CXR

Question 1

which test is best used to discover a pulmonary embolism

Answer 1

V/Q scan with CT

Question 2

what structure on CXR is most radiopaque

Answer 2

bone

Question 3

what structure on CXR is most radiolucent

Answer 3

air in the lungs, stomach, and intestines

Question 4

what causes right side of heart to be unseen in CXR

Answer 4

AP film can cast a shadow over the right side of heart

Question 5

indications for CXR outpatient

Answer 5

unexplained dyspnea
severe persistent cough
hemoptysis
fever and sputum production
acute severe chest pain
positive TB skin and blood test

Question 6

indications for CXR inpatient

Answer 6

placement of ETT
placement of pulmonary artery catheter
placement of central venous pressure catheter
sudden onset of dyspnea or chest pain
elevated or changing pressure during mech vent
sudden decline in oxygenation

Question 7

Lag Behind

Answer 7

CXR may lag behind the patients clinical condition

people with pneumonia may not show air infiltrates for 12-24 hours

Question 8

what is the best position for CXR film

Answer 8

standing

PA

Question 9

considerations for AP exposure

Answer 9

heart may appear enlarged

things might appear closer

Question 10

rotation and CXR

Answer 10

projecting midline structure to the right or left
mediastinum unusually wide
obscures pulmonary arteries as they emerge from the mediastinum and parenchyma

Question 11

overexposed film

Answer 11

leaves lung parenchyma black

difficult to visualize peripheral blood vessels and abnormalities

Question 12

clinical indication for CT

Answer 12

lung nodules
masses
great vessels
mediastinum
pleural diseases
lung volumes 
pulmonary embolism

Question 13

diseases evaluated with HRCT

Answer 13

interstitial lung disease
emphysema
bronchiectasis

Question 14

limitations of MRI

Answer 14

it is magnetic
patients with pacemakers
metal objects like gas cylinders and ICU ventilators

Question 15

structures evaluated with MRI

Answer 15

mediastinum
hilar regions
large vessels in lungs

Question 16

which two areas in chest do ultrasound evaluate

Answer 16

small and large pleural effusions
pleural fluid from solid tissue
differentiates blood vessels and arteries 
placement of catheters
thoracentesis 
heart volumes and volume status

Question 17

blunt costophrenic angles mean

Answer 17

pleural effusion

Question 18

lateral decubitus XRAY

Answer 18

detecting small amounts of pleural fluid
taken from frontal view as the patient is lying on effected side
5mL of fluid can be detected

Question 19

identifying spontaneous pneumothorax

Answer 19

observing a think pleural line along the periphery of the lung with absence of lung markings between the lung margin and inner aspect of chest wall

Question 20

identifying tension pneumothorax

Answer 20

inferior displacement of the hemidiaphragm on the side of the pneumothorax or mediastinal shift away from the pneumothorax (midline)

Question 21

what are infiltrates

Answer 21

airspace opacities

Question 22

which cardiac complications are associated with pulmonary edema

Answer 22

left heart failure

Question 23

interstitial lung disease on CXR

Answer 23

diffuse, bilateral opacities scattered and poorly defines nodules and lines
honeycombing = scarring (end stage)
volume loss

Question 24

what is sarcoidosis and how common

Answer 24

one of two of the most common interstitial lung diseases
HRCT establishes
volume loss
idiopathic

Question 25

most common cause of pulmonary fibrosis

Answer 25

interstitial lung disease
idiopathic
autoimmune disease
hazardous material

Question 26

causes of atelectasis

Answer 26

airway obstruction causes volume loss
incomplete expansion
central bronchial obstruction
positive pressure ventilation
obstructive diseases

Question 27

angiogram

Answer 27

intravenous contrast dye is injected at a high rate to darken or opacify the vascular structures
pulmonary emboli in tiny peripheral arteries

Question 28

alveolar disease

Answer 28

fluid that fills alveoli and watery that contains few cells
pulmonary edema
left heart failure
- enlargement of pulmonary blood vessels in apex of lung