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RT Tech > Chest Radiographs > Flashcards

Chest Radiographs Flashcards

1
Q

What are the various standard positions of chest radiographs?

A

PA, AP, LAteral, Decubitus, Oblique

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2
Q

Cfcyyc

A

Guvu

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3
Q

Which imaging technique uses a magnetic field to produce images?
A) CT
B) MRI
C) Both A and B
D) None of the above

A

B) MRI uses a magnetic field to produce images.

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4
Q

Which imaging technique is quick and less expensive?
A) CT
B) MRI
C) Both A and B
D) None of the above

A

A) CT is quick and less expensive than MRI.

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5
Q

Which imaging technique is more suitable for evaluating soft tissue injury and spinal cord injuries?
A) CT
B) MRI
C) Both A and B
D) None of the above

A

B) MRI is more suitable for evaluating soft tissue injury and spinal cord injuries.

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6
Q

Which imaging technique is more suitable for detecting trauma injuries, bleeding, and staging of cancer?
A) CT
B) MRI
C) Both A and B
D) None of the above

A

A) CT is more suitable for detecting trauma injuries, bleeding, and staging of cancer.

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7
Q

Which imaging technique may be contraindicated for patients with metal implants, tattoos, or obesity?
A) CT
B) MRI
C) Both A and B
D) None of the above

A

C) Both CT and MRI may be contraindicated for patients with metal implants, tattoos, or obesity, but for different reasons. MRI may be contraindicated due to metal implants or tattoos causing artifacts, while CT may be contraindicated due to the equipment not accommodating larger patients.

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8
Q

Which of the following is a disadvantage of using computed tomography (CT) imaging?

A) Can cause allergic reactions to contrast materials
B) Can only be used on patients who are not pregnant or possibly pregnant
C) Provides unlimited monitoring capabilities during imaging
D) Is not limited by the size of the patient

A

A) Can cause allergic reactions to contrast materials. One of the disadvantages of using CT imaging is that patients may have an allergic reaction to the contrast materials used to enhance the images. CT also exposes patients to excessive radiation, which can be a concern for repeat imaging. It is limited for pregnant or possibly pregnant patients due to the potential risk to the fetus. Transportation of critical patients can also be difficult due to the size and weight of the equipment. CT is limited in size and may not accommodate larger patients. Patient movement and artifacts can also be problematic, and CT does not provide unlimited monitoring capabilities during imaging.

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9
Q

Which of the following is an advantage of using computed tomography (CT) imaging over magnetic resonance imaging (MRI)?

A) Can image soft tissue with higher resolution
B) Can be used to measure and evaluate blood flow
C) Is not affected by implanted devices
D) Is less expensive and widely available

A

C) Is not affected by implanted devices. One of the advantages of using CT imaging is that it can be used on patients with implanted devices, such as pacemakers or artificial joints. CT can image bone, tissue, and blood vessels simultaneously, provide real-time imaging, and is cost-effective. However, CT is not as sensitive to soft tissue as MRI, which is known for its high-resolution imaging of soft tissues.

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10
Q

What is the primary purpose of using imaging techniques such as CT or MRI in medical settings?

A) To diagnose and treat infections
B) To detect and monitor internal injuries
C) To measure and evaluate blood flow
D) To evaluate and treat skin conditions

A

B) To detect and monitor internal injuries. Imaging techniques such as CT or MRI are often used to detect and monitor internal injuries, guide biopsies and drainages, plan for and assess the results of surgery, stage and plan radiation treatment, and monitor response to chemotherapy.

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11
Q

What is a common radiological finding in atelectasis?
a) Decreased density or opacity on the affected side
b) Increased density or opacity on the affected side
c) No change in density or opacity on the affected side
d) Increased lung markings in the affected area

A

b) Increased density or opacity on the affected side

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12
Q

What is a possible result of atelectasis on the mediastinum?
a) Displacement toward the affected side
b) Displacement away from the affected side
c) No displacement
d) No effect on the mediastinum

A

a) Displacement toward the affected side

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13
Q

What is a radiological finding in pneumothorax?
a) Increased lung markings in the affected area
b) Absence of lung markings in the pleural space
c) Decreased density or opacity on the affected side
d) Presence of lung markings in the pleural space

A

b) Absence of lung markings in the pleural space

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14
Q

What is the border seen on a chest x-ray in pneumothorax?
a) Visceral and parietal pleurae
b) Costophrenic angle
c) Mediastinum
d) Diaphragm

A

a) Visceral and parietal pleurae

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15
Q

What is a radiological finding in hyperinflation?
a) Decreased size of the lungs
b) Flattening of the heart shadow
c) Narrowing of the intercostal spaces
d) Widening of the intercostal spaces

A

d) Widening of the intercostal spaces

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16
Q

What is a radiological finding in congestive heart failure?
a) Decreased heart size
b) Absence of vascular congestion
c) Fluid accumulation in the interstitial spaces and alveoli
d) Clear lung fields

A

c) Fluid accumulation in the interstitial spaces and alveoli

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17
Q

What may be present in congestive heart failure?
a) Pleural thickening
b) Bronchial wall thickening
c) Pulmonary nodules
d) Pleural effusions

A

d) Pleural effusions

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18
Q

What is a radiological finding in pleural effusion?
a) Blunting or rounding of the costophrenic angle
b) Increased lung markings in the affected area
c) Absence of lung markings in the pleural space
d) Displacement of the mediastinum toward the affected side

A

a) Blunting or rounding of the costophrenic angle

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19
Q

What is the amount and distribution of the effusion in pleural effusion dependent on?
a) The age of the patient
b) The cause and severity of the effusion
c) The location of the effusion
d) The time of day

A

b) The cause and severity of the effusion

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20
Q

What is the hallmark of ARDS on radiological examination?
a. Widespread patchy opacities throughout both lungs
b. Absence of lung markings and displacement of the mediastinum
c. Increased density or opacity of the affected lung field and blunted costophrenic angle
d. Patchy or lobar distribution of increased density or opacity.

A

Widespread patchy opacities throughout both lungs are the hallmark of ARDS on radiological examination.

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21
Q

What are the common radiological findings for atelectasis?

A

An area of increased density or opacity on the affected side with loss of volume and displacement of the mediastinum toward the affected side.

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22
Q

What is the most common cause of atelectasis?

A

Obstruction of the bronchus or bronchiole, which may be due to mucus, a foreign body, or a tumor.

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23
Q

What is the radiological finding for pneumothorax?

A

Absence of lung markings in the pleural space, resulting in a dark area.

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24
Q

What is the line seen at the border of the collapsed lung?

A

It represents the visceral and parietal pleurae.

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25
Q

What are the radiological findings for hyperinflation?

A

Increase in the size of the lungs, flattening of the diaphragm, and a long, narrow heart shadow.

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26
Q

What may be more prominent due to air trapping in hyperinflation?

A

Lung markings.

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27
Q

What are the radiological findings for congestive heart failure?

A

Enlarged heart, vascular congestion, and fluid accumulation in the interstitial spaces and alveoli.

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28
Q

What may be present in congestive heart failure?

A

Pleural effusions.

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29
Q

What is the radiological finding for pleural effusion?

A

Blunting or rounding of the costophrenic angle.

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30
Q

What may vary depending on the cause and severity of the effusion?

A

The amount and distribution of the effusion.

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31
Q

What is the radiological finding for consolidation?

A

An area of increased density (whiteness) or opacity, which may be patchy or lobar in distribution.

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32
Q

What are air bronchograms?

A

The visible air-filled bronchi in the consolidated area.

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33
Q

What are the radiological findings for ARDS?

A

Widespread, patchy opacities throughout both lungs, which can progress to a more confluent consolidation pattern.

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34
Q

What is the hallmark of ARDS?

A

Lack of response to oxygen therapy.

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35
Q

The standard chest radiographs are taken in two directions:

A

posteroanterior and lateral views

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36
Q

On a lateral
image, the shadows of the left and right lung are often
superimposed and cannot be distinguished. For this reason,
the lateral image is often obtained with the patient slightly

A

oblique (about 5 degrees) to the image (an oblique view), to
allow easier identification of the individual lung shadows.

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37
Q

Which view is helpful in identifying pleural fluid in the chest?
a. Lateral decubitus view
b. Oblique view
c. Expiratory view
d. Apical lordotic view

A

a. Lateral decubitus view

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38
Q

Why are patients with suspected pneumothorax placed on the opposite side for radiologic examination?
a. Air tends to rise
b. Water tends to fall
c. To detect pleural fluid
d. To detect free air in the pleural space

A

d. To detect free air in the pleural space

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39
Q

Which view is helpful in localizing an abnormality in the lung?
a. Lateral decubitus view
b. Oblique view
c. Expiratory view
d. Apical lordotic view

A

b. Oblique view, AKA apical lordotic view, when then the tube is angled 45 degrees, at the right middle lobe and the top apical region of lung, the shadows of the clavicles projected above the thorax and the top of the lungs are much more easily visible.

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40
Q

Which view is helpful in detecting a small pneumothorax?
a. Lateral decubitus view
b. Oblique view
c. Expiratory view
d. Apical lordotic view

A

c. Expiratory view

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41
Q

What is Sonography?
a) Imaging technique using X-rays to produce real-time images
b) Imaging technique using sound waves to produce images
c) Imaging technique using magnetic fields to produce images
d) Imaging technique using radio waves to produce images

A

b) Imaging technique using sound waves to produce images

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42
Q

Sonography is helpful in the assessment of which of the following?
a) Coronary artery blockages
b) Neurological disorders
c) Pulmonary emboli
d) Intra pleural fluid collections

A

d) Intra pleural fluid collections, both to detect free fluid and localized pockets of fluid.

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43
Q

Which of the following is not a common use of sonography?
a) Assessing the growth and development of a fetus during pregnancy
b) Identifying blockages or the reason for a heart attack
c) Detecting breast cancer
d) Guiding the placement of needles during medical procedures

A

b) Identifying blockages or the reason for a heart attack (this is typically done with other imaging techniques such as CT or angiography)

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44
Q

What is the benefit of performing Posterior Anterior (Upright) imaging technique?
a. It is a portable imaging technique.
b. It provides the best view of the heart.
c. It is done in the ICU.
d. It provides the best view of the lungs.

A

d. It provides the best view of the lungs.

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45
Q

What is the positioning required for Lateral (L Side) imaging technique?
a. Supine position.
b. Standing with the right side against the cassette.
c. Standing with the left side against the cassette.
d. Prone position.

A

c. Standing with the left side against the cassette.

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46
Q

Which imaging technique is used to view fluid in the chest?
a) Anterior Posterior (Portable)
b) Lateral Decubitus
c) Apical Lorodotic
d) Expiratory

A

b) Lateral Decubitus, Lying down on either side depending on pathology. Looks at fluid

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47
Q

What is the purpose of the Apical Lorodotic view?
a) To view the heart
b) To view the lungs
c) To view the scapula
d) To view fluid in the chest

A

b) to view Upward angle to view upper lung areas

48
Q

Which imaging technique increases the density of the lung to make pneumothorax easier to view?
a) Anterior Posterior (Portable)
b) Lateral Decubitus
c) Apical Lorodotic
d) Expiratory

A

d) Expiratory, Increases density of lung so pneumothorax is easier to view

49
Q

How is patient rotation assessed in chest x-rays?
a) By measuring the distance between the spinous processes and the medial ends of the clavicles
b) By counting the posterior ribs visible above the diaphragm
c) By evaluating the degree of inspiratory effort
d) By observing the relationship of the spinous processes to the tracheal air shadow

A

d) By observing the relationship of the spinous processes of the vertebral column to the medial ends of the clavicles.

50
Q

What happens if the patient is rotated during a chest x-ray?
a) The lung fields may appear too white to detect certain abnormalities
b) The heart may appear abnormally enlarged
c) Both a) and b)
d) Neither a) nor b)

A

c) Both a) and b)

51
Q

How is the degree of inspiratory effort evaluated on a chest x-ray?
a) By measuring the distance between the spinous processes and the medial ends of the clavicles
b) By counting the posterior ribs visible above the diaphragm
c) By evaluating the relationship of the tracheal air shadow to the lung fields
d) By observing the size of the heart shadow

A

b) By counting the posterior ribs visible above the diaphragm, On a PA image, 10 ribs indicate a good inspiratory effort. A poor inspiratory effort may cause the heart to appear abnormally enlarged and increase the density of the lung fields so that they appear too white to allow detection of certain lung abnormalities.

52
Q

What can be inferred if the vertebral bodies are easily seen on a chest x-ray image?
a. The image is properly exposed
b. The image is underexposed
c. The lungs will appear white
d. The image is overexposed

A

d. The image is overexposed

Explanation: If the vertebral bodies are easily seen on a chest x-ray image, it means that the image is overexposed, and the lungs will appear black. Proper exposure will allow for proper visualization of both the vertebral bodies and lung fields, while underexposure will make identification of the vertebral bodies more difficult and cause the lungs to appear whiter than on a properly exposed image.

53
Q

Vertebral bodies visible above the heart and
barely through heart means underexposed or overexposed?

A

Underexposed, and can hide pathologies.

54
Q

good quality should have how many ribs on Inspiration

A
  • 8-10 posterior ribs
  • Greater than 10 = Hyperinflation
55
Q

Where is the ideal location for an endotracheal tube (ETT) placement?
a) Just above the clavicles
b) 3-5 cm above the carina, below the clavicles
c) 5-7 cm above the carina, above the clavicles
d) 2 cm past the mediastinum

A

b) 3-5 cm above the carina, below the clavicles

56
Q

What is the ideal location for the placement of a pulmonary capillary wedge pressure (PCWP) line?
a) Just past the diaphragm into the stomach
b) Shadow of the mediastinum
c) 1st intercostal space of the superior vena cava (SVC)
d) Posterior intercostal space

A

b) Shadow of the mediastinum, or 2 cm past

57
Q

where should the central line be inserted?

A

Central line – SVC at the 1st
intercostal space

58
Q

where should the ng tube inserted?

A

10 cm past diaphragm
into stomach

59
Q

if the head is up or down then how the ett is adjusted?

A

Head up, ETT up 2.0 cm
* Head down, ETT down 2.0 cm
* Head rotated, 0.7 cm up
normal is ETT 3-5 cm above carina,
below clavicles

60
Q

Infiltrates that appear to overlap the heart
border on the image but do not affect its sharpness are
located in

A

donot effect its sharpness is in the posterior

61
Q

Which lung segments are most likely to cause an infiltrate that obliterates the heart border on a chest radiograph?
a) Lower lobes
b) Posterior segments
c) Upper lobes
d) Anterior segments

A

d) Anterior segments

62
Q

Which sign can help localize an infiltrate to a specific lobe on a chest radiograph?
a) Diaphragm border sign
b) Heart border sign
c) Silhouette sign
d) Mediastinum border sign

A

c) Silhouette sign, If the lung tissue in contact with either heart border
or sections of diaphragm becomes consolidated, the
contrast in densities is lost, and the corresponding heart or
diaphragm border is blurred. This phenomenon is called the silhouette sign.

63
Q

Infiltrates that create a silhouette sign by blurring the diaphragm border are thought to be in the lower lobes. true or false

A

true

64
Q

Why are intrapulmonary bronchi not normally visible on chest images?
a) They are too small to be detected by X-rays.
b) They are surrounded by air-filled alveoli.
c) They are located too deep within the lung tissue.
d) They are not visible due to technical limitations of X-ray machines.

A

b) They are surrounded by air-filled alveoli., Intrapulmonary bronchi are
not normally visible on chest images because they contain
air and are surrounded by air-filled alveoli

65
Q

In what circumstances would bronchi become visible on chest images?
a) When they are surrounded by air-filled alveoli.
b) When they are located in the upper lobes of the lungs.
c) When they are inflamed and filled with mucus.
d) When they are surrounded by consolidated alveoli.

A

d) When they are surrounded by consolidated alveoli, Bronchi surrounded
by consolidated alveoli are visible because the air
within their lumina will stand out in contrast to the surrounding
consolidation and fluid

66
Q

What is the significance of air bronchograms in chest radiography?
a) Indicates the presence of fluid-filled alveoli
b) Confirms intrapulmonary disease
c) Suggests the lesion is located in the mediastinum
d) Rules out intrapulmonary disease

A

b) Confirms intrapulmonary disease

67
Q

Why are intrapulmonary bronchi not normally visible on chest images?
a) They are too small to be seen
b) They are surrounded by air-filled alveoli
c) They are located outside the lungs
d) They are obscured by mediastinal structures

A

b) They are surrounded by air-filled alveoli, this is how normally it is.

68
Q

How do air bronchograms appear on chest radiographs?
a) As areas of consolidation
b) As linear branching air shadows
c) As fluid-filled cavities
d) As circular nodules

A

b) As linear branching air shadows

69
Q

What is the significance of the absence of air bronchograms?
a) Confirms intrapulmonary disease
b) Rules out intrapulmonary disease
c) Suggests the lesion is located in the mediastinum
d) Indicates the presence of fluid-filled alveoli

A

b) Rules out intrapulmonary disease

70
Q

Which type of disease will not produce air bronchograms?
a) Diseases that consolidate lung tissue
b) Diseases that fill the airways
c) Both of the above
d) None of the above

A

c) Both of the above
but if the bronchi was surrounded by consolidated alveoli then broncho grams would be visible due to air within the lumina, which stands out in contrast to the surrounding consolidation and fluid.

71
Q

In asthma patient acute bronchospasm, or acute pulmonary embolism (PE), even though the patient may be severely symptomatic, the
chest radiograph often appears normal. TRUE OR FALSE

A

TRUE

72
Q

Which of the following surgeries is most likely to result in postoperative atelectasis?
a) Knee replacement surgery
b) Hip replacement surgery
c) Upper abdominal surgery, thoracic surgery, or obese patient who have chronic lung disease
d) Eye surgery

A

c) Upper abdominal surgery, thoracic surgery, or obese patient who have chronic lung disease

73
Q

What is atelectasis?

A

Atelectasis is a condition in which one or more(small or complete) areas of the lungs collapse or do not inflate properly, resulting in difficulty breathing and decreased oxygen levels in the blood. It can be caused by various factors, including surgery, underlying lung disease, and blocked airways.

74
Q

Findings of atelectasis?

A

Rapid shallow breathing
* Decreased to absent breath sounds
* Decreased to absent vocal fremitus
* Decreased resonance to percussion
* Cyanosis
* Shift of the mediastinum toward the affected side(towards atelectasis)
* Elevation of diaphragm on affected side
* Elevation of hilum
* Narrowing of the space between the ribs
* Shift of thoracic contents if large enough

75
Q

pneumonthorax often causes what?

A

atelectasis

76
Q

define pneumothorax and its type

A

Air enters pleural space causing lung collapse (partial,
full or tension). Pneumothorax
is a condition in which air enters the pleural space
either externally from a hole in the chest wall or internally
from a hole in the lung

77
Q

what is tension pneumothorax?

A

With a tension pneumothorax, the air cannot get out of the pleural space, and pressure builds up. Air accumulates in pleural space on inspiration but cannot exit on exhalation
This pressure eventually shifts the heart away from the involved lung and puts pressure on the mediastinum and the other lung, altering blood and airflow. Requires immediate decompression with chest tube
or needle aspiration of trapped air

78
Q

With a tension pneumothorax, physical
findings are?

A

With a tension pneumothorax, physical
findings are as follows:
* Chest wall: reduction in movement in the chest wall on
the side where the pneumothorax has occurred
* Auscultation of the lung: loss of breath sounds or distant
breath sounds on the affected side
* Percussion: increased resonance to percussion on the
affected side
* Heart: usually a rapid heart rate (tachycardia) and low
blood pressure
* Other: cyanosis, an external wound, or bruising on the
affected side
* Absent whispered voice sounds and tactile fremitus
Air / lung interface
* Loss of lung volume
* Shift of thoracic contents away from affected lung
shift of trachea away from the affected lung

79
Q

In a patient with a tension pneumothorax, which of the following is NOT true?
a) Air cannot escape from the pleural space
b) The heart shifts away from the involved lung
c) The pressure can alter blood and airflow
d) The affected lung’s ability to oxygenate is not affected
e) Venous return of blood to the heart may be compromised

A

d) The affected lung’s ability to oxygenate is not affected

80
Q

In a patient with a tension pneumothorax, which of the following is the most common cause of the condition?
a) Trauma to the chest
b) Lung cancer
c) Pneumonia
d) Chronic obstructive pulmonary disease (COPD)
e) Congenital lung abnormalities

A

a) Trauma to the chest

81
Q

when seeing chest rediograph, which sign is helpful in diagnosing pneumothorax?

A

deep sulcus sign, which outlines the the outer margin of lung.

82
Q

Tension pneumothorax is a life-threatening condition that
is seen on the chest image as extreme hyperlucency on the
affected side, with a shift of the mediastinal structures away
from the air-filled pleural space. ture or false

A

true

83
Q

how does pneumthorax occur?

A

Spontaneously because of rupture of a bleb
* Trauma
* Accidental from invasive procedure such as a CV line
* Mechanical ventilation; called barotrauma

84
Q

what pneumothorax causes inside the lung on an image?

A

Causes lung margin to pull away from chest wall in affected
region. Presence of air can be better visualized by comparing
inspiratory vs expiratory CXR

85
Q

common chest finding of pneumothorax?

A

Common CXR Findings:
* Air / lung interface
* Loss of lung volume
* Shift of thoracic contents towards from affected lung
* Shift of trachea towards from affected lung 42

86
Q

Lung hyperinflation is seen commonly in patients with?

A

Lung hyperinflation is seen commonly in patients with
emphysema

87
Q

what is lung hyperinflation due to?

A

Overinflated lungs due to obstructive lung disease, If due to COPD, you may see bat wing type appearance due to engrossed pulmonary vasculature. Additionally bullae may be present.

88
Q

chest xray findings of hyperinflated lung disease.

A

More than 10 posterior ribs above
diaphragm
* Flattening of hemi-diaphragms
* Enlarged intercostal space
* Narrow heart
* Increased AP diameter (lateral), Large barrel chest
* Increased resonance to percussion
* Decreased breath sounds
* Limited motion of low-set diaphragms
* Wheezing (may not be present with emphysema)
* Prolonged expiratory phase
* Rapid respiratory rate
* Use of accessory muscles to breathe

89
Q

what CHF?

A

Inability of the heart to pump effectively
causes a backup of blood into the lungs
* Heart failure – bad pump
* Fluid overload – too much fluid administration
* Kidney disease – no excretion

90
Q

difference between normal image and abnormal image of CHF in context to pulmonary blood vessels?

A

The normal chest image shows the pulmonary blood vessels most
prominent in the lower lobes. Left heart failure increases
venous pressure, and the increased pressure distends upper
lobe vessels that would otherwise carry very little blood.

91
Q

CHF diagnosis on image with context to heart size and mediastinal structures.

A

Increase width of the heart in relation to that of the thorax.
Normally, the base of the heart occupies about half
of the width of the thorax. In CHF, that ratio increases,
and the heart appears large. Increase in
the width of the shadows of the mediastinal structures is
another sign of fluid overload.

92
Q

chest finding of CHF

A

Common CXR Findings:
* Overall whiteness due to:
* Redistribution of pulmonary vasculature (edema
in the hilar regions of both
* Kerley B lines (thin lines seen near the
pleural edge AND ARE <1MM THICKNESS AND 1-2 CM LONGER MORE ON RIGHT BASE)
* Pleural effusions R>L especially if chronic
* Alveolar infiltrates or filling
* Increased heart size if chronic

93
Q

CHF with severe hyperinflation physical exam

A

Fine inspiratory crackles
* Rapid heart rate, either regular or irregular in rhythm.
Third heart sound (S3), a consistent finding in CHF
* Jugular venous distention
* Enlarged liver (hepatomegaly)
* Hepatojugular reflex
* Ankle edema (swelling)

94
Q

Heart size is increased with congestive heart failure. An
enlarged heart is present if the width of the heart exceeds
50% of the width of the thorax on a PA chest radiograph. true or false

A

true

95
Q

what is pleural effusion?

A

Pleural fluid generally is categorized as either a transudate or an exudate.

96
Q

What is the primary function of the pleural fluid?
a) To provide oxygen to the lung
b) To lubricate the pleural surfaces
c) To remove waste from the lung
d) To maintain blood pressure

A

b) To lubricate the pleural surfaces and decrease friction between them as the lung moves.

97
Q

How much pleural fluid must be present before it can be seen on a chest radiograph?
a) 10 mL
b) 50 mL
c) 100 mL
d) 200 mL

A

c) 100 mL (book), About 200 ml of pleural fluid will blunt
costophrenic angle(ppt)

98
Q

What is the difference between a transudate and an exudate?
a) Transudates are low in protein content and caused by infection, while exudates are high in protein content and caused by an imbalance in hydrostatic pressures.
b) Transudates are high in protein content and caused by inflammation, while exudates are low in protein content and caused by blockage of lymphatic flow.
c) Transudates are almost always free flowing, while exudates are often loculated or compartmentalized.
d) Transudates are caused by tumor growth, while exudates are caused by an imbalance in hydrostatic pressures.

A

c) Transudates are almost always free flowing, while exudates are often loculated or compartmentalized.

99
Q

What can lead to the formation of pleural effusion?
a) An increase in hydrostatic pressure
b) A decrease in hydrostatic pressure
c) Infection
d) All of the above

A

d) All of the above (an increase in hydrostatic pressure, a decrease in hydrostatic pressure, infection, inflammation, or blockage of lymphatic flow by tumor)

100
Q

How does the pleural fluid maintain its volume and composition?
a) By secreting more fluid as needed
b) By reabsorbing excess fluid
c) By producing a transudate
d) By producing an exudate

A

b) By reabsorbing excess fluid.

101
Q

What are the causes of transudative pleural effusion?
A. Bacterial pneumonia, PE, malignancy
B. CHF, hepatic failure, atelectasis
C. Hemothorax, chylothorax, empyema
D. Hydropneumothorax, pyopneumothorax

A

B. CHF, hepatic failure, atelectasis

102
Q

Which of the following can cause exudative pleural effusions?
A. Atelectasis
B. Hepatic failure
C. Tuberculosis
D. All of the above

A

C. Tuberculosis (and others like bacterial pneumonia, PE, malignancy, viral disease, fungal infections)

103
Q

What is the radiographic finding of small volume pleural effusion?
A. Complete whiteout of the involved side
B. Complete obscuring of the hemidiaphragm
C. Blunting of the costophrenic angle
D. Shift of the thoracic organs away from the effusion

A

C. Blunting of the costophrenic angle

104
Q

What is the radiographic finding of large (massive) volume pleural effusion?
A. Complete whiteout of the involved side
B. Complete obscuring of the hemidiaphragm
C. Blunting of the costophrenic angle
D. Shift of the thoracic organs away from the effusion

A

A. Complete whiteout of the involved side

105
Q

What imaging technique can be used to differentiate between free fluid and loculated fluid, pneumonia, or tumor in pleural effusion?
A. Chest radiograph
B. Lateral decubitus view
C. CT scan
D. MRI

A

B. Lateral decubitus view

106
Q

What are the radiographic findings of small volume pleural effusion?
A. Complete or nearly complete whiteout of the involved side
B. Blunting of the costophrenic angle and small meniscus sign
C. Obscuring of the hemidiaphragm and shift of thoracic organs
D. Unchanged view from upright position

A

B. Blunting of the costophrenic angle and small meniscus sign.

107
Q

What are the radiographic findings of large (massive) volume pleural effusion?
A. Blunting of the costophrenic angle and small meniscus sign
B. Complete or nearly complete whiteout of the involved side
C. Obscuring of the hemidiaphragm and shift of thoracic organs
D. Unchanged view from upright position

A

B. Complete or nearly complete whiteout of the involved side, complete obscuring of the hemidiaphragm, and shift of the thoracic organs away from the effusion.

108
Q

What is the small meniscus sign in pleural effusion?
A. A complete or nearly complete whiteout of the involved side
B. A shift of the thoracic organs away from the effusion
C. An opaque white crescent next to the chest wall
D. A partially obscured diaphragm with elevation

A

C. An opaque white crescent next to the chest wall.

109
Q

what is exudate and transudate pleural effusion?

A

fluid which is a clear watery material, caused by the imbalance
in hydrostatic pressures (more fluid being secreted under
higher pressure or less fluid being reabsorbed under lower
pressure). This type of pleural fluid is low in protein content
(<3 g/dL) and called a transudate. Alternatively, infection,
inflammation, or blockage of the lymphatic flow by tumor
can lead to production of fluid with a high protein content
(>3 g/dL), called an exudate

110
Q

what is loculation of pleural fluid?

A

Loculation of pleural fluid
* The trapping so that the fluid does not
move freely with changing positions. Loculated pleural effusions are more
difficult to manage because different pockets of fluid do
not communicate with each other, making them difficult to drain.

111
Q

other fluids that can come in pleural space inc;ude:

A

Other fluids that collect in the pleural space include
blood (hemothorax), a fatty fluid called chyle (chylothorax),
and pus (empyema or pyothorax). Sometimes, there will be
a mixture of air, fluid, and blood or pus in the pleural space
(hydropneumothorax or pyopneumothorax).

112
Q

how can we relieve fluid when necessary?

A

open thoracotomy with decortication.

113
Q

what is consolidation?

A

Infection that causes the lung
tissue to fill with mucus

114
Q

common xray findings of consolidation

A

Common CXR Findings:
* Generally no volume loss (space
occupying)
* Homogeneous density +/-Air
bronchograms
* May or may not be confined to a
particular lobe

115
Q

wht is ARDS?

A

Acute Respiratory Distress
Syndrome or “Non cardiogenic
pulmonary edema”

116
Q

common xray findings of ARDS OR NON CARDIOGENIC PULMONARY EDEMA

A

bilateral opacity or alveolar
infiltrates

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