RADIOLOGY MCQ--Yo-Yo reflux and Weigert-Meyer law

Yo-Yo reflux  and Weigert-Meyer law

Q1.Yo-Yo reflux is noted in

a.incomplete duplication of pelvis

b.hydronephrosis

c.ectopic insertion of ureter

d.crossed fused ectopia

Q2.Weigert-Meyer law is related to 

a.incomplete duplication of pelvis
b.duplex collecting system with incomplete duplication of ureter
c.duplex collecting system with complete duplication of ureter
d.complete duplication of ureter only

ANS.1==a==incomplete duplication of pelvis
        2==c==duplex collecting system with complete     duplication of ureter

www.urology-textbook.com 

•  Duplication of the upper collecting system is one of the most common of  renal anomalies
• Complete duplication is associated with ectopic ureter, ureterocele or vesicoureteral reflux. 
•  The incomplete duplication of the upper collecting system rarely causes urinary symptoms and usually does not carry clinically importance 
•  Reflux of the urine from one limb of the collecting system to the other limb, rather than down towards the bladder  is called yo-yo reflux (saddle reflux) 
•  Cause : Disorders in ureteric peristalsis at the site of ureteric fusion may cause yo-yo reflux.
•  Another explanation of yo-yo reflux is the pressure gradient between two ureteric  segments. The pressure of the lower moiety is generally  higher than the upper moiety and therefore the urine  generally refluxes from the lower moiety to the upper moiety 

Weigert-Meyer law

• Weigert-Meyer law applies to duplex collecting systems, when complete, duplicated ureters insert separately into the bladder.
•  The Weigert-Meyer rule states that. the upper pole ureter is the ectopic ureter and its orifice inserts inferomedially in the bladder in relationship to the lower pole normal ureter 
• When duplicated ureters insert separately into the bladder, the laterocranial ostium corresponds to the caudal renal pelvis and the medio caudal ostium the cranial renal pelvis.

RADILOGY MCQ---view of chest x ray

MCQs on view of chest x ray 

Q1.The chest view which is often useful to determine whether pleural abnormalties represent freely flowing fluids
a.The PA view
b. The lateral view
c.Lateral decubitus view
d.Apical lordotic view


Q2. For  visualization of diseases of lung apices,which view of chest is preferred
a. PA View
b.Lateral view
c.Lateral decubitus view
d.Apical lordotic view



ANS---1===C==LATERAL DECUBITUS POSITION
             2===D==APICAL LORDOTIC VIEW

PA vs AP

This is the simulated patient in PA (posterioranterior) position.
Note that the x-ray tube is 72 inches away.

Left, in the supine AP (anteriorposterior) position the x-ray tube is 40 inches from the patient. 

This is a PA film on the left compared with a AP supine film on the right.
The AP shows magnification of the heart and widening of the mediastinum.  Whenever possible the patient should be imaged in an upright PA position.  AP views are less useful and should be reserved for very ill patients who cannot stand erect.

PA VIEW  ---

• X ray pass from posterior to the anterior of the paients .
• Edges of scapula are retacted laterally with only small portion projected over the lung field.
• It assess the cardiac size more acurately

AP VIEW ---

• X ray pass from  anterior to posterior of  the patients.
• Scapula is not retarcted laterally and remain projected over the lung field.
• Here cardiac size is exaggerated.

Lateral decubitus position

The patient can also be examined in a lateral decubitus position. This could be heThe patient can also be examined in a lateral decubitus position. This could be helpful to assess the volume of pleural effusion and demonstrate whether a pleural effusion is mobile or loculated.s air trapping.

REF 

RADIOLOGY MCQ --DEMENTIA

DEMENTIA

Q1.All are neuroimaging feature suggestive of dementia exept
a.Alzheimer’s disease---hippocampal atrophy and posterior dominant cortical atrophy
b.Fronto-temporal lobe degenaration(FTD)—frontal,insular and or temporal atrophy,spares posterior parietal lobule
c.Dementia with Lewy body(DLB)—posteror parietal atrophy,hippocampi larger than AD,greater involvemet of amygdale than hippocampi
d.Cruetzfeld -Jacob diseases(CJD)—cortical ribboning , basal ganglia or thalamus hypointensity on diffusion or FLAIR MRI

ANS---d===Cruetzfeld -Jacob diseases(CJD)—cortical ribboning,  basal ganglia or thalamus hyperintensity on diffusion or FLAIR MRI

Alzheimer’s disease

www.proprofs.com

•  the most common cause of primary degenerative dementia,
•  incidence increases with age, rising sharply over 70 years.
• It is a generalized disorder, although in its early stages it may affect the medial part of the temporal lobe, especially the hippocampus, more than elsewhere.

Structural imaging

• This is usually normal, although occasionally accentuated atrophy medially in the temporal lobe is indicated by widening of the perihippocampal CSF spaces, which should be both bilateral and symmetrical

Functional imaging

• In established disease, characteristic symmetrical posterior temporal and parietal perfusion defects on regional cerebral blood flow (rCBF) SPECT have a predictive value for the diagnosis of AD of over 80% and the severity of rCBF reduction correlates with the degree of cognitive decline
•  [¹⁸F]deoxy-d-glucose (FDG)-positron emission tomography (PET) studies show reduced glucose uptake that is not explained by atrophy
•  Receptor imaging using radioligands for central benzodiazepine receptors has shown a similar distribution of deficits in AD

Frontotemporal dementia

• These comprise less than 10% of the primary degenerative dementias. They include Pick's disease.
• MRI and even CT show atrophy in the anterior and medial parts of the temporal lobe, which usually is markedly asymmetric (right or left)  and diminishes posteriorly. Asymmetric frontal lobe atrophy may also be present

Functional imaging Perfusion deficits on rCBF SPECT are predominantly frontal and anterior temporal with preserved perfusion posteriorly.

• Reduced frontal perfusion is not specific to frontotemporal dementia and can occur in a variety of other conditions, such as schizophrenia, depression, human immunodeficiency virus (HIV) encephalopathy, Creutzfeldt–Jacob disease (CJD) and in some cases of AD

Lewy body dementia

• Lewy body dementia is now recognized as the second most common degenerative dementia after AD and it accounts for approximately 20% of all dementia.
• 
  
•  Neither structural imaging nor rCBF SPECT can reliably distinguish between Lewy body dementia and AD on subjective assessment, as posterior temporoparietal defects occur in both. However, reduced frontal perfusion with HMPOA SPECT and reduced uptake in the cerebellum and visual cortex with FDG-PET is seen in Lewy body dementia compared with AD.

Vascular dementia

• This is the clinical diagnosis in about 20% of all dementias. Evidence of ischaemic damage on CT or MRI is mandatory for diagnosis,

Prion diseases

• These mainly comprise CJD (sporadic, iatrogenic, familial) and very recently in Europe (especially in the UK) new variant CJD (nvCJD). Rapidly progressive dementia, often with myoclonus, is the usual clinical picture, often preceded by behavioural disturbances, especially in nvCJD.
• Structural imaging usually appears normal in early stages, but rapidly progressive atrophy soon develops.
•  Symmetrical increases in signal in the putamen and caudate nuclei may be shown by MRI in about 10% of sporadic CJD, and in the posterior part of the thalami in over 50% of nvCJD;

REF

Adam: Grainger & Allison's Diagnostic Radiology, 5th ed.