Respiratory

Question 1

Answer 1

Left Upper Lobe Collapse

• hazy / veiling opacity in L upper zone

obscured L heart border

mediastinal shift -> loss of volume of left hemithorax

elevation of L hilum

Question 2

Answer 2

increased opacification in the R middle and lower zones, with air bronchograms visible

Opacification up to the horizontal fissure suggests involvement of R middle lobe

R heart border and R hemidiaphragm are obscured

-> RML AND RLL lobar pneumonia

Question 3

Answer 3

increased opacification over the L lower zone

obscuration of the L hemidiaphragm

L heart border still visible -> suggesting anterior L upper lobe is not affected

-> left lower lobe pneumonia

usually community acquired pneumonia e.g. strep pneumoniae, h influenzae

Question 4

Answer 4

large volume lungs (v. hyperinflated)

flattened diaphragms

-> emphysema (due to smoking - bullae in apices or a1 antitrypsin deficiency - bullae mainly in bases)

or asthma

Question 5

Answer 5

Cardiomegaly

Distension of upper lobe veins

perihilar opacification

septal lines (going right out to the edge of the lungs - normal lungs should be quite dark along the periphery)

-> Cardiogenic Pulmonary Oedema

Question 6

Answer 6

dense perihilar consolidation

heart size normal (AP film - cant comment)

diagnosis:
non cardiac pulmonary oedema

Question 7

Answer 7

multifocal consolidation L>R

-> bronchopneumonia

(HAP)

PLUS

NGT in LLL

Question 8

Answer 8

loss of volume left hemithorax (mediastinal shift) compared to R

depression of L hilum

*triangular opacity behind heart (Sail sign)

-> LLL collapse

Question 9

Answer 9

opacification of whole left lung

marked loss of volume of left hemithorax -> mediastinal shift to L

tracheal deviation to the L

-> Left lung collapse

or lobectomy

Question 10

Answer 10

white hemithorax

L: mediastinal shift towards abnormal side

-> lung collapse

R: mediastinal shift away from abnormal side

-> pleural effusion

Question 11

Answer 11

pleural effusion but not much mediastinal shift

plus lobulated pleural thickening

-> malignant mesothelioma

(fibrotic pleura)

Question 12

Answer 12

numerous well defined nodules throughout both lungs

cannon ball lesions

-> pulmonary metastases

Question 13

Answer 13

dark hemithorax, visible lung edge

mediastinal shift to R

-> tension pneumothorax - medical emergency

Question 14

Answer 14

linear lucency adjacent to mediastinum

• > pneumomediastinum
• may feel surgical emphsema (crackly skin)