MedicoNotebook: 2014

Medical One Liners 401 - 410

401. Osteoporosis: decreased bone mass but normal mineralization. (Mineral to matrix ratio normal)

402. Osteomalacia: decreased rate of mineralization, hence increased quantity of non-calcified matrix. (Mineral to matrix ratio decreased)

403. MRI breast: In pre-menopausal women it should be performed between 7th-14th day (2nd week) after start of menstrual cycle, to avoid interference from normal enhancing breast tissue that may otherwise lead to false negative/positive results.

404. Woven bone with osteoblastic rimming:

Ossfying fibromas (=osteofibrous dysplasia)
Osteoblastoma
Paget’s disease

405. Woven bone without osteoblastic rimming: Fibrous dysplasia

406. Gamekeeper thumb = skier thumb: tear of ulnar collateral ligament (UCL) of the thumb (at 1st metacarpophalyngeal joint)

407. Colles fracture: extra-articular distal radius fracture with dorsal angulation

408. Barton fracture: intra-articular distal radius fracture extending to dorsal aspect

409. Smith fracture - type I: extra-articular distal radius fracture with volar angulation

410. Reverse Barton fracture = type II Smith: intra-articular distal radius fracture extending to volar aspect.

MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Restricted diffusion (MRI)

MCQ 166

Q. Which of the following defines "Restricted Diffusion" in MRI ?

a. Hyperintense on DWI, Hypointense on ADC
b. Hypointense on DWI, Hyperintense on ADC
c. Hyperintense on DWI and ADC
d. Hypointense on DWI and ADC

ANSWER:

MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Paragangliomas

Paraganglion is defined as non neuronal cell derived from the neural crest.

Types:

Chromaffin cells (Sympathetic paraganglion)

Pathology e.g.- Pheochromocytoma

Non chromaffin cells (Para-sympathetic paraganglion)

Pathology e.g.- Carotid body tumor, Glomus juglare, Glomus tympanicum

[ sometimes called Glomus tumors* ]

*Not to be confused with Glomangioma which are also called Glomus tumors: benign vascular tumors (75% in hand).

MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Medical one liners 391 - 400

391. Bouquet of flowers appearance = paintbrush appearance - seen in Medullary sponge kidney on IVP.

392.Gallbladder ghost triad - seen sonographically in Biliary atresia

atretic gallbladder length <19 mm,
thin or absent mucosal lining or indistinct wall,
irregular gallbladder contour

393. Triangular cord sign : Sonographic sign showing > 4mm thickness of echogenic anterior wall of the right portal vein (EARPV) in cases of Biliary Atresia.

394. Omental cake can be seen in Metastases (most common) from ovarian, gastric or colon cancer, Tuberculous peritonitis and Lymphoma.

395. Absence of swallow tail sign - Parkinson's disease.

396. Aphthous ulcers are seen in Crohn's disease. They are NEVER seen in Ulcerative colitis.

397. Lobster claw sign: seen in papillary necrosis.

398. Manta ray sign seen in bladder exstrophy.

399. Eye of tiger sign seen in Hallervorden-Spatz syndrome.

400. Uterine choriocarcinoma can occur following molar pregnancy, abortion and even normal pregnancy.

MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Medical one liners 381 - 390

381. Most common leukaemia in downs syndrome - ALL

382. Leukodystrophy (Dysmyelinating disease) with amino acid metabolism disorder - Canavan disease.

383. Primary extra-gastrointestinal stromal tumors - mostly found in - omentum and mesentery.

384. Amyotrophic lateral sclerosis (ALS) = Lou Gehrig's Disease - between the ages of 40 and 70 - affects corticospinal tracts (runs through posterior limb of internal capsule).

385. Weigert-Meyer law : (for complete duplication of renal collecting system and ureters)

Upper renal moiety - Hydronephrosis ; distal end in bladder offten has ureterocele
Lower renal moiety - shows frequent reflux (inserts ectopically - lateral and superior in bladder)

386. Psammoma body associations :

Papillary thyroid carcinoma
Mesothelioma
Papillary renal cell carcinoma
Serous papillary ovarian adenocarcinoma
Endometrial adenocarcinomas (papillary serous carcinoma)
Meningioma

387. Goldblatt kidney - constriction of the renal artery - renal ischemia - release of renin - hypertension.

388. The superior anastomotic vein or Vein of Trolard drains the superficial middle cerebral vein into superior sagittal sinus.

389. The inferior anastomotic vein or Vein of Labbe drains the superficial middle cerebral vein into transverse sinus.

390. Chang’s sign - seen in pulmonary embolism - abrupt change in diameter of pulmonary artery.

MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Medical one liners 371 - 380

371. Metastases to thyroid gland is rare. Most common metastases to thyroid is from MELANOMA.

372. Most important point of differentiation between extradural hematoma (EDH) and subdural hematoma (SDH) - Is the ability of SDH to cross the suture lines whereas EDH does not cross suture line.
Though EDH is usually biconvex and SDH is usually concavo-convex BUT It is important to remember that even SDH can be biconvex.

373. Most common site of gastrointestinal lymphoma - Stomach.

374. The dripping candle wax sign or flowing candle wax is described in Melorheostosis which demonstrates sclerotic cortical thickening.

375. Oesophageal varices - are Submocosal.
Gastric varices - are Subserosal.

376. Double decidual sac sign helps to distinguish between an early intrauterine pregnancy and a pseudogestational sac.
It is formed by decidua parietalis and decidua capsularis which form two concentric rings around the true gestational sac.

377. Nuchal translucency > 3 mm between 10-14 wks gestation has significant association with chromosomal abonormality.

378. Syndromes ass. with omphalocele

pentalogy of Cantrell
Beckwith-Wiedemann syndrome

379. USG signs of chorionicity

Lamda sign - Dichorionic twins
T sign - Monochorionic twins

380. With increase in kVp (keeping other factors constant), the radiation dose to patient increases.
Radiation dose is directly proportional to square of kVp.

MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Chorion and Amnion

MCQ 165.

Q. Which of the following is not possible in twin pregnancy ?

a. Dichorionic diamniotic
b. Monochorionic diamniotic
c. Dichorionic monoamniotic
d. Monochorionic monoamniotic

ANSWER:

MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Early gastric carcinoma

MCQ 164

Q. Which of the following is best to describe early gastric carcinoma ?

a. involves mucosa and submucosa only.

b. causes regional lymph node enlargement

c. does not cause lymph node enlargement

d. involves muscularis propria

ANSWER:

MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Medical One Liners 361 - 370

361. Trilateral retinoblastoma

bilateral retinoblastoma and
intracranial primitive neuroectodermal tumor ( pineal or suprasellar )

362. T-shaped uterus : seen in cases of in-utero diethylstilbestrol (DES) exposure.

363. Intra-aortic baloon pumps are used in patients with cardiogenic shock.
Ideally placed just distal to left subclavian artery origin.

364. Left lower lobe basal atelactasis is frequently seen in patients with heart transplantation.

365. Right upper lobe bronchus arising from trachea is called - PIG bronchus.

366. Congenital lobar emphysema is a misnomer as there is no alveolar wall destruction.

It is better termed as Congenital lobar overinflation.
MC affects Left upper lobe of lung (43% cases)

367. Most common location of bronchogenic cyst is : Mediastinal - carinal.

368. Most common location for Intralobar pulmonary sequestration : Medial left lower lobe.

369. Leiomyoma of oesophagus affects lower 2/3rd as this part has smooth muscle.

370. Double pyloric canal - seen when gastric antral ulcer fistulate to the duodenal cap.

MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Sliding hiatus hernia

MCQ 163

Q. Which of the following best describes Sliding hiatus hernia ?

a. Oesophago-gastric junction (OG junction) sliding just above the diaphragmatic hiatus
b. OG junction sliding 1cm above the diaphragmatic hiatus
c. OG junction sliding 2cm above the diaphragmatic hiatus
d. OG junction sliding > 2cm above the diaphragmatic hiatus

ANSWER:

MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Intra-articular Metaphyses

MCQ 162

Q. Which of the following does not have intra-articular metaphyses ?

a. Hip joint
b. Elbow joint
c. Knee joint
d. Ankle joint

ANSWER:

MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Medical One Liners 351 - 360

351. Causes of Apple core sign femur

synovial chondromatosis (Most common)
pigmented villonodular synovitis
amyloidosis
rheumatoid arthritis

352. Anterior tibial translation/translocation > 7mm is highly suggestive of Anterior cruciate ligament tear.

353. Laryngo-tracheo bronchitis or croup is the commonest cause of tracheal narrowing.

354. Most common primary malignant tumor of parotid gland - Mucoepidermoid carcinoma.

355. Type 3 accessory navicular bone - is called a cornuate navicular.

356. Myoinositol concentrations in brain are abnormally increased in patients with demyelinating disease and alzheimer's. Detected by MR spectriscopy.

357. Morel Lavalle lesion - degloving injury in severe trauma resulting in abrupt separation of the skin and subcutaneous fatty tissue from the underlying fascia.

358. Overproduction of protein and lipid rich material from Type II pneumocytes which is not cleared by lungs - leads to Pulmonary alveolar proteinosis.

359. Subpleural lucent line - seen in Pulmonary alveolar microlithiasis
Subpleural linear opacities - seen in Asbestosis.

360. Lymphangioleiomyomatosis (LAM) is indistinguishable to lung involvement in tuberous sclerosis but Chylothorax and chyloperitoneum are common in LAM.

MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Medical One Liners 341 - 350

341. Primary amyloid can cause an inflammatory response in lungs. This does not happen in case of secondary amyloid.

342. Drugs which can cause eosinophilia and pulmonary infiltrates- Penicillin, sulfonamides, methotrexate, asprin, nitrofurantoin, PAS.

343. The cytotoxic drugs have fibrogenic effect. This is enhanced by radiotherapy and high levels of inspired oxygen.

344. Intra renal calculi are usually asymptomatic. But an intra renal calculus can obstruct at the level of infundibulum and present with pain.

345. Shiny corner sign is seen in Ankylosing spondylitis.

346. MRI is the modality of choice in the assessment of glutaric aciduria type 1

347. Most common offending vessel in vascular loop compression -

Causing trigeminal neuralgia - superior cerebellar artery
Hemifacial spasm - Anterior inferior cerebellar artery.

348. Porencephalic cyst is lined by white matter whereas arachnoid cyst is lined by grey matter.

349. Dandy-Walker variant can not be diagnosed before the 18th week of gestation because the inferior vermis is not formed at this time.

350. Most consistent pathological finding in chronic bronchitis - hypertrophy of mucous secreting glands of bronchi.

MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

World health day 2014

7th April 2014 - World health day

Theme - Vector-borne diseases: small bite, big threat

MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Consolidation in post-primary tuberculosis

MCQ 161

Q. Consolidation in post-primary tuberculosis almost never occurs in ?

a. Apical segment of upper lobe

b. Apical segment of lower lobe

c. Anterior segment of upper lobe

d. None of the above

ANSWER:

MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Posterior shoulder dislocation

MCQ 160

Q. Which is the most common type of posterior shoulder dislocation ?
a. subacromial
b. subglenoid
c. subspinous
d. subcoracoid

ANSWER:

MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Neurocysticercosis - Stages

MCQ 159.

Q. Which of the following stage of neurocysticercosis shows maximum edema around the lesion on MRI ?

a. vesicular
b. colloidal vesicular
c. granular nodular
d. nodular calcified

ANSWER:

MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Medical One Liners 331 - 340

331. Strawberry shaped skull - seen in trisomy 18 (Edward syndrome).

332. H-shaped vertebra (also known as Lincoln log vertebra) - 10% cases of sickle-cell anaemia, occasionally Gaucher disease.

333. Fat ring sign or fat halo sign in messentry is seen in - Messenteric panniculitis

334. Aortic nipple sometimes seen on a Chest Xray PA view, is formed by left superior intercostal vein.

335. Most common Soft tissue sarcoma

Middle age and elderly - Malignant fibrous histiocytoma > liposarcoma > leiomyosarcoma >malignant peripheral nerve sheath tumors(MPNST).
Younger individuals - Fibrosarcoma > Rhabdomyosarcoma > Synovial sarcoma > MPNST

336. Bilateral posterior iliac horns are considered pathognomonic for Fong's disease = Nail patella syndrome.

337. Bochdalek's hernia is mostly left sided because of protective effect from liver on the right.

338. Mini Brain sign is seen in Solitary Plasmacytoma - It is due to prominent thickened residual trabeculae seen in a solitary expansile bone lesion.

339. Tube ring sign on ultrasound is highly specific(95%) for tubal ectopic pregnancy.

340. Ring of fire sign on color doppler can be seen in Ectopic pregnancy and Corpus luteum cyst.

MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Medical One Liners 321 - 330

321. CT scan is most sensitive investigation to detect pulmonary nodule of 3mm or greater diameter.

322. Dysmyelinating disease with MR Spectroscopy showing markedly elevated NAA peak - Canavan disease.

323. In PET scan, 18-FDG accumulates in metabolically active cells as FDG -6-phosphate but it does not enter citric acid cycle.

324. Most accurate imaging technique for the staging of primary lung tumors - PET

325. Most common posterior fossa tumor in adult - Cerebellar metastases.

326. Most common primary posterior fossa tumor in adult - Hemangioblastoma.

327. Fishhook ureter = hockey stick ureter = J-shaped ureter, seen in : significant BPH.

328. S-shaped ureter : seen with retrocaval ureter.

329. Masaoka staging system is used for - thymomas.
Stage II and above - thymic carcinoma.

330. Chauffeur fractures = Hutchinson fractures = backfire fracture : intraarticular fracture of the radial styloid process.

MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

Medical One Liners 311 - 320

311. Lung tissue interposing between the main pulmonary artery and aorta was the most consistent diagnostic feature of Congenital absence of the pericardium (CAP).

312. Mathe’s sign- Absence of downward displacement of kidney in perinephric abscess.

313. Snowcap sign - Avascular necrosis - there is dense sclerosis over the head of humerus or femur.

314. Christmas tree / Pine cone bladder - cystogram appearance of urinary bladder in neurogenic bladder (not pathognomonic)

315. Sail sign - Seen on Xray lateral view with Elbow joint effusion.

316. Holly leaf sign - Chest X-ray showing calcified pleural plaques (most commonly in asbestos related disease)

317. Coca-cola bottle sign - thyroid ophthalmopathy (usually in Grave's disease)

318. Panda sign : Wilson disease (neuroradiology) and Sarcoidosis (bilateral involvement of parotid and lacrimal glands)

319. Bright rim sign on FLAIR - seen in dysembryoplastic neuroepithelial tumors (DNET)

320. Round atelactasis with comet tail - seen in asbestos related disease.

MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

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