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46 terms

MSU CHM radiology 2

MSU CHM radiology 2
STUDY
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Ionizing radiation
CTo Meningitis: Ceftazidime is the antibiotic of choice because of its high penetration into the subarachnoid space and the high susceptibility of Pseudomonas to this drug.
o Eye Infection: Ophthalmic aminoglycoside solution.
o Ear Infection: Local antibiotics
o UTI: Parenteral aminoglycoside OR quinolones.
o Skin: Double antibiotic therapy should be instituted in accordance with the local susceptibility patterns because burn centers may harbor Pseudomonas strains that are resistant to multiple drugs.
o General list for treatment: newer aminoglycosides, carbenicillin, ticarcillin, 3rd and newer cephalosporins (ceftazidime, cefepime, cefoperazone), carbapenems, monobactams, ciprofloxacin. Combination therapy is useful, especially -lactam + aminoglycoside.
• Prevention - Vaccines incorporating somatic antigens from multiple P. aeruginosa serotypes have been developed, though they are still experimental.
• Complications -
o Pseudomonal endocarditis may cause brain abscess, cerebritis, and mycotic aneurysms. Septic emboli to the lungs and spleen are not uncommon, and cardiac complications may include conduction blocks and congestive heart failure.
o Pseudomonal bacteremia can cause septic shock and death.
o Pseudomonal pneumonia may be severe enough to require respiratory support.
o Ear infections can cause perichondritis; sinusitis; mastoiditis; osteomyelitis of the temporal bones; cranial nerve involvement of seventh, ninth, eleventh, and twelfth nerves; and thrombosis of the lateral and sigmoid sinuses. Meningitis and brain abscesses are relatively rare.
o Eye infections can result in corneal perforations, endophthalmitis, and orbital cellulitis.
o GI involvement by Pseudomonas can cause typhlitis, cecal perforation, and peritonitis.
o A severe bout of diarrhea can result in vascular collapse and death.
o Pseudomonas skin and soft tissue infections can be destructive and can cause massive necrosis and gangrene.

o Meningitis: Ceftazidime is the antibiotic of choice because of its high penetration into the subarachnoid space and the high susceptibility of Pseudomonas to this drug.
o Eye Infection: Ophthalmic aminoglycoside solution.
o Ear Infection: Local antibiotics
o UTI: Parenteral aminoglycoside OR quinolones.
o Skin: Double antibiotic therapy should be instituted in accordance with the local susceptibility patterns because burn centers may harbor Pseudomonas strains that are resistant to multiple drugs.
o General list for treatment: newer aminoglycosides, carbenicillin, ticarcillin, 3rd and newer cephalosporins (ceftazidime, cefepime, cefoperazone), carbapenems, monobactams, ciprofloxacin. Combination therapy is useful, especially -lactam + aminoglycoside.
• Prevention - Vaccines incorporating somatic antigens from multiple P. aeruginosa serotypes have been developed, though they are still experimental.
• Complications -
o Pseudomonal endocarditis may cause brain abscess, cerebritis, and mycotic aneurysms. Septic emboli to the lungs and spleen are not uncommon, and cardiac complications may include conduction blocks and congestive heart failure.
o Pseudomonal bacteremia can cause septic shock and death.
o Pseudomonal pneumonia may be severe enough to require respiratory support.
o Ear infections can cause perichondritis; sinusitis; mastoiditis; osteomyelitis of the temporal bones; cranial nerve involvement of seventh, ninth, eleventh, and twelfth nerves; and thrombosis of the lateral and sigmoid sinuses. Meningitis and brain abscesses are relatively rare.
o Eye infections can result in corneal perforations, endophthalmitis, and orbital cellulitis.
o GI involvement by Pseudomonas can cause typhlitis, cecal perforation, and peritonitis.
o A severe bout of diarrhea can result in vascular collapse and death.
o Pseudomonas skin and soft tissue infections can be destructive and can cause massive necrosis and gangrene.
Excellent discrimination between subtle tissue density differences
CT
First line evaluation in suspected cerebral vascular events (hemorrhagic vs. ischemic)
CT
First line evaluation in soft-tissue and skeletal trauma
CT
First line evaluation in suspected pulmonary embolism
CT
First line evaluation in suspected urinary calculi
CT
CVA evaluation
CT
Primary applications of CT (head/neck)
* CVA evaluation
* Carotid and intra-cerebral vascular evaluation
* Head/neck trauma - evaluation for subdural and epidural hematoma - evaluation for cervical fracture
* Neoplasm staging
Carotid and intra-cerebral vascular evaluation
CT
Head/neck trauma - evaluation for subdural and epidural hematoma - evaluation for cervical fracture
CT
Neoplasm staging
CT
Primary applications of CT (thorax)
* Lung - mediastinum nodule/mass evaluation
* Cardiac, coronary, pulmonary and great vessel vascular evaluation
* airway evaluation
* neoplasm staging
Lung - mediastinum nodule/mass evaluation
CT
Cardiac, coronary, pulmonary and great vessel vascular evaluation
CT
airway evaluation
CT
Primary applications of CT (abdomen/pelvis)
* solid organ evaluation
* urinary tract evaluation for calcification
* CT angiogram
* CT colonography
* CT urography
* Lumbar spine evaluation (pacemakers, stimulators)
* Neoplasm staging
solid organ evaluation
CT
urinary tract evaluation for calcification
CT
angiogram
CT, MRI
colonogram
CT, MRI
Urogram
CT, MRI
Lumbar spine evaluation (pacemakers, stimulators)
CT
Primary applications for CT (bones/joints)
* 3D joint reconstructed images
* Evaluation of fracture union
* Evaluation of neoplasm/extent
3D joint reconstructed images
CT
Evaluation of fracture union
CT
Secondary applications of CT
- Evaluation of patients with a contraindication to MRI imaging
- Bone mineral density analysis
Primary applications of MRI
- first line evaluation of suspected neurologic abnormality
- first line evaluation of soft tissue mass/neoplasm
- first line evaluation of joint disarrangements
- first line evaluation of bone neoplasm
first line evaluation of suspected neurologic abnormality
MRI
first line evaluation of soft tissue mass/neoplasm
MRI
first line evaluation of joint disarrangements
MRI
first line evaluation of bone neoplasm
MRI
Developmental anomalies of the head
MRI
Effect of arthritis and degenerative changes of the neck
MRI
Infection of the head
MRI
Spine - cord, roots, body, farming, stenosis, arthritis
MRI
Heart - function, perfusion
MRI
Liver - mass, iron content, biliary tree
MRI
Retroperitoneum
MRI
Prostate hypertrophy
MRI
Uterus/Ovary Masses
MRI
Uterus/ovaries leiomyoma
MRI
tendon/ligament injury
MRI
articular cartilage evaluation
MRI
Muscle abnormality
MRI
RLL Pneumonia (front view)
Density at the right lateral diaphragm, obliteration of lateral diaphragm border.
RLL Pneumonia (side view)
Density at the mid diaphragm, sharp margination at the major fissure.