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RD4.1-3 | Interdisciplinary Imaging Communication — Practice Quiz
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A house officer sends a CT abdomen requisition that reads only "abdominal pain – please scan." The reporting radiologist phones back asking for more detail. Which single addition to the requisition would MOST improve the radiologist's ability to choose the right protocol and answer the clinical question?
Correct. The specific clinical question, supported by focused relevant history, is the heart of the requisition — it lets the radiologist pick the right modality, protocol and contrast phase and direct the search pattern.
A high-quality requisition gives the radiologist everything needed to choose the right study, run it safely, and answer a SPECIFIC question — relevant history plus a precise question, not clutter.
The radiologist needs a focused clinical question and relevant history to select the protocol and search pattern, not administrative or unfocused data.
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Which set of safety flags is MOST important to include explicitly on an imaging requisition because it directly affects whether the study can be performed safely?
Correct. Renal function (contrast nephrotoxicity), allergy history, pregnancy (ionising radiation), and implants/metalwork (MRI safety) are the safety flags that determine whether and how the study can proceed.
Safety flags — renal/allergy/pregnancy/implants — must be on every requisition; they govern contrast safety, radiation justification and MRI compatibility.
Safety flags are the items that change whether the study can safely proceed: renal function, allergy, pregnancy, and implants/metalwork.
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A 45-year-old is admitted with new severe headache. The medical team is unsure whether CT or MRI is the appropriate first study. According to RD4.1, what is the MOST appropriate action?
Correct. When in doubt about appropriateness, RD4.1 requires clarifying with the radiologist — a justification conversation that selects the study best matched to the clinical question and avoids unnecessary or unsafe imaging.
Clarifying appropriateness (justification) with the radiologist is one of the three explicit RD4.1 behaviours — it matches modality to the clinical question and respects radiation/contrast risk.
RD4.1 explicitly names clarifying appropriateness with the imaging specialist when in doubt; do not order indiscriminately or default by waiting time.
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Before transporting a ventilated, critically ill patient to CT, the team estimates oxygen needs. The portable cylinder gauge and a fresh-gas flow rate are known. What is the SAFEST way to decide whether the cylinder is adequate?
Correct. Calculate the oxygen, never guess it: usable minutes equal cylinder contents divided by fresh-gas flow, and must exceed the round-trip time with a safety margin for delays.
Pre-transport oxygen is calculated (contents ÷ flow = usable minutes) and must exceed round-trip time plus a delay margin — never guessed, never assumed adequate.
Oxygen must be calculated, not estimated: contents ÷ flow gives usable minutes, which must exceed round-trip time plus a delay margin.
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A junior doctor wheels a standard steel oxygen cylinder and a non-MRI-compatible infusion pump toward the MRI scanner room. What is the principal hazard, and what is the correct rule?
Correct. The magnet is always on; ferromagnetic items (steel cylinders, ordinary pumps) become lethal projectiles. Only MRI-conditional/MRI-safe equipment is permitted into Zone IV.
MRI projectile hazard: the field is permanently on; ferromagnetic objects fly. Use only MRI-conditional/safe equipment; control access through Zones I–IV.
The static field is always on and exerts a powerful pull on ferromagnetic objects — turning equipment off does not make it safe. Only MRI-conditional equipment may enter Zone IV.
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A ventilated patient in the MRI scanner suddenly arrests. What is the correct immediate response with respect to the MRI environment?
Correct. Standard resuscitation equipment (laryngoscopes, defibrillators, cylinders) is ferromagnetic and unsafe in Zone IV, so the patient must be moved out of the magnet room and resuscitated outside it.
Resuscitate OUTSIDE Zone IV — crash equipment is ferromagnetic. Plan rapid egress from the magnet room as part of every critically-ill MRI transfer.
Crash equipment is ferromagnetic and cannot enter Zone IV; the patient must be removed from the magnet room and resuscitated outside. Quenching is a last resort, not the immediate step.
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A 68-year-old with chronic knee pain has a weight-bearing knee X-ray. Which combination of findings is the classic radiographic signature of osteoarthritis, and what is the underlying pathophysiology?
Correct. OA shows joint-space narrowing (cartilage loss), osteophytes, subchondral sclerosis and cysts — the radiographic map of cartilage degradation and the bone's response to altered load.
OA clinico-radiological correlation: cartilage loss → joint-space narrowing; abnormal load → osteophytes, subchondral sclerosis and cysts. Treat the patient, not the film — radiographic and symptom severity correlate poorly.
Marginal erosions and periarticular osteopenia describe inflammatory (e.g. rheumatoid) arthritis. OA = narrowing + osteophytes + subchondral sclerosis + cysts.
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A 55-year-old presents with a swollen, tender calf two weeks after surgery. The clinician suspects deep vein thrombosis. Which imaging finding on compression ultrasonography/Doppler confirms an acute DVT, and why is USG chosen?
Correct. The hallmark of acute DVT is loss of venous compressibility — a normal vein collapses under probe pressure, a thrombosed one does not. USG/Doppler is preferred as it images soft tissue and flow in real time without radiation.
DVT correlation: thrombus fills the lumen → vein no longer compresses under the probe. Compression USG/Doppler is first-line — real-time soft-tissue and flow imaging, no ionising radiation.
Wall thickening/pericholecystic fluid is cholecystitis; joint-space narrowing is OA. The DVT sign is LOSS of compressibility. Full compressibility is normal.
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