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SOFT B > FINAL Fall 2013 > Flashcards

FINAL Fall 2013 Flashcards

1
Q

Congenital heart disease has a prevalence in the general population of ___ although CDC puts it slightly higher:

A. 1/120
B 3/100
C. 5/100
D. 2/110

A

A. 1/120

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2
Q

The most common neoplasm to produce a paraneoplastic syndrome such as HPT, Cushing Syndrome or acromegaly and produce mediastinal widening (Y&R p. 1784)

A. Squamous cell
B. Small Cell
C. Large cell
D. Carcinoid

A

B. Small Cell

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3
Q

On this view, the right ventricle forms the heart border with the right atrium

A. PA
B. Lateral
C. LAO
D. RAO

A

C. LAO

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4
Q

Small bowel obstruction (mechanical ileus) produces ____ on the plain film upright radiograph

A. Multiple water filled loops of bowel
B. Distended gas filled loops/air-fluid levels
C. Distended gas filled loops/ no air-fluid levels
D. Fluid/fluid levels due to fat and fluid separation

A

B. Distended gas filled loops/air-fluid levels

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5
Q

All of the following are causes of large bowel obstruction (mechanical ileus). Which are the most common?

A. Intussusception, adhesions
B. Bowel hernia, distended bladder
C. Ovarian mets, volvulus
D. Colon cancer, diverticulitis

A

D. Colon cancer, diverticulitis

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6
Q

Lymphangitis carcinomatosis/pulmonary lymphatic mets causes reduced lymph absorption edema, is most commonly related to primaries of the stomach, pancreas, prostate and breast and will show which of the following findings?

  1. Kerley lines
  2. Hilar LAN
  3. Reticulonodular patterns
  4. 3-5mm nodules
A. 1,2
B. 2,3,4
C. 1,2,3
D. 3,4
E. 1,4
A

C. 1,2,3

  1. Kerley lines
  2. Hilar LAN
  3. Reticulonodular patterns
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7
Q

Descending order of incidence for aortic aneurysm location is:

A. Aortic arch, thoracic, ascending, abdominal
B. Thoracic, ascending, abdominal, arch
C. Ascending, arch, thoracic, abdominal
D. Abdominal , arch, , thoracic, ascending

A

D. Abdominal , arch, , thoracic, ascending

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8
Q

Syphillis could cause a ___ aneurysm:

A. Stanford A
B. Stanford B

A

A. Stanford A

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9
Q

A common posterior mediastinal mass:

A. Bronchogenic cyst
B. IVF Schwannoma
C. Aortic aneurysm
D. Esophageal achalasia

A

B. IVF Schwannoma

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10
Q

When secondary post primary TB HEALS is usually produces a radiographic upper lung ___ which may lead to ___

A. fibrosis, cicatrix atelectasis
B. fibrotic nodules, conglomerate masses
C. nodular densities, multiple calcific nodules
D. Air space consolidation, cavitation

A

D. Air space consolidation, cavitation

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11
Q

Probably the most common potentially life-threatening disorder encountered in patients presenting with back pain:

A. Infectious discitis
B. Multiple myeloma
C. Emphysematous cholecystitis
D. AAA

A

D. AAA

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12
Q

Which of the following characteristic findings of acquired valvular heart disease (usually mitral and aortic) which typically causes valvular stenosis: Pick all the correct choices. HINT: Think about workload

A. Alteration in cardiac size
B. Valvular calcification may be present
C. Alteration in pulmonary vascularity
D. Alteration in size and shape of specific cardiac chambers

A

C. Alteration in pulmonary vascularity

D. Alteration in size and shape of specific cardiac chambers

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13
Q

Carcinoid tumor is a ___

A. Bronchogenic carcinoma
B. Carcinosarcoma
C. Alveolar cell carcinoma
D. Bronchial adenoma

A

D. Bronchial adenoma

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14
Q

Aortic coarctation is an area of aortic lumenal constriction:

A. At the aortic valve
B. Prior to the left common carotid
C. Prior to the brachiocephalic artery
D. Distal to elft subclavian

A

D. Distal to left subclavian

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15
Q

Upright abdominal or lumbar spine films would not be helpful in the evaluation of:

A. Free peritoneal air
B. Cholecystitis
C. Abnormal calcifications
D. Gas and fluid patterns

A

B. Cholecystitis

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16
Q

The presence of hematogenous mets:

A. Indicates slow primary growth
B. May have no signs & symptoms at discovery
C. Indicates the primary lesion is a carcinoma
D. Indicates the primary lesion is an adenoma

A

B. May have no signs & symptoms at discovery

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17
Q

A patient with multiple small caveatting pulmonary nodules without air-fluid levels, nasopharyngeal mass with difficulty nose breathing and renal disease is likely suffering from?

A. Carter’s syndrome
B. Wegener’s disorder
C. Erasumus syndrome
D. Langerhans histocytosis/eosinophilic granuloma

A

B. Wegener’s disorder

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18
Q

Where in the human body are air-fluid levels normal?

A. Maxillary sinus
B. Proximal large bowel
C. Lung
D. Gastric fundus

A

B. Proximal large bowel

D. Gastric fundus

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19
Q

A patient with acute abdomen showing distended loops of small bowel 5 cm in diameter has a (n) ____ small bowel pattern.

A. Normal
B. Abnormal

A

B. Abnormal

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20
Q

Which of the following cause pulmonary edema related to pulmonary venous hypertension? Pick all that apply

A. Mitral stenosis
B. Pulmonary fibrosis
C. Congestive heart failure
D. Ammonia gas inhalation

A

A. Mitral stenosis
C. Congestive heart failure
D. Ammonia gas inhalation

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21
Q

Periostitis- diffuse, synovitis, and digital clubbing may be a clinical indication of:

A. Atelectasis
B. Previous pulmonary tuberculosis
C. Pleuritis
D. Pulmonary neoplasm

A

d. Pulmonary neoplasm

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22
Q

Radiographic features of pulmonary embolism/infarction include which two?

A. Westermark’s sign
B. Hampton’s hump
C. Berqvist’s sign
D. Wegener’s triad

A

A. Westermark’s sign

B. Hampton’s hump

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23
Q

The pancoast syndrome consists of:

A. Localized emphysema, apical pulmonary mass, rib pain
B. arm pain, cervical spine pain, hilar pulmonary mass, Horner’s syndrome
C. Bloody sputum, apical pulmonary mass, arm pain, vertebral destruction
D. Oculosympathetic interference, arm pain, neck pain, apical pulmonary mass

A

B. arm pain, cervical spine pain, hilar pulmonary mass, Horner’s syndrome

**confirm

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24
Q

The end stage findings of empyema (infectious, massive, pleural effusion) may result in:

A. Pleural scar calcification & passive atelectasis
B. Herniation of ipsilateral lung tissue
C. Tracheal deviation to contralateral side
D. Expanded rib cage on ipsilateral side

A

C. Tracheal deviation to contralateral side

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25
Q

Eisenmenger physiology results in?

A. Marked pulmonary arterial hypertension
B. Great exercise for the right ventricle
C. Left atrial enlargement
D. Increased pulmonary (…)

A

A. Marked pulmonary arterial hypertension

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26
Q

Three direct signs of lung collapse, seen on plain film are:

A. Increased lung lucency, displaced fissures, hilar elevation
B. Hilar displacement, displaced fissures, hyper lucency of unaffected lung
C. unilateral hemidiaphragm elevation, tracheal deviation, displaced fissures
D. Increased lung opacity, displaced fissures, and vascular bronchial crowding

A

D. Increased lung opacity, displaced fissures, and vascular bronchial crowding

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27
Q

Chiropractic clinicians should be aware that many intrinsic organ disorders refer pain . Abdominal/viscerak disease may refer pain to the musculoskeletal system. Pancreatic cancer may refer pain to the ___ (MAR. P. 126 or 136)

A. Mid lumbar spine
B. Lower lumbar spine
C. Lower thoracic spine
D. Mid to upper thoracic spine

A

D. Mid to upper thoracic spine

**Confirm

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28
Q

Costophrenic angle blunting may be related to: Pick all that apply

A. Free pleural effusion
B. Pleural scar
C. Low flat diaphragm
D. Subpulmonic effusion

A

A. Free pleural effusion

B. Pleural scar

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29
Q

What are likely 3 most common middle mediastinal masses:

A. Lymph nodes
B. Esophagus
C. Ectopic thyroid
D. Bronchogenic cyst

A

A. Lymph nodes
B. Esophagus
D. Bronchogenic cyst

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30
Q

Best cardiac examination for chamber wall thickness and volume?

A. Echocardiography
B. Retrograde aortography
C. Coronary arteriography
D. Thallium scan

A

A. Echocardiography

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31
Q

For plain film detection of pleural effusion, which has the correct of sensitivity from most to least sensitive?

A. Lateral decubitus, lateral decub with Trendelenburg, lateral view, PA view
B. PA view, lateral view, lateral decub. with Trendelenburg, lateral decubitus
C. Lateral decubitus with Trendelenburg, lateral decubitus, lateral view, PA view
D. Lateral view, PT view, lateral decubitus, lateral decub. with Trendelenburg

A

C. Lateral decubitus with Trendelenburg, lateral decubitus, lateral view, PA view

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32
Q

All of the following would be considered true statements regarding pulmonary metastasis except:

A. May have no known primary
B. May have no symptoms at discover
C. Pleural effusion commonly accompanies
D. Lymph more common than hematogenous

A

D. Lymph more common than hematogenous

33
Q

Hilar mediastinal lymphadenopathy is most often due to ____ in patients > 40

A. Lung cancer spread
B. Histoplasmosis
C. Coccidiodomycosis
D. Sarcoidosis

A

A. Lung cancer spread

34
Q

Which of the following are potential findings of pneumothorax: Pick all correct choices

A. Peripheral hyperlucency/ pleural space air
B. Mediastinal shift to the affected side
C. Visceral pleural line
D. Tracheal deviation to unaffected side

A

A. Peripheral hyperlucency/ pleural space air
C. Visceral pleural line
D. Tracheal deviation to unaffected side

35
Q

Which one of the following is associated with pulmonic stenosis, ASD and right ventricle hypertrophy:

A. Tetralogy of Fallot
B. Trilogy of Fallot
C. Transposition of great vessels
D. Tricuspid atresia
E. Ebstein's anomaly with cyanosis
A

B. Trilogy of Fallot

36
Q

ASD with mitral stenosis would be expected to produce ___ which will eventually produce ___? Pick two

A. Left ventricular enlargement
B. Fallot physiology
C. High volume left to right shunting
D. Eisenmenger’s physiology

A

C. High volume left to right shunting

D. Eisenmenger’s physiology

37
Q

Which one of the following would not have an ASD

A. Trilogy of Fallot
B. Truncus arteriosus
C. Tricuspid atresia
D. Pentalogy of Fallot
E. Ebstein's anomaly with cyanosis
A

B. Truncus arteriosus

38
Q

On a recumbent AP chest film, upper and lower lung blood vessels of equal size may indicate pulmonary blood pressure alteration.

A. True
B. False

39
Q

Which one of the following is non-cyanotic?

A. VSD & Eisenmenger
B. Trilogy of Fallot
C. Ebstein's & ASD
D. Lutembacher's syndrome
E. Pentalogy of Fallot
A

D. Lutembacher’s syndrome

40
Q

Which condition would not be a precursor for left ventricular failure?

A. Emphysema
B. Aortic stenosis
C. Mitral regurgitation
D. Coronary artery disease

A

A. Emphysema

41
Q

Which type of aortic dissection is the most common and has the worst prognosis, using the DeBakey classification?

A. Type II
B. Type I
C. Type III
D. Type IV

42
Q

Which dissection in the Stanford system would have better prognosis?

A. Type II
B. Type I
C. Type III
D. Type IV

A

C. Type III

43
Q

What is a classic sign of pulmonary arterial hypertension?

A. Small hilar areas
B. Pulmonary edema
C. Constriction of upper lobe blood vessels
D. Large pulmonary artery

A

D. Large pulmonary artery

44
Q

A common finding of mitral stenosis and congestive heart failure is:

A. Right atrial enlargement 
B. Right lung base airbronchogram sign
C. Phantom tumor
D. Pulmonary venous hypertension
E. Left ventricular enlargment
A

D. Pulmonary venous hypertension

45
Q

A patient with multiple posterior mediastinal masses and enlarged IVF’s may have:

A. Myasthenia Gravis
B. Neurofibromatosis
C. Multiple sclerosis
D. Muscular dystrophy

A

B. Neurofibromatosis

46
Q

Chamber enlargement at the right ventricle would be expected with which of the following:

  1. Ebstein’s anomaly
  2. Aortic coarctation
  3. Pulmonic stenosis
  4. ASD
  5. Ventricular septal defect
A. 1,2,3
B. 2,3,4
C. 1,2,4
D. 3,4,5
E. 1,3,4
47
Q

Which primary malignancy is responsible for 3-5mm metastatic nodules?

A. Osteosarcoma
B. Colon cancer
C. Seminoma
D. Breast cancer

A

C. Seminoma

48
Q

Pulmonary vascular obstructive disease secondary to chronic increased pulmonary blood flow can convert a “left to right” to a “right to left” shunt

A. True
B. False

49
Q

With regard to lung tumor staging, all of the following combinations of TNM are stage 3a or b cancers except:

A. T1 N1 M0
B. T2 N2 M0
C. T4 N2 M0
D. T3 N3 M0

A

A. T1 N1 M0

50
Q

Which of the following combinations would involve only ipsilateral lymph node groups on CT examination?

A. T1 N0 M0
B. T2 N1 M0
C. T1 N2 M0
D. T3 N3 M0

A

B. T2 N1 M0

51
Q

Berqvist’s triad is associated with ___,___ and ___

A. Rib fractures
B. Traumatic hernia of the left hemidiaphragm
C. Splenic rupture
D. Spine and/or pelvic fracture
E. Traumatic hernia of the right hemidiaphragm

A

A. Rib fractures
B. Traumatic hernia of the left hemidiaphragm
D. Spine and/or pelvic fracture

52
Q

Lower extremity cyanosis with Eisenmenger is associated with:

A. PDA only
B. VSD and ASD
C. ASD only
D. VSD only

A

A. PDA only

53
Q

Pulmonary infarction related to DVT and pulmonary embolism:

A. Has no radiographic signs
B. Is seen as a pulmonary mass
C. Seen as a round or oval opacity near the lung hilus
D. Seen as air space consolidation at the lateral lung

A

D. Seen as air space consolidation at the lateral lung

54
Q

Carcinoid tumor of the lung is a ____

A. Bronchiolar carcinoma
B. Bronchial adenoma
C. Carcinosarcoma tumor
D. Bronchogenic carcinoma

A

B. Bronchial adenoma

55
Q

Which of the following would not be a cause of left ventricular enlargement?

A. Mitral stenosis
B. Systemic hypertension
C. Large VSD
D. Aortic Coarctation

A

A. Mitral stenosis

56
Q

Echinococcosis (hydatid disease) is a pulmonary infection:

A. Causing a “water-lilly sign” and bone disease
B. Caused by a parasite found in South Asia
C. That occurs in newborns with inactivated surfactant
D. Complicating comatose or quadripeligic patients

A

A. Causing a “water-lilly sign” and bone disease

57
Q

Which of the following would be causes of proximal aortic enlargement? Pick two

A. Coarctation
B. ASD
C. Mitral stenosis
D. PDA

A

A. Coarctation

D. PDA

58
Q

Squamous cell and small cell carcinomas are:

A. Peripheral tumors
B. Smoking related neoplasms
C. Bronchial adenomas
D. Bronchiolar carcinoma’s

A

B. Smoking related neoplasms

59
Q

Which cause of atypical pleural effusion is usually right sided and inter fissure major and minor?

A. Empyema
B. congestive heart failure
C. pulmonary infarction
D. SLE
E. Pleural metastasis
A

c. Pulmonary infarction

60
Q

_____ must be considered (by location) in the differential diagnosis of mediastinal pericardial cyst:

A. Teratoma
B. Aortic aneurysm
C. Lymphoma
D. Morgagni hernia

A

B. aortic aneurysm

61
Q

The “extra pleural sign” (remember what this tells us) helps to differentiate lung lesions from all of the following except:

A. Free pleural effusion
B. Ribs mets. or fractures
C. Mediastinal lesions
D. Intercostal lesions

A

A. Free pleural effusion

62
Q

The distended gas filled loops of bowel in adynamic or paralytic ileus can be differentiated from mechanical/obstructive ileus because paralytic ileus will have ___

A. Rectal gas
B. No large bowel gas
C. No small bowel gas
D. Gastric distention

A

A. Rectal gas

63
Q

Gallstone mechanical ileus is caused by:

A. A stone filled, spastic gallbladder
B. A gallstone in the small bowel
C. A gallstone lodged at the biliary duct
D. A gallstone lodged in the pancreatic duct

A

B. A gallstone in the small bowel

64
Q

The percentage of gallstones calcified and visible on plain film:

A. 100%
B. 10-15%
C. 50-60%
D. 80-90%

65
Q

Diagnostic abdominal ultrasound is the most cost effective imagine for which two:

A. Gallbladder
B. Small bowel
C. Stomach
D. Aorta

A

A. Gallbladder

D. Aorta

66
Q

Smooth muscle uterine leiomyoma is found in~ ___ % of females over 35 yoa and although >50% are asymptomatic, ____ is the most common symptom

A. 90, bowl obstruction
B. 50, amenorrhea
C. 60, paralytic ileus
D. 40, bleeding

A

D. 40, bleeding

67
Q

The most common reasons for mediastinal lymph node calcification include:

A. Bronchogenic carcinoma and lymphoma
B. Fungal infections and pneumoconiosis
C. Metastatic chondrosarcoma and neurofibroma
D. Sarcoidosis and metastatic osteosarcoma

A

B. Fungal infections and pneumoconiosis

68
Q

Small cell carcinoma may create a radiologic appearance of:

A. Pulmonary nodules
B. Large pulmonary artery
C. Hilar enlargement
D. Apical mass

A

C. Hilar enlargement

69
Q

Interstitial pulmonary edema and normal hilar size and normal upright vascular relationship suggests:

A. pulmonary venous hypertension
B. Ebstein’s anomaly
C. Pulmonic stenosis
D. Increased capillary permeability

A

D. Increased capillary permeability

70
Q

AAA should be suspected on a lateral lumbar X-ray any time the calcified vessel wall diameter measures:

A. >2 cm
B. >3cm
C. >5cm
D. >3.8 cm

A

D. >3.8 cm

71
Q

Periostitis, synovitis and digital clubbing:

A. Is associated with atelectasis
B. Is an indication of pleural effusion
C. Related to pulmonary tuberculosis
D. A paraneoplastic syndrome related to bronchogenic ca.

A

D. A paraneoplastic syndrome related to bronchogenic ca.

72
Q

With skeletal metastasis, which should be remembered relative to bronchogenic carcinoma? Pick two

A. Commonly causes mixed metastasis
B. May spread beyond axial skeleton
C. Causes osteolytic mets.
Typically spreads only to the rib cage

A

B. May spread beyond axial skeleton

C. Causes osteolytic mets.

73
Q

The potential seriousness of AAA is directly related to lumen diameter. The rule is in clinical practice, AAA measuring

74
Q

The normal lapse rate in air pressure is linear from sea level to 18K ft, and is ___ (something) of mercury per __ feet of altitude. High altitude edema begins subclinical at ___L ft and clinical above ___k ft.

A. 2, 500: 10,20
B. 1, 1000: 8,15
C. 2.5, 1500: 10,12
D. 1.5, 1200: 5,8

A

B. 1, 1000: 8,15

75
Q

MATCHING

High altitude edema

A. Non-obstructive/paralytic ileus
B. Hypervolemic arterial hypertension
C. Hemoptysis common
D. Clinical above 15K ft.
E. Bronchiolar carcinoma
AB. Caplan's syndrome
AC. Honeycomb lung or cicatrix atelectasis
AD. Clinical above 5K ft. 
AE. Cyanosis in upper extremity
A

D. Clinical above 15k ft.

76
Q

MATCHING

Coal miners pneumoconiosis

A. Non-obstructive/paralytic ileus
B. Hypervolemic arterial hypertension
C. Hemoptysis common
D. Clinical above 15K ft.
E. Bronchiolar carcinoma
AB. Caplan's syndrome
AC. Honeycomb lung or cicatrix atelectasis
AD. Clinical above 5K ft. 
AE. Cyanosis in upper extremity
A

AB. Caplan’s syndrome

77
Q

MATCHING

Acute traumatic spine compression fx

A. Non-obstructive/paralytic ileus
B. Hypervolemic arterial hypertension
C. Hemoptysis common
D. Clinical above 15K ft.
E. Bronchiolar carcinoma
AB. Caplan's syndrome
AC. Honeycomb lung or cicatrix atelectasis
AD. Clinical above 5K ft. 
AE. Cyanosis in upper extremity
A

A. Non-obstructive/paralytic ileus

78
Q

MATCHING

Sarcoidosis

A. Non-obstructive/paralytic ileus
B. Hypervolemic arterial hypertension
C. Hemoptysis common
D. Clinical above 15K ft.
E. Bronchiolar carcinoma
AB. Caplan's syndrome
AC. Honeycomb lung or cicatrix atelectasis
AD. Clinical above 5K ft. 
AE. Cyanosis in upper extremity
A

AC. Honeycomb lung or cicatrix atelectasis

79
Q

MATCHING

PDA

A. Non-obstructive/paralytic ileus
B. Hypervolemic arterial hypertension
C. Hemoptysis common
D. Clinical above 15K ft.
E. Bronchiolar carcinoma
AB. Caplan's syndrome
AC. Honeycomb lung or cicatrix atelectasis
AD. Clinical above 5K ft. 
AE. Cyanosis in upper extremity
A

B. Hypervolemic arterial hypertension

SOFT B (10 decks)

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