Chest

Question 1

what paraneoplastic syndrome do patients with thymic carcinoid often present with?

Answer 1

cushings

Question 2

what hereditary syndrome is thymic carcinoid associted with?

Answer 2

MEN 1

Question 3

where does a right sinus of valsalva aneurysm rupture into?

Answer 3

RV

Question 4

what is a satellite nodule?

Answer 4

tumor nodule in the same lung as the primary lung ca with the same histology

Question 5

what does air trapping look like on CT?

Answer 5

an area of hyperattenuation

Question 6

what does hilar and subcarinal LAD look like on a lateral CXR?

Answer 6

fillin in of the infrahilar window and LAD surrounds the bronchi resulting in a “donut” sign on lateral

Question 7

what is the most common manifestation of amiodarone toxicity in the lung

Answer 7

organizing pna

Question 8

what is the dependent viscera sign of diaphragmatic rupture?

Answer 8

abdominal organs like v close to the vertebral body and rib cage in the thorax

Question 9

what is the most common type of VSD?

Answer 9

membranous

Question 10

what is the westermark sign of PE on a CXR?

Answer 10

regional oligemia

Question 11

what is the fleishner sign of PE on a CXR?

Answer 11

dilation of central pulmonary arteries

Question 12

what is the most common location for bronchial atresia?

Answer 12

LUL apicoposterior segment

Question 13

what is the most common CT finding of small cell ca?

Answer 13

bulky mediastinal mass/infiltrative mass or mediastinal LAD

Question 14

what valve abnormality is mitral annular calcification most associated with? how does it appear on CXR?

Answer 14

mitral regurg. appear “j” or “c” shaped calcification

Question 15

what is empyema neccistans? what are the organisms that cause it?

Answer 15

empyema that breaks thru the chest wall with assoc osteo of the rib. BATMAN: blasto, actino, TB, mucor, aspergillus, nocardia

Question 16

what are the two most common organisms to cause bronchiolitis (tree in bus opacities)?

Answer 16

mycoplasma and mycobacteria

Question 17

what are the findings of DIP on CT?

Answer 17

hyperattenuating lung (due to pigment laden macropahges) and small cysts

Question 18

where is the defect in minimal aortic injury

Answer 18

intimal injury

Question 19

what is the diff on CT btw mediastinal hematoma and periaortic hematoma

Answer 19

fat plane btw is preserved in mediastinal hematoma, high density surrounds the aorta in periaortic hematoma

Question 20

what ribs do u NOT see notching within in coarctation? where do u see notching?

Answer 20

first and second ribs bc they are supplied by cervicothoracic trunk not internal mammary artery, see notching in 4th thru 8th ribs

Question 21

at what pressure do u treat aortic coarctation?

Answer 21

20 mmHg

Question 22

what percent of pts with aortic coarc have biscuspid aortic valve

Answer 22

40-50%

Question 23

what is aortic pseudocoarc

Answer 23

kinking of the aortic with no significant pressure gradient

Question 24

at what diameter do u intervene in asc aortic aneurysm due to degenerative causes vs heritable aortopathy?

Answer 24

5.5 cm, 5 cm

Question 25

how do u decrease pulsation artifact in the mid ascending aorta?

Answer 25

use prospective gating

Question 26

what scanning parameter do u change to decrease pulsation artifact in the mid ascending aorta?

Answer 26

use prospective gating

Question 27

what scanning parameter do u change to decrease pulsation artifact in the mid ascending aorta?

Answer 27

use prospective gating, increase z axis coverage (more rows on CT scanner), increase the pitch

Question 28

what is the most common cause of iatrogenic PA pseudoaneurysm

Answer 28

PA catheter placement

Question 29

what is the most common cause of iatrogenic PA pseudoaneurysm? what is the treatment for a PA pseudoaneurysm?

Answer 29

PA catheter placement. Rx: coil

Question 30

what is the time frame to classify a chronic PE

Answer 30

acute PE more than 3 months

Question 31

what forms the roof of the left main bronchus on the lateral CXR

Answer 31

the pulmonary artery

Question 32

what is the next best step in mgmt with malignant course of RCA that is symptomatic?

Answer 32

stress test

Question 33

what is more common, anomalous RCA or LCA?

Answer 33

RCA by 10:1

Question 34

what are the two most common assoc conditions with subaortic stenosis/membrane?

Answer 34

coarc and VSD

Question 35

what is the difference in an image that has misregistration artifact and one that does not? is it easier to edit in prospective or retrospective gating?

Answer 35

EKG editing corrects misregistration artifact, easier to edit in retrospective bc u have more beats u can "delete"

Question 36

what is blooming artifact?

Answer 36

in CT, dense objects appear larger than they really are

Question 37

what is blooming artifact? how do u correct for it?

Answer 37

in CT, dense objects (calcium)appear larger than they really are. cant correct for it

Question 38

what is windmill artifact? how do u know its windmill artifact?

Answer 38

it is low attenuation (black "wings") near a high density object (eg calcium) caused by interpolation process when high density object is oblique to the z axis. you can tell bc u dont see it on all parts of the cardiac cycle.

Question 39

what is a high stick in femoral puncture? what complication does it lead to?

Answer 39

high stick is above inguinal ligament and can lead retroperitoneal hematoma: due to to puncture of inferior epigastric or posterior wall of femoral artery

Question 40

what is a low stick in femoral puncture? what complications does it lead to?

Answer 40

below femoral head, can lead to AVF or pseudoaneurysm: where arteries are bifurcating and veins lie anterior to the arteries causing a fistula. PA results bc the catheters here are often larger than the arteries causing rupture of the vessel

Question 41

where is the optimal access site for a femoral/groin puncture?

Answer 41

at the mid femoral head, halfway btw inguinal ligament and the bifurcation of the superifical and profunda arteries

Question 42

are calcs seen in coal workers or silicosis?

Answer 42

silicosis

Question 43

is emphysema seen in silicosis/coal workers or sarcoid?

Answer 43

silicosis/coal workers

Question 44

what is the most common IIP seen with RA?

Answer 44

UIP

Question 45

what IIP is seen with scleroderma and polymyositis/dermato?

Answer 45

NSIP

Question 46

what IIP is seen in Sjogrens?

Answer 46

LIP

Question 47

what treatment is organizing pna responsive to?

Answer 47

steroids

Question 48

what is fibrothorax?

Answer 48

inflammatory pleuritis causing fusion of visceral and parietal pleura, often when there is empyema or hemothorax. see pleural calcs all around the lung and volume loss

Question 49

what is the most common evidence of metastatic disease to the pleura?

Answer 49

pleural effusion

Question 50

what are the signs of metastatic pleural disease on CT?

Answer 50

thick more than 1 cm, nodular pleural thickening, circumferential thickening, involvement of mediastinal surface

Question 51

what is the most common manifestation of metastatic disease to the pleura?

Answer 51

pleural effusion

Question 52

what are the 4 most common cancers to cause lymph carcinomatosis?

Answer 52

breast, colon, lung, stomach (adenoca)

Question 53

what is the percent of patients that get CT biopsy or aspiration of the lung?

Answer 53

25%

Question 54

what is the percent of patients that get CT biopsy or aspiration of the lung? when do u get CXR after lung biopsy

Answer 54

25%. get CXR at 1 and 3 hours.

Question 55

what is the percent of patients that get pnx after CT biopsy or aspiration of the lung? how long do u observe the patient and when do u get CXR after lung biopsy?

Answer 55

25%. observe for 3 hours and get CXR at 1 and 3 hours.