Chest Practice Flashcards

1
Q

45yo non-smoker presents with rhinorrhea and sneezing

View

  • Airway
  • Bones
  • Cardiac Silhouette
  • Diaphragm
  • Equal lung fields
  • Foreign bodies
  • Gastric bubble
  • Hilum/mediastinum

DX

A

View: PA

  • Airway: OK
  • Bones: OK
  • Cardiac Silhouette: OK borders not well defined
  • Diaphragm: OK
  • Equal lung fields: round opaque lesion in the RML
  • Foreign bodies: none
  • Gastric bubble: NA
  • Hilum/mediastinum: mostly ok, maybe a little wide

DX: carcinoid tumor

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2
Q

38yo male with dyspnea and pleuritic chest pain for a week

View

  • Airway
  • Bones
  • Cardiac Silhouette
  • Diaphragm
  • Equal lung fields
  • Foreign bodies
  • Gastric bubble
  • Hilum/mediastinum

DX

A

View: PA

  • Airway: OK
  • Bones: OK
  • Cardiac Silhouette: ok
  • Diaphragm: ok
  • Equal lung fields: left lung cavitary lesion in the LUL with and air fluid level
  • Foreign bodies: none
  • Gastric bubble: NA
  • Hilum/mediastinum: ok, loss of aortic knob

DX: cavitary lesion associated with community acquired MRSA

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3
Q

45yo female with productive cough and fever for 1 week

View

  • Airway
  • Bones
  • Cardiac Silhouette
  • Diaphragm
  • Equal lung fields
  • Foreign bodies
  • Gastric bubble
  • Hilum/mediastinum

DX

A

View: PA

  • Airway: OK
  • Bones: OK
  • Cardiac Silhouette: OK
  • Diaphragm: OK
  • Equal lung fields
    • hazy opacity in the left lingual segment on PA
    • more pronounced on lateral over the heart
  • Foreign bodies: none
  • Gastric bubble: ok
  • Hilum/mediastinum: ok

DX: LUL lingual pneumonia

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4
Q

38yo male with fever, chills and SOB of 4 days duration

View

  • Airway
  • Bones
  • Cardiac Silhouette
  • Diaphragm
  • Equal lung fields
  • Foreign bodies
  • Gastric bubble
  • Hilum/mediastinum

DX

A

View: PA

  • Airway: OK
  • Bones: OK
  • Cardiac Silhouette: OK
  • Diaphragm: OK
  • Equal lung fields
    • fluffy indistinct opacity in the LLL
    • silhouette against the left diaphragm on PA
    • sillhouette on spine in lateral
  • Foreign bodies: none
  • Gastric bubble: ok
  • Hilum/mediastinum: ok

DX: pneumonia

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5
Q

63 yo male smoker with history of dyslipidemia, HTN and myocardial infarction presents with increasing SOB of 1 week duration

View

  • Airway
  • Bones
  • Cardiac Silhouette
  • Diaphragm
  • Equal lung fields
  • Foreign bodies
  • Gastric bubble
  • Hilum/mediastinum

DX

A

View: PA

  • Airway: midline
  • Bones: OK
  • Cardiac Silhouette: slightly enlarged
  • Diaphragm: OK
  • Equal lung fields
    • increased vascular markings
    • engorged hilar vasculature
    • kerly B lines
    • fluid in horizontal fissure
  • Foreign bodies: OK
  • Gastric bubble: OK
  • Hilum/mediastinum: engorged hilar vasculatire

DX: CHF, diffuse pneumonia, pulmonary edema

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6
Q

20yo with gradually increasing SOB & cough over 6 mo

View

  • Airway
  • Bones
  • Cardiac Silhouette
  • Diaphragm
  • Equal lung fields
  • Foreign bodies
  • Gastric bubble
  • Hilum/mediastinum

DX

A

View: PA

  • Airway: OK
  • Bones: OK
  • Cardiac Silhouette
    • numerous opaque densities bilaterally
  • Diaphragm: OK
  • Equal lung fields
    • numerous round opaque densities bilaterally
  • Foreign bodies: OK
  • Gastric bubble: OK
  • Hilum/mediastinum
    • widenend

DX: metastatic disease

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7
Q

35yo female with history of heavy smoking and chronic lung disease

View

  • Airway
  • Bones
  • Cardiac Silhouette
  • Diaphragm
  • Equal lung fields
  • Foreign bodies
  • Gastric bubble
  • Hilum/mediastinum

DX

A

View: PA

  • Airway
    • right deviation
  • Bones: OK
  • Cardiac Silhouette: OK
  • Diaphragm: OK
  • Equal lung field
    • linear/curvilinear opacities bilateraly
    • assymetry of the left breast
  • Foreign bodies: OK
  • Gastric bubble: OK
  • Hilum/mediastinum: OK

DX: CHF, diffuse pneumonia, interstitial lung disease

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8
Q

60yo female with history of congestive heart failure presents to the clinic with a 3 week history of worsening SOB

View

  • Airway
  • Bones
  • Cardiac Silhouette
  • Diaphragm
  • Equal lung fields
  • Foreign bodies
  • Gastric bubble
  • Hilum/mediastinum

DX

A

View

  • Airway: OK
  • Bones: OK
  • Cardiac Silhouette: NA
  • Diaphragm: NA
  • Equal lung fields
    • RLL and LLL obscured by fluid density
    • fluid in the right horizontal fissure
  • Foreign bodies: OK
  • Gastric bubble: NA
  • Hilum/mediastinum
    • widened, opaque

DX: pleura effusion

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9
Q

24 yo male with sudden onset of SOB while lifting weights

View

  • Airway
  • Bones
  • Cardiac Silhouette
  • Diaphragm
  • Equal lung fields
  • Foreign bodies
  • Gastric bubble
  • Hilum/mediastinum

DX

A

View: PA

  • Airway: OK
  • Bones: OK
  • Cardiac Silhouette: OK
  • Diaphragm: OK
  • Equal lung fields
    • expanded right lung
    • left pulmonary lines lost
    • visceral line noted
    • hyperlucent hemithorax
  • Foreign bodies: OK
  • Gastric bubble: OK
  • Hilum/mediastinum: OK

DX: pneumothorax

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10
Q

52yo female smoker presents to the clinic with 5 month history of a chronic productive cough

View

  • Airway
  • Bones
  • Cardiac Silhouette
  • Diaphragm
  • Equal lung fields
  • Foreign bodies
  • Gastric bubble
  • Hilum/mediastinum

DX

A

View: PA and lateral

  • Airway
    • cant see because the view in under pentrated
  • Bones
    • increased AP diameter
  • Cardiac Silhouette
    • appears small
  • Diaphragm
    • flattened
  • Equal lung fields
    • hyperlucency bilateraly
  • Foreign bodies: OK
  • Gastric bubble: OK
  • Hilum/mediastinum: OK

DX: COPD

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11
Q

34yo male with cough of 10 days duration

View:

  • Airway:
  • Bones:
  • Cardiac Silhouette:
  • Diaphragm:
  • Equal lung fields:
  • Foreign bodies:
  • Gastric bubble:
  • Hilum/mediastinum:

DX:

A

View: PA/lateral

  • Airway: OK
  • Bones: OK
  • Cardiac Silhouette: OK
  • Diaphragm: OK
  • Equal lung fields
    • RUL opacity
  • Foreign bodies: OK
  • Gastric bubble: OK
  • Hilum/mediastinum: OK

DX: lobar pneumonia - RUL

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12
Q

48yo female with substernal chest pain

View:

  • Airway:
  • Bones:
  • Cardiac Silhouette:
  • Diaphragm:
  • Equal lung fields:
  • Foreign bodies:
  • Gastric bubble:
  • Hilum/mediastinum:

DX:

A

View: PA

  • Airway: OK
  • Bones: OK
  • Cardiac Silhouette: OK
  • Diaphragm: OK
  • Equal lung fields: OK
  • Foreign bodies: breast implants
  • Gastric bubble: OK
  • Hilum/mediastinum
    • calcification in the aortic knob

DX: athersclerosis

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13
Q

36yo male with fever, cough and SOB of 1 week duration

View:

  • Airway:
  • Bones:
  • Cardiac Silhouette:
  • Diaphragm:
  • Equal lung fields:
  • Foreign bodies:
  • Gastric bubble:
  • Hilum/mediastinum:

DX:

A

View: PA

  • Airway: OK
  • Bones: OK
  • Cardiac Silhouette
    • silhouette right heart border
  • Diaphragm
    • ill defined opacity on the right
  • Equal lung fields
    • RML opacity with a sharp superior border and difffuse inferior border
  • Foreign bodies: OK
  • Gastric bubble: OK
  • Hilum/mediastinum: OK

DX: pneumonia, RML atelectasis, lung carcinoma

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14
Q

58 yo male with SOB

View:

  • Airway:
  • Bones:
  • Cardiac Silhouette:
  • Diaphragm:
  • Equal lung fields:
  • Foreign bodies:
  • Gastric bubble:
  • Hilum/mediastinum:

DX:

A

View: PA

  • Airway: OK
  • Bones: OK
  • Cardiac Silhouette
    • not visable on the right
  • Diaphragm
    • not visable on the right
  • Equal lung fields
    • no lung markings on the right
  • Foreign bodies: OK
  • Gastric bubble: OK
  • Hilum/mediastinum: OK

DX: pleural effusion, hemothorax, right pneumoectomy

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15
Q

58 yo male smoker with complaints of SOB

View:

  • Airway:
  • Bones:
  • Cardiac Silhouette:
  • Diaphragm:
  • Equal lung fields:
  • Foreign bodies:
  • Gastric bubble:
  • Hilum/mediastinum:

DX:

A

View: PA

  • Airway: OK
  • Bones: OK
  • Cardiac Silhouette
    • narrowed
  • Diaphragm: OK
  • Equal lung fields
    • bullae
    • hyperlucent bilaterally
    • opaque lesion on the right lower lobe
  • Foreign bodies: OK
  • Gastric bubble: OK
  • Hilum/mediastinum
    • narrow

DX: emphysema, asthma, bronchiolitis

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16
Q

26 yo with cough for the past 3 weeks

View:

  • Airway:
  • Bones:
  • Cardiac Silhouette:
  • Diaphragm:
  • Equal lung fields:
  • Foreign bodies:
  • Gastric bubble:
  • Hilum/mediastinum:

DX:

A

View: PA/lateral

  • Airway: OK
  • Bones: OK
  • Cardiac Silhouette
    • right heart border a little enlarged
  • Diaphragm
    • mininimally flattened
  • Equal lung fields: OK
  • Foreign bodies: OK
  • Gastric bubble: OK
  • Hilum/mediastinum: OK

DX: Normal - indicates asthma or bronchitis based on symptoms

17
Q

26yo female who presents with an abrupt onset of SOB following a motorcycle accident

View:

  • Airway:
  • Bones:
  • Cardiac Silhouette:
  • Diaphragm:
  • Equal lung fields:
  • Foreign bodies:
  • Gastric bubble:
  • Hilum/mediastinum:

DX:

A

View: PA

  • Airway
    • Left shift
  • Bones: OK
  • Cardiac Silhouette
    • left shift
  • Diaphragm
    • loss of costophrenic angle due to mediastinal shift
  • Equal lung fields
    • hyperlucent right side
    • no lung markings
    • haziness over left lung
  • Foreign bodies: OK
  • Gastric bubble: NA
  • Hilum/mediastinum
    • left shift

DX: tensio pneumothorax

18
Q

7 year old previously healthy Hispanic male presented to an emergency department with 1 week of a non-productive cough and intermittent fevers measured at home to 103.5°F

View:

  • Airway:
  • Bones:
  • Cardiac Silhouette:
  • Diaphragm:
  • Equal lung fields:
  • Foreign bodies:
  • Gastric bubble:
  • Hilum/mediastinum:

DX:

A

View: PA/lateral

  • Airway: OK
  • Bones: OK
  • Cardiac Silhouette: OK
  • Diaphragm: OK
  • Equal lung fields
    • RUL opacity
  • Foreign bodies: OK
  • Gastric bubble: not visable
  • Hilum/mediastinum
    • slightly increased vascularity

DX: pneumonia

19
Q

60yo female with cough and SOB over the last 6 days

View:

  • Airway:
  • Bones:
  • Cardiac Silhouette:
  • Diaphragm:
  • Equal lung fields:
  • Foreign bodies:
  • Gastric bubble:
  • Hilum/mediastinum:

DX:

A

View: PA/Lateral

  • Airway: OK
  • Bones: OK
  • Cardiac Silhouette: OK
  • Diaphragm
    • high
  • Equal lung fields
    • opacity RUL with air bronchogram
  • Foreign bodies: OK
  • Gastric bubble: not visable
  • Hilum/mediastinum: silhouette with RUL

DX: pneumonia with air bronchogram

20
Q

62 yo male presents to the ER with worsening SOB

View:

  • Airway:
  • Bones:
  • Cardiac Silhouette:
  • Diaphragm:
  • Equal lung fields:
  • Foreign bodies:
  • Gastric bubble:
  • Hilum/mediastinum:

DX:

A

View: PA

  • Airway: OK
  • Bones: OK
  • Cardiac Silhouette
    • silhouette right heart border due to opacity
  • Diaphragm
    • silhouette obscuring right hemi diaphragm
  • Equal lung fields
    • right fluid density ove the RML and RUL
    • peribronchial cuffing on the right and upper left lobes
  • Foreign bodies: OK
  • Gastric bubble: OK
  • Hilum/mediastinum
    • slightly increased vascularity on the right

DX: pleural effusion

21
Q

65yo male with DOE and a feeling that he “can’t catch my breath”

View:

  • Airway:
  • Bones:
  • Cardiac Silhouette:
  • Diaphragm:
  • Equal lung fields:
  • Foreign bodies:
  • Gastric bubble:
  • Hilum/mediastinum:

DX:

A

View: PA

  • Airway: OK
  • Bones: OK
  • Cardiac Silhouette
    • slightly enlarged
    • borders less distincton the RML and RUL
  • Diaphragm: OK
  • Equal lung fields
    • reticular opacity bilaterally
  • Foreign bodies: EKG wires noted
  • Gastric bubble: NA
  • Hilum/mediastinum
    • hazy vascular margins

DX: CHF exacerbation leading to pulmonary edema