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Pathology 3001 > Abnormal Chest X-rays > Flashcards

Abnormal Chest X-rays Flashcards

1
Q

What can increased translucency be due to?

A
  • Air (gas)

- Loss of tissue density

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2
Q

What can too white or white in the wrong place be due to?

A
  • Fluid

- Increased tissue e.g lymphadenopathy

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3
Q

What devices could appear as very white or very radio opaque on a CXR?

A
  • Pacemaker
  • ETT
  • NG tube
  • Sternal wiring
  • Prosthetic heart valves
  • CVP line
  • Chest drain
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4
Q

What does a chest x-ray that is too white with the trachea pushed away indicate?

A

Pleural effusion

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5
Q

What ‘too white’ conditions can pull the mediastinum towards the pathology?

A
  • Collapse/atelectasis

- Fibrosis

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6
Q

What 4 things should you consider on clinical examination?

A
  • Inspection
  • Palpatation
  • Percussion
  • Auscultation
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7
Q

What differentiates a tension pneumothorax from a simple?

A

Tension have mediastinal shift

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8
Q

What conditions cause a deviated trachea away from the pathology?

A
  • Tension pneumothorax

- Massive pleural effusion, or any mass effect

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9
Q

What conditions cause mediastinal shift towards the pathology?

A
  • Pneumonectomy / lobectomy

- Lobar collapse atelectasis

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10
Q

What is a pneumonectomy?

A

surgical removal of a lung or part of a lung.

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11
Q

What does blurring of the heart shadow indicate?

A

Opacification is in lingula

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12
Q

What 5 substances and subsequent conditions can cause consolidation?

A
  • Pus - pneumonia
  • Blood - pulmonary haemorrhage
  • Fluid - pulmonary oedema
  • Cells - lung cancer
  • Protein - alveolar proteinosis
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13
Q

What is an air bronchogram?

A
  • Large airways are spared so become visible (black) against a white background
  • Like branches of tree with snow
  • Pus blood or oedema fluid sit in alveoli
  • No loss of volume
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14
Q

What condition is there a loss of volume atelectasis or consolidation?

A

Atelectasis

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15
Q

What differentiates pleural effusion from pulmonary consolidation upon clinical examination?

A

Increased vocal resonance in consolidation decreased in pleural effusion.

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16
Q

What is atelectasis caused by?

A

When a main bronchus has been blocked

17
Q

What is the normal level of the horizontal fissure?

A

Anterior 4th rib

18
Q

What is atelectasis?

A

Reduction in inflation of all or part of the lung

19
Q

What would you see on an X-ray if an individual has an atelectasis?

A
  • Volume loss
  • Displacement of trachea
  • Displacement of diaphragm
  • Displacement of lung fissures
  • Compensatory over inflation of non collapsed lung
  • Crowding of vessels & bronchi
  • Loss of cardio mediastinal contour
  • “Veil like” opacification of left lung field
20
Q

What is seen on an x-ray with pleural effusion?

A
  • Trachea is pushed away
  • Uniformly white
  • Concave upper border (meniscus)
21
Q

What is pleural effusion?

A

Fluid collecting within the pleural cavity

22
Q

What does a large (50% of hemithorax), unilateral pleural effusion usually indicate?

A

Lung cancer

23
Q

What is the cause of an exudate pleural effusion?

A
  • Malignancy
  • Infection
  • Rheumatoid
24
Q

What is usually the cause of a transudate pleural effusion?

A

Congestive Heart Failure

25
Q

What does asbestos exposure look like on a CXR?

A
  • Can see pleura
  • Holly leaf?
  • Whispy calcified white
  • If malignant (mesothelioma)
    unilateral fluffy opacification
26
Q

What are the signs of acute pulmonary oedema from congestive heart failure on a CXR?

A
  • A: batwing shadowing - alveolar oedema coming out from the hilum
  • B: Kerley B lines - little straight lines perpendicular to the thorax interstitial septa
  • C: cardiomegaly
  • D: upper lobe diversion
  • E: pleural effusion - blunting of costophrenic angles
27
Q

What does sternal wiring indicate?

A

Sternotomy for cardiac surgery

28
Q

What can free gas under the diaphragm indicate?

A
  • Laperoscopy (from up to 2 weeks)
  • Post abdominal surgery (from up to 2 weeks)
  • Perforated abdominal viscus most likely
29
Q

What can a bright white structure in the trachea be?

A

Tracheostomy tube

30
Q

What can the hidden areas be?

A
  • Neck
  • Apices
  • Mediastinum
  • Behind the heart
  • Costophrenic angles
  • Behind / below diaphragm
  • Soft tissues
  • Bones
31
Q

What can bilateral hilar lymphadenopathy indicate?

A
  • Lymphoma (hodgkins)

- Sarcoid

32
Q

What can unilateral lymphadenopathy be?

A
  • TB

- Metastic spread

Pathology 3001 (15 decks)

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