Radiology and Imaging

Instructions:
(1) PDF File. Your answers to this examination must be submitted in pdf format. This means all of your answers
must be converted into pdf format by scanning your answers or otherwise using conversion software. DOC files
are specifically not acceptable. In addition, only one pdf file for this exam is acceptable…no separate pdf files for
each question!!
(2) Presentation of Answers: It is preferred that you copy/paste the question or retype each question followed by
your typewritten answer immediately afterward. You may use a separate page(s) for each question (as long as all
pages are combined into 1 pdf file).  Extra  points  are  allocated  for  a  sharp  presentation. We have tested
our PDF exam files and found that you can copy/paste text of Questions successfully by simply selecting a section
with a cursor and pasting into a word processor. You may need to test more than one word processor, and also
may need to test one or more PDF readers (such as Adobe Acrobat Reader) in order to accomplish this.
(3) Answers: Your answer to a question should fully demonstrate your understanding of the subject material. You
may use any additional sources for your answers, including for example your required text readings, internet
research, Assignments and Discussions posted by your Instructor. No particular length is required, but most of
the time,  length of your answer should generally be a minimum of 350-500 words, which is about 1/2 typewritten
page, single spaced. More importantly, the answer should fairly address the question posed and demonstrate a
clear understanding of the point in question.
(4) Plagiarism and copy/paste: For illustration purposes, you may copy/paste into your answers, diagrams,
photos, and other materials to illustrate some point in your answer, provided the source is quoted. Please do not
overdo this, as the exam must feature your thinking and discussion. You may not of course, for your answer,
paraphrase or copy material from any source, but rather, you must demonstrate independent thought and
presentation of ideas.
Abdominal Imaging Text (Questions 1-7)
Questions
1. In your material on Plain X-ray, the author leads with this statement: “A plain abdominal radiograph must be
read with a complete knowledge of the clinical situation. The patient’s history and results of the physical
examination and laboratory studies are always important to evaluate an acute abdomen”.
Why would you the clinician need to know patient history (that is what is chief complaint, physical exam etc) in
evaluating an X-ray of abdomen?
2. Please summarize in your own words the author’s position about usefulness of X-ray for abdominal diagnosis.
3. What is fluoroscopy and barium enema technique? Your answer can be brief, basically explaining how
fluorosopy works in your own words, and how barium enema double contrast fluoroscopy would be used for colon
examination.
4. Please consult your text or go to the Internet to research this question: In reviewing Figure 2-2, barium enema
fluoroscopy of colon is shown (See item 1B in Syllabus) Please find a picture of colon MRI to compare it to, and
give your discussion of the benefit/helpfulness to diagnosis of each procedure, concluding your answer with
your opinion as to which procedure best illustrates condition of colon.
5. What is the author’s opinion about the usefulness of fluoroscopy?
6. You will note Figure 3-13 showing a relatively large stone blocking the right ureter (from your Syllabus material
1C).  Please go to this or any text, or the internet, and find 5 pictures of ultrasound images of kidney stones, and
insert good quality (not blurry) images into this answer, using a sentence or two to describe each one.
7. For the following organs/glands, please tell us a little bit about what you learned in terms of imaging
techniques. Note: We do not expect you to write a book, so please don’t. What we would like to see is that
you read the material in the Syllabus Section 1G-1L, and can comment on one common clinical presentation for
each condition, and how different imaging techniques can be used, or which ones are more useful than the
another.
Small Bowel
Colon
Liver
Pancreas
Kidney
Prostate
Ultrasound Text, Syllabus Section 3:
8. What can ultrasound alone, tell you about a non-pregnant uterus, in other words, the patient presents with
some kind of pelvic pain, and you have to sort it out, in this case, with only ultrasound (physical exam and lab
studies as appropriate) and no other imaging techniques.
9. What is an ectopic pregnancy, how does the patient present to you (what symptoms or complaints), and can an
ultrasound be helpful in diagnosing?
10. Please be sure to review again Syllabus Section 1F. This question is weighted 25 % of this exam and requires
not only that you show a command for what was presented this term, but also that you demonstrate your ability to
think intelligently within this field. Please review the links to radiation danger concerns surrounding use of CT
scans; and then also consider contrast enhanced Ultrasound and 4-D ultrasound; then also consider what you
learned about MRI techniques. Also in answering, please do not be afraid to think independently and realize that
there is a lot of medical politics and lobbying involved concerning which test to use for this or that, with not only
manufacturers lobbying the medical associations and lawmakers, but also radiologists trained on this or that
equipment have vested interests in protecting the usefulness of such equipment. Now, with all the diagnostic
imaging tools available to you, and with the patient in mind, please discuss whether CAT scans can be eliminated
completely from medical imaging. We are proposing for your consideration in this question, that
Ultrasound and/or MRI techniques can completely replace the need for CT scans. Please discuss
your thinking in this regard with reference to specific images to be included in your answer. If you
believe that a CAT scan is still useful in diagnosing some condition(s) that cannot be achieved with ultrasound or
MRI, please be specific and demonstrate using comparative images how a CAT scan is superior to enhanced US or
MRI techniques.  [Note: You are not required to agree with the proposed statement; it is presented for debate
among colleagues and may or may not be true.]
End of Exam

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