MedicoNotebook: January 2016

0 Medical One Liners 441-450

441. MRI - Gadolinium contrast is used (when needed). In patients with renal failure, it may cause Nephrogenic Systemic Fibrosis - plaques of skin (firm, indurated and erythematous) with subcutaneous oedema.

442. Air bronchograms can be seen in alveolar pathologies:

Pneumonia
Pulmonary edema
Hyaline membrane disease
Bronchoalveolar carcinoma

443. Pneumatocele can be seen in

Staphylococcal and klebsiella pneumonia
Hydrocarbon poisoning

444. Viral and mycoplasma pneumonia gives interstitial pattern. No alveolar exudates are seen.

445. Hydatid cyst:

Ultrasound: Cart wheel appearance
in Lungs it does not calcify
Chest X-ray: if contained rupture - water lily sign

Note: Drooping lily sign is seen on IVP in duplex collecting system with upper moiety obstruction

446. Egg in cup:

calyces: Papillary necrosis
heart: constrictive pericarditis

447. Focal nodular hyperplasia (FNH) has high Kupffer cells and takes up technetium 99m sulphur colloid.

448. In Blunt trauma cases:

Ideal and gold standard investigation: Contrast enhanced CT (CECT)
If haemodynamically unstable/1st Investigation: FAST (Focused assessment sonography in trauma)

449. Beaded appearance in Renal artery/Internal carotid/External Iliac: Fibromuscular dysplasia

450. Only Veins (hepatic and portal) form basis of division of couinaud segments of the liver.

2 Pulmonary sequestration

Author: Dr. Ayush Goel

Pulmonary Sequestration = accessory lung (embryonic cut off of a segment from main lung)

Types:	Intralobar	Extralobar
	More common (75-85% cases)	Less common (15-25% cases)
Presentation	Usually Child with recurrent infections	Usually Neonate with respiratory distress and cyanosis
Arterial supply	Aorta (Same in both types)
Venous supply	usually Pulmonary venous drainage	Usually systemic venous drainage
Pleura	Same pleura as ipsilateral lung	Separate pleura from ipsilateral lung
Site	60% cases affect left lower lobe (Most commonly Posterior basal segment); 40% right lower lobe.	Always affect left lower lobe; can be subdiaphragmatic in 10% cases
	Sequestrated lung appears hyperechoic than rest of lung on prenatal ultrasonography