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More facts - Coggle Diagram

- - - - Primary brain tumours:
        
        Astrocytomas: Glioblastoma multiforme (most common)
        
        Meningioma
        
        Oligodendroglioma
        
        pituitary adenoma
        
        schwannoma
        
        GBM:
        
        butterfly shape, crossing the midline at corpus collosum, occupying more than one lobe
        
        originate in cerebrum
        
        hypodense center, calcification uncommon
  - - - <2 years:
        
        teratoma
        
        anaplastic astrocytoma
      - Up to 10 year:
        
        pilocytic astrocytoma - ependymoma
        
        craniopharyngeoma
        
        medulloblastoma (cerebellar)
        
        Pilocytic astrocytoma:
        
        Arise in:
        
        cerebellum,
        
        near brainstem
        
        optic chiasm
        
        Hypodense on CT and mostly calcified
      - Mostly primary tumours, metastases are rare
  - - - 2. Location
        
        Intra or extra parenchymal
        or ventricular?
        
        3. Number of lesions
        
        single or multiple
        
        4. Tissue type
        
        Fat
        
        Cyst
        
        Calcification
- - - - Guided by US, CT, MRI
      - Electrical currents/microwaves are used to produce heat
        
        Destroys small tumours
        
        mostly in liver or liver metastasis (e.g. colon cancer)
        
        used when surgery is not possible
        
        when tumour is very small
  - - - X-ray images taken as the barium flows through the colon
        
        Used for polyps, cancer or other colon abnormalities
      - Sometimes combined with air (double contrast) to distend colon and make it more visible
  - - - Tube inserted through nose or mouth -> stomach -> duodenum/jejunum
        
        Tube injects barium and air
        
        Images taken
    - - Barium suspension is fed to patient, orally
        
        Assess the progress through the small bowel
    - - Retrograde reflux of barium suspension into small bowel during barium enema or via direct injection through iliostomy
  - - - Used to restrict tumour blood supply
- - - - ACUTE:
        
        Traumatic, high energy impact
        
        CT:
        
        hyperdense / heterogenous
        
        crosses suture lines (crescent shaped)
      - CHRONIC
        
        mild trauma
        
        cerebral atrophy
        
        elderly
        
        alcoholics
        
        CT:
        
        hypodense / isodense
        
        crescent
      - MIXED:
        
        fresh haemorrhages seen in a chronic subdural hematoma
        = acute on chronic hemorrhage
  - - - Treatment of Aneurysm:
        
        Surgical clipping
        
        Endovascular coiling
    - - On CT:
        
        subarachnoid blood in basal cisterns, sylvian fissure and along cerebral convexity
        
        intraventricular blood
      - Complication: Vasospasm due to blood breakdown or rebleed 3-10 days after haemorrhage
        
        Ischemic infarct
        
        Nimodipine used to prevent/reduce vasospasm
      - Complication: Increased risk of developing obstructive or communicating hydrocephalus
  - - - Transient loss of consciousness -> recover (lucid interval) -> rapid deterioration (due to hematoma expansion)
        
        Complication:
        
        Transtentorial herniation
        
        CN III palsy
        
        CT:
        
        biconvex (lens shaped) due to dura tight adherance to skull = does NOT cross suture lines
        
        hyperdense blood collection
- - - - Self-limiting
        
        Lymphadenitis
        
        Gastroenetritis
      - More severe
        
        Appendicitis
        
        Cholecystitis
      - Life- threatening
        
        Aortic aneurysm rupture
        
        Pancreatitis
        
        Ischaemia
        
        Bowel perforation
    - - RLQ pain: appendicitis
        
        McBurneys point
        
        On US:
        
        Distended
        
        Noncompressible appendix
        
        Surrounded by hyperechoic inflamed fat
        
        On CT:
        
        fluid- filled
        
        blind ending tubular structure
        
        surrounded by fat stranding
      - LLQ pain: Sigmoid diverticulitis
        
        US:
        
        diverticula: colon wall outpouching
        
        colon with thickened wall
        
        fat enhancement
      - RUQ: Cholecystitis
        
        Murphys sign
        
        patient in pain/gasps when RUQ (beneath costal margin) is pressed after exhalation
        
        On US:
        
        thick ended wall with non-compressible (hydropic) gallbladder
      - If these three classes of pathologies are excluded by US, consider:
        
        Inflammed fat, bowel wall thickening, ileus, ascites, free air
        
        X-ray first
- - - - 0-6:
        0: incomplete
        1: Negative
        2: Benign
        3: Probably benign
        4:Suspicious
        5: Highly suggestive of maligancy
        6: Known biopsy: proven malignancy
      - Due to the importance of breast composition and density: BI-RADS reports this too
        
        Breasts almost entirely fatty
        
        Scattered areas of fibroglandular density
        
        Breasts are heterogenously dense - may obscure small masses
        
        Breasts are extremely dense - lowers the sensitivity of mammogram
      - Incomplete -> Negative -> benign -> Suspicious -> suggestive of malignancy -> biopsy to prove malignancy
- - - - Iodinated IV contrast
        
        Use MDCT: multidetector CT (helical scanner with multislice data)
        
        on pulmonary arteries
        
        look for: HYPODENSE embolisation
    - - Ventilation-Perfusion scan
        
        Ventilation: Xenon-133 inhaled or Tc99m-DTPA
        Perfusion: Tc-99m - MAA (macroaggregated albumin pharmaceutical)
        
        Normal ventilation: Radiotracer homogenously washing into the lung
        Normal perfusion: Uniform uptake in lungs
        
        PE presents as: VQ mismatch with wedge shaped peripheral perfusion defect
        
        Only performed if patient cannot undergo CTPA (e.g. contrast allergy)
- - - - When obstruction occurs, both fluid and gas collect in the intestine
- - - - Transmission of patient information
      - Workstations for interpreting and reviewing images
      - Archives for storage and retrieval of images and reports