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CCP S2 > CCP 212 - Radiology > Flashcards

CCP 212 - Radiology Flashcards

1
Q

The 9 steps of CXR interpretation are:

A
  1. Patient identifiers/labels
  2. Previous imaging
  3. Type of film
  4. Adequacy (inspiration, penetration, and rotation)
  5. Tubes/toys
  6. Soft tissue
  7. Bone
  8. Mediastinum
  9. Lungs
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2
Q

ETT Height should be ‘x’ above carina?

A

5cm above carina.

This allows for head flexion & extension without “pushing” the tube into the R bronchus.

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3
Q

Deep sulcus sign indicates ___.

A

Pneumothorax.

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4
Q

T or F:

NG appears bigger than OG tube on CXR.

A

True.

NG tube has a radiopaque line that creates this illusion.

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5
Q

Silhouette sign is described as ___.

A

Blurring of the interface between structures on CXR.

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6
Q

What makes up the right heart border on CXR?

A

The RA.

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7
Q

What makes up the left heart border on CXR?

A

The LV AND LA. The LA only makes up 1/4 of the left heart border.

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8
Q

The cardiothoracic ratio (CR) is:

A

Maximum diameter of heart, compared to the maximum diameter of inner rib margin.

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9
Q

Cardiomegally suspected when the cardiothoracic ratio exceeds ___.

A

> 0.5 in PA.

> 0.6 in AP.

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10
Q

Language used to communicate increased pulmonary opacities:

A
  1. Focal airspace disease.
  2. Diffuse multi-focal airspace disease.
  3. Fine reticular patterns.
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11
Q

Silhouette sign is useful in determining:

ie. silhouette sign against right heart border

A

Affected lobes in lung disease.

ie. right middle lobe opacity

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12
Q

Air bronchograms can be described as:

A

A region of bronchiole that is surrounded by increased opacity, highlighting the air-filled bronchiole.

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13
Q

The 3 radiographic stages of CHF are:

A

Stage 1 = Cephalization (thickening of upper lung vascular markings relative to lower lung vasculature)

Stage 2 = Interstitial Pulmonary Edema (increased interstitial markings + pulmonary venous HTN)

Stage 3 = Airspace Pulmonary edema (air space filling with diffuse and patchy distribution; “bat wing”)

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14
Q

Non-central distribution patterns of pulmonary edema on CXR can usually be attributed to:

A

Non-cardiogenic causes of pulmonary edema (ie. negative pressure from choking/laryngospasm, ARDS, etc).

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15
Q

The two main indications for abdominal XR are:

A
  1. Perforation

2. Obstruction

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16
Q

Free air under the diaphragm indicates ____.

A

Perforation.

Air should always be contained within the bowel.

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17
Q

Free air in the abdomen post-surgery (from CO2 injection) may last for up to __ days.

A

10 days.

Free air should not be increasing over serial abdominal XRs.

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18
Q

Rigler’s sign is:

A

Visible bowel wall from air on both sides of the bowel wall.

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19
Q

Large bowel vs small bowel identification on XR:

A

Large bowel = Presence of haustra.

Small bowel = Presence of valvulae conniventes.

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20
Q

Haustra are:

A

Sac-like pockets that make up the large bowel. Mucous folds DO NOT cross the full width of the large bowel.

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21
Q

Valvulae conniventes are:

A

Mucousal folds of the small bowel. They cross the full width of the small bowel on abdominal XR.

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22
Q

Retroperitoneal free air can be caused by:

A

Perforation of an organ within the retroperitoneal space (ie. the ascending colon).

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23
Q

Air in the biliary tree is called:

A

Pneumobilia.

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24
Q

Pneumatosis intestinalis is:

A

Air in the bowel wall.

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25
Q

Presence of MULTIPLE air fluid levels usually indicates:

A

Complete bowel obstruction.

A partial obstruction should allow for passage of gas.

26
Q

A volvulus is:

A

Bowel twisting onto itself, causing obstruction.

27
Q

The “Free ABDO” acronym for abdominal XR interpretation stands for:

A 
Free air
Air
Bowel wall
Density
Organs
28
Q

The “ABCS” of cervical spine XR stand for:

A

Alignment
Bone
Cartilage
Soft tissue

29
Q

When assessing alignment on cervical spine XR, identify these four lines:

A
  1. Anterior vertebral line.
  2. Posterior vertebral line.
  3. Spinolaminar line.
  4. Posterior spinous line (curved).

Ensure these lines are SMOOTH and CONTINUOUS.

30
Q

Odontoid view is used for:

A

Visualization of C1 and C2.

31
Q

Spinal XR is generally only used by CCPs for:

A

Looking for abnormalities and displacement from C1 to T1.

32
Q

The “ABBCSS” of CT head stand for:

A 
Asymmetry
Blood
Brain
CSF
Skull
Scalp
33
Q

Subdural hematoma CT features:

A

Chronic subdural may appear black (clotted).

Acute subdural will appear white.

Subdural hematoma don’t cross midline.

34
Q

Epidural hematoma CT features:

A

Appears concave, because of the tight adherence of the dura to the skull.

35
Q

SAH CT features:

A

Diffuse blood across subarachnoid space. Appears as blood within the cisterns and sulci.

May blunt the appearance of the cerebral peduncles. May also present with obstructive hydrocephalus.

36
Q

IPH CT features:

A

Focal opacity in ‘x’ location of parenchyma.

37
Q

Loss of grey/white differentiation indicates:

A

Brain injury, primarily DAI.

38
Q

MRI functions by:

A

Realigning protons in the body, then allowing them to return to normal. The return to normal produces a deflection and image.

39
Q

True or false:

MRI uses radiation.

A

False. It is magnetic.

40
Q

FAST Algorithm:
If + & stable –> ?
If + & unstable –> ?

A

+ & stable –> CT

+ & unstable –> OR

41
Q

High frequency versus low frequency:

A

High = Higher quality, but less depth.

Low = Lower quality, deeper depth.

42
Q

Hypoechoic appearance on ultrasound.

A

Dark (doesn’t bounce back frequency).

43
Q

Hyperechoic appearance on U/S.

A

White (dense).

44
Q

Describe acoustic shadowing on U/S:

A

Acoustic shadowing occurs when a dense structure produces a shadow behind it.

45
Q

Describe acoustic enhancement on U/S:

A

Sound bounces between the proximal and distal walls of a cyst or fluid-filled space. Produces a brighter image on the distal wall of tissue.

46
Q

Describe reverberation artifact on U/S:

A

Production of false lines of hyperechoity from “shaking” of the ultrasound wave. Produces comet tails.

47
Q

Describe mirror image artifact on U/S:

A

A mirror image is reflected on the opposite side of a dense structure. This occurs in images that have air on the distal side of a dense structure (ie. bladder).

48
Q

Linear probe is best for assessing:

A

Shallow structures.

49
Q

Phased array or curvilinear probes are best for assessing:

A

Deeper structures (ie. IVC or organs).

50
Q

“Optimizing” an U/S image refers to:

A

Centring the image in the screen, and adjusting the gain.

51
Q

Explain what “Spine sign” is:

A

Being able to see the spine through a fluid-filled space. This is an abnormal finding when assessing the lung bases, because air will reflect reverberation, rather than producing spine imaging.

52
Q

What is “BART”?

A

“Blue away, red towards”. Mnemonic for doppler imaging.

53
Q

An ONSD of 5.5mm indicates an ICP of ___.

A

~15 mmHg

Use a ONSD of 6mm for BCEHS CCP purposes

54
Q

Measurement of the ONSD occurs where?

A

3mm behind the optic disk. This ensures the area is undistorted by the optic disk.

55
Q

Why do we use the ONSD as a surrogate for ICP?

A

It is the only area outside the cranium that is subject to the same pressure that ICP elicits. The ONS is continuous with the subarachnoid space.

56
Q

ONS contraindications :

A

1) Depressed skull fracture.
2) Globe trauma.
3) Hydrocephalus.

57
Q

IVC measurement occurs where?

A

~2cm caudal to the junction with the hepatic vein.

58
Q

True IVC measurement is validated when a patient meet the following criteria:

A

1) Paralyzed
2) PEEP of 5cmH2O
3) ???????

59
Q

IVC collapsibility index equation:

A

([IVC max - IVC min] / IVC mac) x 100

60
Q

Grading scales of SAH?

A

Hunt-Heiss, Fischer, WFNS.

CCP S2 (8 decks)

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