Chapter·AnatomyImaging/Clinical

Anatomical variants in imagingDownloads

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1

A 75-year-old man presents to the clinic for chronic fatigue of 3 months duration. Past medical history is significant for type 2 diabetes and hypertension, both of which are controlled with medications, as well as constipation. He denies any fever, weight loss, pain, or focal neurologic deficits. A complete blood count reveals microcytic anemia, and a stool guaiac test is positive for blood. He is subsequently evaluated with a colonoscopy. The physician notes some “small pouches” in the colon despite poor visualization due to inadequate bowel prep. What is the blood vessel that supplies the area with the above findings?

AIleocolic artery

BSuperior mesenteric artery

CInferior mesenteric artery

DMiddle colic artery

ERight colic artery

2

A 56-year-old man presents to the emergency room after being in a motor vehicle accident. He was driving on an icy road when his car swerved off the road and ran head on into a tree. He complains of severe pain in his right lower extremity. He denies loss of consciousness during the accident. His past medical history is notable for poorly controlled hypertension, hyperlipidemia, and major depressive disorder. He takes enalapril, atorvastatin, and sertraline. His temperature is 99.1°F (37.3°C), blood pressure is 155/85 mmHg, pulse is 110/min, and respirations are 20/min. On exam, he is alert and fully oriented. He is unable to move his right leg due to pain. Sensation is intact to light touch in the sural, saphenous, tibial, deep peroneal, and superficial peroneal distributions. His leg appears adducted, flexed, and internally rotated. An anteroposterior radiograph of his pelvis would most likely demonstrate which of the following findings?

AFracture line extending between the greater and lesser trochanters

BFemoral head larger than contralateral side and inferior to acetabulum

CFracture line extending through the femoral neck

DFracture line extending through the subtrochanteric region of the femur

EFemoral head smaller than contralateral side and posterior to acetabulum

3

An 11-year-old girl is brought to the office by her mother due to complaint of intermittent and severe periumbilical pain for 1 day. She does not have any significant past medical history. She provides a history of a recent school trip to the suburbs. On physical examination, there is a mild tenderness around the umbilicus without any distension or discharge. There is no rebound tenderness. Bowel sounds are normal. An abdominal imaging shows enlarged mesenteric lymph nodes, and she is diagnosed with mesenteric lymphadenitis. However, incidentally, a mass of tissue was seen joining the inferior pole of both kidneys as shown in the image. Which of the following best describes this renal anomaly?

AFused kidneys ascend beyond superior mesenteric artery.

BRapid progression to acute renal failure

CKidneys are usually non-functional.

DIncreased risk of developing renal vein thrombosis

EAssociation with ureteropelvic junction obstruction (UPJO)

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