Pulmonary Diagnostics Flashcards
CXR indications for use? (5)
Initial study for:
1) cough
2) hemoptysis
3) chest injury
4) chest pain
5) SOB
CXR benefits? (4)
1) Low radiation
2) Low expense
3) Availability
4) Fast
CXR risks?
Limitations?
Radiation (0.1 mSv)
Pregnancy
Undetectable:
small CA
PEs
Computed Tomography (CT) indications for use? (4)
1) Add’l exam for CXR abnormalities
2) Characterize nodes
3) Eval/Staging CA
4) Differentiate LAD from vascular structures
CT benefits? (6)
1) More detail than CXR
2) Real-time imaging
3) Fast, available
4) Less expense than MRI
5) Few motion artifacts
6) Can use w/ metal implants
CT risks?
Limitations?
High radiation (8 mSv)
Contrast allergy/nephrotoxicity
Pregnancy
Kids ↑ risk CA
CT Angiography (CTA) indications for use? (3)
1) Blood vessel detail
2) Identification of arteriovenous malformation
3) Assess pulmonary artery invasion by neopl
4) r/o PE
5) Surgical guidance
CTA benefits?
Less invasive/expensive/time than catheter-directed
CTA risks?
Limitations?
Contract allergy/nephrotoxicity High radiation (15 mSv)
ø catch sub-segmental PE
Can’t fit fatties
Pulmonary Angiography (PA) indications for use? (2)
1) Gold Standard for PE
2) Inconclusive/suspicious V/Q or CTA
PA risks?
1) Arrhythmia
2) Bleeding
3) Contract allergy/nephrotoxicity
4) Radiation (5 mSv)
5) Invasive/expensive
Magnetic Resonance Imaging (MRI) indications for use? (3)
1) Hilar/mediastinal densities
2) Sulcus tumors
3) Cysts/lesions of chest wall
MRI benefits? (2)
1) No bone artifacts (vs CT)
2) No ionizing radiation
Magnetic Resonance Angiography (MRA) indications for use?
High quality image of blood vessels w/ less parenchyma resolution
MRA limitations?
1) Gadolinium (MRA contrast), can’t use w/ kidney dx
2) No fatties
3) No implants (pacemaker, metals, etc)
VQ Nuclear Imaging Scan indications for use?
1) Eval PE
2) Lung surgery preop eval
VQ phases of detection?
1) IV (perfusion): Tech-99-labeled albumin follows blood flow
2) Inhalation (ventilation): radio-labeled Xenon gas
VQ benefits?
1) Allergy rare
2) Low radiation (2 mSv)
Positron Emmission Tomography (PET) indications for use?
1) CA detection
2) Eval of CA tx
PET mechanism of action?
radio-labeled glucose injected,
uptake values measured,
↑ uptake = ↑ CA probability
PET benefits?
1) Early detection of biochem Δs
2) Radioactivity short-lived (low exposure)
PET limitations?
False + w/: Inflammatory lesions (granulomas)
False - w/:
slow-growing tumors
Ultrasound indications for use?
Limited
Localized fluid collection
ABCs of CXR?
Airways Bone/Breast shadows Cardiac silhouette Diaphragm Edges Fields
CXR findings for pneumonia?
Bronchopneumo:
Patchy
Small bronch/adjacent alveoli
Lobar Pneumo:
Consolidation
>= 1 lobe
Air Bronchograms seen when?
In what conditions?
fluid-filled alveoli surround air-filled bronchus -> makes it visible (dark spots)
Pulm Edema
Blood
Gastric Aspirate
Inflamm Exudate
Interstitial Lung Dx (ILD)
slide 55 blank
ILD caused by?
slide 56 blank
Causes of increased radiolucency? (3)
COPD
Cysts/bulla from emphysema
Pneumothorax
CXR findings w/ COPD? (5)
Hyperlucent lung fields Prominent pulm arteries ↑ AP diameter Flat diaph Retrosternal and infracardial air (air trapping)
Transudative Pleural Effusion is?
Accumulation of fluid b/w membranes in lungs/chest cavity, caused by abn lung pressure
(e.g. HF, cirrhosis)
Exudative Pleural Effusion is?
Accumulation of fluid b/w membranes in lungs/chest cavity, caused by inflamm of pleura
(e.g. infection, CA, PE)
Pneumothroax is?
Causes what?
Air trapped b/w lung and chest wall
Atelectasia (lung collapse)
Pneumothorax caused by?
Trauma
Iatrogenic (post tx)
Chronic lung dx
