Question 1 : Compare Testicular Torsion, Epididymo-orchitis and Epididymitis

Question 1  Describe symptoms, historical features and US findings in • Testicular torsion • Epididymoorchitis , epididymitis Ultrasound is an essential tool in differentiating between the different causes of testicular pain however ultrasound alone cannot exclude torsion. Initially ultrasound findings in testicular torsion may be unremarkable and then become heterogeneous or diffusely hypo-echoic, mimicking epididymo-orchitis both Read more about Question 1 : Compare Testicular Torsion, Epididymo-orchitis and Epididymitis[…]

Question 2: Trauma to testes

Question  2 Cricket ball to groin in young adult. Describe how you would perform scrotal US on this patient and your possible findings Performing scrotal US in the context of trauma • Private area • Chaperone • Analgesia • Gloved hand • Patient supine • Ample gel and warm if possible • Place towel beneath Read more about Question 2: Trauma to testes[…]

Question 3 : Tender groin and palpable mass

Question 3 :  A 30 year old man presents with a tender groin and palpable mass • List the DD (5 marks) • Describe the E Physician sonographic approach to this problem (10 marks) Differential diagnosis: Inguinal hernia direct or indirect Femoral hernia Lymph node Varicocoele Hydrocoele Femoral artery aneurysm Tumour  of spermatic cord or Read more about Question 3 : Tender groin and palpable mass[…]

Question 4 : Acute left groin pain

Question 4 A 25 year old man presents with acute left groin pain a) Discuss your US evaluation. Include choices of probe/s, the areas that you would examine and your method b) What additional clinical information is important? c) During the examination you cannot find the left testicle in the scrotum I. Discuss your further Read more about Question 4 : Acute left groin pain[…]

Question 5: Groin lump post angioplasty

Question  5 Groin lump after angioplasty. Approach and US findings Approach The lump should be evaluated clinically for pulsatility and for the presence of bruits or palpable thrill. The differential diagnosis includes large haematoma, a pseudo aneurysm AV fistula• Use a 5 -7.5 MHz linear array probe. May need a 3.5 MHz curvilinear if patient Read more about Question 5: Groin lump post angioplasty[…]

Question 1 : Assessment of fluid status with ECHO

Question 1 A haemodynamically decompensating patient requires assessment of the intravascular fluid status. Describe the Doppler echo cardiographic methods that can assist outlining the supportive evidence for their use, in addition to any obvious limitations in their application Assessment of fluid status can be achieved by using the LVOT VTI as a surrogate for stroke Read more about Question 1 : Assessment of fluid status with ECHO[…]

Question 2 : Pericardial disease

Question 2. Discuss the use and value of echocardiography in evaluating pericardial disease of various types Value is to look at the pericardium for structural abnormalities (thickening/calcification), assess associated pericardial effusions (may have strands suggesting inflammatory more chronic problem, may be anechoic, may show swirling cells) , look for haemodynamic signs of pericardial constriction. Pericardial Read more about Question 2 : Pericardial disease[…]

Question 3 : Complications of myocardial infarction

Discuss the use of Echocardiography/Doppler in the assessment of the complications of acute myocardial infarction Acute/subacute complications Cardiogenic shock Thrombus formation Myocardial rupture Papillary muscle rupture Ischaemic ventricular septum defect Chronic Remodelling of the heart Aneurysm Right heart failure Late thrombus Mitral regurgitation Assessment using ECHO Regional wall abnormalities Will depend on size and coronary Read more about Question 3 : Complications of myocardial infarction[…]

Question 4 : Severe back pain

Question 4  A 45 year old presents with sudden onset of severe acute central chest and back pain suggestive of acute dissection. Discuss the role of transthoracic and transoesophageal echo –cardiography in the initial assessment and ongoing management Role of ECHO in initial assessment: Differentiate between aortic dissection and other causes of chest pain such Read more about Question 4 : Severe back pain[…]

Question 5: septic shock

Describe the echocardiographic features not uncommonly seen in the patient with septic shock 1. ECHO exam may be normal 2. Septic cardiomyopathy: Left ventricular dilatation : if  LV EDD > 5.5cm however dependent of size of patient. If patient is an athlete LVEDD may be increased and normal.   Measure in PLAX view using calipers – Read more about Question 5: septic shock[…]