CPD QUESTIONNAIRE 152 SA JOURNAL OF RADIOLOGY • December 2011 Give one correct answer for each question. 1. Which one of the following statements is false? A. Peer-reviewed literature demonstrates increasing support for the use of Focused Abdominal Sonography in Trauma (FAST) in the setting of blunt trauma. B. Indications are that, compared with abdominal CT, the sensitivity and specificity of FAST for the detection of free fluid is 0.64 - 0.98 and 0.86 - 1.00, respectively. C. Utilising ultrasound in trauma triage increases efficiency, cost-effectiveness and reduces reliance on CT compared with using CT alone. D. There is overwhelming evidence to support reliance solely on a negative FAST and physical exams for patient management. 2. Which one of the following statements is false? A. A representative sample of occupationally exposed workers surveyed in Kenya found that the annual exposure levels range from 0.32 to 6.98 mSv. B. There is a skewed annual distribution showing a median value of 2.5 mSv. C. The technologists were in the upper quartile in this radiation exposure distribution, thus being the largest exposed group in the medical sector. D. In Kenya, there exist shortcomings governing radiation exposure of workers whereby additional safety measures for pregnant radiation workers is lacking. 3. Which one of the following statements is false? A. Malignant melanoma is one of the most common malignancies to metastasise to the GI tract. B. Symptomatic metastasis to the GI tract is seen in 20% of patients. C. It metastasises via lymphatic channels to parenchymal organs. D. Metastases may present at the time of primary diagnosis or decades later as the first sign of recurrence. 4. Which one of the following is true? A. The ‘dural tail sign’ was first described by Wilms in 1889, as a post-contrast linear thickening of the meninges that resembles a tail extending from a mass on T1-weighted MR imaging. B. In 1990, Goldsher and colleagues devised a subset of radiologic criteria that proved to be of no value in identifying the absence or presence of the dural tail sign sign. C. This sign consists of a tapering rim ranging from 0.5 to 3.0 cm in length with an inner surface that is either smooth or slightly nodular. D. Due to its high specificity, it remains the only sign in assessing the morphology, enhancement pattern and centricity of a meningeal lesion. 5. Which one of the following statements is false? A. Cystic and cavitatory pulmonary lesions are abnormalities commonly encountered on chest radiography and computed tomography (CT). B. A cyst is defined as any round circumscribed space that is surrounded by an epitheloid or fibrous wall of variable thickness. C. Malignant lesions including metastases often present as cystic lesions. D. High-resolution CT of the chest helps to define morphological features that may serve as clues regarding the nature of cystic and cavitatory lung lesions. 6. Identify the one false statement among the following choices. A. Oculodentodigital dysplasia (ODDD), also known as ‘oculodentoosseous dysplasia’, is an extremely rare autosomal dominant disorder with high penetrance, intra- and interfamilial phenotypic variability, and advanced paternal age in sporadic cases. B. ODDD is caused by mutations in the connexin 43 (Cx43) or gap junction protein alpha-1 (GJA1) gene. C. The actual incidence of this disease is not known, but only 243 cases have been reported in the scientific literature, suggesting an incidence of the order of one affected person in ten million people. D. It is marked mainly by eye abnormalities, craniofacial dysmorphism, dental anomalies, hand and foot malformations, various skeletal defects, and markedly delayed mental development. 7. The following are true, except for: A. Tissue injury due to the propagation of a shockwave is well described with ballistic injuries where the energy transfer from the missile to the tissue is responsible for the severity of the wound. B. The relationship between the kinetic energy and the projectile can be derived from the formula: Kinetic energy (KE) = 0.5 x mass x (velocity)². C. Shockwave injury to adjacent tissue is a rare complication of extracorporeal shock wave lithotripsy. D. In the case of bullet wounds where the mass of the projectile is relatively small, the extent of damage to surrounding tissues is largely determined by the velocity. 8. Identify the one false statement among the following. A. Investigators have not been able to demonstrate direct tumour involvement of the dural tail. B. Dural tails represent reactive changes to the dura mater, adjacent to but not in contiguity with the tumour. C. The dural tail sign is also reported in a variety of other intra-axial as well as extra-axial lesions including neuromas, chloromas, metastases, lymphoma, glioma, pituitary diseases and granulomatous disorders. D. The dural tail sign is a highly specific feature of meningioma. 9. Regarding the following, identify a single false statement. A. Primary GI melanoma can arise in various GI mucosal sites, including the oral cavity, oesophagus, small bowel, rectum and anus. B. Primary melanoma of the GI tract is rarely diagnosed at an early stage. C. Distinguishing between a primary GI mucosal melanoma and melanoma metastases to the GI tract from unknown or regressed cutaneous primary may be difficult. D. GI metastasis is the most common manifestation of the disease. 10. Identify the one false statement below. A. GO RAD is a 2-year-old consortium of 30 continental/multinational/national society journals. B. GO RAD (Global Outreach-Radiology – www.isradiology.org/gorad) is a global outreach programme of the International Society of Radiology. C. Partnering society journals agree to provide select open access immediately on publication to appropriate content (e.g. one article per issue). The mechanics are that GO RAD simply places hyperlinks from the selected GO RAD articles back to the respective home journal. Since the SAJR is a quarterly open-access journal, it is easy to link the content. An example from SAJR Vol. 15 No. 3 is: Pseudomyxoma peritonei (PMP) - a rare entity http://www.sajr.org.za/index.php/sajr/article/view/344 D. At GO RAD you will find freely available links to Barack Obama, George Bush and Gerry Springer. CPD Instructions: 1. CPD questionnaires must be completed online by going directly (not via Google) to www.cpdjournals.co.za, and registering. You will then receive an email notifying you of your username and password for subsequent logging on. 2. Read the articles in the journal to find the answers to the questions. 3. After completing the questionnaire, you can check the answers and print your own CPD certificate. 4. Please contact Gertrude Fani on 021 681 7200 or gertrude@hmpg.co.za in the event of queries. Accreditation number: MDB 001/010/01/2011