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Medical Imaging > Intro > Flashcards

Intro Flashcards

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USMLE® Step 1 flashcards
1
Q

who discovered x-rays and how

-what was the first xray?

A

Wilhelm Conrad Roentgen; while investigating emissions from a Crookes tube;
wife’s hand

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2
Q

what is an x-ray?

A

a form of of electromagnetic radiation (energy of extremely short wavelengths)
-volts

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3
Q

the ____ the wavelength, the ____ its energy and the _______ the ability to penetrate various material

A

shorter; greater; greater

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4
Q

define attenuation and example

A

the degree to which xrays are absorbed/deflected by the body part
ex: bones attenuate more radiation than tissue so they have heavier “shadows” on film.
—–
the lower the atomic weight/density the more transparent it is
ex: lungs are see throughish
—-
vice versa: the GREATER the density of anatomy = the greater absorption

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5
Q

shadow on xray film means… vs black

A

white i.e. bone

black: xray reached the film

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6
Q

what are the 4 types of radiographic densities from darkest to shadow

A
  • gas (air)
  • fat
  • water (mucus, vessels)
  • bone
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7
Q

factors affecting image quality (5)

A
  • thickness of the body part
  • motion
  • scatter
  • magnification
  • distortion
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8
Q

how does scatter affect xrays?

A

scatter causes deflection; is seen between the body and film of which the xray absorbs

  • want scatter as reduced as possible
  • a grid is used to reduce scatter
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9
Q

when the object is not perpendicular to the xray beam, this is known as…

A

need to line it up to get the right angle/image

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10
Q

fluoroscopy film

A

real-time motion

ex: heart, diaphragm, abdomen, guiding GI tube placement

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11
Q

what is contrast used for

A

better to distinguish what you’re looking at

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12
Q

contraindication of contrast examination

A

pt allergic or renal failure

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13
Q

tomography and examples

A

xray and film move synchronously around a focal point (slices)
ex: CT, PET
—
lungs, kidneys, and bony structures

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14
Q

CT scan contraindications

A

expensive, often needs IV contrast, increased exposure to radiation

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15
Q

contrast on a cerebral bleed? why?

A

no; bc contrast IS fluid* so it will blend with the bleed.

-order with NO contrast

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16
Q

a 3D reconstruction image is taken by ___

A

Spiral (helical) CT

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17
Q

what are the most common diagnostic xray

A

plain fils: ex. chest, abdomen, skeletal films

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18
Q

variations of plain films includde

A

fluoroscopy, tomography

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19
Q

barium contrast agent is mostly used for

A

from esophagus all the way to colon

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20
Q

water soluble agents is used in…

A

urography

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21
Q

biliary contrast agents

A

absorbed n the gut and excreted in the bile for biliary studies

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22
Q

MRI enhancement agaents

A

gadolinium

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23
Q

oil-soluble agents are used for

A

inhalation in bronchograms

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24
Q

contraindication on Nuc med imaging

A

caution in pregnancy

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25
Q

what radioisotope is used

A

technetium 99

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26
Q

what is taken up in Bone scana

A

phosphate -technetium 99

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27
Q

____ scan measures blood flow, O2, and glucose metabolism

A

PET

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28
Q

what happens to the Tc99-pertchetate once it is inside the cell?

A

it is reduced and cannot diffuse back out

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29
Q

what tissues take up iodine for this type of scan

A

thyroid tisse; thyroid scan

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30
Q

a cold nodule is more likely to be _____ than hot nodules, meaning there will be no uptake in cold

A

cancerous

–

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31
Q

what is thallium used to assess

A

regional blood flow of the coronary arteries blood supply to heart muscle

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32
Q

how do you test for delayed gastric emptying

A

if >50% of foood (eggs) remains in stomach after 2 hours

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33
Q

pros and cons of MRI

A

pros: no ionizing radiation, noninvasive, detailed images
- -
cons: artifact due to pt motion, no ferrous object near the magnet (pacemaker/defib, aneurysm clips), expensive, slower process than CT

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34
Q

what is an MRI contrast risk

A

due to the gadolinium

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35
Q

pros and cons of US

A

pros- inexpensive noninvasive, no radiation

cons: quality of US images is tech dependent, pt body habitus

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36
Q

the diaphragm should be between which ribs

A

the 7th and 10th ribs

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37
Q

what type of cxr position make the heart appear enlarged and lungs hypoinflated?

A

AP and supine (portable)

38
Q

a lateral decubitus film aids in identifying what?

A

pleural effusion

39
Q

which type of films are used to view the apices of the lungs?

A

lordotic

40
Q

what type of view can be helpful for pneumothorax

A

expiratory

41
Q

with normal exposure: the vessels should be visualized to at least the peripheral _____ of the lung

A

2/3

42
Q

how many ribs indicates adequate inspiratory effort?

A

> 7 ribs

43
Q

the width of the heart should be less than ____ the width of the thoracic cavity

A

1/2

44
Q

a greater than .5 ratio of the heart to thoracic indicate…

A

cardiomegaly (dilation or hypertrophy), pericardial effusion, small lung volumes, or pectus excavatum

45
Q

which hilum should be higher

A

left hilum should be higher than the right

46
Q

tracheal deviation is indicative of

A

air pushes it to the other side

47
Q

how many lobe does the right lung have

A

3

48
Q

how many lobes does the left lung have

A

2

49
Q

lung infiltrates indicate

A

pneumonia

50
Q

____ usually arise/connected from the mediastinal

A

can indicate cancer

51
Q

____ are not as dense

A

lung nodules

52
Q

round edge of the bottom leg vs sharp edge on the opposite lung indicates

A

pleural effusion

“costophrenic angles”

53
Q

a tumor on the sternum makes it look like…

A

the sternum is being pushed out

54
Q

improper placing of the ET tube causes_____ and appearance shows ____

A

all white on cxr

55
Q

the NG tube should be seen where on cxr

A

curving to the left in the stomach past the gastroesophageal junction

56
Q

alveolar vs interstitial

A

interstitial= tissue OUTSIDE of the alveoli are affected

57
Q

focal or diffused?

A

alveolar and focal (single lobe)

58
Q

if pneumonia is viral, this usually shows in a cxr as interstitial or alveolar? focal or diffused?

A

interstitial and diffuse (bilateral)

59
Q

if there is mycoplasma this is either alveolar or interstitial? diffuse or focal?

A

interstitial and diffuse

60
Q

air bronchogram sign

A

seen with alveolar processes

61
Q

what is the most likely cause of an interstitial pneumonia in a normal adult?

A

Mycoplasmal infection

62
Q

which type of acquired pneumonia shows on xrays that is more common in children than adults

A

Round

63
Q

what evolves from a normal cxr to an interstitial pattern to an alveolar pattern?

A

usually immunocompromised patients –> HIV

64
Q

a healing TB appears on a cxr as ____

and is known as ____

A

appears as a calcified nodule

65
Q

in a lung abscess, what must you rule out?

A

neoplasm by bronchoscopy or CT directed needle bx

66
Q

what do you expect to see in a cxr w lung abcscess

A

air fluid with thick wall; cavitation

67
Q

what are the most common type of lung CA and usually occur peripherally?

A

Adenocarcinomas

68
Q

SCC usually occur ____ and tend to cavitate

A

centrally

69
Q

what is the dilation of the bronchi called? is it diffuse or focal? what is it caused by?

A

Bronchiectasis;

could be both

70
Q

tramtracking or honeycomb infiltrates can be indicative of

A

Bronchiectasis

71
Q

when are cxr needed for COPD

A

they are usually not needed for eveluation
UNLESS
there’s an exacerbation of sx needed to be ruled out

72
Q

deviation of mediastinum due to air in pleural cavity is due to?

A

tension pneumothorax

73
Q

how is hemopneumothorax represented on an xray

A

horizontal line along the base, pushes diaphragm down due to airfluid level

74
Q

what does the deep sulcus sign indicate

A

the affected is lower compared to the other one

75
Q

pneumomediastinum

A

where air presents in mediastinum due to injury/perforation of tracheobronchial

76
Q

fluid in pleural space indicates

A

pleural effusion

77
Q

what type of effusion shows in a pleural effusion due to chf

A

bilateral/cardiomegaly

78
Q

what type of effusion shows on a pleural effusion due to pneumonia

A

small

79
Q

what type of effusion shows on a cirrhosis pt with pleural effusion?

A

R side effusion

80
Q

what type of effusion shows up on xray on a pt with pancreatitis and pleural effusion

A

L side

81
Q

describe pleural effusions in upright, supine, and lateral positions

A

upright–> blunted angle of costophrenics

supine–> increased density of affected hemithorax (may be misread as infiltrate)

lateral–> fluid along lateral chest wall

82
Q

loops of bowel in the lower chest cavity indicate

A

“there shouldnt be a connection b/w upper and lower lung/rupture

83
Q

if pt with hemoptysis is at risk for cancer what should be done next? what if pt is not at risk?

A

not @ risk –> CT

84
Q

when would you get a cxr in chest pain or dyspnea?

A 
you would not be wrong to get one
---
but mostly if abnl exam 
- if >40yo or 
-at risk of cardiovascular dz
85
Q

what does the mediastinum consist of

A

heart, major vessels, and central lymph nodes situated between the lungs

86
Q

what are focal and diffuse lesions caused by in mediastinal lesions?

A

focal: masses
diffuse: infxn, bleeding, infiltrating tumor
* bottom of slides

87
Q

which mediastinal compartment are the lymph nodes in?

A

all three

88
Q

what is the most common anterior mediastinal mass

A

thymoma

89
Q

most frequent cause of middle mediastinal mass?

A

enlarged lymph nodes

seen on trachea border

90
Q

what are the most common posterior lesions?

A

neurogenic lesions

Medical Imaging (2 decks)

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