2. Interpreting X-Rays Flashcards
What are the Pros of receiving X-Rays
- Quick identification of tumour and growth
- Cheap-ish
- Usually does not involve staying in the hospital for long durations
What are some disadvantages of X-rays/Radiation?
- Skin Irritation
- Hair Loss
- Nausea and Diarrhoea
- Dry Mouth
- Ionising Radiation can cause Cancer/Gene Defects
How many Broad Densities of Images exist?
Four
- Air (No absorption): Black
- Fat (Some absorption): Dark
- Water/Soft Tissue (More): Mid-Grey
- Bone/Calcium: WHITE
- Metal: BRIGHT WHITE!
What would you expect for a Pulmonary Pathology?/
- Pneumothorax
- Infection
- Tumour
- Oedema
- Effusion
What would you expect for a Cardiac/Mediastinal Pathology?
- Cardiomegaly
2. Aortic Dissection
What would you expect for an Abdominal Pathology?
- Sub-diaphragmatic Free Gas
What is the acronym allowing for initial X-ray inspection?
DR ABCDE
- Details
- RIPE
- Airway/Mediastinum
- Breathing
- Circulation
- Diaphragm
- Everything Else
For the DR ABCDE Acronym, what is meant by D?
Details
- Correct Patient
- Correct X-ray
For the DR ABCDE Acronym, what is meant by R?
RIPE
- Rotation: Spinous processes equal distance from Clavicles
- Inspiration:
- 5-7 Anterior Ribs in Midclavicular line
- 10-11 Posterior Ribs
- MORE = Obs Lung Disease - Position:
- PA/AP
- Judge via Costophrenic Angle/Apices - Exposure:
- Penetration and visible Vertebrae
For the DR ABCDE Acronym, what is meant by A?
Airway and Mediastinum
- Is the Trachea normal? Shifted?
- Mediastinal/Paratracheal Masses
- Mediastinal Widening?
- Dilated Vessels?
- Goiter?
What reasons could cause deviation of the Trachea AWAY from the Lesion?
- Tension Pneumothorax
- Effusion
- Mass
What reasons could cause deviation of the Trachea TOWARDS the Lesion?
- Collapsed Lung
2. Pneumonectomy
For the DR ABCDE Acronym, what is meant by B?
Breathing
- Split the lung fields into Upper/Middle/Lower Zones
- Compare each side for
- Fissures
- Infiltrates
- Lung Markings
- Lesions
You usually cannot see the Pleura
For the DR ABCDE Acronym, what is meant by C?
Circulation
- Heart Position/Borders/Shape
- 1/3 Right, 2/3 Left
- Size of 50% Thoracic Diameter
- Aorta
For the DR ABCDE Acronym, what is meant by D?
Diaphragm
- RIGHT is higher than left cuz the Liver pushes it up
- Flat or Raised?
- Subdiaphragmatic Air
- Costophrenic Angles
For the DR ABCDE Acronym, what is meant by E?
Everything Else
- Bones
- Lines/Metal
- Soft Tissue
- Emphysema from Surgery
If a 60 yo Patient presents with a:
- PMH of Breast Cancer
- Dyspnoea
- Cough
X-Ray:
- Meniscus of Dense opacification in lower zone
- Obliteration of Costophrenic Angle
Pleural Effusion
If a 75 year old Male Patient presents with:
- Left Shoulder Pain
- Hoarse Voice
- Weight Loss
X-Ray:
- Apical Opacity
Pancoast Tumour
What is a Pancoast Tumour?
Primary Lung Cancer in the Lung Apex around the clavicular region
When a 70 yo Female Patient presents with Heart Failure, what can generally be presented?
- Progressive Exertional Dyspnoea
- Coughing White Frothy Sputum
- Orthopnoea (breathless when recumbent)
When a 70 yo Female Patient presents with Heart Failure, what can generally be seen in an X-ray?
- Alveolar shadowing ‘Bat Wings’
- Kerley B lines
- Cardiomegaly
- Dilated Upper Lobe Vessels (Cephalisation)
- Pleural Effusion
When a 24 yo male with a previous hernia repair presents with:
- Severe Abdominal Pain
- Bloating
- Bilous Vomit
Chest X-ray showing:
- Free air under the diaphragm
Bowel Perforation
When a 5 yo male presents with these after choking on peanuts:
- Persistent Cough
- Dyspnoea
Chest X-Ray shows:
- Increased Lung opacity (SAIL SIGN)
- Mediastinal Shift towards affected side
Sail Sign generally depicts Left Lower Lobe Collapse (LLLC)
When a 40 yo woman presents with:
- Fever
- Dry Cough
- Loss of Taste for 10 days
- O2 Sats of 75%
Chest X-Ray showed
- Bilateral Peripheral Patchy Opacifications in Lung Space
- Diffuse Bilateral Ground Glass Appearances
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