Chest I & II Flashcards by Jojo Barnes-Jones

Standard employment screening for tuberculosis for a 32 year old female revealed bilateral perihilar and right paratracheal radio densities that are consistent with lymphadenopathy. These findings are consistent with

A. corona radiata.

B. garland’s triad

C. rigler’s notch.

D. the snowman sign

E. the viking helmet sign

B. garland’s triad

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Standard employment screening for tuberculosis for a 32 year old female revealed bilateral perihilar and right paratracheal radiodensities consistent with lymphadenopathy and the bilateral lung fields demonstrating These findings are suggestive of

A. Stage 1 Tuberculosis

B. Stage 2 Tuberculosis

C. Stage 1 Sarcoidosis

D. Stage 2 Sarcoidosis

E. Stage 3 Sarcoidosis

C. Stage 1 Sarcoidosis

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Patients with Sarcoidosis uniquely complain of

A. productive cough.

B. hemoptysis.

C. exertional dyspnea.

D. bradycardia.

E. dysphagia.

C. exertional dyspnea.

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Eggshell calcification is most likely associated with sarcoidosis and

A. asbestos .

B. talcosis.

C. stannosis.

D. silicosis.

E. mesothelioma

Marchiori, pg. 1215, Table 12f.

Clinical Imaging: Skeletal, Chest, and Abdominal Differentiation

D. silicosis

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A 20 year old male presented with sharp chest pain. No other pertinent clinical history was provided. Radiographs revealed a decrease in peripheral lung marking displacement (often referred to as the visceroparietal line). What is the likely diagnosis?

A. Resorptive Atelectasis

B. Hydropneumothorax

C. Fribothorax

D. Pneumothorax

E. Poland’s syndrome (Hansel, pg. 1063)

D. Pneumothorax

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Rib approximation, ipsilateral diaphragm elevation and mediastinal shifting in a neonate are findings associated with the radiographic appearance of

A. pulmonary agenesis.

B. pneumothoraces.

C. a unilateral hyperlucent lung.

D. a bell shaped thorax.

E. pulmonary aplasia.

(Hansel, 1102)

E. pulmonary aplasia.

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A 13 month old male patient has a history of upper respiratory infections. A chest radiograph demonstrates a triangular opacity superimposing the lower lobe of the left lung with sparing of the cardiac silhouette. Additional findings include ipsilateral hemidiaphragm elevation and the absence of an air bronchogram sign. The most likely represents a diagnosis of

A. Pulmonary agenesis.

B. Hypogenetic lung syndome.

C. Extralobular pulmonary sequestration.

D. Intralobular pulmonary sequestration.

E. Infection.

(Hansel, 2219)

C. Extralobular pulmonary sequestration.

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The most common etiology of extrapulmonary sequestration is

A. acquired.

B. congenital.

C. infectious.

D. venous congestion

E. pulmonary arterial hypertension

(Hansel, pg. 1119)

B. congenital.

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The left pulmonary artery arising from the right pulmonary artery and passing above the right main bronchus between the trachea and esophagus is anomalous. This presentation can be concerning for a sequelae of

A. sinus inversis.

B. aberrant right pulmonary arteritis.

C. infection.

D. pulmonary sling.

E. tracheal stenosis.

Fraser and Pare, 638)

E. tracheal stenosis.

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The most common cause of community acquired bacterial pneumonia is

A. Staph Aureus infection.

B. Streptococcus pneumonia

C. Klebsiella infection.

D. Mycobacterial infection.

E. Candida infection.

(Hansel, pg. 190)

B. Streptococcus pneumonia

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Homogeneous consolidation bounded by fissures is characteristic with which pattern of lung disease?

A. Alveolar pneumonia

B. Lobar pneumonia

C. Spherical pneumonia

D. Interstitial pneumonia

E. Necrotizing pneumonia

(Hansel, pg. 190)

B. Lobar pneumonia

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The essential radiographic feature of pneumonia is pulmonary consolidation, which may show cavitation and may be accompanied by pleural effusion. In complications associated with pneumonia, what modality is recommended for the further evaluation and characterization of the lesion(s)?

A. MRI

B. Doppler Ultrasound

C. PET

D. DEXA

E. CT

(Hansel, pg. 205)

E. CT

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A 45 year old immigrant presents with hemoptysis. Chest radiographs were taken and revealed moderate upper lobe fibrosis and cavitation. TB skin test elicited positive findings. The most likely diagnosis is

A. Primary TB

B. Post-primary TB

C. Klebsiella

D. Sarcoidosis

E. Progressive Massive Fibrosis

(Hansel, 213-15)

B. Post-primary TB

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The absence of a border on chest imaging is commonly known as

A. a negative silhouette sign.

B. a congenital variant

C. congenital lobar overinflation.

D. a positive silhouette sign.

E. a heterogenous density increase.

(Goodman, pg. 98)

D. a positive silhouette sign.

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A localized collection of air located within the pleura that develops most often over the lung apices with walls that are less than 1mm in thickness are characteristic of

A. a bulla.

B. a pulmonary cyst.

C. a bleb.

D. a pneumatocoele.

E. a dilated bronchus.

(Hansel, pg. 187)

C. a bleb

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The etiological cause of pneumatocele formation is most commonly due to

A. Staph Aureus pneumonia.

B. Streptococcus pneumonia.

C. Klebsiella pneumonia.

D. Mycobacterial pneumonia.

E. Candida infection.

(Hansel, pg. 187)

A. Staph Aureus pneumonia.

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A 60 year old veteran with history of breast cancer had a procedural follow-up chest study. The patient is having some mid back discomfort. The images revealed a right axillary surgical artifact and a vertically oriented structure similar in density to adjacent bone within the left thorax. This incidental finding is suggestive of a supernumerary intrathoracic rib, intercostal synostosis, hilar or mediastinal mass. As the radiologist, the recommendation course of action is to

A. order a magnetic resonance study for further evaluation computed

B. order a computed tomography study for further evaluation.

C. order a dual energy x-ray absorptiometry study for further evaluation

D. order a repeat chest series following conservative treatment.

E. order an ultrasound for further evaluation.

B. order a computed tomography study for further evaluation.

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Pulmonary gangrene is a rare but recognized phenomenon associated with lung cavitation and is most commonly seen with

A. Staph Aureus infection.

B. Streptococcus pneumonia

C. Klebsiella infection.

D. Mycobacterial infection.

E. Candida infection.

(Hansel, pg. 190)

C. Klebsiella infection.

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Primary and reactivation tuberculosis may extend to extrathoracic sites, which of the following locations has an increased incidence of visible active pulmonary tuberculosis?

A. Kidneys

B. Joints

C. Genitourinary system

D. Gastrointestinal tract

E. Larynx

(Fraser, ——)

E. Larynx

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Radiographic examination of an otherwise healthy 45 year old male demonstratea a mulberry calcification pattern. This clinical and radiographic evidence is concerning for the most common systemic fungal infection, referred to as

A. Blastomycosis

B. Aspergillosis

C. Coccidiomycosis

D. Pseudomonas

E. Histoplasmosis

(Hansel, pg. 222)

E. Histoplasmosis

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A rounded soft tissue mass within a pre-existing cavity in the right superior lung segment is very suggestive of

A. a fungal cavity

B. a mycetoma

C. a hydatid cyst

D. a coin lesion

E. a tuberculoma

(Hansel, pg. 244)

B. a mycetoma

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A PA chest study of a 58 year old female that presented with cough and a shortness of breath demonstrated superior migration of the horizontal fissure with an associated increase in density of the right upper lobe. Tracheal deviation towards the density increase and ipsilateral elevation of the diaphragm was also seen. The patient has a 20-year pack history. These findings most like represent a case of

A. bronchogenic carcinoma.

B. adenocarcinoma.

C. mycetoma.

D. aspiration pneumonia.

E. tuberculosis.

(Marchiori , 1187)

A. bronchogenic carcinoma. *adenocarcinoma*….

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Bronchogenic carcinomas are most likely classified as

A. squamous cell

B. fast growing

C. small cell

D. benign

E. slow growing

(Marchiori, pg. 1189)

A. squamous cell

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Further evaluation of densities in the the lung apices are best seen on a(n)

A. lateral decubitus view

B. lateral chest film

C. apical lordotic view

D. full expiration study

E. lateral thoracic view

C. apical lordotic view

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Myastenia gravis is associated with which of the following anterior mediastinal masses:

A. Thymic neuroendocrine neoplasm

B. Thymolipoma

C. Thymoma

D. Thymic cyst

C. Thymoma

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What is the most common lethal, genetically transmitted airway disease among caucasians?

A. Dyskinetic cilia syndrome

B. Mucoviscidosis

C. Alveolar microlithiasis

D. Riley-Day syndrome

B. Mucoviscidosis

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A thin linear opacity seen perpendicular to, and adjacent to, the pleura in the lower lung fields caused by localized hypoventilation, most likely represents…

A. Kerley B lines

B. Discoid atelectasis

C. Linear pneumonia secondary to Klebsiella infection

D. Bronchectasis

B. Discoid atelectasis

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It is present in 75% of normal individuals. It is not visible on 44% of normal chest films. It can be seen on frontal and lateral projections if it is visible. This fissue is…

A. The minor fissure

B. The major fissure

C. The inferior accessory fissure

D. The superior accessory fissure

A. The minor fissure

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Hyaline membrane disease of the newborn is associated with which type of atelectasis?

A. Passive atelectasis

B. Cicatrization atelectasis

C. Adhesive atelectasis

D. Resorptive atelectasis

C. Adhesive atelectasis

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The majority of pharyngeal primary malignancies are of which type?

A. squamous cell carcinoma

B. adenocarcinoma

C. fibrosarcoma

D. lymphoma

A. squamous cell carcinoma

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A chest roentgenogram reveals an hyperlucent lung mildly reduced in size compared to the normal contralateral side. The affected side demonstrates an absent hilum. This condition is though to be due to:

A. Viral infection

B. Blunt trauma

C. Pulmonary artery agenesis

D. Diaphragmatic paralysis

C. Pulmonary artery agenesis

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Following severe automobile accidents, 95% of all aortic ruptures occur where?

A. isthmus, at the site of the ligamentous arteriosum B. Ascending aorta

C. Descending aorta

D. Distal aortic arch

A. isthmus, at the site of the ligamentous arteriosum

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Which of the following bronchogenic carcinomas is characterized by early metastasis and ectopic hormone production, notably adrenocorticotropic hormone, antidiuretic hormone, and melanocyte stimulating hormone?

A. Squamous cell (epidermoid) carcinoma

B. Adenocarcinoma

C. Small (oat) cell carcinoma

D. Large cell carcinoma

C. Small (oat) cell carcinoma

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Fleischner lines refers to what type of atelectasis?

A. Adhesive

B. Obstructive

C. Cicatrical

D. Discoid

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Which of the following is an example of a lung disease caused by the inhalation of noxious gases and vapors?

A. Silo filler disease

B. Farmer’s lung

C. Bird fancier’s lung

D. Kaolin lung

A. Silo filler disease

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Plain film radiographs of the chest for a 45 year old patient reveals a peripherally located, 2.5cm well-circumscribed, homogenous nodule that demonstrates “popcorn” calcifications. What is the most likely diagnosis?

A. Adenocarcinoma

B. Hamartoma

C. Teratoma

D. Bronchogenic cyst

B. Hamartoma

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A cyanotic patient reveals a barrel chest, shallow breathing, a long vertical heart with a widened retrosternal space and flattened hemidiaphragms. What is your diagnosis?

A. Bronchiolitis

B. Varicose bronchiectasis

C. Dyspneic pulmonary type emphysema (pink puffer)

D. Normopneic-bronchial type emphysema (blue bloater)

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A lesion that obliterates the right border of the ascending aorta (silhouette sign) cannot be situated in which of the following?

A. Anterior segment of the RUL

B. RML

C. Superior segment of the lower lobe

D. Anterior mediastinum

C. Superior segment of the lower lobe

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What is the most common form of diaphragmatic hernia in infants?

A. Hiatal hernia

B. Bochdalek hernia

C. Morgagni hernia

D. Paraesophageal hernia

B. Bochdalek hernia

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Round atelectasis is characteristicaly associated with which pneumoconiosis?

A. Silicosis

B. Asbestosis

C. Talcosis

D. Stannosis

B. Asbestosis

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Which type of bronchogenic carcinoma demonstrates a female predilection?

A. Small cell carcinoma

B. Large cell Carcinoma

C. Adenocarcinoma

D. Squamous cell carcinoma

C. Adenocarcinoma

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The “sign of the camalote” is seen in…

A. Tuberculosis

B. Pulmonary edema

C. Pulmonary echinococcal cyst

D. Septic pulmonary emboli

C. Pulmonary echinococcal cyst

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The majority of cases of cavitary carcinoma are of which cell type?

A. Squamous cell carcinoma

B. Large cell carcinoma

C. Small cell carcinoma

D. Adenocarcinoma

A. Squamous cell carcinoma

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The “pulmonary sling” anomaly, where an anomalous artery passes between the trachea and esophagus, is seen with?

A. Aberrant left pulmonary artery

B. Aberrant right pulmonary artery

C. Double aortic arch

D. Anomalous origin of the right subclavian artery

A. Aberrant left pulmonary artery

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Lobar collapse caused by cardiac enlargement results from compression of a lobar bronchus by an enlarged left atrium or left pulmonary artery. It most commonly involves which lobe?

A. LLL

B. Lingula

C. RLL

D. LUL

A. LLL

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Conventional radiographs of the chest in a 40 year old african american female demonstrates bilateral and symmetrical hilar lymphadenopathy with associated right paratracheal adenopathy. No parenchyma involvment is observed. The patient is Kveim test positive. Which of the following is the appropriate diagnosis?

A. Stage 1 sarcoidosis

B. Silicosis

C. Stage Il sarcoidosis

D. Lymphoma

A. Stage 1 sarcoidosis

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Ultrasound examination of the chest may be helpful delineating all of the following lesions except…

A. Pleural effusion

B. A central parenchymal lung lesion

C. Subphrenic cysts

D. Diaphragmatic rupture

B. A central parenchymal lung lesion

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The most common cause of chronic cor pulmonale is…

A. Pulmonary artery disease

B. Kyphoscoliosis

C. Tuberculosis

D. Pulmonary emphysema

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The most common sign of bronchogenic carcinoma is…?

A. Post-stenotic localized over-inflation

B. Reflex oligemia

C. Partial or complete atelectasis

D. Bronchial stenosis

C. Partial or complete atelectasis

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What is the most direct and reliable roentgen sign of lobar collapse?

A. Loss of aeration

B. Displaced septa

C. Unilateral elevation of the diaphragm

D. Deviation of the trachea

B. Displaced septa

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The most commonly associated abnormality seen in 85% of patients with coartation of the aorta is…

A. Patent ductus arteriosus

B. Ventricular septal defect

C. Bicuspid aortic valve

D. Atrial septal defect

C. Bicuspid aortic valve

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A Rasmussen aneurysm is associated with which type of infection?

A. Strep pneumonia

B. Cytomegalovirus

C. Tuberculosis

D. HSV

C. Tuberculosis

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Which of the following characteristics does not relate to the “extrapleural” sign?

A. Tapered margins

B. Acinar shadow near the density with ill-defined borders

C. The base is wider than the height

D. The lesion has a sharp convex contour facing the lung field

B. Acinar shadow near the density with ill-defined borders

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Air bronchograms are NOT seen in which of the following types of atelectasis?

A. Resorptive

B. Passive

C. Cicatrical

D. Adhesive

A. Resorptive

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What is the commonest cause of bronchopneumonia?

A. Staphylococcus aureus

B. Streptococcus pneumoniae

C. Streptococcus pyogenes

D. Escherichia coli

A. Staphylococcus aureus

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The combination of a primary parenchymal nodule (Ghon focus) and regional lymph node calcification on plain film radiographs in a patient wih primary tuberculosis is known as:

A. Ranke complex.

B. Aschoff-Puhl focus.

C. Assamnn-Redeker-Simon complex.

D. Simon focus.

A. Ranke complex.

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Which of the following causes of inferior rib notching has a bilateral presentation?

A. Subclavian artery obstruction

B. Coactation of the aorta

C. Tetralogy of fallot

D. Superior caval obstruction

B. Coactation of the aorta

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Which of the following findings is not typical of alveolar (air-space) consolidation?

A. Air bronchograms

B. Increased opacity

C. Kerley B lines

D. Air alveolograms

C. Kerley B lines

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A screening chest roentgenogram on a 40 year old patient demonstrates a solitary, round, sharply circumscribed, homogenous radiodensity in the medial third of the right lower lobe. There is no calcification or air-fluid levels observed. Previous films form ten years ago on the same patient reveal no gross change from the present images. Which of the following is the most likely diagnosis?

A. Congenital bronchial cyst

B. Pneumatocele

C. Congenital lobar emphysema

D. Cavitated tuberculoma

A. Congenital bronchial cyst

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Lobar expansion is characteristic of which of the following types of pneumonia before the modern antibiotic era?

A. Freidlander’s pneumonia

B. Bronchopneumonia

C. Staph aureus pneumonia

D. Tularemic pneumonia

A. Freidlander’s pneumonia (aka Klebsiella)

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Which of the following organisms is the most common cause of community-acquired pneumonia in developed countries?

A. Klebsiella

B. Haemophilus influenzae

C. Streptococcus pneumoniae

D. Mycoplasma pneumoniae

C. Streptococcus pneumoniae

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Which is the most common bronchogenic carcinoma cell type to cause superior vena cava syndrome?

A. Squamous cell carcinoma

B. Small cell carcinoma

C. Adenocarcinoma

D. Undifferentiated large-cell carcinoma

B. Small cell carcinoma

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The most common form of pulmonary calcification is:

A. Healed primary granuloma

B. Hamartoma

C. Primary carcinoma

D. Solitary metastatic focus

A. Healed primary granuloma

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Regarding congenital diaphragmatic hernias, which of the following is true?

A. The underlying compressed lung is normal in development

B. There usually is no herniating material from the abdomen into the thoracic cavity

C. Usually occurs on the left through the foramen of Bochdaleck

D. Will rarely result in mediastinal shift

C. Usually occurs on the left through the foramen of Bochdaleck

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The combination of air within the stomach and a blind proximal esophageal pouch is seen with…

A. Trapheoesophageal fistula

B. Hypertrophyc pyloric stenosis

C. Duodenal atresia

D. Down’s syndrome

A. Trapheoesophageal fistula

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Chemical analysis of post-traumatic pleural effusion demonstrates chylomicrons (chylous material) within the fluid. What is the most likely etiology of the fluid?

A. Rupture of the thoracic duct

B. A ruptured intercostal artery

C. From a tracheoesophageal fistula

D. From a fistula with the subarachnoid space

A. Rupture of the thoracic duct

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Moniliasis is cause by which infectious agent?

A. Toxoplama gondii

B. Sporotrichum schenckii

C. Candida albicans

D. Aspergillus fumigatus

C. Candida albicans

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“Ring-around-the-artery” sign is associated with…?

A. Broncholithiasis

B. Near-drowning

C. Hamman-Rich syndrome

D. Pneumomediastinum

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Patients presenting with situs inversus, paranasal sinusitis and bronchiectasis have radiographic characteristics in the chest that are similar to the radiographic findings in:

A. Cystic fibrosis

B. Bronchiolitis obliterans

C. Loffler’s syndrome

D. Congenital lobar emphysema

A. Cystic fibrosis

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Which of the following is a transient cause of Kerley’s lines?

A. Lymphangitic metastases

B. Pneumoconiosis

C. Rheumatic mitral valve disease

D. Pulmonary edema

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Conventional radiographs of a 50 year old male quarry worker reveal multiple, 5-10mm, homogenous, well-defined nodules of the upper lung zones producing a “snowstorm” appearance. There is hilar lymphadenopathy with associated peripheral, “eggshell” calcifications. Which of the following is the most likely diagnosis.

A. Silicosis

B. Sarcoidosis

C. Post-primary tuberculosis

D. Berylliosis

A. Silicosis

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What is the single most useful roentgenographic sign of infarction? It is usually most evident during the first 24 hours following embolism.

A. Elevation of the hemidiaphragm

B. Oligemia

C. Increased size of the feeding artery

D. Abrupt tapering of the feeding artery

A. Elevation of the hemidiaphragm

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What is the most common cause of a middle mediastinal mass?

A. Enteric cyst

B. Aneurysm

C. Lymphadenopathy

D. Hiatal hernia

C. Lymphadenopathy

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The “string of cysts” pattern is a classic CT sign seen with…

A. Chronic bronchitis

B. Swyer-James syndrome

C. Varicose bronchiectasis

D. Asthma

C. Varicose bronchiectasis

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What is the most common cause of life-threatening infection in AIDS?

A. Pseudomonas

B. Aspergillus fumigatus

C. Pneumocystis carnii

D. Nocardia

C. Pneumocystis carnii

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Conventional radiography of the chest in a patient with post-primary tuberculosis demonstrates a round, homogenous, mobile opacity within an apical cavitary lesion. This opacity is further characterized by the the presence of an “air crescent” sign. No calcifications of the opacity are noted. Which condition below best fits the description of the opacity.

A. Toruloma

B. Mycetoma

C. Ranke Complex

D. Simon Foci

B. Mycetoma

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Which of the following statements is not true in regard to Friedlander’s pneumonia?

A. The bacteria involved is Klebsiella pneumoniae

B. The bacteria involved is mycoplasma pneumoniae C. Bulging of the interlobar fissure may be seen

D. Frequently occurs in debilitated patients or alcoholics

B. The bacteria involved is mycoplasma pneumoniae

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Westermark’s sign, associated with thromboembolism without infarction, describes:

A. Increased heart size

B. Local oligemia

C. Decrease in vessel size

D. Decreased lung volume

B. Local oligemia

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Which of the following statements adequately differentiates intralobar and extralobar sequestrations?

A. Intralobar types have systemic arterial supply and systemic venous return, while extralobar type have systemic arterial supply and pulmonary venous return.

B. Extralobar types have systemic arterial supply and systemic venous return, while intralobar type have systemic arterial supply and pulmonary venous return.

C. Extralobar types have systemic arterial supply and systemic venous return, while intralobar types have pulmonary arterial supply and systemic venous return.

D. Intralobar types have systemic arterial supply and systemic venous return, while extralobal types have pulmonary arterial supply and systemic venous return.

B. Extralobar types have systemic arterial supply and systemic venous return, while intralobar type have systemic arterial supply and pulmonary venous return.

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Which of the following etiologies is most probably responsible for epiglottitis and tracheitis in a child under the age of three?

A. Hemophilus influenzae

B. S. pneumonia

C. S. aureus

D. Klebsiella pneumonia

A. Hemophilus influenzae

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A 25 year old female presents with dyspnea. The left hemithorax is hyperlucent and lacks bronchovascular markings. The heart and mediastinum are shifted to the right. The ribs are flared and the left hemidiaphragm is depressed. This most likely represents:

A. Tension pneumothorax

B. Hydrothorax

C. Swyer-James syndrome

D. Congenital lobar emphysema

A. Tension pneumothorax

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Which of the following is a postcapillary cause of pulmonary hypertension?

A. Left ventricular failure

B. Emphysema

C. Pulmonary emboli

D. Diffuse interstitial disease

A. Left ventricular failure

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Due to the high diagnostic value of bronchoscopy and CT, bronchography is not performed as often as before. For which of these conditions was bronchography the exam of choice?

A. Pulmonary sequestration

B. Right middle lobe atelectasis

C. Foreign body aspiration

D. Bronchiectasis

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The term “potatoe nodes” refers to the characteristic pattern of lymphadenopathy seen with:

A. Tuberculosis

B. Sarcoidosis

C. Hodgkin’s lymphoma

D. Histoplasmosis

B. Sarcoidosis

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The most common cause of pulmonary edema is:

A. Left-sided heart failure

B. Traumatic fat embolism

C. Decreased capillary oncotic pressure

D. Congenital venous stasis

A. Left-sided heart failure

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What is the most common bronchopulmonary malformation?

A. Congenital bronchial atresia

B. Bronchogenic cyst

C. Bronchopulmonary sequestration

D. Pulmonary hypoplasia

B. Bronchogenic cyst

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In the majority of cases, intrathoracic calcification is of which type?

A. Metastatic

B. Dystrophic

C. Psammomatous

D. Local parenchymal ossification

B. Dystrophic

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Although a family history may suggest the diagnosis, demonstration of elevated levels of sodium and chloride in sweat confirms which of the following diagnoses?

A. Agammablobulinemia

B. Wiskott-Aldrich syndrome

C. Cystic fibrosis

D. Ivemark’s syndrome

C. Cystic fibrosis

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With increasing loss of volume of the left upper lobe, the upper margin of the aortic knob once again becomes visible because the superior segment of the lower lobe takes the place of the posterior segment of the upper lobe. The radiogrphic sign associated with this phenomenon is known as:

A. Aortic nipple sign

B. Clear space sign

C. Luftsichel sign

D. Löfflers sign

C. Luftsichel sign

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An opacity that obliterates (silhouettes) the left border of the aortic knob (descending portion) lies in the:

A. Apicoposterior segment of the LUL

B. Superior segment of the LLL

C. Anterior segment of the LUL

D. Anterior medistinum

A. Apicoposterior segment of the LUL

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The most common cause of exudative pleural effusion is:

A. Thromboembolism

B. Malignant neoplasm

C. Trauma

D. Connective tissue disease

B. Malignant neoplasm

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A patient presents with the following clinical findings: Tall and slender, chronic patellar and hip dislocations, occular problems and a positive “thumb” sign. X-rays demonstrate arachnodactyly and tall vertebrae with posterior scalloping. If this patient were to develop an aneurysm, it would most likely occur…

A. Descending thoracic aorta

B. Ascending thoracic aorta

C. Left subclavian artery

D. Abdominal aorta

B. Ascending thoracic aorta

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What is the most common cause of pleural effusion due to extrathoracic disease?

A. Pancreatitis

B. Nephrotic syndrome

C. Meigs-Salmon syndrome

D. Cirrhosis

A. Pancreatitis

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The “signet ring” sign is a classic CT sign seen with…?

A. ABPA

B. Cylindrical bronchiectasis

C. Cystic bronchiectasis

D. Varicose bronchiectasis

B. Cylindrical bronchiectasis

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Pneumomediastinum secondary to transmural esophageal rupture from forceful vomitting is seen in:

A. Mallory-Weiss syndrome

B. Plummer-Vinson syndrome

C. Achalasia

D. Boerhaave’s syndrome

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A 25 year old male is involved in a severe accident shattering his femur. Three days later in the hospital, he develops a severe air-space consolidative pattern that is peripheral in nature. The heart size is normal. The most likely cause is…

A. Cardiogenic pulmonary edema

B. Staphylococcal pneumonia

C. Idiopathic vasculitis

D. Fat embolism

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The roentgenologic signs of______include the classic triad of overinflation, oligemia, and bullae.

A. emphysema

B. pneumothorax

C. atelectasis

D. pneumatocele

A. emphysema

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Which of the following signs is not included in the clinical triad of Pancoast syndrome?

A. Horner’s syndrome

B. Ipsilateral arm pain

C. Hematemesis

D. Wasting of the muscles of the hand

C. Hematemesis

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Which of the following diagnoses should be considered in a 75 year old patient whose radiographs demonstrate a rapidly progressing consolidative pattern that involves the upper lobes bilaterally, and results in an increased lung volume and early cavitation.

A. Pneumococcal pneumonia

B. Aspiration pneumonia

C. Legionnaires’ disease

D. Friedlander’s (Klebsiella) pneumonia

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The unchecked enzymatic destruction of the elastic and collagen framework of the lung results in which of the following diseases:

A. Chronic bronchitis

B. Emphysema

C. Bronchogenic carcinoma

D. Asthma

B. Emphysema

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Asbestosis can cause all of the following pleural changes except…

A. Vanishing tumor

B. Pleural plaques

C. Shaggy heart border

D. III-defined diaphragmatic border

A. Vanishing tumor

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A consolidation pattern within the lung fields demonstrating bulging of the fissures may be associated with which of the following infectious agents?

A. Toxoplasma gondii

B. Klebsiella pneumoniae

C. Haemophilus influenzae

D. Bacillus anthracis

B. Klebsiella pneumoniae

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The most common benign tumor of the diaphragm is?

A. Lipoma

B. Angioma

C. Angiofibroma

D. Chondroma

A. Lipoma

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Which of the following conditions is responsible for multiple opacities (0.5-2 mm) on radiographs that are greater than soft tissue density?

A. Fibrosing alveolitis

B. Acute extrinsic allergic alveolitis

C. Coal miner’s pneumoconiosis

D. Hemosiderosis

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A conglomeration of intertwined fungal hyphae matted together with fibrin, mucus and cellular debris, within a pulmonary cavity defines:

A. Pulmonary abcess

B. Pulmonary mycetoma

C. Alveolar cell carcinoma

D. Pulmonary blastoma

B. Pulmonary mycetoma

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Pleural effusion associated with which of the following disorders is most commonly found in male patients?

A. SLE

B. Sarcoidosis

C. Dermatomyositis

D. Rheumatoid arthritis

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Approximately what percentage of patients with sarcoidosis will eventually progress to stage 4?

A. 5-20

B. 30-40

C. 45-60

D. 80-90

A. 5-20

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Magnesium silicate may sometimes be demonstrated in the sputum of which of the following lung disorders?

A. Adenocarcinoma

B. Asbestosis

C. Embolism without infarction

D. Rickettsial pneumonias

B. Asbestosis

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Which of the following may be associated with pleural calcification?

A. Sarcoidosis

B. Aspergillosis

C. Collagen vascular disease

D. Healed hemothorax

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Immunoreactive ACTH is commonly present in the serum of patients with_____ causing a small percentage of these patients to develop Cushing’s syndrome.

A. Small cell carcinoma

B. Squamous cell carcinoma

C. Large cell carcinoma

D. Adenocarcinoma

A. Small cell carcinoma

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A complete or incomplete fissure seen on a PA projection of the chest at the right medial base of the lung field, beginning at the diaphragm and extending upward to the hilum probably represents which of the following?

A. Azygous fissure

B. Accessory dorsal fissure

C. Inferior accessory fissure

D. Posterior accessory fissure

C. Inferior accessory fissure

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Post-primary (re-activation) tuberculosis most commonly involves the:

A. basal segments of the lower lobes.

B. right middle lobe and lingula.

C. apical and posterior segments of the upper lobes. D. entire right lung field.

C. apical and posterior segments of the upper lobes.

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Which of the following would be the expected scintigraphic findings in an area of pulmonary infarction?

A. Normal perfusion and ventialtion scan

B. Wedge-shaped perfusion defect with wedge-shaped ventilation defect

C. Normal perfusion scan and wedge-shaped ventilation defect

D. Wedge-shaped perfusion defect and normal ventilation scan

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Golden’s reverse S-shaped surve represents a sign of…

A. Pleural effusion and parenchymal disease

B. Apical pleural capping from normal aging

C. Localized honeycombing of the lungs adjacent to the hilar region

D. Right upper lobe collapse and mediastinal/parenchymal tum

Which of the following radiographic signs represents circumferential interstitial spread with regards to bronchogenic carcinoma?

A. Pleural tail

B. Riggler’s notch

C. Corona radiata

D. Fissural tail

C. Corona radiata

Scimitar syndrome is associated with which congenital malformation of the lungs?

A. Congenital arteriovenous fistula

B. Hypogenetic lung syndrome

C. Anomalous pulmonary venous return

D. Coarctation of the aorta

B. Hypogenetic lung syndrome

Pulmonary collapse in the presence of a space-occupying intrathoracic process such as hydrothorax describes:

A. Passive atelectasis

B. Cicatrixation atelectasis

C. Adhesive atelectasis

D. Resorption atelectasis

A. Passive atelectasis

Localized air-space disease may be caused by:

A. Acute respiratory distress syndrome

B. Goodpasture’s syndrome

C. Pulmonary infarction

D. Hematogenous metastases

C. Pulmonary infarction

Which of the following is not an adequate indication for a lateral decubitus chest examination?

A. Air trapping

B. Cavity assessment

C. Pleural effusion

D. Vascular assessment

Which of the following stages of sarcoidosis is characterized by diffuse pulmonary disease without the presence of lymph node enlargment?

A. Stage l

B. Stage II

C. Stage III

D. Stage IV

C. Stage III

Which of the following syndrome is responsible for a unilateral lucent lung caused by unilateral congenital absence of pectoral muscles with or without rib defects?

A. Macleod’s syndrome

B. Swyer-James syndrome

C. Wilson-Mikity syndrome

D. Poland’s syndrome

Ninety percent of extralobar pulmonary sequestrations are found in the:

A. Apical posterior segment of the left upper lobe

B. Superior segment of the left lower lobe

C. Medial segment of the right middle lobe

D. Posterobasal segment of the left lower lobe

The gaseous radiopharmaceutical most widely used for studying the pulmonary perfusion is…

A. Xenon-133

B. Technicium-99

C. Thallium-201

D. Iodine-131

A. Xenon-133

The radiographic hallmark of airspace edema is:

A. Perihilar haze

B. Perivascular cuffing

C. Septal lines

D. Acinar shadow

A right sided aortic arch is seen in 25% of patients suffering from …

A. Tricuspid atresia with pulmonary stenosis

B. Complete transposition of the great vessels

C. Total anomalous pulmonary venous return

D. Tetralogy of fallot

The invaluable technique used to identify small pleural effusions is…

A. Apical lordotic projection

B. Lateral decubitus position

C. Lateral position

D. Posteroanterior position

B. Lateral decubitus position

Honeycombing is a roentgen sign of:

A. Interstitial fibrosis

B. Consolidation

C. Mass formation

D. Atelectasis

A. Interstitial fibrosis

Which of the following radiographic projections is extremely valuable in confirming the presence of middle lobe and lingular disease?

A. Lateral decubitus view

B. Apical lordotic view

C. Expiratory view

D. Posterior oblique view

B. Apical lordotic view

Which of the following histological classes of bronchial carcinoma is currently considered the most prevelant?

A. Squamous cell (epidermoid) carcinoma

B. Adenocarcinoma

C. Superior sulcus tumor

D. Small (oat) cell carcinoma

B. Adenocarcinoma

The association between deficiency of the serum protein alpha-1-antitrypsin (alpha-1-protease inhibitor) and the development of is well established.

A. centrilobular emphysema

B. panlobular emphysema

C. paraseptal emphysema

D. distal acinar emphysema

LOOK UP .. THIS WORDING IS OFF

B. panlobular emphysema

The radiographic appearance of bilateral three-lobed lungs and abnormal visceral situs associated with asplenia is known as:

A. Shaver’s disease

B. Wilson-Mikity syndrome

C. Ivemark’s syndrome

D. Riley-Day syndrome

C. Ivemark’s syndrome

The most common location of congenital bronchial atresia or stenosis of a segmental bronchus is…

A. The left lingular segment

B. The right upper anterior segment

C. The left apicoposterior segment

D. The right lateralbasal segment

C. The left apicoposterior segment

What is the most undoubtedly important roentgenologic feature that distinguishes benign from malignant lung nodules?

A. Absolute size

B. Calcification

C. Character of the lung-nodule interface

D. Change in size with time

B. Calcification

The most common form of asbestos-related pleuropulmonary disease is:

A. Focal visceral pleural fibrosis

B. Pleural effusion

C. Mesothelioma

D. Parietal pleural plaques

“Popcorn-ball” pulmonary calcification is characteristic of:

A. Adenoma

B. Tuberculosis

C. Hamartoma

D. Histoplasmosis

C. Hamartoma

Which of the following fungal infections is almost exclusively found in the western hemisphere, which in the United States includes the San Joaquin Valley.

A. Coccidioidmycosis

B. Aspergillosis

C. Blastomycosis

D. Histoplasmosis

A. Coccidioidmycosis

What is the most common cause of bronchial stenosis or occlusion found in the wall of the bronchi?

A. Bronchial adenoma

B. Bronchial atresia

C. Bronchial carcinoma

D. Sarcoid granuloma

C. Bronchial carcinoma

A 27 year old male construction worker complains of fever, headaches, chills, cough, and retrosternal discomfort. He has clinical signs of erythema nodosum. Physical examination of the chest was normal. He reports that the symptoms began about three weeks after demolishing an old chicken coup for a local farmer. A plain film radiographic study of the chest was ordered. Which of the following best describes the most common radiographic manifestation seen in a patient with his condition?

A. A round homogenous opacity that demonstrates some degree of mobility and an “air crescent” sign.

B. Focal reticular, linear, and ill-defined opacities associated with hilar lymphadenopathy.

C. Homogenous or mottled parenchymal consolidation of the lower lobes of the lungs with associated pleural effusion and hilar lymphadenopathy.

D. A sharply defined nodules measuring 2 cm in diameter that demonstrates central calcification, producing the “target” lesions, and multiple satellite lesions.

Multiple well-defined nodules of uniform density ranging from 1 to 10 mm in diameter, commonly showing considerable upper zonal predominance is associated with which occupation?

A. Sandblasting

B. Asbestos miners

C. Welders

D. Farmers

A. Sandblasting

Pulmonary vessels can be identified to within about 1.5 cm of the pleural surfaces of the lungs except at the apices, where the distance may be_ from the pleura.

A. 1 cm

B. 2 cm

C. 3 cm

D. 5 cm

C. 3 cm

A frontal radiograph of the chest demonstrates mediastinal and deep cervical subcutaneous emphysema, upper rib fractures and a pneumothorax which does not respond to therapeutic aspiration. The most likely diagnosis is…

A. Tension pneumothorax

B. Tracheobronchial fracture

C. Rupture of a subpleural bleb

D. Middle lobe syndrome

B. Tracheobronchial fracture

Individuals working with silica are more likely at risk to develop which of the following conditions?

A. Tuberculosis

B. Wegener’s granulomatosis

C. Systemic lupus erythematosus

D. Aspergillosis

A. Tuberculosis

A disease characterized by destruction of the alveolar walls and the formation of enlarged airspaces which selectively involves the alveolar ducts and sacs in the peripheral portion of the acinus is called:

A. Paraseptal emphysema

B. Chronic bronchitis

C. Centrilobular emphysema

D. Paracicatricial emphysema

A. Paraseptal emphysema

Eggshell calcification is most commonly noted in which nodes?

A. Medistinal

B. Hilar

C. Axillary

D. Retroperitoneal

B. Hilar

A pleural based wedge-shaped density seen in the costophrenic sulcus, with a rounded apex pointing towards the hilum is classically seen with…

A. Benign lung fibroma

B. Pulmonary infarction

C. Viral pneumonia

D. Progressive primary tuberculosis

B. Pulmonary infarction

Which of the following fiber types of asbestos is considered to have the greatest fibrogenic and carcinogenic potential?

A. Serpentine

B. Amphiboles

C. Crocidolite

D. Chrysotile

C. Crocidolite

What is overwhelmingly the most common etiologic agent influencing the development of COPD?

A. Air pollution

B. Cigarette smoking

C. Heredity

D. Gender

B. Cigarette smoking

The pathologic hallmark of sarcoidosis is:

A. Non-caseating granuloma

B. Potato nodes

C. Interstitial fibrosis

D. Pleural effusion

A. Non-caseating granuloma

Which of the following congenital cardiac anomaly is non-cyanotic?

A. Truncus arteriosus

B. Ebstein’s anomaly

C. Tetralogy of fallot

D. Patent ductus arteriosus

Staphylococcal pneumonia commonly progresses to resemble lobar pneumonia and often demonstrates air bronchograms.

T or F

False

Lines that are short, thin, faint, linear shadows 1 to 3 cm in length and 1 to 2 mm in width, arranged in a horizontal stepladder pattern, 0.5 to 1.0 cm apart usually along the lower, lateral lung margins are known as…?

A. Kerley A lines

B. Kerley B lines

C. Kerley C lines

D. Kerley D lines

B. Kerley B lines

A 52 year old male complains of chest wall pain and pain in the right arm. Conventional radiographs of the chest were obtained and revealed a thickening of the left pleural cap and questionable appearance of the posterior aspect of the first rib on the left. The companion shadows of the clavicles were intact. Technetium 99m (99mTc) bone scan was ordered and demonstrated increased uptake in the left first rib. As the reading radiologist, which of the following would best represent your perliminary diagnosis and recommendation for this patient..

A. No further work-up is necessary since the ribs commonly have increased up-take on bone scans and the pleural cap is probably benign.

B. An apical lordotic projection should be obtained to better evaluate the appearance of the first rib.

C. Magnetic resonance imaging should be recommended to rule out the presence of a superior sulcus (Pancoast) tumor with associated osseous invasion of the first rib.

D. Computed tomography should be ordered to rule out asbestosis plaque formation. The appearance of the first rib is probably just a confluence of shadows and commonly demonstrates increased activity on bone scans.

C. Magnetic resonance imaging should be recommended to rule out the presence of a superior sulcus (Pancoast) tumor with associated osseous invasion of the first rib.

Mediastinal lymph node enlargement involving the anterior mediastinum, with subsequent involvement of the diaphragmatic group of parietal lymph nodes is characteristic of a disease that also may create which of the following appearance in the axial skeleton?

A. Picture-frame vertebra

B. Rugger jersey spine

C. Ivory vertebra

D. Sandwich vertebra

C. Ivory vertebra

The sail sign (“spinnaker sail sign”) is associated with which of the following anatomic structures?

A. Thyroid gland

B. Thymus

C. Left atrial appendage

D. Hilum

B. Thymus

The “luftsichel” sign is seen when the_____segment of the left lower lobe takes the place of the posterior segment of the upper lobe.

A. Superior

B. Upper lingular

C. Lower lingular

D. Posterior basal

A. Superior

What percentage of bronchogenic carcinomas are histologically classified as squamous cell (epidermoid) carcinomas?

A. 35-40%

B. 30-35%

C. 15%

D. 10%

B. 30-35%

What is the most common source of lobar pneumonia?

A. Tuberculosis

B. Klebsiella pneumoniae

C. Streptococcus pneumoniae

D. Staphylococcus aureus

C. Streptococcus pneumoniae

Spontaneous pneumothorax occurs predominantly in:

A. Tall, thin females

B. Tall, thin males

C. Short, thin males

D. Short, thin females

B. Tall, thin males

A patient demonstrating pulmonary hemorrhage, iron-deficiency anemia and glomerulonephritis will show evidence of which of the following substance in the blood?

A. Rheumatoid factor

B. Anti-basement membrane antibodies

C. IgM

D. Anti-nuclear antibodies

B. Anti-basement membrane antibodies

Which of the following statements regarding asbestosis is correct?

A. Pleural plaques most commonly involve the visceral pleura

B. Recurrent pleural effusions are usually bilateral

C. Pleural plaques spare the apices and the costophrenic sulci

D. Approximately 50% of patients develop malignant mesothelioma

C. Pleural plaques spare the apices and the costophrenic sulci

Which of the following is considered the major indication of fluoroscopy study of the chest?

A. Hiatal hernia analysis

B. Thromboembolic disease

C. Paradoxical motion of the diaphragm

D. Pneumothorax

C. Paradoxical motion of the diaphragm

Which of the following conditions is responsible for multiple opacities (0.5-2 mm) on radiographs that are greater than soft tissue density?

A. Fibrosing alveolitis

B. Acute extrinsic allergic alveolitis

C. Coal miner’s pneumoconiosis

D. Hemosiderosis

The most common cause of chylothorax is:

A. Traumatic rupture of the thoracic duct

B. Neoplastic invasion of the thoracic duct

C. Pulmonary embolism

D. Elevated triglyceride and cholesterol levels

B. Neoplastic invasion of the thoracic duct

A. Adenocarcinoma

B. Hamartoma

C. Teratoma

D. Bronchogenic cyst

B. Hamartoma

Of the following primary lung carcinomas, which of the following grows the slowest?

A. Small cell carcinoma

B. Squamous cell carcinoma

C. Undifferentiated carcinoma

D. Adenocarcinoma

Pleural plaque is the radiographic hallmark of:

A. Siderosis

B. Talcosis

C. Baritosis

D. Stannosis

B. Talcosis

The most common infectious agent identified in the lungs at autopsy of patients with AIDS is:

A. Cytomegalovirus

B. Escherichia coli

C. Yersinia pestis

D. Pseudomonas aeruginosa

A. Cytomegalovirus

Which of the following fiber types of asbestos is considered to have the greatest fibrogenic and carcinogenic potential?

A. Serpentine

B. Amphiboles

C. Crocidolite

D. Chrysotile

C. Crocidolite

The combination of air within the stomach and a blind proximal esophageal pouch is seen with…

A. Trapheoesophageal fistula

B. Hypertrophyc pyloric stenosis

C. Duodenal atresia

D. Down’s syndrome

A. Trapheoesophageal fistula

In the majority of cases, intrathoracic calcification is of which type?

A. Metastatic

B. Dystrophic

C. Psammomatous

D. Local parenchymal ossification

B. Dystrophic

The most common cause of chronic cor pulmonale is…

A. Pulmonary artery disease

B. Kyphoscoliosis

C. Tuberculosis

D. Pulmonary emphysema

In a previously healthy lobe whose bronchus is acutely obstructed, all air disappears within:

A. 5-10 hours.

B. 18-24 hours.

C. 36-48 hours.

D. 72 hours.

B. 18-24 hours.

Which mycotic disease of the lungs is characteristic of patients living in the San Joaquin Valley?

A. Histoplamosis

B. Cryptococcosis

C. Blastomycosis

D. Coccidioidomycosis

Which of the following congenital anomalies is associated with Rendu-Osler-Weber disease?

A. Pulmonary sequestrations

B. Scimitar syndrome

C. Bronchogenic cysts

D. Pulmonary arterivenous malformations

Which of the following statements is not true in regard to Friedlander’s pneumonia?

A. The bacteria involved is Klebsiella pneumoniae

B. The bacteria involved is mycoplasma pneumoniae

C. Bulging of the interlobar fissure may be seen

D. Frequently occurs in debilitated patients or

alcoholics

B. The bacteria involved is mycoplasma pneumoniae

Which of the following is a transient cause of Kerley’s lines?

A. Lymphangitic metastases

B. Pneumoconiosis

C. Rheumatic mitral valve disease

D. Pulmonary edema

A roentgentographic manifestation not seen in any stage of pulmonary alveolar proteinosis is…

A. Lymph node enlargement

B. Pulmonary edema

C. Reticulonodular pattern

D. Pulmonary fibrosis

A. Lymph node enlargement

Approximately what percentage of patients with sarcoidosis will eventually progress to stage 4?

A. 5-20

B. 30-40

C. 45-60

D. 80-90

A. 5-20

Conventional radiographs of the chest of a skeletally mature patient demonstrates a confluent, patchy consolidation in the lower lobe of the left lung, and is associated with a large empyema. Which of the following etiologies should be considered?

A. Bordetella pertussis

B. Mycobacterium tuberculosis

C. Streptococcus pyogenes

D. L. pneumophilia

C. Streptococcus pyogenes

The radiograph of a 40 year-old female demonstrate a honeycomb pattern within the lungs. Examination of previous films taken one and a half years earlier, reveals Kerley B lines. Which of the following conditions could be responsible for these findings?

A. Lymphangitis carcinomatosis

B. Tuberous sclerosis

C. Sarcoidosis

D. Neurofibromatosis

C. Sarcoidosis

A conglomeration of intertwined fungal hyphae matted together with fibrin, mucus and cellular debris, within a pulmonary cavity defines:

A. Pulmonary abcess

B. Pulmonary mycetoma

C. Alveolar cell carcinoma

D. Pulmonary blastoma

B. Pulmonary mycetoma

The most common location of congenital bronchial atresia or stenosis of a segmental bronchus is…

A. The left lingular segment

B. The right upper anterior segment

C. The left apicoposterior segment

D. The right lateralbasal segment

C. The left apicoposterior segment

Cystic bronchiectasis will infallibly show a stricking enlargement on inspiration and shrinkage on expiration and cough. Which of the following examination techniques will best demonstrate this finding?

A. Laryngography

B. Bronchography

C. Fluoroscopy

D. Computed tomography

C. Fluoroscopy

Which is the most common bronchogenic carcinoma cell type to cause superior vena cava syndrome?

A. Squamous cell carcinoma

B. Small cell carcinoma

C. Adenocarcinoma

D. Undifferentiated large-cell carcinoma

B. Small cell carcinoma

A thin linear opacity seen perpendicular to, and adjacent to, the pleura in the lower lung fields caused by localized hypoventilation, most likely represents…

A. Kerley B lines

B. Discoid atelectasis

C. Linear pneumonia secondary to Klebsiella infection

D. Bronchectasis

B. Discoid atelectasis

What is the most common cause of life-threatening infection in AIDS?

A. Pseudomonas

B. Aspergillus fumigatus

C. Pneumocystis carnji

D. Nocardia

C. Pneumocystis carnji

Moniliasis is cause by which infectious agent?

A. Toxoplama gondii

B. Sporotrichum schenckii

C. Candida albicans

D. Aspergillus fumigatus

C. Candida albicans

The “shaggy heart” pattern, which results from blurring of the cardiac margins, is most associated with:

A. Pertussis pneumonia.

B. Pseudomonas pneumonia.

C. pneumonia caused by E coli.

D. S. pyogenes pneumonia.

A. Pertussis pneumonia

Patients with Lofgren syndrome may demonstrate which positive test?

A. Tuberculin test

B. Casoni test

C. Kveim test

D. Weinberg test

C. Kveim test

Which of the following is the most common presentation of a cystic adenomatoid malformation?

A. Multiple small cysts smaller than 1 cm

B. A single small cyst

C. Multiple large cysts

D. A bulky firm mass

C. Multiple large cysts

Oxyacetylene torch workers are susteptible to which of the following pneumoconiosis?

A. Siderosis

B. Talcosis

C. Silicosis

D. Stannosis

A. Siderosis

What is the most common lethal, genetically transmitted airway disease among caucasians?

A. Dyskinetic cilia syndrome

B. Mucoviscidosis

C. Alveolar microlithiasis

D. Riley-Day syndrome

B. Mucoviscidosis

A. A round homogenous opacity that demonstrates some degree of mobility and an “air crescent” sign.

B. Focal reticular, linear, and ill-defined opacities associated with hilar lymphadenopathy.

C. Homogenous or mottled parenchymal consolidation of the lower lobes of the lungs with associated pleural effusion and hilar lymphadenopathy.

D. A sharply defined nodules measuring 2 cm in diameter that demonstrates central calcification, producing the “target” lesions, and multiple satellite lesions.

Which of the following is false regarding MRI scanning of the chest?

A. Imaging of lung parenchyma is poor with MRI because of the low proton density of the lung tissue and the many air-tissue interfaces that cause loss of signal

B. The time required for most MRI examinations is less than for CT scanning

C. Biopsy and other interventional techniques require specially designed open scanner equipment

D. Motion artifacts can be minimized with techniques such as cardiac gating and presaturation of inflowing blood

B. The time required for most MRI examinations is less than for CT scanning

The gaseous radiopharmaceutical most widely used for studying the pulmonary perfusion is…

A. Xenon-133

B. Technicium-99

C. Thallium-201

D. Iodine-131

A. Xenon-133

Bilateral hilar enlargement can be caused by which of the following?

A. Congenital heart disease (left to right shunt)

B. Herniation of the pulmonary artery through a congenital pericardial defect

C. Pulmonary artery thromboembolism

D. Aneurysm

A. Congenital heart disease (left to right shunt)

Which of the following statements is false in regards to the detection of a pneumothorax?

A. In an upright patient, the pleural air maybe seen in the apical regions

B. A questionable pneumothorax can be seen better with a PA chest during inspiration

C. Supine patients will have pleural air collection within the anterior costophrenic sulcus

D. Displacement of the visceral pleural line by air is seen in the peripheral portion of the lung field

B. A questionable pneumothorax can be seen better with a PA chest during inspiration

A 52 year old male complains of chest wall pain and pain in the right arm. Conventional radiographs of the chest were obtained and revealed a thickening of the left pleur and questionable appearance of the posterior aspect of the first rib on the left. The companion shadows of the clavicles were intact. Technetium 99m (99mTc) bone scan was ordered and demonstrated increased uptake in the left first rib. As the reading radiologist, which of the following would best represent your perliminary diagnosis and recommendation for this patient..

A. No further work-up is necessary since the ribs commonly have increased up-take on bone scans and the pleural cap is probably benign.

B. An apical lordotic projection should be obtained to better evaluate the appearance of the first rib.

C. Magnetic resonance imaging should be recommended to rule out the presence of a superior sulcus (Pancoast) tumor with associated osseous invasion of the first rib.

What is the most common cause of acute upper airway obstruction?

A. Laryngo-tracheobronchitis

B. Choanal atresia

C. Retropharyngeal abscess

D. Retropharyngeal hemorrhage

B. Choanal atresia

A. Viral infection

B. Blunt trauma

C. Pulmonary artery agenesis

D. Diaphragmatic paralysis

C. Pulmonary artery agenesis

Although a family history may suggest the diagnosis, demonstration of elevated levels of sodium and chloride in sweat confirms which of the following diagnoses?

A. Agammablobulinemia

B. Wiskott-Aldrich syndrome

C. Cystic fibrosis

D. Ivemark’s syndrome

C. Cystic fibrosis

Most cystic hygromas arise in the:

A. Neck

B. Anterior mediastinum

C. Middle mediastinum

D. Posterior mediastinum

A. Neck

A chest radiograph demonstrates an elevated right hemidiaphragm above the normal range, while sniffing produces a paradoxical motion. The most common cause of this abnormality is?

A. Idiopathic

B. Brachial neuritis

C. Neoplastic invasion of the phrenic nerve

D. Medistinal lymph node enlargement

C. Neoplastic invasion of the phrenic nerve

Which disorder will lead to the “figure 8” or “snoman” cardiovascular configuration?

A. Cor pulmonale

B. Total anomalous pulmonary venous return

C. Pulmonary sling

D. Macleod’s syndrome

B. Total anomalous pulmonary venous return

Recurrent spontaneous pneumothoraces associated with the classic triad of mental deficiency, seizures and skin lesions are characteristic of:

A. Niemann-Pick disease

B. Gaucher’s disease

C. Tuberous sclerosis

D. Churg-Strauss syndrome

C. Tuberous sclerosis

Which of the following causes of inferior rib notching has a bilateral presentation?

A. Subclavian artery obstruction

B. Coactation of the aorta

C. Tetralogy of fallot

D. Superior caval obstruction

B. Coactation of the aorta

Stannosis represents a pneumoconiosis that occurs following the inhalation of?

A. Silver

B. Yttrium

C. Antimony

D. Tin

Fleischner lines refers to what type of atelectasis?

A. Adhesive

B. Obstructive

C. Cicatrical

D. Discoid

Kaposi’s sarcoma is thought to be associated with which type of infection?

A. HSV

B. CMV

C. Pseudomonas

D. Streptococcal

B. CMV

Scimitar syndrome is associated with which congenital malformation of the lungs?

A. Congenital arteriovenous fistula

B. Hypogenetic lung syndrome

C. Anomalous pulmonary venous return

D. Coarctation of the aorta

B. Hypogenetic lung syndrome

Which of the following statements is true concerning the failure of muscular development of part of one hemidiaphragm?

A. Is more common than failure of muscular development of all the hemidiaphragm

B. Usually occurs on the posterolateral portion of the hemidiaphragm

C. Occurs almost exclusively on the left side

D. Occurs much more commonly in women

A. Is more common than failure of muscular development of all the hemidiaphragm

The radiographic hallmark of airspace edema is:

A. Perihilar haze

B. Perivascular cuffing

C. Septal lines

D. Acinar shadow

A. Cardiogenic pulmonary edema

B. Staphylococcal pneumonia

C. Idiopathic vasculitis

D. Fat embolism

Lobar collapse caused by cardiac enlargement results from compression of a lobar bronchus by an enlarged left atrium or left pulmonary artery. It most commonly involves which lobe?

A. LLL

B. Lingula

C. RLL

D. LUL

A. LLL

Multiple well-defined nodules of uniform density ranging from 1 to 10 mm in diameter, commonly showing considerable upper zonal predominance is associated with which occupation?

A. Sandblasting

B. Asbestos miners

C. Welders

D. Farmers

A. Sandblasting

What is the earliest radiographic change in cystic fibrosis?

A. Saccular bronchiectasis

B. Pleural effusion

C. Hyperinflation

D. Pneumonia

C. Hyperinflation

A coarse reticulonodular pattern with progressive increased lung volume in a patient with tuberous sclerosis represents most likely…?

A. Fibrosing alveolitis

B. Lymphangioleiomyomatosis

C. Loeffler’s syndrome

D. Extrinsic allergic alveolitis

B. Lymphangioleiomyomatosis

Which of the following is an example of a lung disease caused by the inhalation of noxious gases and vapors?

A. Silo filler disease

B. Farmer’s lung

C. Bird fancier’s lung

D. Kaolin lung

A. Silo filler disease

The “luftsichel” sign is seen when the segment of the left lower lobe takes the place of the posterior segment of the upper lobe.

A. Superior

B. Upper lingular

C. Lower lingular

D. Posterior basal

A. Superior

Golden’s reverse S-shaped surve represents a sign of…

A. Pleural effusion and parenchymal disease

B. Apical pleural capping from normal aging

C. Localized honeycombing of the lungs adjacent to the hilar region

D. Right upper lobe collapse and mediastinal/parenchymal tumor

A small triangular soft tissue density structure is commonly seen on mediastinal windows of CT examination at the posterior aspect of the ascending aorta and should not be confused with adenopathy. What is the name of this structure?

A. The inferior pleuroaortic stripe

B. The ascending aortic isthmus

C. The superior pericardial recess

D. The posterior ascending stripe

C. The superior pericardial recess

Computed tomography (CT) examination of a 74 year old male demonstrates submucosal osseous and cartilaginous deposits of the trachea and central bronchi, producing nodules that result in irregular narrowing of the tracheal and bronchial lumens. These nodules affect the anterior and lateral walls, while sparing the posterior aspect of the structures. Which of the following is the most likely diagnosis for this patient’s presentation?

A. Tracheobronchopathia Osteochondroplastica

B. Polychondritis

C. Tracheobronchomegaly

D. Tracheobronchomalacia

A. Tracheobronchopathia Osteochondroplastica

The association between deficiency of the serum protein alpha-1-antitrypsin (alpha-1-protease inhibitor) and the development of_____ is well established.

A. Centrilobular emphysema

B. Panlobular emphysema

C. Paraseptal emphysema

D. Distal acinar emphysema

B. Panlobular emphysema

Which of the following syndrome is responsible for a unilateral lucent lung caused by unilateral congenital absence of pectoral muscles with or without rib defects?

A. Macleod’s syndrome

B. Swyer-James syndrome

C. Wilson-Mikity syndrome

D. Poland’s syndrome

Which of the following names is not associated with the presence of partial anomalous pulmonary venous return below the diaphragm, occurring much more often on the right side, and draining into the inferior vena cava :

A. Venolobar syndrome

B. Hypogenetic lung syndrome

C. Anomalous pulmonary venous return syndrome D. Scimitar syndrome

C. Anomalous pulmonary venous return syndrome

A patient presenting with recurrent inflammatory episodes that affect various cartiliginous structures, particularly the pinna, nose and airways and demonstrates a non-erosive inflammatory polyarthritis most likely suffers from…

A. Dermatomyositis

B. Relapsing polychondritis

C. Behcet disease

D. Polyarteritis nodosa

B. Relapsing polychondritis

The “signet ring” sign is a classic CT sign seen with…?

A. ABPA

B. Cylindrical bronchiectasis

C. Cystic bronchiectasis

D. Varicose bronchiectasis

B. Cylindrical bronchiectasis

Due to the high diagnostic value of bronchoscopy and CT, bronchography is not performed as often as before. For which of these conditions was bronchography the exam of choice?

A. Pulmonary sequestration

B. Right middle lobe atelectasis

C. Foreign body aspiration

D. Bronchiectasis

Swyer-James syndrome is though to be the result of:

A. Minor pulmonary trauma

B. Congenital bronchial stenosis

C. Viral infection

D. Tumor invasion of a main bronchus

C. Viral infection

Which of the following does not represent a feature of Wegener’s syndrome?

A. Necrotizing granulomatous lesions of the upper and lower respiratory tracts

B. Necrotizing angiitis of the arteris and veins

C. Necrotizing glomerulonephritis

D. Necrotizing oral ulcerations

A lung demonstrating hypertranslucency and attenuated vascular markings, small in size in inspiration with no change in expiration, and bronchoscopic findings of abruptly terminated bronchi indicates which conditions?

A. Congenital lobar emphysema

B. Bullous emphysema

C. Goodpasture’s syndrome

D. Swyer-James syndrome

A patient demonstrating pulmonary hemorrhage, iron-deficiency anemia and glomerulonephritis will show evidence of which of the following substance in the blood?

A. Rheumatoid factor

B. Anti-basement membrane antibodies

C. IgM

D. Anti-nuclear antibodies

B. Anti-basement membrane antibodies

Chemical analysis of post-traumatic pleural effusion demonstrates chylomicrons (chylous material) within the fluid. What is the most likely etiology of the fluid?

A. Rupture of the thoracic duct

B. A ruptured intercostal artery

C. From a tracheoesophageal fistula

D. From a fistula with the subarachnoid space

A. Rupture of the thoracic duct

The most sensitive method for detection of coronary artery calcification is…

A. Plain films of the chest

B. Helical CT

C. Fluoroscopy

D. Electron-gun CT

Right-sided pleural effusion in a patient with an ovarian fibroma is known as:

A. Familial paroxysmal polyserositis

B. Uremic pleuritis

C. Dressler’s syndrome

D. Meigs-Salmon syndrome

Cystic dilatation of the tracheobronchial tree that may extend all the way from the larynx to the periphery of the lungs is called?

A. Tracheomalacia

B. Tracheobronchomegaly

C. Saber-sheath trachea

D. Tracheobronchopathia osteochondroplastica

B. Tracheobronchomegaly

The “pulmonary sling” anomaly, where an anomalous artery passes between the trachea and esophagus, is seen with?

A. Aberrant left pulmonary artery

B. Aberrant right pulmonary artery

C. Double aortic arch

D. Anomalous origin of the right subclavian artery

A. Aberrant left pulmonary artery

The bacille Calmette-Guérin (BCG) represents an attenuated and relatively avirulent strain of which of the following pathogens?

A. M. laprae

B. M. kansasii

C. M. bovis

D. M. tuberculosis

C. M. bovis

Which of the following statements regarding carcinoid tumors is false?

A. Pulmonary carcinoid tumors have a slight female predominance

B. The indicence of carcinoid tumors is distinctly higher in black patients that in white patients

C. There is no link with cigarette smoking

D. Peripheral carcinoid tumors are also known as “spindle-cell” tumors

B. The indicence of carcinoid tumors is distinctly higher in black patients that in white patients

A. Kerley A lines

B. Kerley B lines

C. Kerley C lines

D. Kerley D lines

B. Kerley B lines

A fungal infection, most often causing meningoencephalitis, with concomitant involvement of the lungs, is likely a result of a ________infection.

A. Nocardiosis

B. Blastomyces dermatiditis

C. Coccidioides immitis

D. Cryptococcus neoformans

A. Paraseptal emphysema

B. Chronic bronchitis

C. Centrilobular emphysema

D. Paracicatricial emphysema

A. Paraseptal emphysema

Conventional chest radiographs demonstrates a smail, hyperlucent right lung. There is asymmetry of the hila, with the right being smaller, and a reduction in the amount of vascular markings. No air trapping was observed on expiratory views. VQ scan reveals markedly reduced perfusion to the right lung. Which of the following represents the correct diagnosis?

A. Obstructive emphysema

B. Swyer-James syndrome

C. Pulmonary artery hypoplasia

D. Wilson-Mikity syndrome

C. Pulmonary artery hypoplasia

The condition brought about by the inhalation of cotton fibers is know as:

A. Bagassosis

B. Suberosis

C. Sequoiosis

D. Byssinosis

Rendu-Osler-Weber disease is associated with which pulmonary malformation?

A. Congenital aneurysm of the pulmonary artery

B. Pulmonary artery stenosis

C. Congenital arteriovenous fistula

D. Anomalous pulmonary venous drainage

C. Congenital arteriovenous fistula

Westermark’s sign, associated with thromboembolism without infarction, describes:

A. Increased heart size

B. Local oligemia

C. Decrease in vessel size

D. Decreased lung volume

B. Local oligemia

The most common benign tumor of the heart is…

A. Fibroma

B. Hamartoma

C. Myxoma in the left atrium

D. Myxoma in the right atrium

C. Myxoma in the left atrium

Which of the following congenital cardiac anomaly is non-cyanotic?

A. Truncus arteriosus

B. Ebstein’s anomaly

C. Tetralogy of fallot

D. Patent ductus arteriosus

Which of the following is considered the major indication of fluoroscopy study of the chest?

A. Hiatal hernia analysis

B. Thromboembolic disease

C. Paradoxical motion of the diaphragm

D. Pneumothorax

C. Paradoxical motion of the diaphragm

A. Toruloma

B. Mycetoma

C. Ranke Complex

D. Simon Foci

B. Mycetoma

Acure respiratory distress caused by aspiration of gastric contents of low PH, occurring most commonly in patients in a comatose state, is know as:

A. Wilson-Mikity syndrome

B. Loeffler’s syndrome

C. Mendelson’s syndrome

D. Hamman-Rich syndrome

C. Mendelson’s syndrome

Patients presenting with situs inversus, paranasal sinusitis and bronchiectasis have radiographic characteristics in the chest that are similar to the radiographic findings in:

A. Cystic fibrosis

B. Bronchiolitis obliterans

C. Loffler’s syndrome

D. Congenital lobar emphysema

A. Cystic fibrosis

The triad of necrotizing granulomatous inflammation of the upper and lower respiratory tracts; necrotizing vasculitis of both arteries and veins; a focal necrotizing glomerulonephritis is seen with…

A. Behcet disease

B. Wegener granulomatosis

C. Allergic renalpulmonary aspergillosis

D. Kaposi sarcoma

B. Wegener granulomatosis

DeBakey type II dissecting aneurysm is most commonly observed in patients with …

A. Traumatic rupture of the aorta

B. Tertiary syphilis

C. Marfan’s syndrome

D. Rheumatic fever

C. Marfan’s syndrome

A. Tension pneumothorax

B. Tracheobronchial fracture

C. Rupture of a subpleural bleb

D. Middie lobe syndrome

B. Tracheobronchial fracture

The most common benign tumor of the diaphragm is?

A. Lipoma

B. Angioma

C. Angiofibroma

D. Chondroma

A. Lipoma

Hypoplasia of the right lung and pulmonary artery, anomalies of the right bronchial tree, and anomalous pulmonary venous drainage from the right lung to the inferior vena cava best describes which of the following?

A. Total anomalous pulmonary venous drainage (TAPVD)

B. Venolobar syndrome

C. Congenital pulmonary venous stenosis

D. Both A and B are correct

B. Venolobar syndrome

Unilateral pulmonary edema that is located on the opposite side of a pre-existing condition is characteristic of:

A. Pulmonary contusion

B. Bronchial obstruction

C. Rapid thoracentesis of air or fluid

D. Congenital absence of a pulmonary artery

The radiographic appearance of pneumonia in a child, in combination with an enlarged hilum may be due to:

A. Mycoplasm pneumonii

B. Histoplasmosis

C. Yersinia pestis

D. Klebsiella pneumonia

A. Mycoplasm pneumonii

Which of the following statements is true regarding mucoviscidosis?

A. The diagnosis is rarely made before the age of 5 years

B. This desease is much more common in females

C. 70 % of cases are caused by a genetic defect involving a loss of phenylalanine

D. Lower lung predominance is the rule

C. 70 % of cases are caused by a genetic defect involving a loss of phenylalanine

Ultrasound examination of the chest may be helpful delineating all of the following lesions except…

A. Pleural effusion

B. A central parenchymal lung lesion

C. Subphrenic cysts

D. Diaphragmatic rupture

B. A central parenchymal lung lesion

“Ring-around-the-artery” sign is associated with…?

A. Broncholithiasis

B. Near-drowning

C. Hamman-Rich syndrome

D. Pneumomediastinum

The patient who’s systemic venous blood return enters the right atrium, goes into the right ventricle, and exits through the aorta back into the systemic circulation most likely suffers from…

A. Tetralogy of fallot

B. Ebstein’s anomaly

C. Total anomalous pulmonary venous return

D. Complete transposition of the great vessels

Which of the following represents a parasitic infection of the lung?

A. Pneumocystis carnii

B. Cryptococcus neoformans

C. Coccidioides immitis

D. Yersinia pestis

A. Pneumocystis carnii

On CT examination, the normal size of a mediastinal lymph node is no greater than mm.

A. 5

B. 10

C. 20

D. 30

B. 10

A. Aortic nipple sign

B. Clear space sign

C. Luftsichel sign

D. Löfflers sign

C. Luftsichel sign

Of the fungal infections listed below, which one is associated with extremely common spread to the meninges?

A. Coccidioidmycosis

B. Cryptococcosis

C. Blastomycosis

D. Histoplasmosis

C. Blastomycosis

A patient presenting with ANA and anti-double-standed DNA positive tests and pleural and pericardial effusion most likely suffers from…

A. Multiple sclerosis

B. Systemic lupus erythematosus

C. Progressive systemic sclerosis

D. Dermatomyositis

B. Systemic lupus erythematosus

The most common cause of pulmonary edema is:

A. Left-sided heart failure

B. Traumatic fat embolism

C. Decreased capillary oncotic pressure

D. Congenital venous stasis

A. Left-sided heart failure

The radiographic appearance of bilateral three-lobed lungs and abnormal visceral situs associated with asplenia is known as:

A. Shaver’s disease

B. Wlison-Mikity syndrome

C. Ivemark’s syndrome

D. Riley-Day syndrome

C. Ivemark’s syndrome

Pneumomediastinum secondary to transmural esophageal rupture from forceful vomitting is seen in:

A. Mallory-Weiss syndrome

B. Plummer-Vinson syndrome

C. Achalasia

D. Boerhaave’s syndrome

Which of the following would be the expected scintigraphic findings in an area of pulmonary infarction?

A. Normal perfusion and ventialtion scan

B. Wedge-shaped perfusion defect with wedge-shaped ventilation defect

C. Normal perfusion scan and wedge-shaped ventilation defect

D. Wedge-shaped perfusion defect and normal ventilation scan

Pleural calcification is most often the result of:

A. Asbestosis

B. Ehlers-Danlos disease

C. Scleroderma

D. Hemothorax or pyothorax

The Eaton agen is associated with:

A. Mycoplasma pneumonia

B. Legionnaires’ disease

C. Brucellosis pneumonia

D. Pseudomonas pneumonia

A. Mycoplasma pneumonia

The malformation consisting of downward displacement of the tricuspid valve far into the right ventricle, leading to a small right ventricle and a large right atrium is know as…

A. Ebstein’s anomaly

B. Hypoplastic right heart syndrome

C. Endocardiac cushion defect

D. Endocardial fibroelastosis

A. Ebstein’s anomaly

Which of the following represents an organic pneumoconiosis (extrinsic allergic alveolitis)?

A. Talcosis

B. Kaolin lung

C. Siderosis

D. Suberosis

Venous drainage of intralobar sequestration is usually via…?

A. Pulmonary veins

B. Azygos veins

C. Inferior vena cava

D. Portal vein

A. Pulmonary veins

Patients with yellow nail syndrome, in addition of the classic triad, may also have an increased incidence of:

A. Asthma

B. Chronic sinusitis

C. Bronchogenic carcinoma

D. Interstitial fibrosis

B. Chronic sinusitis

Yellow nail syndrome begins in the middle age and is characterized by the triad of yellow nails, lymphedema and______?

A. Pneumothorax

B. Centrilobular emphysema

C. Infertility

D. Pleural effusion

Which of the following would not be an expected finding in a patient with sequestration of the lung?

A. The sequestered lobe would probably be located in the posterobasal segment of the left lobe

B. An intralobar type will show no pleural cover and venous drainage would be via the pulmonary veins

C. An anomalous connection of the sequestered lobe to the bronchial tree

D. An extralobar type will have its own pleural cover

C. An anomalous connection of the sequestered lobe to the bronchial tree

The presence of ground-glass opacification of the lung fields on HRCT with the “crazy-paving” sign is most likely associated with which of the following conditions?

A. Pulmonary edema

B. Sarcoidosis

C. Desquamative interstitial pneumonia

D. Alveolar proteinosis

Lutembacher’s syndrome is defined as:

A. A high ventricular septal defect with associated pulmonic valve stenosis.

B. An inferiorly displaced tricuspid valve resulting in decreased volume of the right ventricle, enlargement of the right atrium, and the “box or square” heart shape.

C. Atrial septal defect with associated congenital or aquired mitral valve stenosis.

D. The presence of Tetralogy of Fallot with associated atrial septal defect.

C. Atrial septal defect with associated congenital or aquired mitral valve stenosis.

Which of the following is/are associated with Dyskinetic Cilia Syndrome?

A. Ventricular septal defect and coarctation

B. Patent ductus arteriosus

C. Mitral regurgitation and situs inversus

D. Situs inversus and septal defects

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Chest I & II Flashcards

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