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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
Q

How to view xray PA/AP view

A

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

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26
Q

How to view xray Lateral Chest

A

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

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27
Q

What structures are represented in these lung markings?

  1. Aorta and Vena Cava
  2. Pulmonary arteries and veins
  3. Bronchi
  4. Lymph nodes
A
  1. Pulmonary arteries and veins
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28
Q

Which views comprise a standard CXR series

  1. AP and lateral
  2. PA and lateral
  3. AP and PA
  4. PA and decubitus
A
  1. PA and lateral
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29
Q

air broncho gram

A

see the main bronchus

on normal xray you shouldnt see the bronchus

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30
Q

silhouette sign

A

inability to see th border of structures due to mass or fluid

normal opacity is obscured

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31
Q

atelectasis

A

scarring

loss of lung tissue due to pneumonia, truama etc

benign finding

32
Q

round atelectasis

A

lung attached to chest wall

33
Q

one of most common causes of fever

A

Atelectasis

following surgery in first 48 hours

34
Q

mucous plug

A

is common cause of atelectasis

bronchus obstruction

35
Q

hydrostatic pulmonary capillary pressure

A

used to determine if its cardiac or not

36
Q

kerley B line

A

small vascular changes on periphery

little white lines

diagnostic for CHF

“ground glass white lines”

37
Q

Batwing

A

Pulmonary edema from CHF

“Wet Drowning”

38
Q

TB

A

Focal patchy airspace

Cotton wool shadows

cavitation, fibrosis

39
Q

Pulmonary Embolism

A

CTA (CT angiogram) (xray will tell you nothing for PE)

Westermark sign (rare)

Hamptons hump (wedge shaped opacity) (rare)

40
Q

What is the most likely CXR finding in a PE?

  1. Hamptons Hump
  2. Westermark Sign
  3. Atelectasis
  4. Normal CXR
A
  1. Normal CXR
41
Q

Pleural effusion amounts

A

200ml needed in fromtal film

75ml on lateral

42
Q

How should costophrenic angles look?

A

costophrenic angle should be sharp and downward pointing

43
Q

Meniscus sign

A

just like the water line on a syringe

signifies presence of effusion

44
Q

Spontaneous Pneumothorax

A

best seen on expiration, upright or decubitus

tall, thin, smoker, marfans

45
Q

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
A
  1. Pneumothorax
46
Q

Tension Pneumo

A

Sucking chest

Midline shift of structures

can be fatal (heart)

47
Q

Hydropneumo

A

Straight line

air and fluid in pleural space

trauma, emphysema, surgery, thoracentisis

need chest tube

no sulcus/menisus sign, just a straight line

48
Q

pneumomediastinum

A

air in in mediastinum

streaky lucencie sover mediastinum

trauma, smoking crack

49
Q

pulmonary fibrosis

A

ground glass

50
Q

Sarcoidosis

A

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
Q

Asbestosis/Mesothelioma

A
  • Pleural involvement from asbestos fibers inhalation
  • See pleural plaques and local fibrosis
52
Q

Silicosis

A
  • Part of pneumoconioses – From inhaled mineral dust
  • Multiple pulmonary nodules bilaterally in “eggshell” pattern
  • Similar appearance to anthracosis and silicosis
53
Q

Emphysema

A

• 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
Q

Diaphragmatic Hernia

A

3 types –

Hiatal hernia –

Bochdalek hernia –

Morgagni hernia

55
Q

Bronchiectasis

A

Abnormal permanent dilation of bronchi (String of pearls)

cough, foul-odor sputum and hemoptysis

Chest CT is ideal

56
Q

Anterior Mediastinal Mass

A

consist of the 4 “T’s”

– Terrible lymphadenopathy (T-cell lymphoma)

– Thymic tumors

– Teratoma

– Thyroid mass

57
Q

lung opacities

mass vs opacities

A

Mass is well defined

infiltrates are not well defined

58
Q

Total lung white out

A

– Total lung collapse – Massive pleural effusion – Pneumonia with total consolidation – Large mass – Pneumonectomy – Severe unilateral pulmonary edema – Severe aspiration

59
Q

Which of the following is an indication to order a CXR?

  • Chest pain
  • Fever
  • Trauma
  • All of the above
A

• All of the above

60
Q

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
A
  1. Community acquired pneumonia
61
Q

BEst imaging for pericardium

A

TEE is the modality of choice for imaging pericardium

62
Q

Echocardiogram

A

Echo is Gold standard for evaluation of valvular heart disease and congenital heart disease

63
Q

Why is cardiac CT better now

A

Much faster scanner

64
Q

CORONARY ANGIOGRAPHY

A

CORONARY ANGIOGRAPHY IS THE “GOLD STANDARD” FOR EVALUATION OF THE CORONARY ARTERIES

65
Q

Saccular aneurysms

A

Saccular aneurysms are caused by trauma, infection or surgery

66
Q

Aortic Dissection

A

Hypertension is the most common cause.

Increased incidence in patients with

Marfan’s

coarctation of the aorta

bicuspid aortic valve

67
Q

Aortic dissection

Key to ID

A

double lumen

CT angiogram is the study of choice

68
Q

Aortic aneurysm

A

infra renal most likely

AAA is most common

saccular (sack) or fulminate (bulge)

69
Q

Aortic Dissection types

A

Type 1 entire aorta

Type 2 is arch

Type 3 is descending

70
Q

Atherosclerotic Arterial Occlusive Disease

A

Atherosclerosisis the primary cause

intermittent claudication and rest pain

71
Q

study of choice to evaluate PAD.

Peripheral arteial disease

A

aortogram with a runoff arteriogram

72
Q

DVT

A

Ultrasound

venous duplex

73
Q

IVC filter

A

DVT history

PE

Prevent emboli

Umbrella filter

74
Q

Percutaneous Transluminal Angioplasty (PTA)

A

ballon to reinflate occluded artery

75
Q

Stent

A

Recurrent stenoses

Angioplasty failure

76
Q
A

PAM Semester 2 (22 decks)

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