Radiology - student questions

What type of fracture is this

A) Complete condylar fracture B) *Incomplete articular condylar fracture* C) Salter Harris Type II D) None of the above

Which of these is not a type of bone lysis?

A) Geographic B) Moth-eaten C) *Amorphous* D) Permeative

Which of these breeds is not predisposed to Craniomandibular Osteopathy?

A) West Highland White Terrier B) Cairn Terrier C) Scottish Terrier D) *Norfolk Terrier I did a short bit of searching to see if I could find a reference for this as a non-affected breed of an affected but poorly reported breed. This breed is indeed NOT listed as one of the reported breeds in the book: The Genetic connection: A Guide to Health Problems in Purebred Dogs*

Which of the following images shows evidence of an interstitial pattern, either structured or unstructured? Select all that apply.

A, B, C

For which clinical presentation/signalment would a pneumocystogram be CONTRAINDICATED as a diagnostic tool? A. 3 yr intact female German Shepherd with closed pyometra B. 8 yr intact male Labrador with caudal abdominal mass and stranguria C. 5 yr SF Bulldog with stranguria and hematuria D. 12 yr NM Miniature Schnauzer with tenesmus and a mass found on rectal palpation

A. 3 yr intact female German Shepherd with closed pyometra B. 8 yr intact male Labrador with caudal abdominal mass and stranguria C. *5 yr SF Bulldog with stranguria and hematuria* D. 12 yr NM Miniature Schnauzer with tenesmus and a mass found on rectal palpation

Indicate which of the 5 fundamental radiographic opacities is represented by each letter in this image.

A. = Fat B. = Metal (hemoclips) C. = Soft tissue/ fluid D. = Gas E. = Bone (mineral)

hypertrophic osteodystrophy

6 month old Weimaraner

Which signalment would fit best with the diagnosis of osteosarcoma? a. 16yr old M Chihuahua b. 1yr old FS Irish wolfhound c. 6 yr old F Mixed breed dog d. 9 yr old MN Great Dane

9 yr old MN Great Dane

canine audal pulmonary artery diameter

< width of 9th rib

What view of the Carpus is this?

DLPMO

name this view

DLPMO of the carpus & hopefully you all now what those letters stand for.

What is the cause of the hind limb lameness in this cat? Select all that apply. a. Right hip luxation b. Type II Salter-Harris fracture c. Type I Salter-Harris fracture d. Left Sacroiliac luxation e. Capital femoral physeal fracture

Capital femoral physeal fracture

A foal presents with the following abnormality. What is the diagnosis?

Carpal Valgus. The limb is directed laterally at the carpus.

target (focal spot)

Converts electrons' kinetic energy into x-rays and heat

What structure is indicated by the blue arrows?

Cranial Mediastinal Reflection

name this view

Cranial proximal to cranial distal intertubercular groove region of the humerus.

You have a young, 5 month old Great Dane puppy come into your clinic with complaint of being lame/painful on both forelimbs. On examination, you find generalized swelling at the carpal joint that is "hot" to the touch, along with a fever. If you were to perform a necropsy at this time, you would see lesions similar to that on the right. Fill in the blank with the most likely condition occurring in this dog

Hypertrophic Osteodystrophy Metaphyseal Osteopathy

In order to highlight a lesion on the medial aspect of the right front carpus, which view would you need to take?

If the lesion is at the true medial aspect of the carpus, then a simple Dorsal-Palmar would suffice. If the lesion were on the dorsal-medial aspect of the carpus then the given answer would be needed: Dorsolateral-PalmeroMedial Oblique

Which of the following locations is the most common for intestinal intussusception in the dog?

Ilio-ceco-colic

What are the unique radiographic signs of alveolar air space disease?

Lobar border sign, air bronchogram, and border effacement

What are the most common features of osteosarcoma? Choose the most correct answer.

Long bones, monostotic, aggressive, metaphyseal

Select the correct diagnosis for the soft-tissue/fluid opacity margin/border pointed out by the purple arrows.

Normal - also referred to as "visible dorsal tracheal membrane." Let's make this choice Dorsal tracheal border - This is frequently seen and in many dogs it is not clinically significant. I think it is truly not known whether this is completely normal or is an abnormality of no clinical significance. If this was the lateral radiograph of a coughing miniature schnauzer - it would definitely be described as a radiographic feature suggestive of tracheal collapse due to tracheal degeneration. If this was the lateral radiograph of Vizsla presented for a firm mass in the left thigh, it would noted as a soft tissue shadow in the plane of the caudal cervical trachea and given the radiographic diagnosis of "visible dorsal tracheal membrane of questionable clinical

How long does it take for bone loss to become apparent on a radiograph.

One to two weeks - correct answer - the lag time for radiographic detection for bone loss is 7-14 days

Name the diagnostic imaging study that provides the most imformation about glomerular filtration rate.

Scintigraphy

Where is the right kidney located in relation to the vertebrae in the dog? a. L1-L4 b. T13-L1 c. L2-L5 d. L2-L4

T13-L1

A pulmonary mass has a/an closed or acute angle with the adjacent chest wall while an extrapleural mass has a/an open or obtuse angle with the adjacent chest wall.

The angle of interest and use with this concept of extrapleural vs pulmonary mass is for radiographic soft tissue lesions that are located peripherally such that the soft tissue opacity/mass is at the interface between the lung and chest wall. The desired decision is whether the mass is originating in the lung tissue or is an external to the pleura mass pushing into the lung surface. *So the angle of decision is between the mass and the chest wall not between the mass and the lung*. The method of evaluation should be to look at the intersection between the chest wall and the contour of the mass - starting away from the mass, trace the inner chest wall to the mass and determine whether there is an acute or closed angle versus an open or obtuse angle between the chest wall and the mass. Figure 1.21 in the MK text is an illustration of the difference. I have changed the wording of this question to make it correct.

Which of the following is not indicative of an alveolar pattern a. Air bronchogram b. Displacement from the thoracic wall c. Lobar border sign d. Border effacement

Displacement from the thoracic wall

What is the most common site of osteochondrosis dissecans lesions in the horse?

Distal intermediate ridge of the tibia

What is the correct pairing for the method used to determine that there is abnormal small bowel distension (abnormally dilated) in the dog and cat?

Dog - >1.6x central height L5, Cat - >4x cranial vertebral endplate height of L2

name this view

Dorsal 65 degree proximal-PalmeroDistal oblique view of the foot for evaluation of the navicular bone.

name this view

DorsoPalmar(Plantar) There is an R in the image so this is a DorsoPalmar. Remember if was to be a rear leg fetlock in a DorsoPlantar view it should have an RH in the image. For thoroughness I would be expecting the region to be named with the proper anatomical terminology = DorsoPalmar R front metacarpo-phalangeal joint.

If you are in the field and palpate a swelling at the level of the head of the medial splint bone (2nd metacarpal) on the left carpus of a horse you would shoot a ____________________ radiograph to get the best view of that area.

Dorsolateral-palmarmedial This is a good thought provoking question. But I would have had a different answer and then it struck me that the description of the location of the swelling is not specific enough to answer the question with only 1 view. So here are 2 collages of normal horse carpus views - 1 with and 1 without the proximal end (head) of 2nd metcarpal outlined [- and yes these images are of the R carpus but that will not make a difference]. Do you think you can choose just 1 view to satisfy the question? Or what if the question stated that the swelling projects medially at the level of the head of the medial splint - which one would you choose? Or what if the question stated that the swelling wraps medial to palmar at the level of the head of the medial splint - which one would you choose?

T/F The joint spaces' width can be accurately evaluated in dogs in left to right lateral projections

FALSE- conclusions about the joint space width cannot be evaluated in non-weight bearing images

T/F When the MRI scanner is not in use, it is okay to enter the room with metal objects.

FALSE- the magnet is ALWAYS on

True or False? Normal kidney size in a cat is 2.5-3.5 x length of L2 vertebral body. Sizing is based on VD view.

False

True/False: Hip dysplasia is a congenital abnormality of the coxofemoral joint

False

Which corresponding letter is not consistent with a mono-articular carpal Fracture?

a. A b. *B* c. C D. If I understand the question correctly D should be correct. Each of the asterisks is located at a articular surface - even B which is at a subchondral bone surface and if a fracture occurred here it would be mono-articular. The line at the D level is demonstrating the bi-articular

This image was obtained by an ultrasound of a dog suspect of urinary calculi. What is the feature indicated by the orange arrow?

acoustic shadow

1Acquired foal angular limb deformities are caused by (choose the one best answer): a. Asynchronous growth across the distal radial physis b. Abnormal development of the distal radial physis c. Abnormal development of the carpal bones All of the above

all ove the above

The lesion associated with the red circle is most likely consistent with which of the following?

thoracic wall abscess

Match each image with the disease present

top: pleural fluid/effusion second: normal thorax for obese patient second to last: pneumothorax last: pleural fluid/effusion

slab fracture

biarticular fracture

T or F: Radiographically, extrapleural masses create an "open" angle junction with adjacent lung, while pulmonary masses create a "closed" angle junction with adjacent lung

true

T/F The intussusceptum is generally formed from the oral portion of the bowel.

true

True or False: Spontaneous Femoral Capital Physeal Fractures in adult cats or slipped femoral epiphysis is much more common in neutered males than others.

true

True or False? The most useful radiographic finding for assessing medial coronoid process disease is looking for secondary degenerative joint changes like osteophytes on the medial coronoid process and subtrochlear sclerosis.

true

True/False A change in tracheal diameter without a change in position is likely primary trachea disease

true

Which type of Salter-Harris fracture is the most difficult to identify radiographically and has the highest (or a high) probability for long-term complications?

type V

True or False- the following diseases are self-limiting? (3pts) ununited anneal process panosteitis hip dysplasia

ununited anneal process - false panosteitis - true hip dysplasia - false

Which type of urinary calculus is not typically visible on radiographs?

urate

Which of the following lesions is not matched with a common site in horses? a. Osteochondritis dissecans- DIRT b. Bi-articular Carpal Fracture- 3rd carpal bone c. Osseous cyst like lesion - medial femoral condyle d. Angular Limb Deformity - Stifle

d. Angular Limb Deformity - Stifle

What is the contraindications for performing an excretory urogram?

dehydration

What is indicated by the blue line designated by the letter B in this equine hoof?

distal impar ligament

length of L7 (<1.7x)

dog large bowel

central height of L5 vertebrae (<1.6x)

dog small intestine

Doubling the mAs has what effect on the number of x-rays in the beam?

doubles

What is the structure indicated by the arrow?

end-on view of deep circumflex iliac vessels

New bone formation at the site of the insertion of tendons, ligaments, or other connective tissue is termed an

enthesophyte

What is the most probable option for this opacity

enthesophyte

What views are required for an OFA radiograph?

extended hip, Ventral-Dorsal view of pelvis through the stifles

A soft tissue opacity is evident at the level of the right 5th through 9th ribs. Its origin is most likely: a. Extrapleural b. Pulmonary c. Cardiac d. Mediastinal

extra pleural

Bone tumor is an example of a ____________ lesion.

extradural

Intervertebral disk disease is an example of a __________ lesion

extradural

Long bones, monostotic, aggressive, metaphyseal

false

T/F In an ultrasound of a normal dog, the liver should be hypoechoic to the spleen.

false

T/F Smooth periosteal new bone growth indicates an aggressive process.

false

True or false. Silver halide grains become white when exposed to xrays and are developed.

false

True or false. The arrow is pointing to a sublumbar nodule and further diagnostics are warranted.

false

True or false: Spondylitis is inflammation of vertebral body and disc tissues.

false

True/False. The lag time between osteoid matrix formation and matrix mineralization in a mature skeleton is 7-10 days.

false; it is 10-14 days

dentoalveolar syndesmosis

fibrou sjoint

. Answer the following T/F about Hypertrophic osteopathy:

• Is commonly seen in animals less than a year of age- FALSE (this is hypertrophic osteodystrophy) • Is commonly associated with pulmonary disease- TRUE • Is bilaterally symmetric and is often seen first in the metatarsal/metacarpal bones- TRUE

Meningioma is an example of a ___________ lesion.

intradural-extramedullary

What is the proper name for the following radiographic view?

intraoral dorsalventral nasal

Radiographic enlargement between the 12 o'clock and 3 o'clock cardiac region on a DV view can be all the following EXCEPT: a) aorta b) left atrium c) left auricle d) pulmonary artery

left atrium

Using the radiograph below, what is your top radiographic differential? a. Gastric dilatation and volvulus b. Linear foreign body c. Neoplasia d. Ascites e. Constipation

linear foreign body

Increasing the ___ will increase the number of x-rays emitted, while increasing the ____ will increase the energy of the x-rays.

mAs; kVp

The most common feature of small animal degenerative joint disease is:

new bone production

In a normal animal, would you expect to see contrast throughout the full length of the ureters when doing an excretory urogram?

no

The thymic "sail" seen on a DV thoracic radiograph in a young animal is most commonly associated with what condition? a. Thymic mass. b. Mediastinal shift. c. Lung consolidation. d. Non-pathologic.

non-pathologic

This is a 9 year old Female, spayed basset hound, based on your interpretation of this radiograph what is your next best step?

nothing, this dog is normal

What is the main Roentgen sign difference between hypertrophic osteopathy and hypertrophic osteodystrophy?

opacity

Typically, younger dogs (typically <1 year old) develop hypertrophic ______________________, whereas older dogs (typically >1 year old) develop hypertrophic _____________.

osteodystrophy; osteopathy

Which cystogram technique is best to detect ruptures in the bladder wall? a. Positive contrast b. Negative contrast c. Double contrast d. Triple contrast

positive contrast

A _______ (positive, negative, double) contrast cystogram is best for detecting bladder ruptures, while a _______ (positive, negative, double) contrast cystogram is best for evaluating mucosal lesions.

positive; double

On a DV radiograph what is in the 2 o clock position in a clock face analogy of the canine cardiac silhouette?

pulmonary artery

What is the required radiographic view to diagnose a gastric dilatation with volvulus? Which is not a key feature you are looking for to make the diagnosis

right lateral a. Gastric dilation with malpositioning b. A fold or compartmentalization of gastric gas with pylorus cranial and predominantly dorsal to the fundus c. A resemblance to a smurf hat d. *Gastric dilation with normal positioning*

Which of the following imaging modalities uses gamma radiation? a. Scintigraphy b. Fluoroscopy c. CT d. Analog X-ray

scintigraphy

The kilovoltage peak (kVP) setting on the x-ray machine determines the _________ of the electrons between the filament and target, which in turn produces the ___________ spectrum of the x-ray beam, and thus the contrast of the image.

speed; energy

coxofemoral joint

synovial joint

cubital joint

synovial joint

True/False: Altered width/thickness of joint space is not a good indicator of joint disease in small animals

True

True or False? You must take a minimum of two orthogonal views in each radiographic study.

True In general true. Can you provide 1 instance where this is not required???????

Which 3 anatomical structures make up the triangle of fat that aids in identification of the prostate on a lateral view?

Urinary bladder, prostate, abdominal wall

Which of the following disease processes is NOT over-represented in German Shepherds?

Wobbler's syndrome

Wilhelm Roentgen took the first radiograph in 1985. What was the subject of the first radiograph? a) A foot b) A face c) A hand d) A dog

a) A foot b) A face c) *A hand* d) A dog

Normal measurement of a dog kidney is:

2.5-3.5 x length of L2 body

List 3 determining factors of aggressive bone change:

- Cortical bone destruction - Irregular bone growth - Bone lysis - Poorly defined zone of transition

What is the most common location for an osseous-cyst like lesion in the horse? - Third carpal bone - Cranial humeral condyle - Cranial femoral condyle - Tibial tuberosity

- Third carpal bone - Cranial humeral condyle - *Cranial femoral condyle* - Tibial tuberosity

filament

. Generates electrons when heated

Choose from the options below. The Vertebral Heart Sum is determined by adding the length and width of the heart from the lateral view and is measured from the beginning of the ______ vertebrae. The sum range for dogs is ___________, while the normal sum range for cats is ________.

...measured from the beginning of the T4 vertebrae. The sum range for dogs is 8.7-10.7v , while the normal sum range for cats is 6.9-8.1v.

1. Which one of the following is not one the standard views of the tarsus? a. Dorsal-palmar b. PalmaroLateral-DorsoMedial Oblique c. Palmar 55 degree Proximal- Palmar Distal Oblique d. DorsoLateral-Palmaromedial Oblique e. Lateral- Medial

1 a. Dorsal-palmar As written this is not one of the standard views of the tarsus because it reads palmar - PALMAR = FRONT; HIND = PLANTAR!!!!!!! I EXPECT YOU TO USE THE PROPER ANATOMICAL TERMINOLOGY. Thus in each one of these responses that has palmar it should be plantar. Or if the question were changed to carpus, then palmar would be true. b. PalmaroLateral-DorsoMedial Oblique c. *Palmar 55 degree Proximal- Palmar Distal* Oblique d. DorsoLateral-Palmaromedial Oblique e. Lateral- Medial

Rank the cell type with the degree of radiosensitivity. From most to least sensitive. Some may be tied.

1 - stem cells 2- endothelial cells and fibroblasts 3 - nerve cells

What does PennHIP stand for

1. Pennsylania Hip Improvement Program

canine trachea diameter

3x width of proximal third rib

Which of the following is not a common feature or location of the primary bone tumor, Osteosarcoma: a. Commonly occurs in long bones b. Commonly appears as monostotic c. Commonly does not cross joint spaces or invade adjacent bone d. Commonly is benign

1. Which of the following is not a common feature or location of the primary bone tumor, Osteosarcoma: a. Commonly occurs in long bones b. Commonly appears as monostotic c. Commonly does not cross joint spaces or invade adjacent bone As stated this is, I think, a confusing "double negative". To make this an easier, yet important to know that you know, distractor for the common feature as designated in the question I would cross out "does not" and this choice would read "Commonly crosses joint spaces and invades adjacent bone". d. *Commonly is benign*

What are the three features of an alveolar lung pattern?

1. air bronchogram 2. lobar border sign 3. border effacement

hypertrophic osteopathy

10 year old Golden Retriever

Answer the following question by thinking about the normal cardiac silhouette as a clock. In a lateral radiograph, the left atrium is at ____. In a VD or DV radiograph, the left atrium is ____.

12:00-2:00, not seen I added normal ot the statement so that "not seen" would be correct. If the left atrium is enlarged it will be visible as part of the border in the DV or VD view at 3:00.

panosteitis

18 month old German shepherd

A two year old Cavalier King Charles spaniel presents to your clinic with a history of exercise intolerance. The following radiographs were obtained of the thorax. 1a. What following structure is abnormal? a. Cranial lungs lobes b. Pulmonary trunk c. Left atrium d. Aortic trunk 1b. True or False: The overall heart size is enlarged? (VHS=11) 1c. Which if the following would you NOT include on a potential etiologic diagnosis list? a. Heartworm disease b. Reverse Patent Ductus Arteriosus c. Mitral valve disease (Would expect enlarged left atrium) d. Chronic respiratory disease

1a: pulmonary trunk 1b: false 1c: Mitral valve disease (Would expect enlarged left atrium)

Which lesion would be most appropriately termed "active and aggressive" in the image below?

A

Which of the following use ionizing radiation? a. Xray b. Ultrasound c. MRI d. CT e. A and D

A and D

Which one of the following diseases cause increased radiolucency? a. Hypertrophic osteodystrophy b. Hypertrophic osteopathy c. Diskospondylitis d. Multiple myeloma e. A and D f. B and C

A and D

Pulmonic stenosis results in what radiographic sign?

A bulge at the 1-3 o'clock position in the cardiac silhouette on the dorso-ventral view

this image shows

A normal Palmar 55-degrees Proximal-Palmar Distal view of the Equine hoof

type 3 salter harris fracture

Articular fracture that goes through epiphysis & out the physis

type 4 salter harris fracture

Articular fracture that goes through epiphysis, through physis and out metaphysis

This image is of a 10 month old Yorkshire terrier. Which answer is most consistent with the changes seen in the image? a. Hip dysplasia b. Avascular necrosis of the femoral head c. Unilateral hip luxation d. Normal hips

Avascular necrosis of the femoral head

1. Which of the letters on this image represents the descending aorta?

B

Choose the image (s) below that have hypertrophic osteopathy:

B and C are correct

In both large and small animal species, one of the radiographic signs of common osteoarthritis includes areas of increased radiolucency - T/F

False - the reason this is False is the inclusion of the small animal species. Radiolucency indicative of bone resorption/lysis is not a characteristic feature of osteoarthritis in the dog or cat. There are of course some uncommon to rare exceptions but the radiolucency would be a result of the underlying primary cause of the joint disease. Thus I added the modified 'common' before osteoarthritis in the statement.

name this view

Flexed lateral to medial There is not enough of the limb letter showing to know front leg versus back leg so I will use front leg and indicate that this is a metacarpo-phalangeal joint.

name this view

Flexed lateral to medial carpus with no marking to know Right vs Left.

type 1 salter harris fracture

Fracture across the physis

type 2 salter harris fracture

Fracture across the physis + metaphysis

The most common location of Osteochondritis dissecans (OCD) in the dog is __________, with the most common location in the horse being ______.

Humeral head; intermediate ridge distal tibia

Which degenerative vertebral disease cannot be diagnosed on radiographs?

Intervertebral Disc Disease - this is not entirely correct. This 3-word phrase is generally used to indicate that the disc material is either bulging up into the plane of the spinal canal or that the annulus has ruptured and some or all of the disc nucleus has extruded into the spinal canal. When the nucleus extrudes into the spinal canal it can stay localized over the disc space or it can disperse cranial and/or caudally to the disc space of origin. So there are 2 distinctive radiographic features that can allow the diagnosis of Intervertebral Disc Disease or Disc Rupture: i. Marked narrowing of the intervertebral disc space - identified in a well positioned view and with a properly projected disc space. ii. Presence of mineralized disc material within the spinal canal, either 1. dorsal to the intervertebral disc space where it will be most easily see within the plane of the intervertebral foramen, or 2. cranial or caudal to the disc space within the spinal canal. Ideally this mineralized disc material can be correlated in both views to be in the spinal canal. Frequently it is difficult to see it in the VentroDorsal view because of the superimposition of the abdominal organs. BUT WHAT IF THE DISC NUCLEUS IS NOT MINERALIZED? Then it of course becomes more difficult to be sure that the diagnosis is truly Intervertebral Disc Disease. And of course there should be clinical and neurological signs that support the suspicion that Intervertebral Disc Disease is highly likely.

Where is the spinal cord lesion? Or This myelographic study shows and example of an _________ spinal cord lesion.

Intradural-Extramedullary

Which of the pairing of contraindications is not correct? a. Iodinated contrast cystogram - Urethral tear b. Pneumocystogram - Hematuria c. Excretory urogram - Dehydration

Iodinated contrast cystogram - Urethral tear

Which bones are commonly affected by metastatic osteitis? ____ ____ ____

L6, L7, sacrum I would have to also accept L5 and the bones of the pelvis. The question could be modified to ask "Which vertebra are commonly affected?"

What does OFA stand for?

Orthopedic Foundation for Animals

Which of the following views would best highlight a fracture on the dorsolateral aspect of an equine metacarpal 3?

PLDMO

Which of these hip dysplasia diagnostic services requires that at a veterinarian be certified to submit radiographs?

PennHIP

Choose the best imaging method for definitively diagnosing rupture of the bladder

Positive contrast cystogram

In what order do the pulmonary vasculature and airway present in a dorsoventral view when moving from medial to lateral?

Pulmonary vein, bronchus, pulmonary artery

A 7 yr old F/S labrador presents to you for a possible foreign body. Radiographs show no foreign body but do show a focal mass on the right adrenal gland. The animal currently has no clinical signs of adrenal disease. What is your best course of action? a. Biopsy to determine nature of disease b. CT scan to determine extent of disease c. Re-radiograph in 4 months to check for any changes d. Begin treatment with broad spectrum antibiotics for possible adrenal infection

Re-radiograph in 4 months to check for any changes

grid

Removes scatter radiation from the patient directed at the detector

collimator

Restricts the size of the x-ray field on the patient

Choose the correct statement below in regards to equine osteoarthritis. a) The intertarsal joints experience low load and high motion and are therefore more prone to developing primary degenerative joint disease. b) The tibial-tarsal joints experience high load and high motion and are therefore more prone to developing primary degenerative joint disease. c) The intertarsal joints experience high load and low motion and are therefore more prone to developing primary degenerative joint disease. d) The tibial-tarsal joints experience low load and high motion and are therefore more prone to developing primary degenerative joint disease.

The intertarsal joints experience high load and low motion and are therefore more prone to developing primary degenerative joint disease.

Which of the following is the best explanation for a lack of significant findings on radiographs in a dog with clinical signs of pancreatitis:

The onset of pancreatitis was within 24 hours of taking the radiograph

A 4yr old Welsh Corgi has presented for coughing. Upon taking thoracic radiographs you have measured his heart and tracheal size. His vertebral heart score was 11 and his TD:TI was 0.27. What is the interpretation of these measurements? a. VHS: normal TD:TI: normal b. VHS: abnormal TD:TI normal c. VHS: normal TD:TI : abnormal d. VHS: abnormal TD:TI: abnormal

VHS: abnormal TD:TI normal

Which does not fit? a) Boxer; Arrhythmogenic right ventricular cardiomyopathy b) Scottish Terrier: Craniomandibular osteopathy c) Thoroughbred, Mastiff, Great Dane: Wobbler's Syndrome d) Yorkie; osteochondrosis dessicans

a) Boxer; Arrhythmogenic right ventricular cardiomyopathy b) Scottish Terrier: Craniomandibular osteopathy c) Thoroughbred, Mastiff, Great Dane: Wobbler's Syndrome d) *Yorkie; osteochondrosis dessicans*

Which of the following breeds is/are predisposed to the condition illustrated in the following image? Choose all that are correct. a) Dachshund b) Beagle c) Great dane d) Weimaraner

a) Dachshund b) Beagle c) *Great dane* d) *Weimaraner*

Match the number with the correct anatomical location

a) Intervertebral disc space There is no number actually designating a disc space b) Caudal articular processes of L2 This is #3 in the VD only; #3 in the lateral view is the caudal articular process of L1. c) Mammillary processes of L2 - these processes are designated by the #s4 in VD view; they are not designated in the lateral view; the #s4 in the lateral view are the accessory processes d) Transverse processes of L4- designated by #1 in both the lateral and the VD views e) L1 canal intervertebral canal In the VD view the #5 arrows point to the lateral borders of the L1 spinal canal; the actual borders to which the arrows point are the pedicles of the vertbra f) Cranial articular processes of L4 - this is designated by #s 2 in both views

Choose the incorrect statement: a) Kidney size in dogs should normally not exceed 2.5-3.5 x the length of L2 body. Kidney size in cats should normally not exceed 2.0-3.0 x the length of L5 body. Do you also know which view should be used to assess this??????? b) Gas/air use is contraindicated in retrograde urethrograms due to concern for extravasation into cavernous vascular tissue. c) Water soluble iodinated positive contrast is the safest, most expedient and reliable means of documenting rupture anywhere in the urinary tract. d) Lumbar vertebrae &/or pelvic bone smooth to palisade new bone proliferation suggests regional metastasis, most commonly from prostate and lower urinary neoplasia.

a) Kidney size in dogs should normally not exceed 2.5-3.5 x the length of L2 body. Kidney size in cats should normally not exceed 2.0-3.0 x the length of L5 body. Do you also know which view should be used to assess this???????

1) Where is/are the most common site(s) for canine appendicular osteosarcoma? a) Proximal Humerus b) Distal Radius c) Distal Femur d) Proximal Tibia e) All of the above

a) Proximal Humerus b) Distal Radius c) Distal Femur d) Proximal Tibia e) *All of the above* Be sure that you understand the specific region of the bone involved - I expect you to know that the location is METAPHYSIS, not diaphysis or epiphysis!!!!!

What is the proper name for this view? Choose all that are correct. a) VD of the pelvis b) Flexed hip ventrodorsal pelvis c) Extended hip ventrodorsal pelvis d) Ventrodorsal extended hip

a) VD of the pelvis b) Flexed hip ventrodorsal pelvis c) *Extended hip ventrodorsal pelvis* d) *Ventrodorsal extended hip*

Also called funnel chest, this developmental disease results in an indentation in the ventral chest. What is its proper name?

a) ventral pectus b) *pectus excavatum* c) ventral indentum d) pectus indentum

Which of the following are characteristic of hypertrophic osteopathy? a. Bilateral b. Unilateral c. Proliferative only d. Starts out lucent and later has periosteal new bone e. Predominantly in older dogs f. Predominantly in younger dogs g. Starts at the 2nd and 5th metacarpals/ tarsals and progresses proximally h. Focuses at the metaphysis

a. *Bilateral* b. Unilateral c. *Proliferative only* d. Starts out lucent and later has periosteal new bone e. *Predominantly in older dogs* f. Predominantly in younger dogs g. *Starts at the 2nd and 5th metacarpals/ tarsals and progresses proximally* h. Focuses at the metaphysis

Which of the following are radiographic signs of alveolar air space disease? (Choose all that apply). a. Lobar border sign b. Border effacement c. Bronchiectasis d. Cavitary bulla e. Air bronchogram

a. *Lobar border sign* b. *Border effacement* c. Bronchiectasis d. Cavitary bulla e. *Air bronchogram*

Which of the following is non-ionizing radiation? a. MRI b. Fluoroscopy c. CT d. Scintigraphy

a. *MRI* b. Fluoroscopy c. CT d. Scintigraphy

Which of the following has an effect on quality of the image?

a. *kVp* This controls the scale of contrast primarily (because it controls the energy and thus penetration ability of the x-rays) but also the overall degree of exposure (blackness) in the image. Increasing the kVP has its greatest effect in changing the number of shades of gray, but with every incremental increase in kVP there is also an increase in the degree of exposure- it is just not a simple direct relationship as there is with the mAs. Visa versa, when the kVp is decreased the x-ray are less energetic and thus the range of differential absorption is not as great and thus the image will have fewer shades of gray. But the image will also be overall less exposed. b. mAs - If the final image is of poor quality because it is overall too black (overexposed) or too white (underexposed) then there is a very high likelihood that the mAs is incorrect for this body area. Under or over exposure definitely affects the quality of the image. c. Distance - this could affect the quality of the image in a couple of ways: 1) magnification either simple or unequal, the latter causing image distortion; 2) exposure - changing the distance of the x-ray source from the detector is equivalent to changing the mAs. d. Size of patient - this factor is an everyday occurrence and one of the challenges of getting a good quality image. The larger the patient the greater the amount of scatter radiation that is generated and when that scatter reaches the detector it reduces the contrast in the image - meaning that areas are exposed that were not intended to be exposed. When a patient is very small it is difficult to not overexpose the image. e. All of the above - Actually in total they all do. 'Quality' is too broad of a term to use in this question without a modifier to lead you to the correct choice. Looking at the dictionary definition of 'Quality' I think the meaning with respect to the x-ray beam the "characteristics of the x-ray beam energy" - so a definition restricted to the x-ray beam. "Quality of the image" is meant to refer to the overall features of the image. A question asking whether a radiographic image is of good quality would have to take into account the contrast, detail, positioning, area included, and features of the patient. So - bottom line - "Quality of the image is under multifactorial effects" but "Quality of the x-ray beam" is controlled only by the kVp".

Which of the following is a characteristic of Hypertrophic Osteopathy? a. Age of onset is typically <1 year b. Lucency is present early in the course of disease and periosteal new bone later in course of disease c. Periosteal new bone formation d. Lucency predominates during course of disease

a. Age of onset is typically <1 year b. Lucency is present early in the course of disease and periosteal new bone later in course of disease c. *Periosteal new bone formation* d. Lucency predominates during course of disease

Which of these statements is/are true a. All calcified discs have undergone degeneration b. Not all calcified discs protrude or rupture c. An isolated finding of intervertebral disc space narrowing in VD view is less reliable than both VD and lateral radiographic views d. A,B, and C are true.

a. All calcified discs have undergone degeneration b. Not all calcified discs protrude or rupture c. An isolated finding of intervertebral disc space narrowing in VD view is less reliable than both VD and lateral radiographic views d. *A,B, and C are true.*

What view is best used to assess the navicular bone in horses? a. Dorsal- palmar b. Palmar 55-degrees proximal-palmar distal c. Dorsal 60-65-degree proximal-palmar distal d. Lateral-medial

a. Dorsal- palmar b. *Palmar 55-degrees proximal-palmar distal* c. *Dorsal 60-65-degree proximal-palmar distal* d. Lateral-medial Both b and c are correct choices - there is not a singular view that is best for assessing the navicular bone. Many would argue that b is overall better than c in that b depicts the medullary cavity and flexor cortex much more effectively and independently (meaning without superimposition) than does view c. View c shows the navicular bone summated with the opacity of the 2nd phalanx and cannot differentiate the medullar cavity from the flexor cortex. To make c the only correct answer, I would add the condition of the distal border as a specific area to be assessed - "What view is best used to assess the distal border of the navicular bone in horses?"

Which of the following is not a standard view of the equine carpus? a. Dorsal-Palmar b. DorsalProximal-Dorsal Distal Oblique c. Lateral-Medial d. DorsoLateral-PalmaroMedial Oblique e. Flexed Lateral-medial f. PalmaroLateral-DorsoMedial Oblique

a. Dorsal-Palmar b. *DorsalProximal-Dorsal Distal Oblique* c. Lateral-Medial d. DorsoLateral-PalmaroMedial Oblique e. Flexed Lateral-medial f. PalmaroLateral-DorsoMedial Oblique

Which of the following breeds and distribution would be the most common presentation for hypertrophic osteodystrophy? a. German Shepherd, unilateral b. Weimaraner, bilateral c. German Shepherd, bilateral d. Weimaraner, unilateral

a. German Shepherd, unilateral b. *Weimaraner, bilateral* c. German Shepherd, bilateral d. Weimaraner, unilateral

Which of the following is not true [meaning which of the following is False] of mAs?

a. It is a calculation of mA x seconds of exposure b. It affects the quantity of x ray beam c. *It affects the quality of x ray beam* d. It has a directly proportional effect (doubling the mAs doubles the number of electrons)

What type of bone production (pictured below) is columnar, with spikes which maintain a perpendicular orientation to the cortex?

a. Lamellar b. Palisading this is very, very similar, with a difference being palisade has smoother, rounder ends whereas spiculated has sharper, pointier ends c. Smooth d. *Spiculated*

Which of the following is a difficult diagnosis to make based solely on radiographic appearance?

a. Medial coronoid disease - this would be the correct answer because radiographic findings are very vague and it's difficult to visualize the lesion on radiographs b. Chip fracture of the medial coronoid - depending on where on the medial coronoid this fracture fragment occurred it too could be very difficult to diagnosis by radiography. How about changing this to a periarticular site such as the cranial glenoid rim of the scapula. c. Gastric dilatation volvulus d. Pulmonary osteoma

What is the name of the bone the arrow is pointing to in the following picture?

accessory carpal bone

Which of the following would be on your differential list for an extradural lesion of the spinal cord? a. Neoplasia b. Intervertebral disc disease c. Granuloma d. Myelitis

a. Neoplasia This is true if it was a tumor arising from the vertebra or from the paravertebral soft tissues that extended into the spinal canal. A neoplasm originating with in the spinal cord including the meninges however would not cause an extradural lesion. b. *Intervertebral disc disease* c. Granuloma - Similar to neoplasia it depends on where the granuloma is. If the granuloma is in the epidural space then it would cause an extradural lesion. d. Myelitis

Match the provided image with the proper name.

a. PalmaroLateral-DorsoMedial Oblique_ b. _DorsoLateral-PalmaroMedial Oblique_ **** OOPS!!! I would have to count each of these at least partially incorrect as the images are of the tarsus and the wording in the answers is PALMAR which implies the front leg. Because these radiographic images are the tarsus the word should be PLANTAR. I expect you to use the proper limb anatomy terminology in the naming of these views!!!!!!!!!!!!!!!!!!!

Name the most likely enlarged structure in this cardiac shadow.

a. Pulmonary artery - this is the correct answer - the bulge visible on the cranial left aspect of the heart is in the location of the pulmonary artery b. Aorta - the shadow of the aorta is visible in this image but so it is not enlarged.

A 10 year old male domestic short hair presents with lethargy and 8% dehydration. CBC, chem and UA indicate that the patient is azotemic. Which of the following would be contraindicated as an imaging modality for determining changes to the kidney such as size, shape, contour, and opacity?

a. Radiographs b. *Excretory urogram*; The rationale here is the 8% dehydration c. CT urography - This would also be contraindicated based on the dehydration. CT urography is really an Excretory Urogram with the images collected by CT rather than by standard radiographs. d. Scintigraphy e. MRI The concern, and thus the contraindication for the Excretory Urogram in the presence of significant dehydration is that the iodinated contrast media have variable potential nephrotoxicities -some can cause worsening of renal function. So the point is that it is best to restore the patient to the euhydrated state before performing an Intravenous Iodinated contrast study - whether the images are to be collected by standard radiography or by CT or by Fluoroscopy.

Label each of the following statements as true or false. a. Radiographs are moderately sensitive indicators of heart enlargement and thus heart disease. b. Size and shape changes are by themselves indicators of cardiac failure. c. Radiographs alone generally have poor specificity for the cause of heart disease. d. Radiographs provide good differentiation of ventricular muscular hypertrophy versus chamber dilation.

a. Radiographs are moderately sensitive indicators of heart enlargement and thus heart disease. True b. Size and shape changes are by themselves indicators of cardiac failure. False c. Radiographs alone generally have poor specificity for the cause of heart disease. True d. Radiographs provide good differentiation of ventricular muscular hypertrophy versus chamber dilation. False

Answer the following questions based on the two images provided below. a. What type of fracture is seen in the images? b. Is this an articular fracture?

a. What type of fracture is seen in the images? Salter Harris Type 4 b. Is this an articular fracture? Yes

intervertebral disc space joint

cartilaginous

pubic symphysis

cartilaginous joint

length of L5 (>1.48x is megacolon, <1.28x is normal)

cat large bowel

cranial endplate of L2 (<2.0x)

cat small intestine

What lung distribution pattern would you expect for inflammation and/or pneumonia?

cranioventral

The most common location of Osteochondrosis dissecans (OCD) in the dog is __________ and in the horse is ____________.

humeral head; intermediate ridge of the distal tibia (DIRT) In order for you to reinforce the pathophysiology of Osteochondrosis - dessicans variation - a suggestion is to be more anatomically specific about the names of these areas - particularly when you are discussing this as veterinarian to veterinarian. The humeral head lesion is actually in the caudal subchondral bone of the proximal humeral epiphysis; and in the tibia of the horse it is in the subchondral bone of the distal tibial epiphysis in the region of the dorsal portion of the intermediate ridge. Never hurts to repeat the "long winded" location as a method of reinforcement.

What is the best radiographic view to assess for ununited anconeal process in dogs?

hyper-flexed medial-lateral

On CT scan bone appears _______ attenuated, while air appears ______ attenuated. (fill in the blank).

hyper; hypo

Which is NOT characteristic of degenerative joint disease (DJD)?

• Periarticular osteophytes • Enthesiophytes • Decreased size of fat pad - Not entirely true. It is true that the fat pads will likely be decreased when there is degenerative joint disease BUT!!!!! If the only visible change at a joint is the decreased size of the fat pad it does not allow the diagnosis of DJD to be made. - Where a fat pad is visible associated with a joint, its size is not a unique or characteristic feature of DJD but rather a feature that most commonly indicates that there is an abnormal distension of the joint cavity. The distension of the joint cavity could be due to hemorrhage; to increased synovial fluid production; to the presence of purulent exudate in the joint cavity; or to proliferation of the tissue of the joint capsule - such as synovial tissue proliferation or even neoplastic infiltration of the synovial tissue. Also don't forget that in the joints associated with a fat pad that there is skin and subcutaneous tissue and commonly a ligament or tendon that is located adjacent to the fat pad - this is particularly true of the stifle joint's infrapatellar fat pad in all of our common species. So if there was a swelling, say hemorrhage from trauma, to that overlying subcutaneous tissue or ligament/tendon then the enlargement of that tissue could also decrease the size of the fat pad and not at all be affecting the interior or periarticular components of the joint. • *All of the above are consistent with DJD*