SPEX SPEX Radiology and Imaging 3

Question 1

A patient with blunt abdominal trauma has free fluid on FAST exam but is hemodynamically stable. What is the next step?

Accepted Answer

CT scan of the abdomen and pelvis with contrast

Answer

In a hemodynamically stable patient, CT abdomen/pelvis with contrast is the definitive next step to characterize the source and extent of injury.

Question 2

Which X-ray finding is characteristic of rickets in children?

Accepted Answer

Widening and fraying of the metaphysis

Answer

Rickets causes inadequate mineralization, leading to widening, cupping, and fraying of the metaphyses on X-ray, particularly at the wrist and knee.

Question 3

On CT angiography, which finding is diagnostic of aortic dissection?

Accepted Answer

An intimal flap with true and false lumens

Answer

CTA demonstrating an intimal flap separating the true and false lumens is the hallmark and diagnostic finding of aortic dissection.

Question 4

Which type of pneumothorax requires immediate needle decompression before imaging confirmation?

Accepted Answer

Tension pneumothorax with hemodynamic instability

Answer

Tension pneumothorax causing hemodynamic instability is a clinical diagnosis requiring emergent needle decompression without waiting for imaging.

Question 5

What is the significance of a Kerley B line seen on chest X-ray?

Accepted Answer

Pulmonary interstitial edema

Answer

Kerley B lines are short horizontal lines at the lung periphery representing thickened interlobular septa due to pulmonary interstitial edema.

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