new frcr2a

Ayat

2012-07-18T11:30:00.001+03:00

Ayat
آيـــات هو برنامج قرآنى شامل بمميزات فريدة يدعم أغلب أنظمة التشغيل ومترجم لأشهر اللغات العالمية. وتم استخدامه على أكثر من 100,000 جهاز حاسب حول العالم.

2012-05-29T14:27:00.002+03:00

2012-05-04T00:56:00.002+03:00

Long case answer sheet for training

2011-09-09T20:57:00.000+03:00

LCAnswerBookTemplate.pdf - Powered by Google Docs

FRCREGYPTIANS مجموعه من الاطباء الدارسين للزماله البريطانيه

2011-09-09T02:06:00.002+03:00

https://www.facebook.com/groups/frcregyptians/

no body should miss this facebook group

2011-04-21T22:26:00.001+03:00

Aortoiliac occlusion rx

View more presentations from Ehab M.

ultrasound teaching manual

2010-11-25T14:09:00.002+03:00

Editorial Reviews

Review

"Hands-on guide..organized like a sonography course, including positioning and step-by-step descriptions of each procedure. The front and back covers open for additional quick information. This edition is updated with the newest techniques.. It is heavily illustrated with sometimes extra alternative imaging modalities. Checklists and some normal values are provided on pocket-sized cards, which is convenient for a quick review. In conclusion, this new edition of a famous ultrasound workbook is ideal and attractive for radiology residents as a self-teaching manual."--Surgical Radiologic Anatomy

"A brief but handy reference...the back cover's flap makes identification of the numbered anatomy easy...The arrangement of the sonograms with a corresponding line drawing makes it a very useful anatomical reference...a good addition to the basic reference library for beginning sonographers...a useful book for a beginner as a means to learn basic sonography."--ADVANCE for Imaging and Radiation Therapy

"Oriented for use as a workbook and self-study manual."--Book News

"Will certainly have..success in the USA. The manual, which..is quite inexpensive, represents the desire by the publisher to offer an easy-to-obtain didactic "workbook" on general ultrasonography directed to the students of sonography and to the young physicians interested in the roles of ultrasonography. The text is very clear, with informative drawings, and there is a good number of scoring boards reporting the normal values of the different measurements, in particular dealing with the pregnancy status. The iconography is of good quality.."--Clinical Imaging

do you think this spotting is ok

2009-08-07T16:00:00.000+03:00

Radiology personal image Database

2009-07-24T13:44:00.002+03:00

Hope you like it,

http://www.mediafire.com/file/znoyug2zqgt/radbasefinal.zip

This is a program of Database to store your X rays, Ultrasound , CT and MRI images as long as they have a formate can be stored in computer.

You can store your images, diagrams together with small report and small discussion for future revising

you can search by diagnosis, or date of addition or by the name of the person who added it.

you can sort them also by any way mentioned above.

Hope it will help all radiologists.

Ehab Taher. (Ehabtahermm@gmail.com)...

Your comments are appreciated.

Single best answer collection

2009-07-24T13:39:00.003+03:00

in This program you can make your collection of single best answers with images and keep them in database.

http://www.mediafire.com/?znoyug2zqgt

frcr 2a single best answer quistions

2009-07-17T11:40:00.003+03:00

single best answer quistions for frcr part A

check this URL, may be helpful

http://www.mediafire.com/?uhlujvd3jbe

مهم جدا للجزء الاول من الزماله البريطانيه very useful for part one frcr

2009-05-22T11:12:00.002+03:00

The following URLs are collection of mcq and summaries for studying FRCR part one, every one can download then and he will find them useful in studying for frcr 1

http://www.4shared.com/file/96896844/845f4301/MCQ1Ultrasound.html

http://www.4shared.com/dir/8883489/576898d6/sharing.html

http://www.4shared.com/file/96898704/bb0b60b/MAMMOGRAPHY.html

http://www.4shared.com/file/96899069/9ea81cd0/_3__GAMMA_IMAGING.html

http://www.4shared.com/dir/8883489/576898d6/sharing.html

http://www.4shared.com/file/96903172/b852cf9e/IRR99.html

http://www.4shared.com/file/96905235/65777ebc/IRR99.html

http://www.4shared.com/file/96917204/ae34fcd2/COMPUTED_TOMOGRAPHY.html

http://www.4shared.com/file/96917457/4ec7259f/Chapter_6__Legislation_-_2.html

http://www.4shared.com/file/96917890/750c0654/CH6-summary.html

http://www.4shared.com/file/96918196/cbdd88b8/CH5-summary.html

http://www.4shared.com/file/96918627/5a617760/CH4-summary.html

http://www.4shared.com/file/96919709/369135b7/CH3-summary.html

http://www.4shared.com/file/96920347/88e44032/CH2-IMAGING_WITH_Xrays.html

http://www.4shared.com/file/96921265/eda24ece/CH12-summary.html

http://www.4shared.com/file/96927583/ba668f2c/_2__CH12-summary.html

http://www.4shared.com/file/96929501/7c6e133b/_2__MCQ1Ultrasound.html

http://www.4shared.com/file/96929757/ebfe9625/_2__Statutory_Requirements_2000_summary_.html

http://www.4shared.com/file/96929983/53a3017b/_2__Statutory_Requirements_1999_summary_.html

http://www.4shared.com/file/96930345/5b8a08ae/_2__QBaseFRCR1.html

http://www.4shared.com/file/96930524/7e5ae30c/QBase2_for_FRCR1.html

http://www.4shared.com/file/96930874/bf5841a/_2__MCQs_com.html

http://www.4shared.com/file/96933619/3b35ddc5/MCQs_for_the_FRCR.html

http://www.4shared.com/file/96934099/6ab613c6/MCQs_for_the_FRCR_Part_1.html

http://www.4shared.com/file/96937431/8b3e744c/Final_test_on_radiation_diagnostics_and_radiation_therapy.html

http://www.4shared.com/dir/8883489/576898d6/sharing.html

http://www.4shared.com/file/97140392/8844b689/mcq_gamma_imaging_and_radioactivity.html

http://www.4shared.com/file/97140728/8c6c2e80/Films_and_screens.html

http://www.4shared.com/file/97140997/f5b9c7d0/Grids.html

genitourinary SBA II

2009-05-19T05:55:00.002+03:00

2-1: Regarding Wilm's tumor, please answer with TRUE or FALSE.

a.	T or F	Associated with with inherited aniridia.
b.	T or F	Associated with Beckwith-Weidemann.
c.	T or F	Invades the IVC.
d.	T or F	Most common pediatric renal/perinephric tumor to encase vessels.

2-2: Regarding malacoplakia: Please answer with TRUE or FALSE.

a.	T or F	Premalignant.
b.	T or F	Associated with E.coli infection.
c.	T or F	More common in females.
d.	T or F	Most commonly occurs in the bladder.
e.	T or F	Michaelis-Gutmann bodies on biopsy are a definitive diagnostic finding.
f.	T or F	Predisposition in diabetics..

2-3: What is the MOST COMMON cause of lateral deviation of the ureters?

A	Lymphoma
B	Retroperitoneal fibrosis
C	Aneurysm
D	Lipomatosis

1- A F, B-T, C-T, D-F
2- A F, B-T, C-T, D-T,E-T, F-T
3- LYMPHOMA Probably the best answer. Accoring to Dunnick, p371, lymphoma is the most common cause of lateral deviation of the proximal and middle thirds of the ureter.

genitourinary single best answer 1

2009-05-19T01:29:00.002+03:00

1-1: A corpus luteum cyst usually resolves by what gestational age? Pick ONE answer.

A	5 wks
B	10 wks
C	15 wks
D	18 wks

1-2: Which ONE of the following testicular neoplasms is not of germ cell origin?

A	Seminoma
B	Leydig cell tumor
C	Choriocarcinoma
D	Embryonal cell carcinoma
E	Teratoma

1-3: Scenario: A 30 year old male with enlarged testicle. Ultrasound reveals a hypoechoic intratesticular mass. Please answer EACH of the following with TRUE or FALSE.

a.	T or F	Ultrasound can distinguish benign from malignant.
b.	T or F	Intratesticular location (vs extratesticular location such as epididymis) suggests malignancy.
c.	T or F	Elevated b-HCG and AFP suggest metastatic disease.
d.	T or F	Earliest metastases are to the iliac chain.

1-4: What is the most likely cause of penile strictures and filling of Littre's glands in a patient with symptoms of forced stream. Choose the BEST answer.

A	Prior gonococcal infection.
B	Prior instrumentation
C	Saddle injury answers: 1- d 2- b 3- b 4- a

help for frcr1 candidates MRI and U.S. physics mcq

2009-05-09T00:26:00.001+03:00

FRCR Part 1 : U.S. / CT / MRI Physics

Regarding CT of brain:
1. CSF has a lower attenuation than brain
2. the fourth ventricle is triangular in section
3. sections are taken at 30% to the orbitomeatal line
4. basilar artery can be seen on unenhanced scans

Regarding hazards of MRI:
1. radiofrequency pulses can cause electric currents in the patients
2. MRI is useful in dectecting intraocular foreign bodies
3. pregnancy is a relative contraindication
4. unchelated gadolinium is safe
5. the major cause of damage by RF pulse is thermal injury

In CT:
1. filtered back projection is commonly used in modern scanners
2. a window level of 200 is useful for bone imaging
3. dose is linearly related to number of contiguous slices
4. the efficiency of a gas detector is better than that of a scintillation detector

In Magnetic Resonance Imaging:
1. signals come only from excess nuclei in one direction
2. paired protons have zero spin angular momentum
3. Larmor frequency is the frequency of pulsed magnetic weld
4. precession occurs when the magnetic vector of nuclei is parallel to the external magnetic field
5. nuclei with an even number of protons and neutrons can be used

In Magnetic Resonance Imaging:
1. flow of blood can cause a loss of signal
2. fat can be suppressed by STIR sequence
3. all hydrogen nuclei in a tissue have the same Larmor frequency
4. Larmor frequency is inversely proportional to the gyromagnetic ratio
5. Larmor frequency of the same nuclei is proportional to the external magnetic field

In CT scanning:
1. photomultiplier tubes are generally used as detectors
2. only the detectors rotate in 4th generation machines
3. data manipulation generally uses a Fast Fourier transform
4. the spatial resolution is limited by the number of pixels
5. image noise is reduced by using a faster scan-time

In magnetic Resonance Imaging (MRI):
1. the image is reconstructed from radio signals emitted by precession of atomic particles in a magnetic field
2. hydrogen is the element most suitable for MRI in man
3. magnetic field strengths up to 0.1 Tesla are generally required
4. superconducting electromagnets cooled by liquid Helium are often used
5. proton density imaging gives good soft tissue discrimination

Larmor frequency
1. is directly related to the strength of the applied magnetic field
2. is inversely related to be gyromagnetic ratio
3. is the same for all hydrogen nuclei in a tissue
4. is the same as the frequency of the radiofrequency pulse

MRI:
1. pregnancy is an absolute contraindication
2. the radiofrequency pulse may induce electric currents in the patient
3. the radiofrequency pulse may cause heating of the patient
4. the T1 of fat is shorter than that of water
5. is the investigation of choice in suspected intraocular foreign body

In CT
1. the spatial resolution is improved with a larger pixel size
2. most interactions are due to the photoelectric effect
3. each detector has its own collimator
4. scintillation detectors are less efficient than ionization detectors

MRI:
1. flowing blood gives signal void on T2 TSE sequence
2. pregnancy in the first trimester is a relative contraindication
3. gadolinium decreases T1 and T2 of appropriate tissues
4. gadolinium is safe in the unchelated form
5. gadolinium is a superparamagnetic substance

Modern CT Scanner:
1. uses several X-ray tubes to acquire data from different directions
2. uses several hundred detectors
3. produces images x resolution of 5 Lp/mm
4. produces images x min detectable contrast <>
5. can be considered low dose equipment

Concerning the CT image:
1. noise is independent of dose
2. is made up of pixels
3. resolution is equal to pixel size
4. will have less artifacts from partial vol. effect if x slice thickness
5. Can x partial vol. if x mA

In CT image, noise:
1. depends upon scan time
2. depends upon mA
3. will be greater when x slice thickness
4. will affect spatial resolution
5. will make low contrast objects difficult to detect

Contrast of CT image controlled by:
1. kV setting
2. mAs setting
3. type of detectors
4. window width
5. window level

MRI – acquisition time decreased by:
1. decreasing slice thickness
2. using short TR
3. using short TE
4. increasing the number of excitations
5. use of pre-saturation bands

CT:
1. 5mm copper filters used
2. photoelectric effect is main one in CT
3. Hounsfield no. of fat is about –100
4. pixel = Representation of linear attenuation coefficient of voxel
5. use of narrow windows gives higher contrast

MRI:
1. CSF has a low signal on T1
2. CSF is brighter than grey matter on T2
3. white matter is brighter than grey matter on T1
4. longitudinal relaxation is always longer for all tissues than transversal relaxation
5. use of mascara causes artefact

MRI:
1. useful in evaluation of intra ocular foreign bodies:
2. Faraday (age encloses the fringe field)
3. pregnancy is a relative contra indication (1^st trimester)
4. radio Frequency pulse – causes local heating
5. RF pulse – causes electrical currents in the body

Concerning MRI
1. fields above 2T should not be used
2. produces images of proton density
3. measures spin-lattice relaxation
4. requires radio-frequency pulse to induce the signal
5. requires a field gradient for spatial coding

MRI Policies - Safety and Contraindications

Metallic fragments, clips or devices in the brain, eye, spinal canal, etc.:
Movement in the bore of the magnet may damage sensitive tissues. Plain radiography is sufficient for screening. Some intracranial clips may be safe, but these must have been tested in the OR just prior to implantation.

Magnetically activated implanted devices:
Cardiac pacemakers, insulin pumps, neurostimulators, cochlear implants, etc. may be de-programmed.

Non-graphite spinal cord tongs: Graphite tongs are compatible.

Thermodilution Swan-Ganz catheter: Local heating can result.

Metal outside the brain and eye is Not a contraindication: Magnetic deflection is minimal compared to normal physiologic forces. Cardiac valves), inferior vena cava filters, IUD's and metallic prostheses are safe, unless there is doubt as to positional stability.

Link to: AHA Scientific Statement (exerpts) on "Safety of Magnetic Resonance Imaging in Patients With Cardiovascular Devices"

Gadolinium Administration

Decreased renal function is Not a contraindication: Gadolinium contrast agents are not nephrotoxic at does used as per our protocols, although excretion is primarily renal.

Signed consent is not needed unless a patient is identified as high risk for gadolinium.

Risk of nephrogenic systemic fibrosis (NSF) in patients with severe renal failure (stage 4 or 5; GFR <>:

1. Benefit/risk and indication for gadolinium contrast agent should be reevaluated by a radiologist.

2. If unenhanced MRI is likely to provide sufficient information, gadolinium should not be administered to these patients.

3. If, after review of clinical indications, gadolinium enhancement is judged to be important for diagnosis, the lowest effective dose of contrast agent should be used. MultiHance (gadobenate dimeglumine) is preferred for these patients, since it allows a comparable effect to be obtained at lower gadolinium dose (see below). NSF case material thus far suggests that MRI using 20 ml or less of Magnevist or MultiHance poses negligible risk of NSF. Most NSF has occurred using more than 30 mL of gadolinium contrast agent, and most have been following Omniscan (gadodiamide).

4. For patients treated with hemodialysis, a hemodialysis session within a few hours following gadolinium contrast injection is likely to further reduce NSF risk.

----------------------------------------------------------------------------------------------------

Standard Gadolinium doses:

Magnevist
standard dose: 0.1 mmol/kg
single station Body MRA: 0.15 mmol/kg
MRV or bolus chase MRA: 0.2 mmol/kg

MultiHance
standard dose: 0.07 mmol/kg
FNH characterization, MRA, MRV: 0.1 mmol/kg

----------------------------------------------------------------------------------------------------

Steroid pretreatment policy: There is no routine pretreatment of patients with prior reaction to either iodinated or gadolinium contrast agents, since there has been no evidence that this is beneficial. Decisions to pretreat, or not to use contrast agent, may be made on an individual basis. If a prep is administered, it is identical to the prep for iodinated contrast: Medrol 32 mg po (or its equivalent) 12 and 2 hours prior to contrast administration.

Pregnancy

MRI is not contraindicated, but... Prudence is urged, although there is no evidence that MRI is harmful to the fetus during any trimester.

Documented benefit. The risk is minimal at most, but the benefit must be finite. Ask: "Would CT be performed if MRI were not available." If "No", MRI should not be performed.

Only essential sequences should be performed.

Informed consent. Verbal and signed consent should be obtained, and the referring physician must be informed that bioeffects cannot be excluded with certainty. The dictation should mention the informed consent.

Pregnant women who are not being scanned should not enter the magnet room to accompany the patient. The benefit/risk ratio of the medical indication covers the patient, not friends or family.

Do not use gadolinium unless essential for diagnosis and management. Although there is no documented harm, it is known that gadolinium crosses the placenta into the amniotic fluid and is then swallowed and urinated back into the amniotic fluid. It's stability during this path, and the half life in the fetus, have not been determined.

ULTRASOUND

Ultrasound as used in diagnostic radiology: f?fft
1. is an electromagnetic radiation with a frequency of 1-15 MHz
2. has a wavelength of 0.1 – 1.5mm in soft tissue
3. is attenuated exponentially
4. is heavily absorbed in air
5. is reflected at tissue interfaces with different acoustic impedances

The absorption of ultrasound: tff
1. occurs as a result of longitudinal relaxation processes
2. is due to scattering
3. is primarily dependant on resonance coupling

Concerning Ultrasound
1. the velocity in water is twice that in muscle
2. for the same incident angle the refracted angle is greater at a soft tissue/bone interface than at a soft tissue/fluid interface.
3. the velocity is dependent on temperature
4. impedance is inversely proportional to density

In the following statements concerning diagnostic ultrasound, ‘soft tissue’ excludes gas, cartilage and bone:
1. the attenuation coefficient of ultrasound in typical soft tissue when expressed in units of dB cm^–1, is approximately proportional to frequency
2. the attenuation coefficient at a given frequency is the same in all soft tissues to within  10%
3. the speed of sound in most soft tissue is within 5% of 1540 ms^–1 independent of frequency
4. the fraction of intensity reflected by a plane wave of ultrasound at normal incidence to a flat interface between typical soft tissues is usually less than 1%
5. a decrease in intensity by a factor of 2000 is equivalent to a change of –33 dB (to the nearest dB)

The function of a swept gain amplifier in an ultrasound scanner is:
1. to increase the gain of the transmitter for improved penetration
2. to reduce high frequency noise in the received signal
3. to compensate for signal attenuation of deeper echoes
4. to increase the receivers signal band-width
5. to steer electronically the transmitted beam

Ultrasound used for diagnostic purposes:
1. has a wave length in tissue of the order of 1mm
2. is generated by a sodium iodide crystal transducer
3. has a mean intensity of the order of 10 watt per cm²
4. is readily transmitted from tissue to air

Ultrasound of the breast:
1. requires a 3.5 MHz transducer
2. is a sensitive indicator of microcalcification
3. can accurately distinguish cystic and solid lesions
4. is of no value in the young dense breast
5. typically demonstrates acoustic enhancement behind the nipple

In ultrasound
1. ultrasound is produced by applying a magnetic field to a piezoelectric crystal
2. velocity and frequency are constant regardless of wavelength
3. with a curved transducer, focal length will decrease with curvature
4. resolution is better in central axis of the beam
5. spatial resolution is improved with a shorter pulse width

Ultrasound used in diagnostic imaging
1. is a longitudinal pressure wave
2. will not travel through a vacuum
3. has a velocity of the order of15m/s in water
4. can be deflected by a magnetic field
5. attenuation is measured in decibels (dB)

The resolution of an ultrasound scanner
1. is improved along the beam axis by increasing the ultrasound pulse height
2. is improved laterally by increasing the pulse repetition frequency
3. is dependent laterally on the beam width
4. with a mechanical is symmetrical in all axes
5. improves as the ultrasound frequency is increased

A pulse of ultrasound from a medical transducer
1. has a velocity that is inversely proportional to the media density
2. propagates with a transverse wave motion
3. has a band width that is inversely proportional to pulse length
4. has the lower frequencies within its spectrum preferentially absorbed by the media
5. is diffracted by small targets of similar dimensions to the beam

concerning diagnostic ultrasound
1. modern piezoelectric crystals are quartz compounds
2. a piezoelectric with a high Q factor makes a good receiver of echoes
3. the diameter of the crystal determines the resonant frequency
4. increasing the frequency increases the absorption of the sound
5. the absorption coefficient for fat is higher than that of water

In the display of an ultrasound image
1. A-mode utilises a moving time base
2. B-mode produces an image of a section or slice through the patient
3. returning echoes can be displayed either as white or black dots
4. a digital scan converter uses binary code storage
5. the time gain compensation graph is linear

Concerning the effects of ultrasound
1. heat results from the interaction of ultrasound and tissue
2. 'cavitation' occurs in the lungs
3. the intensity of the sound is unrelated to the chance of biological effects
4. medical ultrasound is safe
5. it does not cause ionisation

In grey-scale, real-time ultrasound
1. returning echoes are assigned a shade of grey according to their intensity
2. at least 16 frames/second are needed for a flicker-free display
3. image resolution is increased when frame rate is increased
4. an increase in the number of lines per field of view requires a decrease in the frame frequency
5. decreasing the angle of a sector scan has no effect on image resolution
Ultrasound:
1. is electromagnetic radiation
2. can be focused to a certain extent
3. at soft tissue to soft tissue interface about 3% is reflected
4. at soft tissue to bone interface about 40% is reflected
5. is safe at diagnostic energies

Ultrasound:
1. is sound above 20 kHz (cycles per second)
2. 1 MHz has wavelength of 1.5mm
3. the higher the frequency the better the resolution, hence use of 15–19 MHz in ophthalmic work
4. the higher the frequency the greater the penetration
5. lateral resolution of ultrasound is about 2cm
6. linear resolution of ultrasound is about 0.1mm
7. linear and lateral resolutions of X-ray film are less than 0.5mm

Ultrasound:
1. may be detected by a piezoelectric crystal
2. voltage changes across the crystal cause expansion and contraction resulting in pressure waves
3. the same crystal cannot be used for producing as well as receiving ultrasound
4. continuous sound is used to detect doppler effect
5. in pulsed ultrasound the pulse width is shorter than the listening interval

Ultrasound:
1. is used in short wave diathermy
2. produces heating of tissues
3. can be reflected
4. produces ionising radiation
5. produces blackening of a photographic emulsion
6. interfaces are not usually detected if less than 5% of the incident beam is reflected
7. substances of different densities have different acoustic impedances

Ultrasound in clinical medical practice:
1. is used in 1-15 MHz range
2. uses wavelengths of 0.15mm –1.5mm
3. is completely attenuated in air
4. the longer the wavelength the better the resolution
5. is refracted at an interface
6. an interface is most clearly shown when incident beam strikes it at right angles.

Ultrasound:
1. has a speed of 3000 m/s in soft tissue
2. changing acoustic impedance causes refraction
3. delay can be used to decrease amplitude of strong echoes behind fluid filled structures
4. time gain compensator is used to enhance echoes from deeper structures

A phase arrayed ultrasound scanner can vary:
1. direction of beam
2. focal length
3. axial resolution
4. lateral resolution
5. pulse repetition frequency

An ultrasound beam travelling through soft tissues:
1. has approximately the same velocity as in water
2. has a velocity of approximately 1500m per second
3. the amount (i.e. angle) of refraction at an interface depends on the ratio of the velocities of the two media
4. is attenuated at a rate of approximately 1 dB/MHz/cm
5. is usually in the frequency range 0.1 to 1 MHz for diagnostic purposes

Ultrasound reflected at the interface between two organs:
1. is optimum when the beam is incident at 90 degrees to the interface
2. relies on 5% of the beam reflected for adequate detection
3. requires the organs to remain stationary
4. there must be a density difference between the two organs
5. depends on the difference in the product of density and speed

Ultrasound:
1. causes heating of tissues as it is absorbed
2. slows down as it is absorbed
3. always travels in straight lines

Ultrasound:
1. piezoelectric material distorts when subjected to mag. field
2. piezoelectric material produce pot. difference when distorted
3. max. transmission from transducer when crystal backed x air
4. high q factor crystal will produce wide range of amplitudes
5. impedence = density x particle veloctiy

Use of a preprocessing curve:
1. x noise in a B scan
2. x gain of A scan
3. expand displayed dynamic range of certain tissues
4. match hardcopy input + scanner output dynamic range
5. enables faster scan conv.

Ultrasound:
1. velocity of sound in water is approx. 1500 meters/second
2. velocity of sound waves proportional to frequency
3. cannot detect sound if <5%>
4. get reflection with a difference in products of velocity and density
5. for reflection, tissues should have a density difference

The following statements are true concerning diagnostic ultrasound:
1. a 5MHz probe is suitable for examining the adult liver
2. the common bile duct can usually be demonstrated in normal subjects
3. the kidneys are best examined using a posterior approach
4. a linear scan motion demonstrates liver parenchyma more satisfactorily than a compound scan in motion
5. better results are usually obtained in obese patients than in thin patients

In medical use of ultrasound:
1. the diagnostic frequency range is 1 – 15MHz
2. ultrasound waves are poorly absorbed in soft tissues
3. ultrasound waves pass readily through air
4. reflection of ultrasound waves occurs by the piezoelectric effect
5. the Doppler principle is employed to detect movement of structures

Ultrasonics used in medical diagnosis:
1. has atypical wavelength in tissues of about 1mm
2. is completely harmless to living tissues
3. can be used to locate some soft tissue interfaces
4. is used in preference to some radiation because it is more penetrating
5. can be used to measure instantaneous blood velocity

The length of US pulses is kept to absolute minimum to:
1. improve lat resolution
2. improve axial resolution
3. decrease us intensity produced
4. scattering is reduced
5. scattering is improved

mri ct frcr 2a

FRCR Part 2A: CT/MRI Physics

Regarding CT of brain:
1. CSF has a lower attenuation than brain
2. the fourth ventricle is triangular in section
3. sections are taken at 30% to the orbitomeatal line
4. basilar artery can be seen on unenhanced scans

Regarding hazards of MRI:
1. radiofrequency pulses can cause electric currents in the patients
2. MRI is useful in dectecting intraocular foreign bodies
3. pregnancy is a relative contraindication
4. unchelated gadolinium is safe
5. the major cause of damage by RF pulse is thermal injury

In CT:
1. filtered back projection is commonly used in modern scanners
2. a window level of 200 is useful for bone imaging
3. dose is linearly related to number of contiguous slices
4. the efficiency of a gas detector is better than that of a scintillation detector

In Magnetic Resonance Imaging:
1. signals come only from excess nuclei in one direction
2. paired protons have zero spin angular momentum
3. Larmor frequency is the frequency of pulsed magnetic weld
4. precession occurs when the magnetic vector of nuclei is parallel to the external magnetic field
5. nuclei with an even number of protons and neutrons can be used

In Magnetic Resonance Imaging:
1. flow of blood can cause a loss of signal
2. fat can be suppressed by STIR sequence
3. all hydrogen nuclei in a tissue have the same Larmor frequency
4. Larmor frequency is inversely proportional to the gyromagnetic ratio
5. Larmor frequency of the same nuclei is proportional to the external magnetic field

In CT scanning:
1. photomultiplier tubes are generally used as detectors
2. only the detectors rotate in 4th generation machines
3. data manipulation generally uses a Fast Fourier transform
4. the spatial resolution is limited by the number of pixels
5. image noise is reduced by using a faster scan-time

In magnetic Resonance Imaging (MRI):
1. the image is reconstructed from radio signals emitted by precession of atomic particles in a magnetic field
2. hydrogen is the element most suitable for MRI in man
3. magnetic field strengths up to 0.1 Tesla are generally required
4. superconducting electromagnets cooled by liquid Helium are often used
5. proton density imaging gives good soft tissue discrimination

Larmor frequency
1. is directly related to the strength of the applied magnetic field
2. is inversely related to be gyromagnetic ratio
3. is the same for all hydrogen nuclei in a tissue
4. is the same as the frequency of the radiofrequency pulse

MRI:
1. pregnancy is an absolute contraindication
2. the radiofrequency pulse may induce electric currents in the patient
3. the radiofrequency pulse may cause heating of the patient
4. the T1 of fat is shorter than that of water
5. is the investigation of choice in suspected intraocular foreign body

In CT
1. the spatial resolution is improved with a larger pixel size
2. most interactions are due to the photoelectric effect
3. each detector has its own collimator
4. scintillation detectors are less efficient than ionization detectors

MRI:
1. flowing blood gives signal void on T2 TSE sequence
2. pregnancy in the first trimester is a relative contraindication
3. gadolinium decreases T1 and T2 of appropriate tissues
4. gadolinium is safe in the unchelated form
5. gadolinium is a superparamagnetic substance

Modern CT Scanner:
1. uses several X-ray tubes to acquire data from different directions
2. uses several hundred detectors
3. produces images x resolution of 5 Lp/mm
4. produces images x min detectable contrast <>
5. can be considered low dose equipment

Concerning the CT image:
1. noise is independent of dose
2. is made up of pixels
3. resolution is equal to pixel size
4. will have less artifacts from partial vol. effect if x slice thickness
5. Can x partial vol. if x mA

In CT image, noise:
1. depends upon scan time
2. depends upon mA
3. will be greater when x slice thickness
4. will affect spatial resolution
5. will make low contrast objects difficult to detect

Contrast of CT image controlled by:
1. kV setting
2. mAs setting
3. type of detectors
4. window width
5. window level

MRI – acquisition time decreased by:
1. decreasing slice thickness
2. using short TR
3. using short TE
4. increasing the number of excitations
5. use of pre-saturation bands

CT:
1. 5mm copper filters used
2. photoelectric effect is main one in CT
3. Hounsfield no. of fat is about –100
4. pixel = Representation of linear attenuation coefficient of voxel
5. use of narrow windows gives higher contrast

MRI:
1. CSF has a low signal on T1
2. CSF is brighter than grey matter on T2
3. white matter is brighter than grey matter on T1
4. longitudinal relaxation is always longer for all tissues than transversal relaxation
5. use of mascara causes artefact

MRI:
1. useful in evaluation of intra ocular foreign bodies:
2. Faraday (age encloses the fringe field)
3. pregnancy is a relative contra indication (1^st trimester)
4. radio Frequency pulse – causes local heating
5. RF pulse – causes electrical currents in the body

Concerning MRI
1. fields above 2T should not be used
2. produces images of proton density
3. measures spin-lattice relaxation
4. requires radio-frequency pulse to induce the signal
5. requires a field gradient for spatial coding

cvs single best answer

2009-04-09T01:25:00.003+03:00

1-1: Please answer the following with TRUE or FALSE regarding Swyer-James syndrome.
a. T or F The mediastinum deviates away from the effected lung on expiration.
b. T or F The affected side is larger than the contralateral normal lung.
c. T or F Is an example of bronchiolitis obliterans.
d. T or F The segmental bronchi terminate abruptly.
e. T or F Pathologic specimens demonstrate anthracotic changes..

Click here for an overview of Swyer-James syndrome.

1-2: Which choice is NOT seen (or is NOT typically more easily seen) on a supine CXR in a patient with a small pneumothorax.
A Deep sulcus
B SVC
C Elevation of the ipsilateral diaphragm
D Pericardial fat pad
E Abnormal lucency at ipsilateral base

1-3: Which of the following diseases can demonstrate bi-directional shunting? Please answer the with TRUE or FALSE
a. T or F L transposition.
b. T or F D transposition.
c. T or F Pulmonary atresia with intact ventricular septum.
d. T or F PDA.
E T or F TAPVR.

2-1: Which ONE is NOT a cause of high output cardiac failure?
A Thyrotoxicosis.
B Sickle cell anemia.
C Aortic insufficiency.
D Aortocaval fistula.
E Pulmonary AVM.

2-2: Alveolar microlithiasis is associated with which of the following? Please answer with TRUE or FALSE
a. T or F Hypercalcemia.
b. T or F Familial occurrence.
c. T or F Intense uptake on bone scintigraphy.
d. T or F IV drug abuse with talc-containing drugs.

2-3: Which ONE is TRUE regarding extramedullary hematopoiesis involving the thorax?
A Often seen in children
B More often in the mid to lower rather than upper thoracic spine
C Commonly causes polycythemia
D Hypervascular lesion

3-1: Which of the following are causes of pulmonary edema?
a. T or F Left atrial myxoma.
B T or F Mitral stenosis.
c. T or F Mitral regurgitation.
d. T or F Aortic stenosis.

3-2: Which ONE of the following regarding fracture/rupture of the bronchus is FALSE?
A Occurs within one to two centimeters of the carina
B Most commonly presents with pneumomediastinum
C Often associated rib fractures
D More common than tracheal rupture
E Is often associated with pulmonary artery injury

3-3: Which of the following are associated with cystic changes in the lung apices? Please answer with TRUE or FALSE.
a. T or F Histiocytosis X.
b. T or F Lymphangioleiomyomatosis.
c. T or F Tuberous sclerosis.
d. T or F Usual interstitial pneumonia.
E. T or F Ritalin lung.

4-1: Which ONE of the following is NOT associated with transient opacities?
A Simple eosinophilic pneumonia (Loeffler's).
B Chronic eosinophilic pneumonia.
C Allergic angiitis granulomatosis.
D Pulmonary hemorrhage

4-2: Regarding miliary tuberculosis, please answer the following with TRUE or FALSE.
a. T or F A negative PPD is extremely rare.
b. T or F Usually a primary focus of infection can be identified.
c. T or F Patients with miliary TB respond more rapidly than those with other types of tuberculosis.
d. T or F The radiographic changes take several weeks to develop.
E T or F Can present with pleural effusions.

4-3: Regarding lung anatomy, which ONE is TRUE?
A The right upper lobe bronchus is the narrowest lobar bronchus
B The apical posterior segment is on the right
C The anteromedial segment is on the right
D The lingula has superior and inferior divisions

train in single best answer even with image

2009-04-08T23:51:00.011+03:00

History: Young man with 3 days of chest tightness, dysnpea, fever, and nausea.

what is the possible diagnosis:

A Germ cell tumor.

B Lymphoma.

C Sarcoma.

D Thymic tumor.

E All of the above belong to the differential diagnosis

Can you select the correct answer

A- T or F SVC is occluded.

B T or F Mass is mostly necrotic.

C T or F There is evidence of pericardial involvement.

Can you select the actual diagnosis?

A Germ cell tumor.

B Lymphoma.

C Sarcoma.

D Thymic tumor.

E None of the above.

Key points:

Diffuse large B-cell lymphoma (DLBCL) is a fast-growing, aggressive form of non-Hodgkin's lymphoma (NHL)
There are more than 20 types of NHL, DLBCL is the most common type, making up about 30 percent of all lymphomas
Diffuse large B-cell lymphoma can be fatal if left untreated, but with timely and appropriate treatment, up to half of all patients are curable.
This subtype of DLBCL within the chest cavity that usually involvse the thymus.
Primary mediastinal large B-cell lymphoma comprises 7 percent of all diffuse large B-cell lymphomas and accounts for 2.4 percent of all non-Hodgkin's lymphomas. If this subtype of diffuse large B-cell lymphoma recurs, it can cause problems with other organs, including the liver, gastrointestinal tract, kidneys, ovaries, and central nervous system.
The five-year survival rate of patients with DLBCL is between 26 and 73 percent.

answer: E, C, B

frcr2a new system

2009-04-06T21:57:00.000+03:00

History: Woman with normal CNS workup has unexplained headaches and sweating

Which choice best characterizes the salient finding, if one if visible?

A Subacute aortic dissection.

B Mesenteric mass.

C Pancreatic mass.

D Adrenal mass.

E Images are within normal limits.

Which ONE of the following does NOT take up MIBG?

a. Neuroblastoma.

b. Carcinoid.

c. Medullary thyroid carcinoma.

d. Paraganglioma.

e. All of the above take up MIBG.

Images from a I123 MIBG scan are shown. Which choice is the MOST LIKELY diagnosis?

a. Adrenal adenoma

b. Adrenal carcinoma

c. Pheochromocytoma.

d. Neuroblastoma.

e. Myelolipoma.

Which ONE of the following does NOT take up MIBG?

a. Neuroblastoma.

b. Carcinoid.

c. Medullary thyroid carcinoma.

d. Paraganglioma.

e. All of the above take up MIBG.

Findings: CT Abdomen shows right adrenal nodule with HU less than 20 on non contrast CT. Nuclear medicine I123 MIBG (24 hour) scan with SPECT demonstrates focal uptake in the right adrenal gland.

Additional clinical history: Patient was also noted to be hypertensive

Differential Diagnosis

MIBG Uptake

Pheochromocytoma
Neuroblastoma
Carcinoid
Medullary thyroid carcinoma
Paraganglioma

Adrenal MIBG Uptake

Pheochromocytoma
Neuroblastoma

Adrenal Nodule

Adenoma
Adrenal carcinoma
Metastasis
Hematoma
Myelolipoma

Discussion

Pheochromocytoma is a catecholamine secreting tumor which may arise in the adrenal gland (90%) or outside the adrenal gland known as paraganglioma. Pheochromocytoma accounts for 0.05-0.2% of hypertension. Typically, symptoms are intermittent. Pheochromocytoma may occur with MEN 2a, 2b, neurofibromatosis, and Von Hippel Lindau. Laboratory tests include plasma metanephrine (96% sensitive, 85% specific) and 24 hour urine catecholamine and metanephrine (87.5% sensitive, 99.7% specific). Imaging studies include CT, MRI, and nuclear medicine. Treatment includes medication alpha and beta receptor blockade and surgical resection.

Radiologic Overview:

CT or MRI may detect adrenal or extra adrenal nodules but are nonspecific for pheochromocytoma. Nuclear medicine imaging can be considered for extra adrenal pheochromocytoma detection or small adrenal nodules.

I-123 metaiodobenzylguanidine, MIBG, is used for pheochromocytoma and neuroblastoma imaging. It is a precursor of norepinephrine and is taken up selectively by the adrenal medulla, the sympathetic autonomic nervous system, and tumors derived from these tissues. Other tumors, such as carcinoid carcinoma and medullary thyroid carcinoma may be visualized, but with relatively low sensitivity; octreotide imaging may be superior for these tumors. In111 octreotide is less sensitive for pheochromocytoma detection.

There is expected normal activity in the spleen, heart, salivary glands and liver. Urinary bladder activity can sometimes be seen due to free radioiodine.

MIBG can be labeled with either I-131 or I-123. Although it is more expensive, I-123 MIBG is the preferred radiopharmaceutical because of much better image quality. Radiation dose to the thyroid gland should be minimized by blocking of thyroidal I-131 uptake with potassium iodide or Lugol's solution. Technetium pertechnetate may be used to block thyroid uptake if using I123 MIBG.

Many drugs interfere with uptake of MIBG, particularly tricyclic antidepressants, sympathomimetics (e.g., pseudoephedrine), and certain antihypertensives (labetalol, reserpine, and calcium channel blockers). An important indicator of an acceptable MIBG uptake is the presence of cardiac activity.

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Long case answer sheet for training

FRCREGYPTIANS مجموعه من الاطباء الدارسين للزماله البريطانيه

ultrasound teaching manual

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مهم جدا للجزء الاول من الزماله البريطانيه very useful for part one frcr

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genitourinary single best answer 1

help for frcr1 candidates MRI and U.S. physics mcq

FRCR Part 1 : U.S. / CT / MRI Physics

Larmor frequency

Concerning MRI

Gadolinium Administration

Pregnancy

ULTRASOUND

FRCR Part 2A: CT/MRI Physics

Larmor frequency

Concerning MRI

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train in single best answer even with image

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