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radiology exam medical imaging contrast agents medical technology

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These are exam keys for a 4th-year radiology course. The questions cover a range of topics from the differences between contrast and contrast agents to diagnostic imaging techniques. The document also includes information about radiation safety and the types of radiation that affect living tissue.

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Keys for examination 4th year/radiology Q1. What are the differences between contrast and contrast agents? Answer: Contrast of an organ means the normal difference between an organ and its surroundings without giving any contrast agents, whil...

Keys for examination 4th year/radiology Q1. What are the differences between contrast and contrast agents? Answer: Contrast of an organ means the normal difference between an organ and its surroundings without giving any contrast agents, while the Contrast medium (contrast agent) is a substance used to enhance the contrast of structures or fluids within the body in medical imaging. Q2. Full the blanks using proper word/words of the followings: a. Procedures of diagnostic imaging techniques can include ……X-ray…., ….Ultrasound….,….CT…. and …. MRI…. b. The aims of using the diagnostic imaging techniques are to …..rule out…., ….rule in of the disease….. or …….find out new information…... c. The denser the object is, the…… more ….. the radiation will be inhibit and the …..greater…. the object dense is, the less radiation reaches the film. d. The sonogrphaic image is specially used for ….soft tissues….. e. In ultrasound and MRI, it is used …non-ionizing…..radiation, while, in CT and x-Ray,……ionized….. radiation is used instead. f. Radiograph is defined as …..the shadow of the objects that are within the path of x-ray beam producer which will be read on a special films or computers………… g. The quality of the images obtained using ultrasound is highly dependent on the …………skill of the person (sonographer) performing the exam……. and …..the patient's body size……. h. One of the MRI disadvantage is that ….the patient has to hold still for long periods of time in a noisy, cramped space while the imaging is performed……. i. The MRI is typical used for ….soft tissue…. more than ….hard tissues….. Keys for examination 4th year/radiology j. The Positive contrast medium is used in CT and x-ray is ….Barium sulphate or iodine compounds while in MRI ….Gadolinium… k. Four points has the radiological report included: ….A good description…., …… A radiologic diagnosis……., ………A ranked differential diagnosis…… and…… Further recommendations….. l. ……A low kilovoltage/high milliamperage…… technique produces a radiograph showing a high degree of contrast, while, …… a high kilovoltage/low milliamperage …… technique produces a radiograph of low contrast but with a wide range. The former technique is most suitable for areas of low contrast, such as the abdomen. m. ….Two views…… made at……. right angles……. to one another so that a three dimensional impression is gained of the structure radiographically. n. Radioactivity is defined as ….a natural & spontaneous process of radiating (emitting) excessive energy from unstable atoms of an element….. o. The radiations that are existed are either in form of ……particles…..or……waves…… p. The emitted particles or waves are called ……..ionizing radiation…… because they have the ability to remove electrons from the atoms of any matter they interact with. q. Current Annual Occupational Limits of the Skin (including hands/feet) is …..500 mSv …..for workers and public …..50 mSv……. r. Methods of contamination by internal hazards: …Inhalation…,…. ingestion…., ….injection….and …..absorption….. s. Contrast media is necessary to identify the defects of stomach like… obstruction…, ….ulcer…. or …..existence of mass….. usually. t. The abdomen essential radiological views are……lateral (left or right)……. And ……(ventrodorsal)…while, the thoracic region has to be ……lateral (left or right)…….. and ………(ventrodorsal or dorsoventral)…… Keys for examination 4th year/radiology u. Radiographically the distal end of the forelimb or hindlimb has…….one complete digit the 3rd…., with ………….two reduced splints metacarpals the 2nd and the 4th……………each exhibits a ventral ridge. v. Radiographical image of the distal end of limb of bovine shows the main digits are the.. 3rd …and …4th ….. digits while….. 2nd …. and ….5th ……are represented by small dew claws. Q3. Correct the following statements if there is any? a. Two types of radiation may affect on the living tissue particles like β and γ – ray.( α) b. Elements that have different numbers of protons are called isotopes. (neutrons) c. For alpha radiation, two centimeters through the air or using any type of shield can be enough to get rid of the radiation.(four) d. Beta radiation can pass several meters through the air, however; using plastic shield of around 0.6 cm is enough to protect the workers in this field. (correct) e. For X-ray, shield of lead can protect the workers from its danger while, Gamma ray is less penetrating than the x-ray so it is important to have a concrete for a perfect protection extra to lead. (more) f. Current Annual Occupational Limits for Adults of individual organ or tissue other than the lens of the eye must not exceed 0.5 Sv per year and lens of not more than 0.13 Sv per year.(0.15) g. The constant media that may be used in the GIT are either negative contrast agent or positive ones. Iodine compound is the most common contrast agent to be given. However, if suspected penetrated GIT is existed, a barium sulfate compound is replaced. (Barium sulfate, iodine compund) Keys for examination 4th year/radiology h. The most common views for esophagus is the lateromedial as the ventrodorsal will not help to identify the esophagus due to superimpose of the vertebrae for this reason, oblique view is also needed. (lateral) i. Normal existence of gas within the helps cardia identifying the first part of stomach on the right lateral, while, on the left lateral care must be taken when examine the stomach as the pylorus is recognized with some gas accumulation normally that may wrongly diagnosed as an abnormality. (fundus) j. For emergency examination, digestive system is highly recommended to be empty by fastening the animal in addition to give a laxative for better visualization of the abdominal contents in general and urogenital system in specific.( elective examination) k. Both of esophagus and Kidney are seen in about 50% of total images which may be clarify by fat surrounded the esophagus or trace of air in term of kidney. (kidney, esophagus) l. The most common abnormalities within the lung and plural cavity including accumulation of fluids with the plural cavity will decrease the opacity of the cavity and reduce the size of the lung radiographically due to increase the radiopaque of the plural cavity. (increase) m. Radiographically, the hydrothorax is leading to reduce the size of the lung as well however, increase the lung opacity in comparison to the plural cavity. (pneumothorax) n. Due to calcium and phosphorus that bones have, they are easily seen radiographically as the radiation is highly penetrated by these structures. The muscular system is not easily seen radiographically. (absorbed) Q3. What are the differences between density and opacity of an object radiographically? Keys for examination 4th year/radiology Answer: Density: the weight per given volume of a body tissue or object in general. Opacity: the measure of tissue or object to block the x-ray. Q4. What are the factors affecting on x-ray quality? a. Motion-the less motion the animal has during the x-ray capturing time, the better quality the image will be. b. Film properties. c. Film/screen d. Object/ film distance-the distance between the object/ the animal and the film is correlated to other factors like the kilovoltage, the amperage and the time of capturing. Generally, the distance usually ranged between 60-90 cm. e. Grids-reduce the scattered radiation. f. Processing. g. Artifact. h. Distortion. Q5. What is the Border Effacement (Silhouette Sign)? Answer: Border effacement is when two objects of the same radio-opacity are in contact and their individual margins cannot be distinguished from one another. Conversely, an object of a different radio-opacity, such as air or fat, interposed between them will provide contrast, and individual margins can then be identified. This latter effect has sometimes been called a negative silhouette. It is seen commonly in thoracic radiographs. Keys for examination 4th year/radiology Q6. What are the five observation of significance can be made from the study of a radiograph to achieve your diagnosis? Answer: Size Shape Number Position Opacity Q7. What are the types of contrast medias (contrast agents) radiographically? Answer:  Positive contrast medium: substance with high density like (Barium sulphate, iodine compounds-ionic & nonionic, gadolinium).  Negative contrast medium: substance with low density like (air, CO2 and O2) Q8. Give five organs that have normally radiolucent appearance radiographically and other three that have radiopaque appearance radiographically? Answer: Radiolucent organs: external ear canal, lung and frontal sinus, fundus of the stomach, trachea Radiopaque organs: bones, liver, spleen, kidney, heart. Keys for examination 4th year/radiology Q9. List in steps the radiological opacities that can be recognized radiographically? Answer: Metal, Bone/ mineral, Fluid and soft tissue, Fat then Gas (Air). Q10. What are the types of radiation that may affect on the living tissue? Answer: 1. Particles: β and α 2. Electromagnetic waves: γ – ray b. and X – ray. Q11. What are the points that can be done to protect the correlated people from the danger of radiation? Answer:  Time: reducing the exposure type as shorter as possible will help reducing the type of exposing to the radiation them will help increasing the possibility of protection from radiation.  Distance: Considering the standard distance to protect the workers from radiation.  Shielding.  External Exposure Personnel Monitoring.  Posting and Labeling of Radioactive materials. Keys for examination 4th year/radiology Q12. What are the routes of disposal materials of radioactive waste? Answer:  Liquid waste, via disposal sink.  Solid waste to authorized contractor.  Gaseous disposal, via authorized fume cupboard. Q13. A German shepherd dog is named Matt was brought to radiological clinic for examining the abdomen. According to the clinician, the dog started to have distended abdomen and loss of appetite after having big meal then training for more than one hour 36hrs ago. A right lateral radiograph was taken for possible identification of the defects. Write a radiological report regard the below image? Answer: Dear colleague: Keys for examination 4th year/radiology According to the case you sent for having a radiograph, the right lateral plain image shows severe extended of the stomach filled with gas. The small gas-filled structure is referred to pylorus associated with soft tissue bland separated partially that from the rest of the stomach-gas filled structures in addition to severe gas accumulation within the rest of the GIT. Diagnosis: Gastric dilatation and volvulus. Sincerely Your signature Q14. How you read the kidneys radiographically in dog and cat using plain radiograph? Answer: it is read using survey radiograph (plain) usually using two views the lateral and ventrodorsal views. The right kidney in the dog is usually cranial to the left one and located at approximately T13-L2 while, the left at approximately L1-L3. The length of kidney is about 2.5-3.5 of the length of the body of the L2 while, in cat is about 2.4-3.0 of L2. The shape of kidney is also has to be identified as it is bean like shape in dog firmer than the feline which has an oval shape and more mobility is seen in its location. Q15. Write a radiological report for following images: A. Keys for examination 4th year/radiology Answer: a plain radiograph of the carpal region of a dog shows (A) mediolateral and (B) Dorsopalmer views of the carpal, metacarpal and phalanges bones. Diagnosis: transverse fracture lines within the 3, 4 and 5. An overlap between the proximal and distal fracture segments is also seen. B. Keys for examination 4th year/radiology Answer: a plain radiograph of the distal hind limb of a cat shows (A) Dorsoplantar and (B) Mediolateral images of the tarsal, metatarsus and phalanges of a cat. Diagnosis: oblique unstable metatarsal bones fractures. C. Keys for examination 4th year/radiology Answer: plain mediolateral view radiographical image shows a normal appearance of the humerus, elbow joint and both of radius and ulna with no obvious abnormalities within the soft tissue. Recommendation: ultrasound for examination the soft tissue for possible traumatized area. D. Answer: A: Lateral view of the thoracic region shows the esophagus is given positive contrast agents (Babrium sulfate). The image is for normal dog as a linear arrangement of the mucosal folds within the caudal esophagus, while, (B) in cat the herringbone appearance to the mucosa in the caudal aspect of the esophagus that is created by the obliquely oriented smooth muscle in this region. E. Answer: plain mediolateral view image of the forelimb shows normal appearance of the distal humerus, normal elbow joint with complete fracture line of both of the Keys for examination 4th year/radiology radius and ulna. Diagnosis: oblique proximal third fracture site of both of radius and ulna. Q16. Give three features of the canine hip dysplasia or dislocation? Answer: Radiological findings of hip dysplasia or dislocation: 1. Norberg angle (105o) is considered normal 2. Loss of spherical shape of the head. 3. Shallow "C" or cup-shaped acetabulum- in dysplasia (are also heighly seen in feline). Q17. Answer the followings: a. Name the joints referred by the following numbers: 1, 2, and 3 and Name the bones that form these joints? b. What are the views of A and B. Keys for examination 4th year/radiology Answer: a. 1. Coffin joint which connects the 3rd and 2nd phalanx. 2. Pastern joint connects the 2nd and 1st phalanx and 3. Fetlock joint that connects the cannon bone, proximal sesamoid bones and 1st phalanx b. (A) Lateromedial view and (B) dorsopalmer view. Keys for examination 4th year/radiology Q18. What is your radiological report for the below image related to a dog referred to clinic for having complete loss of appetite, fever and vomiting? Answer: plain lateral radiograph of the abdomen shows radiopaque foreign bodies (4-5 screws!) within the stomach with signs of peritonitis. Diagnosis: gastric foreign bodies with peritonitis. Q19. A dog was brought to clinic for having complete hind limb paralysis? Survey radiographic was suggested to be examined as seen below. Write a radiological report regard it? Answer: plain lateral view radiograph of the thoracic and abdomen region for examining the vertebral column shows complete Fractures/luxation at L1-4. Keys for examination 4th year/radiology Q20. A dog was brought to clinic for having dysuria,a radiograph was examined to identify the reason as seen below. Write a radiological report regard it? Answer: a plain lateral view radiograph of the caudal abdomen and pelvic reagion shows two large radiopaque stones within the urinary bladder in addition to anther five ones at the membranous level of the urethra has radiopaque appearance too. With possible antoehr one a the level of the pelvic inlet (membrancous urethra!) which needs to be comfirmed by using ventrodorsal view. Diagnosis: Cystolithiasis and Urethral lithiasis

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