Radiology Flashcards
what is the best initial radiology test for pulmonary complaints:
CXR
cough
sob (dyspnea)
chest pain, particularly when pleuritic or changin with respirations
sputum or hemoptysis
the cxr is also the best intial radiologic test for all forms of abnormalitieson the physical exam of the lungs, including
rales and ronchi wheezing dullness to percussion chest wall tenderness tracheal deviation possible svc syndrome (JVD, plethora of the face, venous distention of hte chest wall)
posterior anterior films (PA)
the PA film is the standard of care when a chest xray is done, pt must be able to stand up
anterior/posterior film (AP)
ap films are the answer for an unstable pt who is too sick to stand up for a PA film. They are often done with protable chest cray equiepment, also done in the ICU
decubitus films
these xrays are done to evaluate a pleural effusion found on a PA film. the pt lies down on each side and an effusion is cofrimed if the fluid in the chest is freely mobile and forms a layer on the side of the xray
widening of the mediastinum on the pa film is the best inital test of
thoracic aorta dissection
decubitus xrays are the answer
when the diagnosis of an infilitrate from pneumonia cannot be distinguished from an effusion
apical lordotic films
are almost never the right answer
lordotic xray of the chest is done with the pt leaning backward to take ribs out of the way in order to examine the upper lobes
lordotic fimls wehre originally the best initial test for tv which has an increased predilection for the apices of the lung
whenever apical lordotic fimls might be done, a CT scan of the chest is generally the best answer
Lateral CXR
done to help identify the precise location of an infiltrate found on a PA film. lateral xrays are the best initial test for an effusion since they detect as little as 50-75 ml of effusion. the pa chest xray becomes abnormal with an effusion only when 200-300 ml of fluid have accumulated
for perforation of the bowel get what type of xray
upright chest xray not an abdominal xray
abdominal xray is only good for
an ileus
bone xray
is the best initial test for osteomyelitis
you will see elevation of the periosteum
long standing bone infection gives destroyed bond with periosteal new bone formation
althorugh it will take at least two weeks for the bone xray to become abnormal with osteomyelitis, you should still do this study first
you will only obtain an mri of the bone or a nuclear bone scan if the xray does not show osteomyelitis
skull xrays
there is no first class indication for skull xray.
it is not the initial or most accurate test for anything
a skull xray does not rule out hemorrhage and an abnormal xray does not mean there is a hemorrhage
non-contrast head CT is the best initial test for
severe head trauma, especially with loss of consciousness or altered mental status
stroke
any form of intracranial bleeding including subarachnoid hemorrhage
CT scan with conrast
cancer and infection will enhance with contrast, you cannot distinguish between neoplastic disease and an abscess by CT scan or MRI, but the head CT with contrast is the best initial test for intracranial mass lesions
do not order contrast with severe
renal failure
