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Pulmonary > Chest Radiology > Flashcards

Chest Radiology Flashcards

1
Q

Indications for CXR

A
  1. Dyspnea, Cough, Hemoptysis 2. Chest pain 3. Fever 4. Weight loss 5. Suspected pulmonary or CV involvement from systemic disease 6. Monitoring of previously defined Pulmn or CV abn 7. ‘Routine’
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2
Q

ABC CXR Mnemonic

A

A – Address B – Bony Cage C – Cardiac silhouette D – Diaphragm E –ETT, Esophagus, Lines etc F – Fields of the lung G – General impression

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3
Q

Four basic densities in XR

A

bone fat soft tissue air

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4
Q

(PA/AP) is for normal, healthy patients who can stand.

A

PA

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5
Q

What is the lantern effect?

A

due to the AP view of the XR, the heart appears larger (hand in front of a flashlight)

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6
Q

What lobe does not extend posteriorly? What lobe does not extend anteriorly?

A

RML RLL

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7
Q

Which lobe has the lingula?

A

LLL

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8
Q

Airspace disease shows up as…

A

acinar shadows, which appear as “cotton ball” patterns or dots

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9
Q

Interstitial disease shows up as…

A

lines or reticulations; web-like

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10
Q

Air bronchograms occur classically in what condition?

A

pneumonia

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11
Q

What condition? CXR shows cardiomedaly with perihilar infiltrate

A

CHF

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12
Q

2 abnormalities seen on this CXR

A

Cardiomegaly

perihilar infiltrate

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13
Q

What is this abnormality called? What’s the related condition?

A

bat wing infiltrate

pulmonary edema

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14
Q

Radiologic signs of CHF

A
  1. Cephalization
  2. Cardiomegaly
  3. Perihilar infiltrates
  4. Peribronchial cuffing
  5. R. Pleural effusion
  6. Enlarged Azygos vein
  7. Kerley B lines (lymphatics containing excess fluid)
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15
Q

Earliest radiologic sign of CHF?

A

cephalization

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16
Q

What’s wrong with this guy?

A

cardiomegaly

17
Q

What is cephalization?

A

LV dysfunction causes increased pressure in pulmonary veins; upper lobe vasculature is more prominet and blood flows cephalic instead of caudal

18
Q

How is the CXR on the R abn?

A

cephalization

19
Q

What is abn?

A

Fluid in the fissures

20
Q

5 air space diseases, and what substance you see in CXR:

A
  • Pulmonary edema – fluid
  • Pneumonia - Exudate, or WBCs
  • Pulmonary hemorrhage – blood
  • Tumor/ Broncho alveolar cell carcinoma
  • Idiopathic – e.g., Pulmn Alveolar proteinosis
21
Q

What do you see on CXR in a patient with sarcoidosis?

A

interstitial lung disease with reticulonodular infiltrates

bilateral hilar adenopathy

22
Q

What conditionas cause bilateral hilar and mediastinal lymphadenopathy?

A
  • Lymphoma
  • Histoplasmosis
  • Phenytoin use
  • Tuberculosis
  • HIV
  • Sarcoidosis
  • (Castleman’s Disease)
23
Q

What does honeycomb pattern indicate?

A

advanced stage interstitial dz

24
Q

What are 2 conditions that will show a honeycomb pattern?

A

IPF

rheumatoid lung

25
Q

What is abnormal about CXR in COPD?

A

flattened hemidiaphragm

increased lung markings

hyperinflation

narrow vertical heart (if no CHF)

(*also, bullous disease possible)

26
Q

What is this condition?

A

COPD

(you shouldn’t see ribs 11 and 12!)

27
Q
A
  1. asc aorta
  2. SVC
  3. PA (pulm artery?)
  4. D. Aorta
  5. carina
28
Q

What is bronchiectasis?

A

persistent dilation of terminal bronchi

29
Q

What is the most common CXR pattern for a patient with a pulmonary embolus?

A

most common = normal

(but pleural effusions may be present when PE is small; atelectasis may be present)

30
Q

Possible CXR associated with pulm embolus:

A

elevated L hemi diaphragm

hampton’s hump

westermark sign (no vasc markings, not pneumo)

31
Q

What % of solitary pulm nodules are malignant?

A

30-40%

32
Q

Features of benignity in solitary pulm nodules

A
  • Well defined nodules
  • No associated lymph node or mediastinal masses
  • No satellite lesions
  • Calcified nodules
33
Q

Types of Benign calcifications

A

Dense
Popcorn
Lamellar

34
Q

Features of Malignancy in solitary pulm nodules

A

Spiculated nodules
Non-calcified nodules
Associated mediastinal or Lymph node masses
Presence of Cavitation
Large nodules

35
Q

What would cause a R silhoutte sign? L?

A

RML infiltrates (cannot see R border)

lingula infiltrate

36
Q

The RV enlarges towards the _____; the LV enlarges towards the _____.

A

sternum

vertebral bodies

37
Q

An obtuse carina demonstrates:

A

LA enlargement

38
Q

Air fluid levels are seen with:

No air fluid level (meniscus) is seen with:

A
  1. hydropneumothorax
  2. pleural effusion

Pulmonary (31 decks)

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