computed tomography (CT)
Practice targeted AMC-style multiple-choice questions on computed tomography (CT).
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A 72-year-old male presents to his general practitioner for a routine check-up. He reports a history of hypertension, hyperlipidemia, and a 40-pack-year smoking history. He denies any abdominal pain, back pain, or lower extremity claudication. On physical examination, his vital signs are within normal limits. Auscultation of the abdomen is unremarkable, and peripheral pulses are palpable and symmetric. As part of his cardiovascular risk assessment, a contrast-enhanced CT scan of the abdomen and pelvis is performed. An axial view from the scan is shown. Based on the image and the patient's clinical presentation, which of the following is the MOST appropriate next step in management?
A 3-year-old child is investigated for a 2-month history of increasing abdominal distension and intermittent pain. On examination, a firm, non-tender mass is palpable in the upper abdomen. Initial blood tests reveal mild anaemia. Vital signs are stable. The provided image was obtained as part of the diagnostic evaluation. Considering the clinical presentation and the findings demonstrated, which of the following investigations is most crucial for determining the extent of disease spread, a key factor in guiding subsequent management decisions for this paediatric patient?
A 68-year-old male presents to the emergency department complaining of new onset left flank pain radiating to his groin. He reports a history of hypertension and hyperlipidemia, both managed with medications. He denies any recent trauma. His vital signs are stable: blood pressure 130/80 mmHg, heart rate 88 bpm, respiratory rate 16 breaths/min, and oxygen saturation 98% on room air. Physical examination reveals mild tenderness to palpation in the left flank, but no guarding or rebound tenderness. Peripheral pulses are normal and symmetric. A contrast-enhanced CT scan of the abdomen and pelvis is performed, the axial view is shown. Given the clinical context and the findings on the image, which of the following is the MOST appropriate next step in management?
A 62-year-old male presents with left lower quadrant pain, fever, and leukocytosis. A CT scan of the abdomen and pelvis is performed, the axial view is shown. What is the most appropriate next step in management?
A 68-year-old man presents to the emergency department with a 2-day history of worsening left lower quadrant abdominal pain, associated with subjective fever, chills, and nausea. He reports some recent constipation. On examination, his temperature is 38.5°C, pulse 95 bpm, BP 130/80 mmHg. Abdominal examination reveals tenderness and guarding in the left iliac fossa. Bowel sounds are reduced. Blood tests show a white cell count of 15 x 10^9/L (neutrophils 85%) and C-reactive protein of 120 mg/L. Urea, electrolytes, and creatinine are within normal limits. A CT scan of the abdomen and pelvis is performed (image provided). Considering the clinical presentation and the findings demonstrated in the provided image, which of the following represents the most appropriate initial management strategy?
A 4-year-old boy presents with left flank pain and a palpable abdominal mass. His mother reports decreased appetite and recent weight loss. A CT scan of the abdomen is performed (image attached). What is the MOST likely diagnosis?
A 62-year-old male presents to the emergency department complaining of left lower quadrant abdominal pain for the past three days. He describes the pain as constant and sharp, rating it an 8 out of 10. He also reports nausea, decreased appetite, and subjective fevers. His past medical history is significant for hypertension and hyperlipidemia, both well-controlled with medications. He denies any recent travel or sick contacts. On physical examination, his abdomen is tender to palpation in the left lower quadrant with guarding. Bowel sounds are present but diminished. The remainder of his examination is unremarkable. His vital signs are: Temperature 38.2°C, Heart Rate 98 bpm, Blood Pressure 140/90 mmHg, Respiratory Rate 18 breaths per minute, and Oxygen Saturation 98% on room air. Laboratory results show a white blood cell count of 14,000/µL with a neutrophilic predominance. A CT scan of the abdomen and pelvis with intravenous contrast is performed, and a representative image is shown. Assuming the patient has no allergies, what is the MOST appropriate initial management strategy?
A 68-year-old male presents to the ED with severe groin pain and a palpable mass. He reports constipation and inability to pass flatus for 24 hours. Examination reveals tenderness and erythema. A CT scan is performed. What is the MOST appropriate next step in management?
A 3-year-old child presents with a 2-month history of increasing abdominal distension and intermittent pain. On examination, a firm, non-tender mass is palpable in the upper abdomen. Initial blood tests reveal mild anaemia. Vital signs are stable. The provided image was obtained as part of the diagnostic evaluation. Based on the findings in the image and the clinical context, which of the following imaging modalities is most likely to provide critical information regarding potential metastatic disease, which is essential for accurate staging and treatment planning in this paediatric patient?
A 28-year-old female presents with right lower quadrant pain for 3 days. She denies fever, vomiting, or vaginal discharge. Her last menstrual period was 2 weeks ago. The shown CT was performed. What is the MOST likely diagnosis?
A 68-year-old male presents with a 2-day history of worsening left lower quadrant abdominal pain, fever (38.5°C), and nausea. He has a history of similar, milder pain episodes. Examination reveals left iliac fossa tenderness with guarding. Bloods show WCC 16, CRP 120. A CT scan is performed (image provided). Considering the clinical picture and the imaging findings, which of the following represents the most appropriate initial management strategy?
A 28-year-old woman presents with pelvic pain that started suddenly 2 days ago. Her periods are regular. She denies fever or vomiting. The shown CT was performed. What is the MOST likely diagnosis?
A 2-year-old with a palpable abdominal mass and periorbital ecchymoses has the shown CT. What is the MOST likely diagnosis?
A 68-year-old woman with a history of hypertension and hyperlipidemia presents to the emergency department with a sudden onset of left-sided hemianopia and mild right-sided weakness. Her symptoms began approximately 4 hours prior to arrival. Initial neurological examination reveals intact language function and no cognitive deficits. A CT angiogram was performed, followed by endovascular coiling. The provided image shows a post-operative angiogram. Despite the intervention, the patient's hemianopia persists, and her weakness has slightly worsened. What is the MOST appropriate next step in the management of this patient?
A 62-year-old male presents to the ED with left lower quadrant abdominal pain, fever, and nausea for 3 days. His WBC count is 14,000. A CT scan of the abdomen and pelvis is performed, the axial view is shown. What is the most appropriate next step in management?
A 28-year-old female presents with a chronic cough and fatigue. She has no significant past medical history. A chest PET-CT was performed as part of her workup. The axial view is shown. What is the MOST appropriate next step in management, considering the image and her presentation?
A 45-year-old woman presents to the ED with right upper quadrant pain, fever, and nausea for 24 hours. Her vital signs are: HR 105 bpm, BP 130/80 mmHg, Temp 38.5°C. Physical exam reveals marked tenderness on palpation of the right upper quadrant. An abdominal CT scan is performed, as shown. What is the MOST appropriate next step in management?
A 32-year-old male presents to the emergency department with a 3-day history of worsening abdominal pain, primarily localized to the right lower quadrant. He reports associated nausea and decreased appetite but denies vomiting or diarrhea. His past medical history is significant for Crohn's disease, diagnosed 8 years ago, managed with intermittent courses of oral corticosteroids and azathioprine. He admits to poor adherence to his azathioprine regimen over the past year. On examination, he is afebrile with a heart rate of 92 bpm, blood pressure of 120/80 mmHg, and oxygen saturation of 98% on room air. Abdominal examination reveals tenderness to palpation in the right lower quadrant with guarding. Bowel sounds are normoactive. Laboratory investigations reveal a white blood cell count of 11,500/µL with neutrophilia, a C-reactive protein (CRP) of 45 mg/L, and normal liver function tests. A CT scan of the abdomen and pelvis with IV contrast is performed, the relevant images of which are shown. Given the patient's presentation and imaging findings, which of the following is the MOST appropriate next step in management?
A 72-year-old man presents to his GP with a 3-month history of intermittent lower back pain, which is worse with activity. He has a history of hypertension, hyperlipidaemia, and is a former smoker. Physical examination reveals normal vital signs and no abdominal tenderness or pulsatile mass. Routine blood tests are normal. An abdominal CT scan is performed as part of the workup. Considering the findings demonstrated in the image, what is the most appropriate next step in the management of this patient?
A 68-year-old man presents with a 3-month history of progressive dysphagia, early satiety, and unintentional weight loss of 8 kg. He has a background of well-controlled hypertension. Physical examination reveals mild epigastric tenderness. Initial blood tests show a normocytic anaemia. An urgent upper endoscopy identified a large, ulcerated mass in the gastric body, and biopsies were taken. A staging CT scan of the abdomen and pelvis was subsequently performed. Considering the clinical presentation and the findings demonstrated in the provided imaging, which of the following statements best reflects the likely prognosis and primary management strategy for this patient?
A 72-year-old patient presents with a 4-month history of tenesmus and occasional bright red rectal bleeding. Colonoscopy was performed, and a representative image is shown. Biopsies confirm adenocarcinoma. Considering the likely stage suggested by the endoscopic appearance, which investigation is MOST crucial for pre-operative staging?
A 45-year-old woman presents to the ED with right upper quadrant pain, fever, and nausea for 24 hours. Her vital signs are: HR 110, BP 130/80, Temp 38.5°C. An abdominal CT scan is performed (image attached). What is the MOST appropriate next step in management?
A 4-year-old presents with abdominal distension and back pain for 2 months. Exam reveals a firm, fixed abdominal mass. Vitals are normal. An abdominal CT is performed (axial view shown). Which lab finding would MOST strongly support the suspected diagnosis?
A 78-year-old man presents to the emergency department with acute, severe right groin pain and a palpable, non-reducible mass. He reports associated nausea but denies vomiting or changes in bowel habit. His vital signs are within normal limits, and bowel sounds are audible. A CT scan of the pelvis is performed, the findings of which are depicted in the image. Given the clinical context and the information revealed by the imaging study, what is the most appropriate immediate management strategy?
A 60-year-old female with a history of a posterior cerebral artery aneurysm presents for routine follow-up. Review the image. What is the MOST appropriate management?
A 62-year-old male presents with a 3-month history of worsening upper abdominal pain, significant fatigue, and a 10 kg unintentional weight loss. His medical history includes long-standing peptic ulcer disease managed with proton pump inhibitors. On examination, he has mild hepatomegaly and trace ascites. Initial blood tests show elevated alkaline phosphatase and gamma-glutamyl transferase, with normal serum bilirubin and transaminases. A contrast-enhanced CT scan of the abdomen and pelvis is performed, and representative images are provided. Considering the clinical presentation and the findings demonstrated on the imaging, which of the following represents the MOST appropriate immediate next step in the management of this patient?
A 72-year-old male presents with a 4-month history of increasing fatigue, anorexia, and a 10 kg weight loss. He reports occasional nausea but no vomiting or abdominal pain. His vital signs are stable. Physical examination reveals mild jaundice and palpable hepatomegaly. Blood tests show Hb 105 g/L, elevated AST/ALT, and a mildly raised bilirubin. An upper endoscopy showed a large gastric mass, with histology pending. A CT scan of the abdomen and pelvis was performed. Considering the clinical context and the findings on the provided imaging, what is the most likely implication for this patient's overall management strategy?
A 3-year-old boy presents to the emergency department with a one-week history of abdominal pain, decreased appetite, and irritability. His parents also report that he has been increasingly tired and pale. On examination, the child is noted to have a palpable abdominal mass. A CT scan of the abdomen is performed, the axial view is shown. Based on the image and clinical presentation, which of the following is the MOST appropriate next step in management?
A 62-year-old male presents with left lower quadrant pain, fever, and leukocytosis. A CT scan of the abdomen and pelvis is performed (image attached). Assuming the diagnosis, which of the following is the MOST appropriate initial management?
A 28-year-old female presents to her general practitioner with a 6-month history of intermittent abdominal pain, predominantly in the right lower quadrant. She describes the pain as cramping and associated with occasional episodes of non-bloody diarrhea. She denies fever, weight loss, or recent travel. Her past medical history is significant for well-controlled asthma, for which she uses an inhaled corticosteroid as needed. Physical examination reveals mild tenderness to palpation in the right lower quadrant, but is otherwise unremarkable. Bowel sounds are normal. Initial laboratory investigations, including a complete blood count and comprehensive metabolic panel, are within normal limits. Stool studies for ova and parasites, bacterial culture, and Clostridium difficile toxin are negative. Given her persistent symptoms, the GP refers her for further evaluation. A CT enterography is performed, and relevant images are shown. Based on the clinical presentation and imaging findings, which of the following is the MOST likely long-term complication this patient is at increased risk of developing?
A 32-year-old woman presents to her general practitioner with a 6-month history of worsening dysmenorrhea and pelvic pain, particularly on the left side. She reports no fever, weight loss, or abnormal vaginal bleeding. Her last menstrual period was 2 weeks ago and was normal. Physical examination reveals mild left adnexal tenderness. A CT scan of the pelvis was performed, the relevant image is shown. Given the clinical context and the imaging findings, what is the MOST appropriate next step in management?
A 28-year-old female presents with sudden onset severe right lower quadrant pain, associated with nausea and one episode of vomiting. Her last menstrual period was 6 weeks ago. On examination, she is afebrile, heart rate 88, blood pressure 120/70. Abdominal examination reveals tenderness in the right iliac fossa. A CT scan of the abdomen and pelvis is performed, with a relevant axial image shown. Considering the clinical presentation and the findings demonstrated in the image, what is the MOST appropriate immediate next step in the management of this patient?
A 45-year-old woman presents to the ED with right upper quadrant pain, fever, and nausea for 24 hours. Her vital signs are: HR 110, BP 130/80, Temp 38.5°C. An abdominal CT scan is performed (image attached). What is the MOST appropriate next step in management?
A 62-year-old male presents with acute onset of LLQ pain, fever, and vomiting. His WBC count is elevated. A CT scan of the abdomen and pelvis is performed. Based on the image, what is the most appropriate next step in management?
A 72-year-old male presents with a 4-month history of increasing constipation and occasional streaks of blood on stool. He denies significant weight loss. Physical exam is unremarkable. A colonoscopy was performed, and the image is shown. Biopsies are taken from the lesion. Assuming the biopsy confirms adenocarcinoma, what is the MOST appropriate initial investigation to guide further management?
A 55-year-old male presents with LLQ pain, fever, and increased WBC. A CT scan is performed, as shown. He is hemodynamically stable. What is the MOST appropriate initial management?
A 60-year-old man, post-chemotherapy, presents with fever and abdominal pain. The images are shown. What is the MOST appropriate initial therapy?
A 28-year-old woman presents with pelvic pain that started suddenly 2 days ago. Her periods are irregular. She denies fever or vomiting. The shown CT was performed. What is the MOST likely diagnosis?
A 68-year-old male presents to the ED with left lower quadrant abdominal pain, fever, and leukocytosis. A CT scan of the abdomen and pelvis is performed. Based on the imaging, what is the MOST appropriate next step in management?
An 68-year-old man attends his GP for a routine check-up. He has a history of well-controlled type 2 diabetes, hypertension, and smoked for 30 years, quitting 5 years ago. He denies any abdominal pain, back pain, or pulsatile sensation. Physical examination is unremarkable. As part of a cardiovascular risk assessment, an abdominal ultrasound is initially performed, which is inconclusive due to bowel gas. A follow-up contrast-enhanced CT scan is arranged. Considering the findings demonstrated in the image, what is the most appropriate next step in the management of this patient?
A 68-year-old male presents for a routine check-up. He has a history of smoking and hypertension, well-controlled with medication. He denies any abdominal pain, back pain, or lower extremity claudication. Physical exam is unremarkable. A contrast-enhanced CT scan of the abdomen is performed, the axial view is shown. What is the MOST appropriate next step in management?
A 45-year-old male with a known history of Blue Rubber Bleb Naevus Syndrome, characterised by recurrent gastrointestinal bleeding and multiple cutaneous vascular lesions, presents to the emergency department with acute onset severe, colicky abdominal pain, nausea, and vomiting. On examination, his abdomen is distended and diffusely tender with reduced bowel sounds. Vital signs are within normal limits. An urgent abdominal CT scan is performed. Based on the clinical presentation and the findings demonstrated in the image, what is the most appropriate immediate next step in management?
A 68-year-old man presents with 3 days of worsening left lower quadrant pain, fever, and nausea. He has a history of diverticulosis. On examination, he is tachycardic (HR 105), afebrile (37.5°C), and has localised tenderness with guarding in the left iliac fossa. His blood tests show a WCC of 16 x 10^9/L and CRP 150 mg/L. He is commenced on intravenous antibiotics. A CT scan is performed (image provided). Considering the clinical context and the findings on the image, what is the most appropriate next step in management?
A 45-year-old patient with a long history of recurrent gastrointestinal bleeding and multiple cutaneous vascular lesions presents with acute onset severe abdominal pain, nausea, and distension. Physical examination reveals a distended, mildly tender abdomen. Bowel sounds are reduced. Vital signs are stable. Imaging is performed. Considering the patient's presentation and the findings demonstrated in the image, which of the following represents the most appropriate initial management approach?
A 65-year-old male presents with acute LLQ pain. The provided image was obtained. What dietary advice is most appropriate upon resolution of acute symptoms?
A 31-year-old woman presents with pelvic pain and bloating for 3 months. Her periods are regular. Pelvic exam reveals mild adnexal tenderness. A CT scan is performed, with a relevant image shown. What is the MOST appropriate next step?
A 63-year-old man presents with increasing postprandial fullness and epigastric discomfort. A CT scan of the abdomen is performed. Based on the image, what is the MOST appropriate next step in management?
A 65-year-old man presents to the emergency department with a 2-day history of worsening left lower quadrant abdominal pain, associated with fever and chills. He reports a change in bowel habit with increased constipation. On examination, he is febrile at 38.6°C and has significant tenderness and guarding in the left iliac fossa. His white cell count is 18 x 10^9/L. A CT scan of the abdomen and pelvis is performed (image provided). Considering the patient's presentation and the findings on the provided image, which of the following represents the most appropriate initial management step in addition to intravenous antibiotics?