CXR Common Pathologies Flashcards
How does pneumonia show on CXR?
dense or patchy consolidation
What can you confuse pneumonia with?
in lower zones hard to distinguish from effusion (mention in differentials)
How do you know which lobes are affected by the pneumonia?
loss of clarity of borders indicates lobes affected
If diaphragm border is affected which lobe has pneumonia?
left or right lower lobe
If the right heart border is not as clear which lobe is affected by pneumonia?
RML
If the left heart border is not as clear which lobe is affected by pneumonia?
linguila
How would you describe a pleural effusion?
a homogenous opacification of (right middle and lower zones) of chest
What are the 4 features of a pleural effusion?
- Loss of costophrenic angle
- Homogenous opacification
- Fluid level (manifests as meniscus)
- Exudates vs Transudates
When is it a transudate?
bilateral effusion
When is it an exudate?
unilateral effusion
How do you really determine if it is an exudate or transudate?
pleural aspiration
How can you tell if pneumothroax and which side?
- trachea central
- darker and less vasculature
- loss of lung markings in peripheral lung field
How can you tell if tension penumothorax?
- tracheal/mediastinal deviation away from pneumothorax (darker side)
- Flattening of ipsilateral dome of diaphragm
How do you treat tension pneumothorax?
immediately (insert cannula into 2 ICS)
What could the 4 causes of a single coin lesion be?
- Malignancy
- Infection
- Infarction
- Inflammation
What could the malignancy causes of a single coin lesion be?
- bronchial
2. single pulmonary metastasis
What could the infection causes of a single coin lesion be?
- pneumonia
- abscess
- TB
- hydatid cyst
What are the inflammatory causes of a single coin lesion?
rheumatoid nodule
What are the two types of causes for hilar lymphadenopathy?
- Neoplastic
2. Infective
What are the neoplastic causes of hilar lymphadenopathy?
- Spread from bronchial cancer
2. Lymphoma
What are the infective causes of hilar lymphadenopathy?
TB
What are the inflammatory causes of bilateral hilar lymphadenopathy?
sarcoidosis
What are the tumour causes of bilateral hilar lympahdenopathy?
- mets
- bronchial cancer
- lymphoma
What are the infection causes of bilateral hilar lymphadenopathy?
- tb
- aids
- recurrent chest infection
What are the features of heart failure on a CXR?
- Patchy heterogenous opacification bilaterally (sparing of upper lobes)
- Cardiac borders blunted and cardiomegaly
- Cardiophrenic angle and costophrenic angle blunted
- Bat wings (type peri-hilar haziness)
What is an ABCDEF description of heart failure?
- A: alveolar (interstitial) shadowing
- B: Kerley B lines
- C: cardiomegaly (cardiothoracic ration >50%)
- D: upper lobe diversion (prominent upper lobe vasculature)
- E: effusion
- F: fluid in horizontal fissure
What are Kerley B lines?
little white horizontal dashes usually in lateral lower edge
How migh interstitial lung disease (pulmonasry fibrosis) show up on CXR?
diffuse bilateral reticular shadowing
How does surgical empysema show up on CXR>
air between skin and subcart tissue
What is surgical emphysema usually caused by?
trauma
What latrogenic trauma can cause surgical emphysema?
- chest drains
- surgery
- thoracotomy
What blunt trauma can cause surgical emphysema?
- stab
2. gunshot wound
How can you determine pneuoperitoneum?
patient usually needs to have sat upright for more than 15 mins to allow air to rise
What are the causes of pneumoperitoneum?
- laparoscopic surgery
2. perforated viscus
What are causes of enlarged heart?
- Congestive cardiac failure
- Pericardial effusion
- Cardiomyopathy
What does a right sided pleural effusion to mediastinum?
pushes mediastinum to left
What does a right sided tension pneumothorax do to the mediastinum?
pushes mediastinum to left
What does a right-sided lung collapse + pneumonectomy do to mediastinum?
pulls the mediastinum to right
