Radiology - Chest

Question 1

Is the heart larger in AP view or PA view?

Answer 1

AP view > PA view

Question 2

What is normal heart size for AP view?

Answer 2

<55-60% of thoracic width

Question 3

What is normal heart size for PA view?

Answer 3

<50% of thoracic width

Question 4

Bilateral pleural plaques can be associated with what condition?

Answer 4

Asbestos!

Question 5

Where is a thoracostamy performed?

Answer 5

2nd rib space MCL

Question 6

What is a hydropneumothorax?

Answer 6

Pneumothorax + plueral effusion

Question 7

What will a Kerley B line look like on x ray?

Answer 7

-horizontal lines in periphery of lungs

Question 8

What disease process are Kerley B lines associated with?

Answer 8

pulmonary edema

Question 9

What view has the highest sensitivity for a pleural effusion?

Answer 9

lateral view

Question 10

What are some defining characteristics of pneumonia on Xray?

Answer 10

• ill defined opacity
• Normal lung expansion
• Lobar opacity (maintained or increased volume)
• “silhouette sign” - loss of border of the heart

Question 11

What are some defining characteristics of atelectasis?

Answer 11

“lung collapse”

• lower lobes
• well-defined borders
• focal volume loss

Question 12

What is exudate?

Answer 12

fluid that filters from the circulatory system into lesions or areas of inflammation.

LEAKS OUT!

Question 13

What is transudate?

Answer 13

causes by hydrostatic or osmotic pressure disturbances, not inflammation

ex. Left ventricular heart failure, loss of protein (ex. nephrotic syndrome) leads to decreased oncotic pressure pulling fluid into vessels

Question 14

What are some intrinsic causes of atelectasis?

Answer 14

• mucus
• foreign body
• poor effort, hypoventilation
• lack of surfactant

Question 15

What are some extrinsic causes of atelectais?

Answer 15

• compressing mass (eg. tumor)
• compressing adenopathy (lymph node)
• misplaced ventilation tube

Question 16

Differential for lung cavities?

Answer 16

• TB
• Granulomatus infection (valley fever)
• Cancer (squamous cell carcinoma)
• inflammatory conditions (eg. Wegner’s disease)

Question 17

Where is an endotracheal tube placed?

Answer 17

3-5 cm above carina

Question 18

Where is a central catheter placed?

Answer 18

Superior vena cava (near the atriocaval junction)

Question 19

If an xray is overexposed it will appear?

Answer 19

too dark, black (too much radiation)

Question 20

In an xray is underexposed it will appear?

Answer 20

too light, white (too little radiation)

Question 21

Steps for reading a chest Xray?

Answer 21

Airway
Bones
Cardiomediastinal
Diaphragms
Effusions/edema
Fields (lung fields)
XSoft tissues

Question 22

Are calcified nodules an issue?

Answer 22

No, benign.

2 types:

• totally calcified
• centrally calcified

Question 23

What is a non-calcified nodule <3cm called?

Answer 23

nodule :)

Question 24

What is a >3cm nodule called?

Answer 24

mass

Question 25

If a nodule is 0.8cm or less what do you do?

Answer 25

follow up until stable for 2 years

Question 26

If a nodule is greater than 0.8cm what is proper treatment?

Answer 26

• Biopsy

- PET scan or CT scan

Question 27

What is a calcified nodule called?

Answer 27

granuloma

Question 28

How much radiation does someone get from a CT?

Answer 28

6-24 months of background radiation