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Y3 Medicine > Radiology Imaging + Pathology > Flashcards

Radiology Imaging + Pathology Flashcards

1
Q

How can you determine whether a CXR is adequately inspired?

A

Anterior ends of at least 6 ribs should be visible

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2
Q

Name the different mediastinal borders on this image:

A
  1. Aorta
  2. Pulmonary artery
  3. Left auricle
  4. Left ventricle
  5. Right atrium
  6. Trachea
  7. Hemidiaphragm (right)
  8. Stomach bubble
  9. Horizontal fissure
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3
Q

What are some potential causes of Lobar Collapse?

A

Occurs when obstruction of a lobar bronchus

Causes of bronchial obstruction include tumours, aspirated foodstuffs, mucus impaction

(lobe supplied by obstructed bronchus no longer ventilation and air is resorbed = loses volume)

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4
Q

Identify this pathology:

A

Left Lower Lobe Collapse

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5
Q

Identify this pathology:

A

Left Upper Lobe Collapse

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6
Q

Identify this pathology:

A

Right Upper Lobe Collapse

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7
Q

Identify this pathology:

A

Right Middle Lobe Collapse

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8
Q

Identify this pathology:

A

Right Lower Lobe Collapse

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9
Q

What type of lobar collapse is visible here?

A

Right Middle & Lower Collapse

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10
Q

What area of the lung is affected by consolidation here?

A

Right Middle Lobe Consolidation

  • Increased density in right lower zone
  • Loss of clarity of right heart border but preservation of hemidiaphragm
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11
Q

Identify this pathology:

A

Left Lower Lobe Consolidation

  • Increased density in left upper + lower zones
  • Loss of clarity of left upper medistinum
  • Volume preserved
  • Air Bronchograms
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12
Q

What kind of pathology is visible on this CXR?

A

Right pleural effusion

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13
Q

What pathology is visible on this CXR?

A

Pneumothorax

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14
Q

What are the 4 main signs of pulmonary oedema on CXR in order of severity/occurence?

A
  1. Dilatation of upper lobe vessels/cardiomegaly
  2. Interstitial opacities (Kerley B lines, peribronchovascular cuffing)
  3. Airspace opacification (filling of alveoli with fluid, severe - batwing)
  4. Pleural effusion
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15
Q

What typical feature of pulmonary oedema is highlighted on this CXR?

A

Alveolar oedema/ BAT WINGS

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16
Q

Describe the placement of this endotracheal tube:

A
  • Tube inserted too far
  • Passed into right main bronchus
  • Signs of early collapse (due to unventilated left lung)

Normal = tip 5cm above carina, width 2/3 tracheal diameter (should not expand trachea)

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17
Q

Describe the placement of this endotracheal tube:

A
  • Correctly placed
  • Tip 5cm above carina
  • Width should be roughly 2/3 diameter of trachea (cuff should not expand trachea)
  • Both lungs are ventilated
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18
Q

Describe the ideal placement of a nasogastric tube?

A
  • Subdiaphragmatic position in stomach
  • Overlying gastric bubble
  • Should be at least 10cm beyong gastro-oesophageal junction
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19
Q

Describe the placement of this nasogastric tube:

A

NG tube misplaced

Located in right lower lobe bronchus

High change of infection/complications

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20
Q

The following image shows the pathways of various central venous catheters - where does each line originate from?

A

Yellow - peripheral central catheter (cephalic, basilic, brachial)

Purple - Right subclavian vein

Light blue - Right jugular vein

Dotted blue - Left jugular vein

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21
Q

What point in the heart is highlighted by the red circle in this image?

A

Cavoatrial Junction

The tip of a venous catheter should sit at the cavoatrial junction (SVC meets and melds with superior wall of right atrium)

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22
Q

What abnormality is visible on this CXR?

A

Pneumoperitoneum

(perforation of hollow viscus resulting in gas within peritoneal cavity)

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23
Q

What artery is affected in this ischaemic stroke?

A

Left PCA (posterior cerebral artery)

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24
Q

Which artery is affected in this ischaemic stroke?

A

Right ACA (anterior cerebral artery)

25
Q

Which artery is affected in this ischaemic stroke?

A

Right MCA (middle cerebral artery)

26
Q

What is visible in this CT and at what stage would you expect to see this during the evolution of a stroke?

A

= Hyperdense segment of a vessel

Direct visualisation of intravascular thrombus/embolus

Often EARLIEST visible sign on CT

27
Q

What is visible on this CT and at what point in a stroke evolution would you expect to see this?

A
  • = Loss of grey-white differentiation, and hypoattenuation of deep nuclei
  • Cortical hypodensity with associated parenchymal swelling (with resultant gyral effacement)
  • Typically seen within first few hours of presentation
28
Q

What is visible on this CT and at what stage in a stroke evolution would you expect to see this?

A
  • This is a later sign in a stroke presentation
  • With time, the hypoattenuation and swelling becomes more profound
  • Results in significant mass effect
29
Q

True or False:

Gliosis is an early finding on CT in stroke?

A

FALSE

Gliosis develops over time, eventually appearning as a region of low density with volume loss

30
Q

What type of cerebral haemorrhage is this?

A

Intra-axial haemorrhage/Intra-cerebral haemorrhage

Bleeding into brain parenchyma

31
Q

What type of cerebral haemorrhage is this?

A

Extra-dural haemorrhage

32
Q

What type of cerebral haemorrhage is this?

A

Sub-dural Haemorrhage

33
Q

What type of cerebral haemorrhage is this?

A

Sub-dural haemorrhage

34
Q

What type of cerebral haemorrhage is this?

A

Subarachnoid Haemorrhage

35
Q

What are the names of these different types of herniation?

A

A - Subfalcine

B - Central

C - Uncal

D - Tonsillar

36
Q

What pathology is imaged here?

A

Hydrocephalus

37
Q

What is the correct descriptions for this fracture types?

A

A - Transverse

B - Oblique

C - Spiral

D - Comminuted

38
Q

What is the correct descriptions for these fracture types?

A

A - Avulsion

B - Impacted

C - Torus

D - Greenstick

39
Q

What fracture is shown here?

A

Humerus surgical neck fracture

40
Q

What abnormality in this X-ray indicates there could be a possible pathology?

A

The anterior fat pad (and posterior slightly) is more visible than it would usually be

This indicates perfusion within that joint (blood or fluid)

41
Q

Which fractures (adults + children) will most commonly show abnormal fat pad?

A

Adults - radial head fracture

Children - supracondylar fracture (anterior sail sign)

42
Q

What is a Colles fractures and who is at most risk?

A

Fracture of distal forearm in which broken end of radius moves dorsally

Common in elderly, fall onto outstretched hand

43
Q

What is a Smith’s fracture?

A

Fracture of distal radius

With associated volar angulation of distal fracture fragments

(aka Reverse Colles fracture)

44
Q

True or False:

Intracapsular fracture of the femur have better healing than extracapsular fractures

A

FALSE

Intracapsular - lose blood supply to femoral head = AVN

Extracapsular - blood supply remains so improved healing

45
Q

What type of femur fracture is shown here?

A

Intracapsular fracture of femur

46
Q

What type of femur fracture is shown here?

A

Intertrochanteric fracture of femur

47
Q

What are some advantages and disadvantages of CT?

A

A - quick, accurate, allows better planning of surgery or intervention

D - radiation exposure, renal impairment,

48
Q

What pathology is seen on this CT?

A

Acute Appendicitis

49
Q

What pathology is this most likely to be?

A

Acute Cholecystitis

50
Q

What type of test is this?

A

MRCP

MR Cholangiopancreatography

(Can be used to show stones in common bile duct or GB causing obstruction)

51
Q

What pathology is shown here and who is most likely to get it?

A

Emphysematous Cholecystitis

= acute infection of GB wall caused by gas-forming organisms

(Air in gallbladder wall visible)

Seen in Diabetics

52
Q

What are some common causes and symptoms of Small Bowel Obstruction?

A

Causes - adhesions, cancer, herniae, gallstone ileus

Symptoms - vomiting, pain, distension

Signs - increased bowel sounds, tenderness, palpable loops

53
Q

What are some common causes of large bowel obstruction?

A

Colorectal cancer (60%)

Volvulus (15%)

Diverticulitis (10%)

54
Q

What are some potential causes of perforation?

A

Common:

  • Perforated ulcer (decreasing incidence as treatment improved)
  • Diverticular perforations (1-2% generalised, most localised)

Less common:

  • Secondary to cancer
  • Secondary to ischaemia
55
Q

What is the normal blood flow to the GI tract and at what level does ischaemia develops?

A

Normal GI blood flow - 20% cardiac output

If <20% ischaemia develops

56
Q

What are some symptoms + signs of bowel ischaemia?

A

Severe abdominal pain

Vomiting

Diarrhoea

Distension inconsistent

Borderline amylase

Raised WCC

Acidotic

57
Q

What pathology is seen on this scan?

A

Right Ureteric Calculus

58
Q

What pathology is seen on this scan?

A

Leaking AAA

Y3 Medicine (8 decks)

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