Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Radiology > Chest > Flashcards

Chest Flashcards

1
Q

28-yo man with a 10 day history of mild cough and low fever. No significant PMH and otherwise healthy. No sputum production or hemoptysis. Chest exam is normal. Next best step in management?

A

Symptomatic management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In which patients should you order f/u imaging in pneumonia?

A

older, current/former smokers, recurrent pneumonias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Atypical pneumonias on CXR appear with which of the following characteristics?

A

1) B/L
2) Ground glass appearance
3) Kerley B Lines (septal lines- thickening of interlobular septa)
4) Relative sparing of bases and apices

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which imaging modalities can be used for radiographic diagnosis of pleural effusions?

A

CXR Right lateral decubitus
US
CT (for loculated and complex pleural collections)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which patients need preoperative CXR?

A

1) Patients with cardiorespiratory signs and symptoms

2) Patients over 65 with stable cardiorespiratory disease and no CXR for six months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Single pulmonary nodules management?

A

Comparison important to assess stability >2yrs

CT if suspicious for malignancy or many risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Single pulmonary nodule concerning characteristics

A

size: greater than 1cm or increasing in size
edge: lobulated, spiculated, ill-defined
pattern of calcifications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Single pulmonary nodule patient risk factors

A 
h/o lung disease 
>40 yrs
smoking history 
granulomatous disease
h/o malignancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Lung cancer screening?

A

low dose CT, current/former smokers or other high risk pts

f/u in-determinants with pet before bx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Best choice of imaging to evaluate for a subtle pneumothorax?

A

erect expiratory CXR (Increased lung density and decreased thoracic volume)
right lateral decubitus CXR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

CXR signs of a tension pneumothorax:

A
  • Mediastinal shift AWAY
  • Diaphragmatic depression on side of pneumothorax
  • Complete lung collapse typical
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Clinical signs of tension pneumothorax:

A
  • Hypoxia
  • Hypotension
  • Pulsus paradox
  • Hyper-resonance on side
  • Decreased respiratory excursions on side
  • Absent breath sounds on side of pneumothorax
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Management of tension pneumothorax:

A

IMMEDIATE temporary relief of by inserting a large-bore needle into the second left interspace in the mid-clavicular line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What pathophysiology correlated to the CXR finding: faint “veil-like” opacification of the middle 2/3 of the left hemithorax?

A

Atelectic left upper lobe that retracts anteriorly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What pathophysiology correlated to the PA CXR finding: Tracheal shift to the left, diaphragmatic elevation, and loss of the left heart border

A

Volume loss in the left hemithorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What pathophysiology correlated to the lateral CXR finding: Sharp edge with opacification over the anterior chest/heart

A

Left upper lobe collapses against the anterior chest wall

17
Q

Differential diagnosis of complete opacification of a hemithorax?

A 
complete lobe atelectasis (collapse) 
Hemi-pneumonectomy (look for clues: rib resections, clips, volume shift) 
large pleural effusion 
large mass 
large pneumonia
18
Q

What is a typical x-ray ‘trauma series’?

A

AP supine CXR
Lateral C-spine
AP supine pelvis

19
Q

Common radiographic findings seen in traumatic aortic injury (TAI)?

A

Widening mediastinum (>8cm)
Mediastinal deviation to the right
No ‘lateral aortic silhouette’
No aortic knob

20
Q

What is a typical CT ‘trauma series’?

A

CT w/o Head
CT C-spine
CT Chest/Abd/Pelvis with contrast

21
Q

Appropriate radiologic aorta evaluation?

A

CT with Contrast
Transesophageal echo (if contrast contraindicated)
MRI (time permitting, if contrast contraindicated)

22
Q

Recognition of a pneumothorax on supine CXR?

A

Deep Sulcus Sign- one costophrenic angle appears much ‘deeper’ and more lucent than the other

23
Q

Radiographic evaluation of chest tube placement?

A

anterior and apical for a pneumothorax

posterior and basal for a pleural effusion

24
Q

Radiographic evaluation of endotracheal tube placement?

A

3-5 cm above the carina

25
Q

Radiographic evaluation of enteric (NG) tube placement?

A

Feeding tube: third portion of the duodenum or duodenal-jejunal junction
Regular NG/OG: Stomach (confirmed by auscultation)

26
Q

Considerations for obtaining baseline CXR for patients with chronic dyspnea of suspected pulmonary origin?

A

age, lung cancer risk, suspicion for- pulmonary fibrosis, COPD, pneumonia, pleural effusion, pneumothorax.

27
Q

CXR signs of COPD?

A

CXR NOT sensitive or specific for COPD…but

  • hyperinflation
  • mediastinal narrowing
  • enlarging central pulmonary arteries
  • increase lucency (darkness)
28
Q

Confirmatory test for CXR suspicious for COPD?

A

Pulmonary function tests

FEV1/FVC 45% predicted (c/w severe obstruction)

29
Q

Imaging options for suspected aortic dissection?

A 
#1 Contrast enhanced CT angiogram of the entire aorta
#2 MRI (if stable) 
#3 Transesophageal echo
30
Q

BEST imaging test to confirm the diagnosis of pulmonary emboli?

A 
#1 CT angiography EXCEPT in patients with contraindications to intravenous contrast (allergy/renal)
#2 Nuclear medicine V/Q scanning
31
Q

Best ways of decreasing the renal toxicity of intravenous iodinated contrast media?

A

hydration before and after
N- acetylcysteine given 12 hours prior
Alkalinization of urine with sodium bicarb :/?

32
Q

CXR findings and radiographic features of pulmonary edema?

A 
Peribronchial cuffing 
Blurring of vascularity
Perihilar haze
Kerley B lines
Fluid in fissures
Alveolar consolidation
Pleural effusions
Cardiomegaly
33
Q

75 y/o male with acute onset of abdominal pain and lower back pain 30 min ago. Pulsatile, midline abdominal mass on exam. BP 140/90 and HR 105. Which imaging procedure would you order?

A

CTA Abdomen and Pelvis with Contrast

34
Q

Best f/u imagining for CXR demonstrating traumatic aortic injury (TAI)?

A

CTA with IV contrast
(or CTA w/o)
Trans-esophageal Echo

35
Q

PIC Line Placement

A

SVC-L Atrium junction

don’t want in the R atrium for fear of arrhythmia from SA node stimulation

36
Q

ET tube placement

A

2-3cm above the carina

37
Q

Swan-Ganz Catheter

A

measures pulmonary wedge pressure. Artery > LA > RV > pulmonary arteries

38
Q

Causes of pneumomediastinum

A

Trauma (knife, GSA)
Vomiting
Iatrogenic during intubation

39
Q

Radiologic findings of pneumomediastinum?

A

outlining of trachea
subcutaneous emphysema
air lines in neck

Radiology (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions