SA Medical - General Medicine And Imaging of Disease

Atoll sign  Atoll sign (ring-shaped opacity) COP - Cryptogenic organizing pneumonia (COP) Bilateral Pulmonary Hypoplasia  Pulmonary hypoplasia in the neonate can be unilateral or bilateral. Bilateral pulmonary hypoplasia is most often the result of compression of the lungs during fetal development. Congenital bone dysplasias and syndromes associated with hort ribs and a small thoracic cage (asphyxiating thoracic dystrophy, thanatophoric dwarfism, Ellis-van Creveld syndrome) compress the lungs and cause hypoplastic lungs. The degree of hypoplasia is often severe and leads to the demise of these infants. Chromosomal abnormalities such as the trisomies are associated with hypoplastic lungs, and in some infants, hypoplasia is “primary” and unexplained.  Black pleura sign Pulmonary alveolar microlithiasis - Sandlike microcalcifications of lung (black pleura sign) Cheerio sign Bronchioloalveolar carcinoma

Calcification of coronary arteries  Calcification of coronary arteries are the most reliable plain film sign of CAD (90% specificity in symptomatic patients), but calcified coronary arteries are not necessarily stenotic. Figure-3 sign Pseudocoarctation Gated CT Chest Retrospective or prospective ECG gated minimize motion artifact from the beating heart; Use of gating enables coronary artery and aortic valve evaluation Indication: anterior chest pain and suspicion of ascending aortic disection requires gating; Coronary artery evaluation - coronary artery disease Functional Valve Imaging requires retrospective cardiac gating Retrospective imaging - functional evaluation prospective ECG gated - limited by CT scan type; lower dose of radiation; LV aneurysm LV aneurysm is the second most reliable plain film sign of CAD. It develops in 20% MI. Normal Aortic Valve 64-detectot c

Circumscribed masses with well-defined borders  Circumscribed masses with well-defined borders (>75% circumference): uncommon sign of malignancy; only 2% of solitary masses with smooth margins are malignant. Inverted teardrop • Inverted teardrop: nonspecific sign seen with extensive gel bleed or focal intracapsular rupture; occurs when silicone enters radial fold and then leaks between internal and external capsules linguini sign by MRI • Flaps (“linguini sign” by MRI) may represent intracapsular rupture. Skin thickening (>3 mm)  Skin thickening (>3 mm) may be a sign of malignancy or benign conditions. Types: Focal: local tumor Diffuse: sign of edema; may be due to inflammatory cancer Spiculated tumor margin • Spiculated: a spiculated tumor margin is the only specific sign of malignancy; however, not all spiculated masses are cancers. Spiculated masses are the e

Splenic size is variable depending on age, nutrition, and patient size; normal 12x4x7 cm; splenic volume Apxtransversexsuperior-inferior /2; normal <150g br=""> Acessory spleens are common; failure of fusion, usually <3cm accessory="" br="" don="" enhances="" for="" like="" mistake="" nodes="" round="" spleen="" spleens="" t=""> Lobulations are common; clefts cause lobulations, dont mistake clefts for lacerations or infarcts 10 HU less then liver Variable enhancements due to the variable circulatory routes through the spleen; white pulp (lyphatic follicles and RE cells); Redpulp (interspersed vascular lakes) Patterns of enhancement: serpentine, cord like enhancement most common - more pronounced with fast injection rates; exagerated in certain patients - decreased cardiac output or heart failure, splenic v

Supraglottic area is the area between epiglottis and true vocal cords (a) Congenital: Aryepiglottic fold cyst (b) Inflammatory: Acute bacterial epiglottitis, angioneurotic edema (c) Neoplastic: Retention cyst, cystic hygroma, neurofibroma (d) Traumatic: Foreign body, hematoma, radiation, caustic ingestion (e) Idiopathic: Laryngomalacia

A. BILE DUCTS 1. Biliary colic/bile duct obstruction 2. Acute cholecystitis/cholangitis B. LIVER 1. Acute hepatitis: alcoholic, viral, drug-related, toxic 2. Hepatic abscess 3. Hepatic tumor: metastases, hepatocellular carcinoma, hemangioma, focal nodular hyperplasia, hepatic adenoma 4. Hemorrhagic cyst 5. Hepatic congestion: acute hepatic congestion, Budd-Chiari syndrome 6. Perihepatitis from gonococcal/chlamydial infection (Fitz-Hugh-Curtis syndrome) C. PANCREAS 1. Acute pancreatitis D. INTESTINES 1. Acute appendicitis 2. Peripyloric ulcer 3. Small bowel obstruction 4. Irritable bowel 5. Colitis/ileitis 6. Intestinal tumor E. LUNG 1. Pneumonia 2. Pulmonary infarction F. KIDNEY 1. Acute pyelonephritis 2. Ureteral calculus 3. Renal/perirenal abscess 4. Renal infarction 5. Renal tumor G. OTHERS 1. Costochondritis 2. Herpes zoster

Types Of Thalassemia Alpha Thalassemia The alpha thalassemia is caused by a decrease in production of alpha globin chains due to a deletion or mutation of one or more of the four alpha globin genes located on chromosome 16. Alpha gene mapping can be obtained to determine the specific mutation. The alpha thalassemia can be generally categorized as: Silent Carrier Alpha Thalassemia Trait Hemoglobin H disease Hemoglobin H-Constant Spring Alpha Thalassemia major Alpha Thalassemia trait in a parent is often dicovered after the birth of an effective child. Beta Thalassemia Minor/carrier/trait : They appear perfectly healthy, however where two carriers decide a family there is one in four chance that their child could inherit their carrier genes and develop Beta Thalassemia Major, one in four of a child being normal and 50% chance of the child also being a carrier. Thalassemia Intermedia : A clinical expression for a condition between Carrier and Major .They often run a hemoglobin of 7-9 g

Intima - prevents thrombosis - most chemically active layer Media - smooth muscle ~ vasoconstriction Adventitia - supportive layer - Arterial wall disease @ vasculitis - wall inflammation @ fibromuscular disease @ connective tissue disease @ trauma @ degeneration (atherosclerosis) - Radiological presentation 1 - weaken and dilated - producing an aneurysm - Can rupture - extravasation; pseudoaneurysm formation; AV fistulae 2 - Thickened by @ growth of vessel layers @ deposition of material - AS plaque - causes vessel to narrow and stenose ~ occlusion 3 - loose ability to prevent coagulation ~ results in thrombosis 4 - proliferation of vessels - results in AV malformation @ ?genetic factors @ ?Aquired factors ~ tumors Angiographic suite has: - patient monitoring devices - radiological equipment @ c-arm fluoroscopy ~ dynamic positioning ~ bolus chasing -