Due to the popularity of last year’s precall quiz post, I am back at it again. Today, I am posting 10 cases from the real 2018 quiz that we used to ensure our residents are ready prior to beginning call. Of course, we used our PACS system to see if they could not only understand the disease entities but also make the findings as well. Unfortunately, you will not have the same option. However, these cases will help to benchmark where you may stand.
When you go through the test, come up with the findings, diagnosis, and if asked/relevant, management. In order to see how you did, answers are at the bottom of this page. (Don’t peek until you are finished!) One more thing… in order to pass the test without conditioning, you need to get at least 70 percent right. Enjoy!
How would you manage this case?
What questions do you need to ask?
How do you manage this case?
1st film- 2 years ago
2nd film- today
What is the differential diagnosis?
What do you want to do next?
Right thalamic/basal ganglia intraparenchymal bleed with intraventricular extension.
Accompanying early transtentorial herniation. (needs to be mentioned for full credit!)
Right-sided pyelonephritis/early abscess formation. Renal mass/neoplasm can be within differential diagnosis.
Aortic dissection extending from the inferior thoracic cavity to iliac arteries.
Accompanying perivascular fluid and effusion- possibly blood products, consider ruptured dissection
For full credit-need to mention that you would call the vascular surgeons
Ultrasound appendicitis with appendicoliths
You need to ask history. (?B-HCG positive)
Ruptured ectopic pregnancy.
Homolateral Lisfranc fracture dislocation
New prominent bilateral hila- Interval development of adenopathy or pulmonary arterial hypertension
CT of the chest recommended for further characterization.
Bilateral chronic pulmonary emboli with pulmonary hypertension
Acute biliary leak with extraluminal radiopharmaceutical.
Focus within the hepatic hila- most likely biloma/origin of the biliary leak
Distal left ureteral stone with left renal hydronephrosis and hydroureter. Accompanying inflammatory change at the left kidney and ureter.
No acute disease. Possible recently ruptured left ovarian cyst.