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Year 3 Lecture Content > Imaging of the heart and lungs > Flashcards

Imaging of the heart and lungs Flashcards

1
Q

What does this person have?

A

Dextrocardia

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2
Q

What imaging modalities are there for heart and lungs

A

Chest radiograph (CXR)

  • CT
  • Ultrasound / echocardiography
  • MRI
  • Angiography
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3
Q

Are chest x rays expected to be used for diagnosis by juniors

A

Can be difficult to interpret

  • Junior staff not expected to make absolute diagnosis
  • Must be reviewed and result recorded in the notes (IRMER)
  • Use your radiologist
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4
Q

What should you consider when you are looking at an X - ray?

A

Name

• Side marker (which way is right and left)

  • PA or AP - AP magnigies heart as it is further from patients - use if patients too unwell to stand
  • Supine or erect - supine enlarge heart + pleural effusions and pneumothoraces difficult to detect; poorer inspiration
  • Inspiration - 5 anterior ribs - underinspired = apparent congestion and lung base lesions to be missed

Rotation - spinous process relation to the medial ends of the clavicle, altered transradiance of the lungs and abnormal mediastinum

penetration - dark enough to see T6, not too dark so you cant see the

exposure - Left hemidiaphragm visible to the spine and vertebrae visible behind heart

See what the density is - dark to light: soft tissue(fat), air, calcification, metallic/contrast

Check for lung abnormalities - soft tissue nodules <3cm, mass >3cm

Air space opacity - consolidation

Reticular opacity - mesh

Nodules - lots of tiny

RIPE(rotation, inspiration, penetrance, exposure )

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5
Q

What does this person have?

A
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6
Q

What does this person have?

A

Osteosarcoma - soft tissue mass

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7
Q

What does this show

A

Knife through the back

  • Clearly shown with a much lighter film
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8
Q

What abnormality can you see on this X-ray?

A
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9
Q

What does this person have?

A

Multiple metastasis - cannonball mets?

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10
Q

What does this person have?

A

Left Upper Lobe - TB - you can see the nodularity - ill defined - more infective lesion

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11
Q

Ulcers, sores and crusting, in and around the nose, with destruction of nasal cartilage.

Rhinorrhoea, often bloody.

Haemoptysis.

Haematuria.

Rashes (up to 50%) - often small red/purple raised areas or blister-like lesions, ulcers or nodules

You see the clinical presentation above and the chest x ray shows this

What does this person have?

A

Granulomatosis with polyangitis (GPA) - cavitating masses

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12
Q

Describe this X ray

A

Left lower lobe air space opacity - could be puss, could be malignancy, could be inflammtory such as pneumonia

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13
Q

Describe the X ray and say what they may have

A

Perihilar region - wings of consolidation - pulmonary oedema secondary to left ventricular failure

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14
Q

What X ray pattern does this person have

Clinical symptoms: persistant life long cough with thick mucus. recurrent pulmonary infection and pancreatic insuffeciency

A

Reticular-nodular -cystic fibrosis - you get thickened bronchial walls and mucus

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15
Q

What does this person have?

A

Reticular pattern - fibrosis Usual interstitial pneumonia (interstitial lung fibrosis)

Honey combing seen - advanced pulmonary fibrosis

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16
Q

What does this person have?

A

Instertitial oedema - scaffolding with fluid - early stage pulmonary oedema

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17
Q

What does this person have?

A

Sarcoidosis is most likely due to nodular pattern

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18
Q

What does this person have?

This person has sudden shortness of breath

A

This person has a silouette sign.

The left border is not seen easily

This person has a left lower lobe collapse

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19
Q

What has this person got?

Sudden shortness of breath

A

Right middle lobe collapse

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20
Q

What has this person got

A

Left upper lobe collapse

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21
Q

What makes up the mediastinal contours?

A
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22
Q

This person has an enlarged heart. How do you know and what can cause it. What other signs support it?

A

CTR >0.5 roughly

23
Q

What has this person got?

A

Mitral valve disease with enlarged left atrial appendage

24
Q
A

This person has dilated ascending aorta - in elderly this could just be tortuois

25
Q

What is this?

A

usually fat pads but this is a pericardial cyst which is not likely

26
Q

What has this person got?

A
27
Q

What does the Hila consist of?

A
28
Q

What sort of nodes are these?

A

These are calcified nodes - silicosis or previous TB

29
Q

They have?

A

TB nodes

30
Q

This person has a congenital defect

A

pulmonary hypertension due to atrial septal defect

31
Q

What do they have?

Left side supine right side

A

Pleural effusion - look for meniscus sign - hard to differentiate on supine

32
Q

What do they have?

A

Pneumothorax

Tension -> clinical diagnosis should be made -> you will see mediastinal shift and flattened diaphragm

33
Q

What procedure did this elderly person have for their TB?

A

Thoracoplasty

34
Q

What is wrong with the left x ray

A

NG tube in the wrong place. IT should be seen in the stomach

35
Q

What is wrong with this endotrachealtubing

A

The endotracheal tube should be above the carina not below

36
Q

What are you worried about if they have air under the diaphragm?

A

Pneumoperitoneum -> perforated bowel

37
Q

What is CT mainly used to see?

Fast multisclice CT shows what organ well?

When is HRCT (high res ct ) done?
When is Helical contrast enhanced (CECT) done?

A
  1. Thorax
  2. Heart
  3. Diffuse parenchymal disease

4- whole chest and for small cancer nodules

38
Q

What does this person have?

A

Lung cancer

39
Q

Whats this person have?

A

Aortic dissection

40
Q

What does this person have? (they have HIV)

A

Invasive aspergillosis

41
Q

Whats happened to this aorta

A

bypass, coarction, stented and calcification

42
Q

What is echocardiography for?

What does this echo show

A
  • Function assessment of the heart

limited by acoustic window - hard on high bmi individuals

no ionising radiation

easy and quick and non invasive

Echo shows pericardial fluid

43
Q

Pros and cons of MRI

A
  • limited use for lung pathology - lack of spatial resolution compared to CT

slow, inaccessible, difficult with ill patients

excellent for anatomical and functional assessment of heart - use if echo nor working

excellent for mediastinum and aorta

44
Q

What does this person have ?

A

Coarction of aorta

45
Q

Person has?

A

transposition of great arteries

46
Q

What is angiography

A

Invasive

used for clarification of diagnosis prior to treatment

facilitates stents and angioplasty

47
Q

Elderly patient

A

Treated for TB - thoracoplasty

48
Q
A

Nodule in left upper zone

49
Q
A

NG tube misplaced

50
Q
A

Left pleural effusion

51
Q
A

Free intraperitoneal gas

52
Q
A

Normal x ray

53
Q
A
54
Q

what happened here

A

misplaced central venous catheter

Year 3 Lecture Content (33 decks)

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