A non-contrast chest CT (D) is adequate to diagnose pulmonary metastatic disease, but not as sensitive as CT chest with IV contrast for the medistinum. She has no medical problems and has had a Mirena IUD for three years. Most Read; Give Answer; What is an example of particulate radiation? It looks like your browser needs an update. A 65-year-old female presents to your office for a routine visit. His BMI is 32. She has noted some weight loss without working on diet or exercise. Choose the one best answer. Join now! What is the most appropriate initial counseling for this patient? Her A1c is found to be 8.0%. MedEdPORTAL Resources for Educators. She is currently menstruating. He is intermittently noncompliant with his medications. A 55-year-old man comes to the clinic for a visit. Her past medical history is significant for hyperlipidemia and hypertension, for which she takes simvastatin and lisinopril. First name CORE (Case-based Online Radiology Education). Her mother died of colon cancer when she was 65 and her father passed away from metastatic prostate cancer at the age of 70. What is the most appropriate next step in this patient's care? Working at your clinic, you receive a call from a patient of yours, Mr Smith, a 45-year-old male who was seen three days ago complaining of lower back pain. Her physical exam is significant for tenderness to palpation over the left calf. On exam, he is afebrile. You are trying to determine if your patient's symptoms are normal grief or if you should diagnose and treat him for Major Depressive Disorder (MDD). Today his blood pressure is 156/94 mmHg. CV Templates. N-acetylcysteine (C) given 12 hours prior has also been shown to somewhat reduce renal toxicity (again this controversial). He did not lose consciousness nor hit his head when he fell. She has found no relief with over the counter NSAIDs. She occasionally uses condoms. A Vegan Hiker With a Rash Self-Treated With Coconut Oil A 29-year-old strict vegan and avid outdoors enthusiast presents with a worsening rash on her feet. Her home BP measurements have been in a similar range. A 55-year-old man with no significant past medical history and generally healthy behaviors presents to clinic for a health care maintenance exam. Non-subscribers – For programs new to Aquifer. She states that she likes to walk 30 minutes every other day with her husband and has been doing that for years now. They may produce a ground glass appearance and increased interstitial markings. A 19-year-old female with no significant past medical history is involved as the driver in a motor vehicle accident and brought to the Emergency Department by EMS. CT (C) is generally more readily accessible than MRI (E) in the ED, but either could be considered. She used to be the head of her Bridge club, but quit two weeks ago and doesn't feel like going out anymore. What is the best way to counsel this patient about what to do after her treatment? She has tenderness at the anterior lower lateral malleolus but not inferiorly nor posteriorly. A 60-year-old woman presents to the office complaining of increased frequency of urination and fatigue for the past several months. Her concerns today are: fatigue, weakness, numbness, insomnia, feeling sad at times, anhedonia, increased appetite, weight gain, dry skin, and increasing hair loss within the past month. In this case, you can also see vascular marking going beyond the questioned PTX on the right side. Second edition published September 2017. He drinks two beers daily. Not all patients with diffuse abdominal pain need imaging studies. Which of the following management steps today do you consider the most appropriate? She also says she feels weak and fatigued and no longer has the energy to do her gardening or shopping. - Size of the nodule (malignancy increases over 1 cm). This will also give us the ability to detect any other lung lesions, evidence of tumor spread to nodes (ipsilateral or contralateral), pleural effusion, or bone metastases. Radiology Interview Questions: Except you are a radiology professional, you probably don’t know much about the job interview process. Some physicians might consider doing a barium enema (D) first since colon disease is also present, and we can see the terminal ileum on the barium enema if the ileocecal valve is not competent. Environmental Case Study Ogalalla Aquifer ... At the peak of irrigation, more water was being drawn out of the aquifer each year than the entire annual flow of the Colorado River. She denies fevers, dysuria, back pain, diarrhea and abdominal pain. No edema or redness is present. Explore our library of interesting radiology cases. ACR DOES NOT advocate the use of routine preoperative CXR in patients who have no cardiac or respiratory symptoms regardless of smoking history and age. The patient asks you why he is taking aspirin along with the other medications. He takes no medications and has no significant past medical history. We also cannot allow any ferromagnetic metal into the MRI scanner and it can be very difficult to be sure there is no metal in or on a trauma emergency patient. She is found to have a blood pressure of 146/96 mmHg. She has noticed some significant swelling which is mostly still present. Given the portable nature of radiology and high bandwidth network connections, it is possible to have a radiologist on the other side of the world report the same studies we are doing here. Right lateral decubitus - The simplest and fastest way to diagnose a right pleural effusion in an ICU patient is to obtain a right lateral decubitus film (C). 12 MedU began as a resource to sustain a Health Resources and Services Administration–funded online, case‐based pediatrics curriculum (CLIPP, now Aquifer Pediatrics). The remainder of his cardiovascular exam is within normal limits. X-rays are not indicated. An aquifer is an underground layer of water- bearing permeable rock or unconsolidated materials (gravel, sand, or silt) from which groundwater can be extracted using a water well. He denies any suicidal ideation and has no previous suicide attempts. After moving into a new home three days ago, he woke up the next morning with bilateral lower back pain without any radiation. Choose the one best answer. He denies having any chest pain or SOB. CXR (B) is part of the normal staging, and provides a baseline for follow-up by CXR, but CT is much more sensitive for small pulmonary metastases. She has no significant PMH. (Pick one or more.). On repeat testing of HbA1C today, you find that his HbA1C has increased to 7.5%. There is no erythema or effusion of his knee joints but there is crepitus on movement of each joint. A 60-year-old male with a past medical history of chronic gout, depression, and Stage 1 hypertension presents to your office for a follow-up visit. It is in the left ureter at the level of the pelvic brim. A 30-year-old male with PMH significant for one month of progressive hoarseness and fever presents with a painful neck mass. A 64-year-old woman who is overweight with well-controlled hypertension comes to your office complaining of a lump in her breast that she noticed while showering. She remembers immediate pain and swelling but was able to weight bear and limp off the field. Question3: Mention what is the unit to measure x-rays exposure? WHAT IS AN AQUIFER??? A 52-year-old woman with a history of diabetes and rheumatoid arthritis presents for her annual examination. Urinalysis of a mid-stream catch is within normal limits, and a pregnancy test on the same sample, performed despite her history, is negative. Which of these factors may be a contraindication to giving intravenous iodinated contrast? At that time he had no history of trauma, pain that improved while lying down and no neurologic deficits. What imaging method(s) could you use to confirm the presence of a right pleural effusion? What is the most appropriate next step in diagnosis? Remembering that Mr. Stoddard had a severe allergic reaction to iodine based IV contrast, what imaging studies might be performed to stage his colon cancer? Register for a personal account using your PCOM email. In general, her chronic diseases are well controlled and she has suffered no target organ damage. He says he goes to church to pray. Oral, rectal, or intravenous contrast for abdominal CT scans? As you consider starting a medication for his hypertension, which of the following medications is most likely to cause an adverse event in this patient? He has a 25-pack-year smoking history. She has worked hard to begin exercising, and is walking vigorously five times a week. MRI (A) is a great means of studying the aorta, but it is a much longer examination and may not be suitable for unstable patients. Which of the following screenings are recommended by the U.S. Preventative Services Task Force (USPSTF)? On physical exam, the posterior right ankle is edematous and palpation is tender. He is 5' 10'' (1.78 m) and weighs 220 lbs (100 kg), BMI = 31.6. A 48-year-old man with a past medical history that includes hypertension, Chronic Obstructive Pulmonary Disease (COPD), and hyperlipidemia presents to clinic as a new patient for a general physical exam. Question2: What are the radiations and technology that radiologist uses? His right foot shows interdigital maceration and he has redness, warmth, and tenderness just inferior to the knee. IV contrast will optimize their ability for showing extra-luminal complications such as perforation and abscesses and fistulae. 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