Pulmonary

Question 1

what do B lines signify on ultrasound?

Answer 1

increased density

Question 2

how do you define diffuse B lines?

Answer 2

at least 2 zones per side with at least 3 b lines per zone

Question 3

t/f b lines move with respiration and go down to the bottom of the field of view

Answer 3

true

Question 4

will pulmonary contusion produce focal or diffuse B lines?

Answer 4

focal

Question 5

what is a C line?

Answer 5

subpleural consolidation or irregularity

Question 6

B and c lines arise from what structure?

Answer 6

visceral pleura

Question 7

how will air bronchograms show up in the lung on ultrasound?

Answer 7

white dots / lines within lung parenchyma

Question 8

in the setting of pneumonia, what is hepatization on ultrasound?

Answer 8

lung tissue looks like liver tissue

Question 9

what finding on ultrasound is pathopneumonic for PNA?

Answer 9

dynamic air bronchograms

Question 10

on ultrasound, you visualize focal B lines, C line, air and fluid bronchograms, and hepatization. what is the most likely diagnosis?

Answer 10

pneumonia

Question 11

what field or view is the most important when assessing for viral PNA with ultrasound?

Answer 11

posterior lung bases

Question 12

what is the primary difference between viral and bacterial PNA on ultrasound?

Answer 12

viral pna typically does not have pleural effusion, which is commonly seen in bacterial

Question 13

where do most pulmonary emboli occur?

Answer 13

posterior / inferior lung

Question 14

a patient with cough / fever has B lines, consolidations, thickened pleural line and air bronchograms, but no pleural effusion on ultrasound. what is the most likely diagnosis?

Answer 14

viral PNA

Question 15

pulmonary emboli subpleural lesions are typically in what measurement range?

Answer 15

> 0.5cm and less than 3cm

Question 16

pulmonary contusions, viral PNA and atelectasis typically will have subpleural consolidations in what measurement range?

Answer 16

< 0.5cm

Question 17

subpleural consolidations > 3cm are typically seen in what pulmonary pathology?

Answer 17

bacterial PNA

Question 18

if mirror sign is present on ultrasound of the lungs, what is most likely not present?

Answer 18

pleural effusion

Question 19

the spine sign is evidence of what pathology on lung ultrasound?

Answer 19

pleural effusion

Question 20

to assess for a pleural effusion, what landmark should you start at for scanning?

Answer 20

mid axillary line

Question 21

what are the four components of routine POCUS multi-organ physical exam for the CV / Resp system?

Answer 21

PLAX, anterior lung fields, RUQ/LUQ, and IVC

Question 22

to scan for pneumothorax, what is the patient position?

Answer 22

supine

Question 23

t/f A lines will be present in PTX and COPD

Answer 23

true

Question 24

what sign is most specific for PTX on ultrasound?

Answer 24

lung point

Question 25

t/f the curtain sign signifies normal lung

Answer 25

true

Question 26

describe the spine sign

Answer 26

spine should stop at the level of the diaphragm in normally aerated lung, if the spine is seen, then it signifies pleural effusion

Question 27

what artifact is sensitive but not specific for pulmonary edema?

Answer 27

b lines

Question 28

to diagnose pulmonary edema, what is the cutoff for amount of B lines per zone and how many zones are affected?

Answer 28

3 or more b lines per zone, 2 or more zones (per side)

Question 29

t/f B line artifact moves with lung sliding

Answer 29

true

Question 30

what is the difference between comet tail and b line artifact?

Answer 30

comet tail - tapers off
b line - goes to the bottom of the field of view