Test Questions
1. What is the study of choice to order in a 70 year old woman who has had 4 abdominal surgeries in the last decade and complains of severe crampy abdominal pain?
a. CT with oral and IV contrast
b. Small bowel follow through
c. Non-contrast CT
d. Abdominal radiograph upright
e. CXR
2. What is the single best test to order for suspected renal stones?
a. Ultrasound
b. Intravenous Pyelogram
c. Non-contrast CT
d. Nuclear renal scan
e. CT with IV and oral contrast
3. 58 year old Joyce Harrison had a 2 cm. breast tumor removed 3 years ago. Her liver function tests are very elevated, she has severe asthma and serum creatinine is 1.8. What is the best imaging test to order for suspected liver metastases?
a. Nuclear medicine liver-spleen scan
b. Ultrasound
c. CT with IV contrast
d. MRI
e. Non-contrast CT
4. A 25 year old young lady sees her family doctor, Dr. Hudson, complaining of right upper abdominal pain and mild nausea. She has a low grade fever and mild tenderness in the right upper quadrant. Her white blood count is normal. What is the best imaging test her doctor should order?
a. Abdominal radiograph supine
b. Non-contrast CT
c. Ultrasound
d. Upper GI series
e. HIDA
5. What is the best test if diverticulitis is suspected?
a. Barium enema
b. Small bowel follow-through
c. CT with oral and IV contrast
d. Nuclear medicine bleeding scan
e. Ultrasound with compression
6. What is the purpose of performing a sonogram in a 75 year old woman presenting to the ER with high amylase and lipase?
a. There is no purpose
b. To look for gallstones
c. To look for pancreatic pseudocysts
d. To use Doppler ultrasound to detect pancreatic necrosis
e. To mark a site for paracentesis
7. Noncontrast CT reveals a low density 3 cm right renal lesion in an 86 year old woman. Her doctor thinks this is probably a cyst but wants to confirm his suspicions. What is the best test to order?
a. MRI
b. CT with IV contrast
c. Nuclear renal scan
d. Ultrasound
e. IVP
8. What is the first line test performed to identify the source of a GI bleed?
a. Endoscopy
b. Angiogram
c. CT angiogram
d. Abdominal film-supine, upright
e. Non-contrast CT
9. A 32 year old afebrile female presents to the ER with a negative pregnancy test, a normal wbc count, and right lower quadrant pain. Physical exam reveals fullness and a 4 cm mass in right adnexa. What is the next best test?
a. Transvaginal ultrasound
b. Abdominal ultrasound
c. MRI
d. Gallium nuclear scan
e. CT with IV contrast
10. A 62 old man presents to the ER with jaundice. Ultrasound reveals a 7mm distal common bile duct stone. What test should be done next?
a. MRCP
b. Ultrasound with IV contrast
c. ERCP
d. CT with oral and IV contrast
e. HIDA scan
11. A 55 year old had one episode of vomiting blood at home. He came to the ER and had a negative endoscopy. The next day, he had a recurrent episode of hematemesis. What test did his gastroenterologist order and why?
a. MRI w/ IV contrast- most sensitive for slow flow
b. CT with oral and IV contrast- to visualize site of bleed
c. Nuclear medicine rbc scan- sensitive for intermittent bleed and slow flow
d. Ultrasound with IV contrast- no radiation
e. CT with IV contrast only- best anatomic resolution
12. An 82 year old female presents with hematuria. Her renal sonogram and cystoscopy are negative. What is the next step in management?
a. Retrograde pyelogram
b. Abdominal plain film
c. No further work-up
d. CT with IV contrast
e. Repeat ultrasound with Doppler
13. Your emergency medicine colleague tells you about an 18-year-old female who is presenting with right lower quadrant abdominal pain, tenderness, and fever. She has no cervical motion tenderness, her urine test is negative for pregnancy, and her WBC count is borderline elevated to 10,000/mm³. This is an image from the right lower abdomen sonogram study. What is the next step in management?
a. CT with oral and IV
b. Transvaginal ultrasound
c. Gallium nuclear medicine scan
d. Surgical consult
e. Endoscopy
14. A 77 year old male is admitted to the floor with abdominal pain and this film is taken. The pain persists. What is the next step in management?
a. MRI
b. CT with IV contrast
c. Surgery
d. Ultrasound
e. Barium Enema