction

b. lacerations of the flexor tendons often result in proximal tendon retraction.

c. central slip lacerations of the extensor tendon are often diagnosed radiographically

d. the course of the flexor tendon can be divided into five anatomic zone with zone I being A1 annular pulley to flexor retinaculum


19. Pulley injuries

a. A3 is the most commonly injured pulley

b. surgical correction is recommended for A2 injuries when bowstringing extends proximal to base of the proximal phalanx

c. MR imaging in the coronal plane are best for making diagnosis

d. climber's finger occurs during powerful extension


20. What is true regarding Gamekeeper's thumb

a. Stener lesion develops in cases of UCL tear and retraction with interposition of abductor aponeurosis between the insertion and torn UCL

b. Gamekeeper thumb is an injury of the UCL usually in the proximal portion

c. Stener is commonly seen as a "yo-yo on a beach" sign

d. the absence of UCL fibers spanning the MCP joint with masslike abnormality proximal to joint requires surgery. 


Additional Question: The rules - +2 points for correct answer; -5 for wrong answer; -2 for no answer

Who was the greatest president of Robert Post's lifetime?

a. Theodore Roosevelt

b. Abraham Lincoln

c. Ronald Reagan

d. JFK

e. FDR