Pulm Diagnostics Flashcards
initial study to evaluate pt w/respiratory problems
Chest xray
indication for CXR
- persistent cough
- chest injury
- hemoptysis
- chest pain
- SOB
conditions cant be detected w/cxr?
very small CA and PEs
indication of CT
further examination, characterize pulm nodules, staging neoplasm, differentiate lympadenopathy form vasculature , aortic dissection and aneurysm
risks of CT
radiation exposure, allergic to iodine and shellfish and kidney impairment if using contrast
pt taking Metformin (glucophage) when CT
should not take it for 48 hrs after exam
increased risk of what in peds pt with CT scans?
leukemia and brain tumors
in utero exposure to radiation w/CT is linked to ?
peds CA mortality in offsprings
CTA
- anatomical detail of vessels, 2. AVM 3. pulm arterial invasion by a neoplasm 4. r/o PE
what can be missed in CTA
subsegmental PEs
radiologic findings of PE
right PA enlargement, hamptons hump, filling defect in pulmonary branch, right pleural effusion
gold standard for PE
pulm angio
indication of pulm angio
V/Q or CTA inconclusive
risks of pulm angio
bleeding/hematoma at insertion site, arrhythmia, allergy, kidney disfunction, radiation
absolute contraindication of MRI/MRA
pacemaker/defibrillator, metal in eye, clips used on brain aneurisms, cochlear implant (relative)
estimating post op reserve capacity for pts undergoing lung resection
nuclear imaging
evaluate for metastasis from primary site
PET
can detect recurrence in previously irradiated, scarred areas of lung
PET
localizing fluid collection is common indication for ?
ultrasound
ABCs of CXR
Airways, Bones/Breast shadows, Cardiac silhouette, Diaphragm, Edges, Fields
bronchopneumonia
patchy, involves small bronchioles and adjacent alveoli
lobar pheumonia
consolidation, involves > or = 1 lobe
air bronchograms are a/w ?
pulm edema, blood, gastric aspirate, inflammatory exudate
sarcoidosis
Interstitial lung dz
honeycombing is a/w
diffuse interstitial fibrosis
increased radiolucency
COPD, Cysts, bulla, Emphysema, pnemothorax
prominent PA and hyper-lucent lung fields are a/w
COPD
lateral view of COPD
barrel chest, flat diaphragms, air trapping (retrosternal and inferacardiac)
transudative effusions caused by
abnormal lung pressure
HF and cirrhosis ? effusion
transudative effusion
exudative effusions caused by
inflammation of pleura
infections, malignancy, PE ? effusion
exudative effusion
PE
accumulation of fluid btw the layers of the membrane that lines the lungs and chest cavity
Pneumothorax
air trapped btw lund and chest wall –> lung caves inward /collapse
