Interpretation of Radiographs - Jarrod Smith, DPM, FACFAS

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What is the key difference between a weightbearing and non-weightbearing radiograph?

The skeletal maturity of the individual
The position of the metatarsals relative to the heel (correct)
The presence or absence of a marker on the radiograph
The number of views taken

If a radiograph is not marked as weightbearing or non-weightbearing, how can one determine the positioning?

It is impossible to determine the positioning without the marker
Check the lateral view for the position of the metatarsals relative to the heel (correct)
Assume all images are weightbearing
Assume all images are non-weightbearing

When are non-weightbearing radiographs typically indicated?

For routine examinations
When the patient is unable to bear weight
To evaluate skeletal maturity
In cases of trauma (correct)

What is the purpose of the introductory statement mentioned in the text?

All of the above (D) Signup and view all the answers

Which type of radiograph is generally preferred for providing more information?

Weightbearing (A) Signup and view all the answers

What is the proper term for an image on X-ray film?

Radiograph (C) Signup and view all the answers

What should be included in the introductory statement when evaluating a radiograph?

Number of views, laterality, skeletal maturity, weightbearing status, image views present, image quality (A) Signup and view all the answers

Why is it recommended to have a structured process for reading radiographs?

To ensure consistency and avoid missing important details (C) Signup and view all the answers

When evaluating radiographs, it is better to have too much or too little information in the introductory statement?

Too much (C) Signup and view all the answers

What is the ultimate goal when evaluating and describing a radiograph?

Both A and C (D) Signup and view all the answers

How can you distinguish the right from the left side on a radiograph?

The text does not provide information on distinguishing right from left (C) Signup and view all the answers

Which of the following views shows the relationship between the forefoot and rearfoot?

Anteroposterior (AP) Foot View (B) Signup and view all the answers

Which view allows for assessment of the lateral column of the foot, including the cuboid and lateral pole of the navicular?

Medial Oblique (MO) Foot View (C) Signup and view all the answers

Which view shows the position of the first ray and the medial column of the foot?

Lateral (LAT) Foot View (A) Signup and view all the answers

Which view allows for assessment of the medial column of the foot, including the navicular tuberosity and tibial sesamoid?

Lateral Oblique (LO) Foot View (D) Signup and view all the answers

Which view shows the sesamoid articulations and position, as well as the frontal plane rotation of the 1st metatarsal?

Sesamoid Axial (SA) View (C) Signup and view all the answers

Which view allows for assessment of the ankle joint, syndesmosis, and lateral gutter?

Anteroposterior (AP) Mortise Ankle View (B) Signup and view all the answers

Which of the following is NOT one of the patterns for complete fractures?

Greenstick (C) Signup and view all the answers

What does the 'A' stand for in the acronym 'OLD ACIDDS'?

Articular (C) Signup and view all the answers

Which of the following is NOT a type of incomplete fracture pattern?

Comminuted (C) Signup and view all the answers

What does the 'D' stand for in the acronym 'OLD ACIDDS'?

Deformity (A) Signup and view all the answers

Which of the following is a type of special fracture?

Salter-Harris (A) Signup and view all the answers

Which of the following is NOT a way to describe the deformity of a fracture?

Articular Involvement (B) Signup and view all the answers

When viewing an anteroposterior (AP) or oblique view of the foot, which aspect is assumed to be on the ground?

Plantar aspect (A) Signup and view all the answers

What should be included in the introductory statement when describing radiographic views of the foot or ankle?

The number of views, the side (left or right), skeletal maturity, and positioning (C) Signup and view all the answers

How can you determine if a bone is skeletally immature or mature based on radiographic images?

Immature bone has at least one open growth plate, while mature bone has no open growth plates (B) Signup and view all the answers

When distinguishing between the right and left foot on an anteroposterior (AP) or oblique view, what should you look for?

The position of the great toe relative to the other toes (A) Signup and view all the answers

What does the term 'non-weightbearing' refer to when describing the positioning of the foot or ankle in radiographic images?

The patient's foot is not bearing any weight during the imaging process (B) Signup and view all the answers

Which of the following statements is true regarding the introductory statement when describing radiographic views of the foot or ankle?

The introductory statement should simply list the image views without specifying their order (A) Signup and view all the answers

What is the mechanism of action of Baloxavir marboxil?

Inhibits the Influenza cap-dependent endonuclease (D) Signup and view all the answers

Which drug is approved for use in individuals 12 years of age and older experiencing acute, uncomplicated influenza?

Baloxavir marboxil (C) Signup and view all the answers

What adverse effect is associated with M2 protein inhibitors like Amantadine and Rimantadine?

Hyperglycemia (A) Signup and view all the answers

Which drug inhibits the activity of the Influenza A M2 protein?

Rimantadine (A) Signup and view all the answers

What is a common adverse effect seen with Baloxavir marboxil?

Cough (C) Signup and view all the answers

Which route of administration is used for Baloxavir marboxil?

Oral (D) Signup and view all the answers

What is the primary mechanism of action for the HCV antiviral drug Glecaprevir?

Inhibits the NS3/4A protease of HCV (C) Signup and view all the answers

Which of the following is NOT a characteristic of the HCV antiviral drug combination Glecaprevir/Pibrentasvir?

Treats chronic HCV in patients with cirrhosis (B) Signup and view all the answers

Which of the following is the correct naming convention for HCV antivirals based on their drug class?

HCV protease inhibitors end in '-previr', HCV RdRp inhibitors end in '-buvir', and HCV NS5A inhibitors end in '-asvir' (D) Signup and view all the answers

Which of the following is the primary function of the HCV NS5B enzyme?

RNA-dependent RNA polymerase activity (D) Signup and view all the answers

What is the primary mechanism of action for HCV NS5A inhibitors like Ledipasvir and Velpatasvir?

Inhibition of the NS5A protein essential for HCV replication (D) Signup and view all the answers

What is the primary function of the HCV NS3/4A protease enzyme?

Proteolytic processing of the viral polyprotein (C) Signup and view all the answers

What is the primary mechanism by which acyclovir exerts its antiviral activity?

Inhibition of viral DNA polymerase after being phosphorylated by viral thymidine kinase (D) Signup and view all the answers

Which of the following is the most common mechanism for the development of antiviral resistance to acyclovir?

Mutations in the viral DNA polymerase gene, reducing acyclovir binding affinity (C) Signup and view all the answers

What is the primary mechanism of action of letermovir and maribavir?

Inhibition of viral terminase enzyme, preventing viral DNA packaging (D) Signup and view all the answers

Which of the following statements about the direct-acting antivirals for chronic hepatitis C virus (HCV) infections is correct?

They target various steps in the HCV life cycle, including viral entry, replication, and assembly (A) Signup and view all the answers

What is the mechanism of action of oseltamivir, zanamivir, peramivir, and baloxavir marboxil?

Inhibition of viral neuraminidase enzyme (B) Signup and view all the answers

Which of the following statements about ribavirin is correct?

It is a nucleoside analogue that inhibits viral RNA-dependent RNA polymerase (A) Signup and view all the answers

What does the '+' symbol indicate in the table showing HBV status?

The presence of the corresponding antigen or antibody (A) Signup and view all the answers

Which of the following statements about the treatment of chronic HBV infection is true?

The development of anti-HBsAg antibodies is a sign of a functional cure (C) Signup and view all the answers

What is the mechanism of action of pegylated interferon in the treatment of HBV?

It induces an antiviral state in cells by signaling through interferon receptors and the Jak/Stat pathway (A) Signup and view all the answers

Which of the following is NOT a potential adverse effect of pegylated interferon therapy?

Pancreatitis (B) Signup and view all the answers

What type of drug is entecavir, which is used in the treatment of chronic HBV?

Reverse transcriptase inhibitor (C) Signup and view all the answers

What is the purpose of pegylation in the context of pegylated interferon?

To enhance the stability and prolong the half-life of the interferon molecule (D) Signup and view all the answers

What is the primary mechanism of action of the newly approved CMV antiviral letermovir?

Inhibition of CMV terminase that cleaves viral DNA (A) Signup and view all the answers

Which of the following statements regarding maribavir, a newly approved CMV antiviral, is correct?

It inhibits the CMV UL97 kinase (B) Signup and view all the answers

What is the primary reason for the high propensity of influenza virus to acquire resistance against antivirals?

High mutation rate due to error-prone viral RNA polymerase (C) Signup and view all the answers

Which of the following statements regarding influenza vaccines is correct?

Both injectable inactivated and inhaled attenuated formulations are available (A) Signup and view all the answers

What is the recommended time window for administering antivirals to have an impact on influenza disease progression?

Within 48 hours of symptom onset (D) Signup and view all the answers

Which of the following statements about the administration of letermovir, a newly approved CMV antiviral, is correct?

It can be administered orally or as an intravenous infusion (B) Signup and view all the answers

Weightbearing radiograph

A radiograph taken with the patient bearing weight on the affected limb.

Non-weightbearing radiograph

A radiograph taken with the patient not bearing weight on the affected limb.