CPD QUESTIONNAIRE Give ONE correct answer for each question. 48 SA JOURNAL OF RADIOLOGY • June 2010 A. Reviews suggest a considerable number of abnormal CT scans following a depressed skull fracture with no focal clinical neurological deficit. B. Although most injuries are minor and possibly do not require intervention, CT of the brain is still warranted retrospectively on the basis of the intracranial pathology. C. CT scans could provide a baseline for comparison of subsequent pathology related to injury in the event of later complications and patient follow-ups. D. A depressed skull fracture is seldom associated with intracranial pathology as observed on CT. 1. In patients with clinically suspected depressed skull fracture and no focal neu- rological deficit, which of the following statements is incorrect? 2. Which one of the following statements is true? A. A patient with normal CT of the brain always has an abnormal MRI. B. An abnormal CT does not predict neurological outcome. C. Previous studies have shown that patients with minor brain injury requiring no surgery or medical interven- tion had an average stay of 5 days in hospital. D. Patients with minor CT abnormalities and normal mental status have a moderate risk of deterioration. 3. Which one of the following statements is false? A. Hepatic vascular lesions are not an uncommon finding in children, and represent the most common benign liver tumours to present in infancy. B. Based on their biological and clinical behaviour, vascu- lar anomalies can be broadly divided into two groups: vascular tumours and vascular malformations. C. Congenital haemangiomas stain positive for glucose transporter-1 protein (Glut-1), a marker of haeman- gioma of infancy. D. Vascular malformations are congenital lesions of vascu- lar dysmorphogenesis, are always present at birth and enlarge in proportion to the growth of the child. 5. The most likely cause of severe pulmonary congestion and a normal heart is: A. Mitral stenosis B. Persistent fetal pulmonary circulation C. Large VSD D. TAPVR. 6. Which one of the following is not characteristic of macrodystrophia lipomatosa (MDL)? A. A rare, non-hereditary, congenital condition B. Presenting with localised macrodactyly and a prolifera- tion of mesenchymal elements C. There is in particular a marked increase in adipose tis- sue with only strands of fibrous tissue around margins. D. Disproportionately large limbs since birth may be a feature. 7. Which one of the following statements is false? A. Macrodystrophia lipomatosa is a rare congenital disor- der of focal gigantism affecting the extremities, more commonly the second and third digits of the foot, but it may also affect the hand. B. It is typically described in a particular nerve distribu- tion; usually the medial plantar nerve or median nerve. C. Plain films show lucent soft-tissue overgrowth as well as hypertrophy of osseous structures in the distribution of the median and plantar nerves. D. MRI findings are relatively inconsistent in confining the differential diagnosis. 8. In MDL, which one of the following statements is incorrect? A. Doppler studies reveal extensive increase in vascularity. B. In older patients, secondary osteoarthritis changes may be seen. C. MRI shows overgrowth of unencapsulated fatty tissue that demonstrates high signal on T1WI and T2WI. D. Suppression of the signal on short inversion time inversion recovery (STIR) sequences. 10. A registrar post recently advertised at one of our radiology departments attracted how many applications? A. 1 B. 28 C. 35 D. 67 Tip: The answer is in the next issue; but a clue is that radiology has become the most sought-after specialty at South African medical schools. CPD Instructions: 1. CPD questionnaires must be completed online by going directly (not via Google) to www.cpdjournals. org.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. Questions may be answered up to 6 months after publication of the journal issue concerned. 4. Please contact Gertrude Fani on 021 681 7200 or gertrude@hmpg.co.za in the event of queries. Accreditation number: MDB 001/007/01/20104. Causes of neonatal pulmonary oedema include all of the following, except: A. Infantile coarctation B. Congenital aortic stenosis C. Acquired mitral stenosis D. Obstructed TAPVR. 9. Regarding MDL, identify one incorrect answer: A. Lack of flow voids and calcifications helps to differenti- ate the condition from vascular malformations of Klippel-Trenauney-Weber syndrome. B. Fibrolipomatous hamartoma of the nerve displays fea- tures similar to MDL; however, fat deposition surrounds the nerve, giving a solid hyperacoustic appearance on ul- trasound and a continuous, linear fat signal on T1 MRI. C. Lymphangiomas and neurofibromas may be hyperin- tense to fat on T2WI, distinguishing MDL from these conditions. D. Proteus syndrome may be similar but has other associ- ated features such as skull anomalies, lung cysts and pigmented naevi.