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PAM Semester 2 > Diagnostics Radiology Quiz 2 > Flashcards

Diagnostics Radiology Quiz 2 Flashcards

1
Q

Plain films

A

diagnosis of heart disease is limited to the determination of cardiac enlargement, pulmonary vascular abnormalities, cardiac calcifications and CHF

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2
Q

PA and lateral chest xray

A

Standard for chest films

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3
Q

Is heart larger in AP or PA

A

heart is larger in ap view

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4
Q

How large should Heart appear

A

heart should be no larger than have rib cage

A-B is heart

C-D is width of cage

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5
Q

Advanced imaging for….

A

cardiac thickness

motion

chamber size

valvular disease

CAD

Function

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6
Q

When to use lateral decubitus position

A

cant stand

or test if effusion is mobile

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7
Q

heart wil appear larger when…

A

any abdominal distention, ascites, preg etc

on expiration (vs inspiration)

AP view (portable

if patient is rotated

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8
Q

Overpenetration vs underpenetration

A

over penetration is black darker KVP too high

underpentration is white cloudy / grayish KVP too low

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9
Q

Lung fissures

A

major fissure is longitudinal

minor fissure is between the lobes

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10
Q

Where is lingula located

A

lingula is on left side where the heart overlaps the lung

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11
Q

What do Hilar regions contain

A

Hilar regions contain the

vessels and the main bronchi

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12
Q

What does it mean when aortic arch is on right side

A

if aortic arch is on right side

it can push the trachea leftward

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13
Q

What does enlargement of azgous vein mean

A

enlargement of azgous vein can mean right sided heart failure

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14
Q

What does a kerley B line on chest xray represent

A

Heart failure / CHF

Presrue above 20mmhg

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15
Q

When are blood vessels smaller or larger

whiter or darker

A

Blood vessels are larger and more visible(white) the lower they are

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16
Q

What vessels are visible in outer edge of lung fields

A

no vessels should be visible in the outer 1 cm of lungs

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17
Q

Pulmonar venous hypertension

A

greater than 12-14mmhg

Pressure in 20’s causes alveolar edmea

can look like diffuse pneumonia

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18
Q

Pulmonary arterial hypertension

A

enlargement of vessels

like a “Sun” appearance

nothing peripherally

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19
Q

epstein anomally

A

large heart, massive right heart enlargment

(tricuspid regurge)

vasculature small

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20
Q

Tetralogy of fallot

A

heart is not enlarged

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21
Q

Tetralogy of fallot

A

Cyanotic heart disease

4 things

Pulomnary valve stenosis

Ventral septal defect

Overriding Aorta

Right ventirular hypertrophy

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22
Q

Pericardial effusion

A

fat pad sign

seen best on lateral view

echo is best for effusion

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23
Q

left atrium enlargement

A

Rheumatic heart disease

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24
Q

xray mneumonic ABCDEFGH

A

A-airways

B-Bones

C-Cardiac and costophrenic angles

D-diaphragm

E-Edges of pleura

F-Fields of the lung (masses, consolidation, effusion)

G-Gastric bubbles

H-Hilar region

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25
How to view xray PA/AP view
Looking at xray PA/AP trace border of lung field looking for pneumos, look for pneumonias look at bottom at costophrenic angles (fluid), cardiophrenic angle(silhoette sign), Hilum, vessels, back to apicies scan lung field in S shape, fissures, atelectisis
26
How to view xray Lateral Chest
Looking at xray Lateral chest start at apex, travel to cardiophrenic angle, then costophrenic angle heart border, posterior border of field, rib fxs congestions, masses, consolidations, back to apices Follow snake pattern back down look at area above cardiac sack, above and behind cardiac sack
27
What structures are represented in these lung markings? 1. Aorta and Vena Cava 2. Pulmonary arteries and veins 3. Bronchi 4. Lymph nodes
2. Pulmonary arteries and veins
28
Which views comprise a standard CXR series 1. AP and lateral 2. PA and lateral 3. AP and PA 4. PA and decubitus
2. PA and lateral
29
air broncho gram
see the main bronchus on normal xray you shouldnt see the bronchus
30
silhouette sign
inability to see th border of structures due to mass or fluid normal opacity is obscured
31
atelectasis
scarring loss of lung tissue due to pneumonia, truama etc benign finding
32
round atelectasis
lung attached to chest wall
33
one of most common causes of fever
Atelectasis following surgery in first 48 hours
34
mucous plug
is common cause of atelectasis bronchus obstruction
35
hydrostatic pulmonary capillary pressure
used to determine if its cardiac or not
36
kerley B line
small vascular changes on periphery little white lines diagnostic for CHF "ground glass white lines"
37
Batwing
Pulmonary edema from CHF "Wet Drowning"
38
TB
Focal patchy airspace Cotton wool shadows cavitation, fibrosis
39
Pulmonary Embolism
CTA (CT angiogram) (xray will tell you nothing for PE) Westermark sign (rare) Hamptons hump (wedge shaped opacity) (rare)
40
What is the most likely CXR finding in a PE? 1. Hamptons Hump 2. Westermark Sign 3. Atelectasis 4. Normal CXR
4. Normal CXR
41
Pleural effusion amounts
200ml needed in fromtal film 75ml on lateral
42
How should costophrenic angles look?
costophrenic angle should be sharp and downward pointing
43
Meniscus sign
just like the water line on a syringe signifies presence of effusion
44
Spontaneous Pneumothorax
best seen on expiration, upright or decubitus tall, thin, smoker, marfans
45
32yo AAM smoker presents to ED for evaluation of sudden onset of Chest Pain and SOB. You obtain following XRay. What is the most likely diagnosis? 1. Pleural Effusion 2. Pneumothorax 3. Pneumonia 4. Tension Pneumothorax
2. Pneumothorax
46
Tension Pneumo
Sucking chest Midline shift of structures can be fatal (heart)
47
Hydropneumo
Straight line air and fluid in pleural space trauma, emphysema, surgery, thoracentisis need chest tube no sulcus/menisus sign, just a straight line
48
pneumomediastinum
air in in mediastinum streaky lucencie sover mediastinum trauma, smoking crack
49
pulmonary fibrosis
ground glass
50
Sarcoidosis
Noncaseating granulomatous inflammation that leads to fibrosis * Hilar and mediastinal lymph nodes are involved bilaterally * Clinically may present with cough, SOB, arthralgias and nodular rash on extensor surfaces
51
Asbestosis/Mesothelioma
* Pleural involvement from asbestos fibers inhalation * See pleural plaques and local fibrosis
52
Silicosis
* Part of pneumoconioses – From inhaled mineral dust * Multiple pulmonary nodules bilaterally in "eggshell" pattern * Similar appearance to anthracosis and silicosis
53
Emphysema
• Destruction of pulmonary capillary bed and alveolar septa See diffuse hyperinflation with flattening of diaphragms and increased retrosternal space COPD causes Hyperaeration, which stretches the heart and makes it look smaller than usual.
54
Diaphragmatic Hernia
3 types – Hiatal hernia – Bochdalek hernia – Morgagni hernia
55
Bronchiectasis
Abnormal permanent dilation of bronchi (String of pearls) cough, foul-odor sputum and hemoptysis Chest CT is ideal
56
Anterior Mediastinal Mass
consist of the 4 "T's" – Terrible lymphadenopathy (T-cell lymphoma) – Thymic tumors – Teratoma – Thyroid mass
57
lung opacities mass vs opacities
Mass is well defined infiltrates are not well defined
58
Total lung white out
– Total lung collapse – Massive pleural effusion – Pneumonia with total consolidation – Large mass – Pneumonectomy – Severe unilateral pulmonary edema – Severe aspiration
59
Which of the following is an indication to order a CXR? * Chest pain * Fever * Trauma * All of the above
• All of the above
60
You are seeing a 33yo WF with cough and fever for 2 days. CXR shows this. What is the most likely diagnosis? 1. Community acquired pneumonia 2. Pulmonary embolism 3. Right middle lobe mass 4. Pneumothorax
1. Community acquired pneumonia
61
BEst imaging for pericardium
TEE is the modality of choice for imaging pericardium
62
Echocardiogram
Echo is Gold standard for evaluation of valvular heart disease and congenital heart disease
63
Why is cardiac CT better now
Much faster scanner
64
CORONARY ANGIOGRAPHY
CORONARY ANGIOGRAPHY IS THE “GOLD STANDARD” FOR EVALUATION OF THE CORONARY ARTERIES
65
Saccular aneurysms
Saccular aneurysms are caused by trauma, infection or surgery
66
Aortic Dissection
Hypertension is the most common cause. Increased incidence in patients with Marfan’s coarctation of the aorta bicuspid aortic valve
67
Aortic dissection Key to ID
double lumen CT angiogram is the study of choice
68
Aortic aneurysm
infra renal most likely AAA is most common saccular (sack) or fulminate (bulge)
69
Aortic Dissection types
Type 1 entire aorta Type 2 is arch Type 3 is descending
70
Atherosclerotic Arterial Occlusive Disease
Atherosclerosisis the primary cause intermittent claudication and rest pain
71
study of choice to evaluate PAD. Peripheral arteial disease
aortogram with a runoff arteriogram
72
DVT
Ultrasound venous duplex
73
IVC filter
DVT history PE Prevent emboli Umbrella filter
74
Percutaneous Transluminal Angioplasty (PTA)
ballon to reinflate occluded artery
75
Stent
Recurrent stenoses Angioplasty failure
76

PAM Semester 2 (22 decks)

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