MID 3 Flashcards
Displacement of an interlobar fissue is indicative of?
a. Volume change
b. Neoplasm
c. Lung expansion only
d. Atelectasis only
A. Volume change
Calcification of a pulmonary nodule indicates that it is most likely:
a. Primary malignant lesion
b. Benign lesion
c. Mets lesion
d. Cystic lesion
B. Benign lesion
A bronchopneumonia type of pattern would not be expected:
a. Aspiration pneumonia
b. Staph A. pneumonia
c. Viral pneumonia
d. Pneumoccoal pneumonia
B. Staph A pn.
WOTF is an infectious granulomatous disease?
a. Sarcoidosis
b. Eosinophilic granuloma
c. Wegener’s granulomatosis
d. Rheumatoid
e. Histoplasmosis
E. Histoplasmosis
Which of the following is not considered to be an associated cause of bronchogenic cancer
a. Cigarette smoking
b. Asbestosis
c. Pulmonary fibrosis
d. Previous histplasmosis
D. Previous histoplasmosis
Dys-motile cilia syndrome/Kartagener’s may have this radiographic finding:
a. Localized air space consolidation
b. Atelectasis
c. Situs inversus totalisa
d. Reticular interstitial disease
e. Multiple lung caviations
c. Situs inversus totalisa
Pulmonary actinomycosis is often contracted via
a. Inhale dust in an endemic area
b. Spread from a dental infection
c. Hematogenous spread from a primary GI infestation
d. Airborne droplet transmission thru coughing or sneezing from an infected individual
B. Spread from dental infection
Which one of the following disorders is related to noxious gas inhalation?
a. Silo filler’s disease
b. Farmer’s lung
c. Bagassosis
d. Byssinosis
e. Air conditioners lung
A. Silo filler’s disease
Early and intermediate stage silicosis is characterized by which radiographic finding?
a. Basilar fibrosis
b. Fibrotic masses adjacent to upper mediastinum
c. Patchy air space consolidation
d. Military nodules
e. Widespread honeycomb lung
D. Miliary nodules
With acute pulmonary infections:
a. Pneumococcal pneumonia usually begins centrally and spreads peripherally
b. Klebsiella pneumonia involves the upper lungs and has a fatality rate approaching 50%
c. Staph A. pneumonia produces pneumatoceles in both adults and children
d. Aspiration pneumonia occurs predominately in the upper lobes.
b. Klebsiella pneumonia involves the upper lungs and has a fatality rate approaching 50%
Thermoactinomyces vulgaris is associated with which two of the following?
a. Silicosis
b. Farmer’s lung
c. Silo filler’s disease
d. Mushroom workers lung
e. Talcosis
B. Farmer’s lung
D. Mushroom workers lung
Silicosis and TB could produce this radiographic finding
a. Subsegmental upper lung consolidation
b. Widespread acinonodular lung disease
c. Miliary interstitial lung disease
d. Calcified parenchymal nodule
C. Miliary interstitial lung disease
TB, Sarcoidosis, Connective tissue diseases & pneumoconiosis all have __________ in common
a. Air space consolidation
b. Interstitial disease
c. Nodular densities
d. Fibrosis
D. fibrosis
Aspiration pneumonitis
a. Causes bilateral patchy consolidation
b. Causes lobar consolidation
c. Causes bronchopneumonia pattern in right lung base
d. May cause a silhouette sign w/the ascending aorta
c. Causes bronchopneumonia pattern in right lung base
Chronic bronchitis
a. Stimulates honeycomb lung
b. >80% of cases related to cigarette smoking
c. Related chronic fungal infections
d. Common in lung bases
b. >80% of cases related to cigarette smoking
Which of the following is not considered to be associated with asbestos exposure?
a. Basilar fibrosis
b. Upper lung fibrosis
c. Mesothelioma
d. Linear diaphragmatic pleural calcification
e. Shaggy heart sign
B. Upper lung fibrosis
leural calcification and thickening would suggest the possibility of previous
a. Histoplasmosis
b. TB
c. Coccidioidmycosis
d. Actinomycosis
e. Moniliasis
B. TB
Caplan’s syndrome is RA plus:
a. Pneumoconioses
b. Fungal infection
c. TB
d. Sarcoidosis
A. pneumoconiosis
A number of connective tissue diseases have been reported to occur with increased prevalence in patients with pneumoconiosis. The combination of coal workers pneumoconiosis and rheumatoid arthritis is referred to as:
a. Carter’s syndrome
b. Wegener’s disorder
c. Langerhan’s granulomatosis
d. Caplan’s syndrome
D. Caplan’s syndrome
WOTF causes a cavitary space seen in association with infectious pneumonia?
a. Tumor cavitation
b. Infarction cavitation
c. Pneumatocele
d. Hematogenous mets
e. Bulla
C. Pneumatocele
WOTF may look similar to post primary TB?
a. Actinomycosis
b. Nocardiosis
c. Pneumocystis carini pneumonia
d. Coccidiomycosis
e. Klebsiella pneumonia
D. Coccidiomycosis
The chest x-ray may be normal with
a. Klebsiella pneumonia
b. Bronchiectasis/thromboembolic disease/acute bronchitis
c. Bronchopneumonia
d. Viral pneumonia
e. Pneumococcal pneumonia
b. Bronchiectasis/thromboembolic disease/acute bronchitis
The MC reason for mediastinal lymph node calcification include
a. Sarcoidosis and met osteosarcoma
b. Bronchogenic carcinoma and lymphoma
c. Fungal infections and TB
d. pneumooccoal and staph a. pneumonia
C. Fungal infections and TB
Understanding lymphatic drainage of the lung helps to explain all of the following except?
a. how pulmonary artery edema behaves
b. how infection may spread to hilus
c. how bronchiogenic cancer may spread to hilus
d. how consolidation spreads within a lobe
D. How consolidation spreads within a lobe
Pulmonary infarction:
a. Has no radiographic signs
b. Is seen as a pulmonary mass
c. Is seen as a round or oval opacity near the lung hilus
d. Is seen as air space consolidation at the lateral lung base
B. Is seen as a pulmonary mass
A vanishing tumor or phantom tumor of the lung could be associated with:
a. Right ventricular failure related to emphysema
b. Pulmonary edema related to high altitude
c. Cardiac disease related to systemic hypertension
d. Adenocarcinoma associated to lymph metastasis
c. Cardiac disease related to systemic hypertension
With large pneumothorax one might see:
a. Accentuated lung markings on the side opposite to the lesion in resorption atelectasis b. A shift of the mediastinum to the affected side with passive atelectasis
c. A pancake heart and no atelectasis
d. Absence of lung markings in the involved hemithorax with same side passive atelectasis.
d. Absence of lung markings in the involved hemithorax with same side passive atelectasis.
Aortic coarctation:
a. Enlarges the ascending aorta
b. Causes unilateral rib notching
c. Postductal, does not stimulate collateral circulation (THIS MIGHT BE THE ANSWER)
d. Compresses the trachea
B. Causes unilateral rib notching
A vanishing tumor or phantom tumor of the lung could be associated with:
a. Right ventricular failure related to emphysema
b. Pulmonary edema related to high altitude
c. Cardiac disease related to systemic hypertension
d. Adenocarcinoma associated to lymph metastasis
c. Cardiac disease related to systemic hypertension
With large pneumothorax one might see:
a. Accentuated lung markings on the side opposite to the lesion in resorption atelectasis
b. A shift of the mediastinum to the affected side with passive atelectasis
c. A pancake heart and no atelectasis
d. Absence of lung markings in the involved hemithoax with same side passive
atelctasis.
d. Absence of lung markings in the involved hemithoax with same side passive
atelctasis.
TB, Sarcoidosis, Connective tissue diseases & pneumoconiosis all have __________ in common
a. Air space consolidation
b. Interstitial disease
c. Nodular densities
d. Fibrosis
D. Fibrosis
ith large amounts of free pleural effusion:
a. The affected hemithorax appears excessively lucent
b. There may be a mediastinal shift to the affected side
c. There may be a mediastinal shift to the unaffected sided.
d. There is no mediastinal shift, but there may be tracheal deviation
c. There may be a mediastinal shift to the unaffected sided.
Pancoast tumor is a(n)?
a. Bronchogenic cancer
b. Bronchial adenoma
c. Alveolar cell carcinoma
d. Sarcoma
A. Bronchogenic cancer
Hypertrophic osteoarthropathy is a syndrome and is most often a clinical indication of
a. Atelectasis
b. Previous pulmonary TB
c. Pleuritis
d. Bronchogenic carcinoma
D. Bronchogenic carcinoma
The most common primary malignancy of the lung is:
a. Alveolar cell carcinoma
b. Bronchial adenoma
c. Carcinoid tumor
d. Bronchogenic carcinoma
D. Bronchogenic carcinoma
Aortic coarctation:
a. Enlarges the ascending aorta
b. Causes unilateral rib notching***
c. Postductal, does not stimulate collateral circulation
d. Compresses the trachea
c. Postductal, does not stimulate collateral circulation
What percentage of malignant mesothelioma will be associated with asbestosis approximately?
a. 80%
b. 60%
c. 50%
d. 90%
e. 40%
A. 80%
A mycetoma would most likely be found within the lung; however, they can also be found in paranasal sinuses. Which of the following could mimic a mycetoma within the lung?
a. Staph aureus cavitation
b. Fungal cavitaiton
c. Infected bulla
d. Incomplete tumor cavitation
B. Fungal cavitation
Indirect roentgen signs of lung collapse include all of the following except:
a. Vascular or bronchial crowding
b. Herniation of lung tissue
c. Tracheal deviation
d. Narrowed rib cage on collapsed side
A. Vascular or bronchial crowding
Three direct signs of lung collapse, as seen on plain film are:
a. Increased lung lucency, displaced fissures, and hilar elevation
b. Increased lung opacity, displaced fissures, and vascular or bronchial crowding
c. Unilateral hemidiaphragm elevation, tracheal deviation, displaced fissures
d. Hilar displacement, displaced fissures, hyperlucency of unaffected lung
b. Increased lung opacity, displaced fissures, and vascular or bronchial crowding
A meniscus sign may indicate:
a. Middle lobe syndrome
b. Atelectasis of a lower lobe
c. Interstitial infiltrates
d. Free pleural effusion
D. Free pleural effusion
On a thoracic spine series, a patient was found to have a fusiform shaped mass density at the retrocardiac space on the lateral view and a soft tissue density superimposing the lower thoracic spine on the AP view. The differential would include all of the following except:
a. Esophageal tumor
b. Aortic aneurysm
c. Hiatal hernia
d. Ectopic fibroid or foramen of morganani hernia
d. Ectopic fibroid or foramen of morganani hernia
Posterior eventration of the hemidiaphragm may be associated with which one?
a. Bronchogenic cyst
b. Esophageal hiatal hernia
c. Epicardial fat pad
d. Foramen of morgagmi
e. Foramen of bochadalek
e. Foramen of bochadalek
An air-fluid level seen behind the heart on a PA and lateral chest x-ray is probably:
a. Esophageal diverticula (Esophageal tumor)
b. Hiatal hernia
c. Esophageal carcinoma
d. Cascade stomach
C. Esophageal carcinoma
Which of the following is associated with ASD and hypoplastic or nonfunctioning right ventricle:
a. Tetralogy of fallot
b. Trilogy of fallot
c. Tricuspid atresia
direct signs of lung collapse, seen on plain film are:
d. Transposition
e. Ebstein’s anomaly with cyanosis
C. Tricuspid atresia
Which combination of defects would have a high volume left to right shunt called loop /
loochenbacher’s syndrome?
a. PA with aortic stenosis
b. ASD with aortic stenosis
c. VSD with pulmonic stenosis
d. ASD with mitral stenosis
e. VSD with mitral stenosis
d. ASD with mitral stenosis
Which of the following would not be the cause of left ventricular enlargement:
a. ASD
b. Systemic hypertension
c. PDA
d. Aortic coarctation
A. ASD
hich one of the following is associated with a common ventricle and a large single blood vessel leaving the heart?
a. Tetralogy of fallot
b. Truncus arteriosus
c. Tricuspid atresia
d. Transposition
e. Ebstein’s anomaly with cyanosis
b. Truncus arteriosus
Which one of the following is non-cyanotic?
a. Tetralogy of fallot
b. Trilogy of fallot
c. Transposition of the great vessels
d. Ebstein’s anomaly*****
e. VSD + Eisenmenger
e. VSD + Eisenmenger
Which condition would not be considered a precursor for congestive heart failure?
Pulmonary fibrosis
Aortic stenosis
Mitral regurgitation
Coronary artery disease or VSD + Eisenmenger
Pulmonary fibrosis
. Mediastinal teratoma’s are usually located in which compartment
a. Anterior
b. Middle
c. Superior
d. Inferior
e. Posterior
A. Anterior
Mediastinal hiatal hernias are located in which compartment? (OLD QUESTION)
a. Anterior
b. Middle
c. Superior
d. Inferior
e. Posterior
B. Middle
Posterior mediastinal masses may:
a. Produce an air fluid level
b. The most common mediastinal masses
c. Most commonly caused by aortic aneurysms
d. Are associated with adjacent bone remodeling changes
d. Are associated with adjacent bone remodeling changes
Esophageal acalasia may present as:
a. An anterior mediastinal mass
b. A middle mediastinal mass
c. Hilar enlargement
c. Sinus polyptosis d. Acute rhinitis
d. Posterior mediastinal mass
b. A middle mediastinal mass
Chamber enlargement confined to the right atrium would be expected with which one of the following:
a. Ebstein’s anomaly
b. Aortic coarctation
c. Emphysema
d. Patent ductus arteriosis
e. V entricular septal defect
a. Ebstein’s anomaly
Which of the following would not be the cause of right ventricular enlargement
a. Emphysema
b. Ebstein’s anomaly
c. Pulmonic stenosis
d. VSD
b. Ebstein’s anomaly
Which of the following conditions usually originates at the lower portion of the anterior mediastinum?
a. Teratoid cyst
b. Lymphadenopathy
c. Aortic aneurysm
d. Substernal thyroid
D. Substernal thyroid
Which primary malignancy is responsible for the greatest number of hematogenous metastatic cases?
a. Osteosarcoma
b. Colon cancer
c. Renal cell carcinoma
d. Ewing’s sarcoma
e. Breast cancer
E. Breast cancer
Eisenmenger physiology converts a left to right shunt to a right to left shunt.
a. True
b. False
True
Patent ductus arteriosus with eisenmenger physiology would have cyanosis.
a. In the lower extremity only
b. In the upper extremity only
c. In the upper and lower extremity
d. Neither, it does not happen with PDA
A. In the lower extremity only
Pulmonary infarction:
a. Has no radiographic signs
b. Is seen as a pulmonary mass
c. Is seen as a round or oval opacity near the lung hilus
d. Is seen as air space consolidation at the lateral lung base
B. Is seen as a pulmonary mass
Which cause of pleural effusion would be expected to produce an “atypical” effusion?
a. Empyema
b. Congestive heart failure
c. Pulmonary infarction
d. SLE
e. Pleural metastasis
B. CHF
Combination of Kerley’s A & B lines, interstitial pulmonary edema & cephalic shift of pulmonary vascularizaiton suggest a diagnosis of:
a. Congestive heart failure
b. Ebstein’s anomaly
c. Pulmonic stenosis
d. Mitral regurgitation
A. CHF
Hodgkin’s disease may create a radiologic appearance of:
a. Silhouette sign
b. Extra pleural sign
c. Bulky mediastinal widening
d. Cephalic shift
e. Vascularization
c. Bulky mediastinal widening
Increased density and widening of the upper mediastinal with tracheal displacement would be
consistent with:
a. a. pericardial cyst
b. b. Lymphadenopathy
c. Thymoma
d. Substernal thyroid (thyrote)
d. Substernal thyroid (thyrote)
Clinical symptomology related to bronchogenic cancer is often times non-specific. What percentage of patients with lung cancer are asymptomatic at the time of diagnosis?
a. 45
b. 25
c. 60
d. 10
B. 25
Pulmonary metastasis happens through 3 mechanisms: Hematogenous, Lymphagenous, and contiguous direct extension.Direct Extension pulmonary metastasis happens most commonly from:
a. Esophagus / Thyroid
b. Lung / Gastric
c. Pleural / Pericardium
d. Mediastinum / Diaphragm
c. Pleural / Pericardium
Calcification within pulmonary metastatic nodules would suggest which type of primary cancer?
a. Osteosarcoma
c. Neuroblastoma
b. Ewing’s sarcoma
d. Fibrosarcoma
A. Osteosarcoma
Rectal gas helps to discriminate between paralytic/adyramic Ilius and mechanic/obstructive Ilius.
a. True
b. False
true
3 Major mediastinal organs are: Esophagus, Trachea, and Aorta. Most commonly middle
mediastinal masses are from:
a. Trachea
b. Esophagus
c. Aorta
d. Lymph nodes
d. Lymph nodes
Hylar mediastinal Lymphadenopathy is most often due to ______ in young patients and ______
in older patients.
a. Sarcoidosis / Lung Cancer
b. Hystoplasmosis / TB
c. Coccidiomycosis / Lymphoma d. Hodgkin’s Dx / Lung Cancer
a. Sarcoidosis / Lung Cancer
Indirect signs of lung collapse are?
a. Increased lung lucency, displaced fissures and hilar elevation
b. Increased lung opacity, displaced fissures and vascular or bronchial crowding
c. Unilateral hemodiaphragm elevation, mediastinal deviation, rib interspace narrowing d. Hilar displacement, displaced fissures, hyperlucency of unaffected lung
c. Unilateral hemodiaphragm elevation, mediastinal deviation, rib interspace narrowing
Which two of the following would be considered acute pulmonary infections?
a. Pneumococcal pneumonia
b. Klebsiella
c. TB
d. Sarcoidosis
e. Coccidiomycosis
a. Pneumococcal pneumonia
b. Klebsiella
