Radiology Flashcards
CXR is best initial test for
All forms of pulm complaints
- Cough, SOB, CP, sputum, hemoptysis
All forms of physical exam abnormalities
- Rales, rhonchi, wheezing, dullness to perc, chest wall tenderness, tracheal deviation, SVC syndrome
How man ribs in NL on CXR in inspiration
10-11
What should the pt do to better visualize PTX
Exhale
Important for PA films
Pt must be standing/Able to stand
Therefore pt is likely stable
CXR on unstable pts
AP - lying down, esp in ICU
Difference between AP and PA
Heart is bigger on AP
When to do decubitus CXR
Evaluate pleural effusion
Pt lies on each side, and effusion will freely move
What do we do instead of lordotic CXRs
Chest CT
When to do lateral CXR
Determine precise location of lesion seen in PA
Best initial test for pleural effusion
Lateral CXR (can detect 50-75mL) PA needs 200-300
Only time to do ABD XR
Ileus or SBO - multiple air fluid levels
The ONLY time to ABD XR for evaluation of stones
Emergency when U/S or CT are not available
Imaging for Bowel perforation
Upright CXR
Best initial test for osteomyelitis
Bone XR - elevation of periosteum
When to do MRI or bone scan for osteomyelitis
XR shows nothing
XR takes 2 weeks to become abnormal
When is skull XR the right answer
Never
When is head CT w/o contrast the best initial test
Severe head trauma
Stroke
Intracranial bleeding
When is head CT w/ contrast used
Cancer and Infection
BIT for any kind of intracranial mass lesion
Important points about CT w/ contrast
Never in severe renal failure
Hydrate w/ saline and give bicarb or NAC for mild insufficiency
Stop metformin before giving contrast
Essential when doing ABD CT
Oral and IV contrast
What is ABD CT good for
Retroperitoneal structures (PANCREAS) Appendicitis and other ABD infections Most accurate test for nephrolithiasis (no contrast) Masses in ABD organs Most accurate test for diverticulitis
When is Chest CT the answer
Hilar nodes Mass lesions Cavities Interstitial lung disease Parenchymal lung disease PE
What is MRI used for
Most accurate test of all CNS disease (except hemorrhage)
When is MRI the answer on the test
Demyelinating diseases Posterior fossa lesion Brainstem Pituitary Facial structures Bone lesions Spinal cord and vertebral lesions
With CA and infection what is the most accurate test
Bx
When is U/S the answer
Gallbladder disease
Renal disease
Gyn organs
Prostate (transrectal)
Endoscopic U/S is the most accurate test for
Pancreatic lesions (esp in the head)
Pancreatic and billiary ductal disease
Gastrinoma localization
What is HIDA for
Cholecystitis
What is a bone scan for
CA mets
Not nearly as specific as MRI
What is Gallium scan for
Fever of unknown origin
Checks Fe metabolism
What is Indium scan for
Fever of unknown origin in ABD
Tagged WBCs
What is V/Q scan for
PE
Replaced by Spiral CT
What is MUGA for
EF
