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Radiographic Pathology > Respiratory System > Flashcards

Respiratory System Flashcards

1
Q
  1. What is the main cause of air-space consolidation?
    o a) Air embolism
    o b) Replacement of air by fluids
    o c) Gas exchange defect
    o d) Tissue hypertrophy
A

B) Replacement of air by fluids

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2
Q
  1. A characteristic sign of consolidation in radiographs is:
    o a) Silhouette sign
    o b) Loss of diaphragm visibility
    o c) Increase in lung volume
    o d) Rib fractures
A

A) Silhouette sign

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3
Q
  1. Which imaging technique is best for detecting lung masses?
    o a) Chest X-ray
    o b) CT scan
    o c) Ultrasound
    o d) MRI
A

b) CT scan

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4
Q
  1. Lobar pneumonia typically starts in which structure?
    o a) Bronchi
    o b) Pleura
    o c) Alveoli
    o d) Blood vessels
A

c) Alveoli

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5
Q
  1. What is the main feature seen in atelectasis?
    o a) Air bronchogram
    o b) Volume loss
    o c) Increased heart size
    o d) Ground-glass opacity
A

b) Volume loss

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6
Q
  1. What radiographic sign suggests heart failure?
    o a) Air bronchogram
    o b) Kerley B lines
    o c) Pleural thickening
    o d) Nodular opacity
A

b) Kerley B lines

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7
Q
  1. What type of consolidation is most likely to show a batwing pattern?
    o a) Lobar consolidation
    o b) Diffuse consolidation
    o c) Bronchopneumonia
    o d) Pulmonary embolism
A

b) Diffuse consolidation

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8
Q
  1. Which abnormality is associated with loss of volume in the lung?
    o a) Atelectasis
    o b) Bronchiectasis
    o c) Emphysema
    o d) Pleural effusion
A

a) Atelectasis

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9
Q
  1. Which modality is best for demonstrating interstitial lung disease patterns?
    o a) MRI
    o b) Ultrasound
    o c) HRCT
    o d) Chest X-ray
A

c) HRCT

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10
Q
  1. The term “honeycombing” is associated with which condition?
    o a) Lobar pneumonia
    o b) Usual interstitial pneumonia (UIP)
    o c) Bronchopneumonia
    o d) Pneumothorax
A

b) Upper Interstitial Pneumonia (UIP)

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11
Q
  1. Which of the following is the characteristic radiographic sign of lobar pneumonia?
    o A. Air bronchogram
    o B. Kerley B lines
    o C. Cavitation
    o D. Pleural effusion
A

A) Air bronchogram

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12
Q
  1. What is the most common imaging technique used for diagnosing lung diseases?
    o A. Ultrasound
    o B. Chest Radiograph
    o C. PET-CT
    o D. Radionuclide Lung Scanning
A

b) Chest Radiograph

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13
Q
  1. Which imaging modality is best for identifying lung masses and determining malignancy?
    a. A. Chest X-ray
    b. B. PET-CT
    c. C. MRI
    d. D. Ultrasound
A

b) PET-CT

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14
Q
  1. Which of the following is not a feature of air-space consolidation?
    a. A. Loss of lung/soft tissue interface
    b. B. Air bronchogram
    c. C. Volume loss
    d. D. Homogeneous opacity
A

c) Volume loss

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15
Q
  1. Which disease typically presents with multifocal ill-defined opacities?
    a. A. Bronchopneumonia
    b. B. Atelectasis
    c. C. Pulmonary embolism
    d. D. Pleural effusion
A

a) Bronchopneumonia

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16
Q
  1. The silhouette sign is a loss of contrast between which structures?
    a. A. Bronchial walls and vessels
    b. B. Heart and diaphragm
    c. C. Lungs and pleura
    d. D. Diaphragm and costophrenic angle
A

b) Heart and diaphragm

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17
Q
  1. What is a common cause of diffuse pulmonary consolidation?
    a. A. Lung cancer
    b. B. Pulmonary embolism
    c. C. Cardiogenic pulmonary edema
    d. D. Pneumothorax
A

c) Cardiogenic pulmonary edema

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18
Q
  1. Air bronchogram is a key feature in which condition?
    a. A. Emphysema
    b. B. Lobar pneumonia
    c. C. Pulmonary embolism
    d. D. Pleural effusion
A

b) Lobar pneumonia

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19
Q
  1. What is the typical radiographic feature of atelectasis?
    a. A. Multifocal consolidation
    b. B. Volume loss with opacity
    c. C. Diffuse hyperlucency
    d. D. Ground glass opacity
A

b) Volume loss with opacity

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20
Q
  1. Kerley B lines are associated with:
    a. A. Pneumothorax
    b. B. Pleural effusion
    c. C. Interstitial edema
    d. D. Bronchopneumonia
A

c) Interstitial edema

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21
Q
  1. In pulmonary embolism, a triangular density on chest x-ray is a sign of:
    a. A. Pleural effusion
    b. B. Infarction
    c. C. Atelectasis
    d. D. Pneumonia
A

b) Infarction

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22
Q
  1. Which structure is typically not visible on a chest radiograph of normal lungs?
    a. A. Bronchi
    b. B. Blood vessels
    c. C. Alveoli
    d. D. Fissures
A

c) Alveoli

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23
Q
  1. The “comet tail sign” is indicative of:
    a. A. Pulmonary edema
    b. B. Bronchial atresia
    c. C. Rounded atelectasis
    d. D. Pneumonia
A

c) Rounded atelectasis

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24
Q
  1. What radiographic sign distinguishes cardiogenic from non-cardiogenic pulmonary edema?
    a. A. Volume loss
    b. B. Air bronchogram
    c. C. Increased heart size
    d. D. Diffuse consolidation
A

c) Increased heart size

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25
Q
  1. Which condition is most likely to show multiple pulmonary masses on imaging?
    a. A. Bronchial atresia
    b. B. Metastases
    c. C. Tuberculosis
    d. D. Pneumothorax
A

b) Metastases

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26
Q
  1. Which of the following is a classic radiographic sign of consolidation?
    a. A) Reticulation
    b. B) Air bronchogram
    c. C) Hyperlucency
    d. D) Kerley B lines
A

d) Kerley B lines

27
Q
  1. The silhouette sign on a chest X-ray indicates:
    a. A) Hyperinflation of lung tissue
    b. B) Loss of lung-soft tissue interface
    c. C) Pulmonary nodule
    d. D) Cavitation
A

b) Loss of lung-soft tissue interface

28
Q
  1. A lung mass with a “comet tail sign” is most likely associated with:
    a. A) Lung cancer
    b. B) Atelectasis
    c. C) Bronchopneumonia
    d. D) Pulmonary embolism
A

b) Atelectasis

29
Q

What imaging technique is most useful for identifying mediastinal masses and enlarged lymph nodes?

A

Computed Tomography

30
Q

What are the radiographic signs of air-space filling (consolidation)? / Describe the radiographic appearance and typical causes of air-space consolidation.

A

Ill-defined homogeneous opacity, silhouette sign, air bronchogram, no volume loss /

  • Radiographic Appearance: Air-space consolidation is characterized by ill-defined homogeneous opacity, often with the presence of air bronchograms, which indicate that the airways remain patent while the surrounding alveoli are filled. The silhouette sign, a loss of lung/soft tissue interface, is also common. The opacity does not typically cross fissures, and there is no associated volume loss.
  • Causes: Common causes include lobar pneumonia, where the alveoli are filled with exudate, hemorrhage, or cells. Other causes include pulmonary edema (fluid accumulation), alveolar hemorrhage, lung infarction, and some lung cancers.
31
Q

What is the significance of the air bronchogram in a chest radiograph? / How can air bronchogram help differentiate lobar pneumonia from other lung pathologies?

A

Indicates consolidation with relatively spared airways. /

  • Air Bronchogram: An air bronchogram is seen when the air-filled bronchi are made visible due to surrounding alveoli being filled with fluid, pus, or other material, as in lobar pneumonia. This sign is a hallmark of consolidation, particularly lobar pneumonia, and is less commonly seen in conditions like atelectasis (where the bronchial airways may collapse) or obstructive lung diseases (where airways are blocked).
32
Q

Explain the difference between cardiogenic and non-cardiogenic pulmonary edema.

A

Cardiogenic edema is related to heart failure and enlarged heart size, non-cardiogenic edema has other causes. /

  • Cardiogenic Pulmonary Edema: This is caused by heart failure and results in fluid accumulation in the lungs. Radiographically, it often presents as perihilar opacities in a batwing distribution with signs of an enlarged heart (cardiomegaly). Kerley B lines (horizontal lines near the pleura) are commonly seen due to interstitial edema.
  • Non-Cardiogenic Pulmonary Edema: Caused by conditions such as ARDS (acute respiratory distress syndrome), infections, or trauma, this type of edema lacks the heart enlargement seen in cardiogenic edema. The opacities are often more diffuse and peripheral, and may present without Kerley B lines.
33
Q

What condition does lobar consolidation typically indicate?

A

Lobar pneumonia

34
Q

How is pulmonary angiography performed, and what does it demonstrate?

A

Involves serial films after injecting contrast to demonstrate pulmonary arteries and veins

35
Q

Describe the key radiographic findings of atelectasis.

A

Sharply defined opacity, volume loss, displaced diaphragm/hilum

36
Q

What are the two types of scans used in radionuclide lung scanning, and what do they assess?

A

Perfusion scan assesses blood flow, ventilation scan assesses gas distribution

37
Q

Describe the radiographic signs and causes of lung consolidation.

A

o Lung consolidation occurs when air in the alveoli is replaced by substances like pus, blood, or tumor cells. Key signs include:
 Homogeneous opacity that obscures lung vessels.
 Silhouette sign (loss of border between lung and soft tissue).
 Air bronchogram (visible larger airways in the dense lung).
o Causes of consolidation include pneumonia (infection), pulmonary hemorrhage, and tumors.

38
Q

Explain the differences between lobar and diffuse consolidation.

A

o Lobar Consolidation:
 Affects one or more lobes of the lung, with sharply demarcated borders along lobar fissures.
 Common in bacterial pneumonia (e.g., lobar pneumonia).

o Diffuse Consolidation:
 Involves widespread lung areas, typically associated with conditions like pulmonary edema or bronchopneumonia.
 Appears as diffuse opacities, often involving both lungs (e.g., heart failure causing pulmonary edema).

39
Q
  1. Discuss the pathophysiology of atelectasis and its radiographic appearance.
A

o Atelectasis results from the collapse of lung tissue due to airway obstruction (e.g., tumor or mucus) or lung compression (e.g., pleural effusion or pneumothorax). The collapse causes volume loss and tracheal or mediastinal shift toward the affected side.
o Radiographically, it presents as:
 Sharply defined opacities.
 Loss of lung volume.
 Displacement of diaphragm or mediastinum.

40
Q

Compare and contrast the imaging findings of pulmonary edema and bronchopneumonia.

A

o Pulmonary Edema:
 Appears as diffuse bilateral perihilar opacities (“batwing” pattern).
 Often associated with an enlarged heart and fluid overload in heart failure.
 Kerley B lines may be visible.

o Bronchopneumonia:
 Starts in bronchi and spreads to surrounding lung tissue, resulting in multifocal ill-defined opacities.
 Typically does not cross lung fissures.
 May show air bronchograms and is often associated with infections.

41
Q

What are the radiographic characteristics of interstitial lung disease, and how is it diagnosed?

A

o Interstitial lung disease involves the lung’s interstitium (supporting structures). On imaging:
 Chest X-ray: Reticular (net-like) pattern.
 HRCT: Honeycombing in advanced fibrosis, ground-glass opacities in early disease.
o Diagnosis is often based on clinical presentation, imaging, and sometimes lung biopsy.

42
Q

Describe how pulmonary nodules and masses are identified and diagnosed using imaging techniques.

A

o Pulmonary Nodules:
 Solitary pulmonary nodules (SPN) are ≤3 cm, well-defined, and surrounded by lung tissue. CT and PET-CT are used to detect malignancy, particularly for nodules ≥1 cm.

o Pulmonary Masses:
 Larger lesions (>3 cm) are considered masses and are often malignant (e.g., lung cancer or metastasis). CT helps define the size, location, and characteristics of the mass.

43
Q

What is the role of CT in evaluating lung abnormalities compared to plain radiographs?

A

o CT provides superior detail compared to plain radiographs and is better for:
 Identifying small nodules or masses not visible on X-rays.
 Assessing mediastinal abnormalities and lymph node enlargement.
 Diagnosing bronchiectasis and fibrosing diseases.
 Pre-biopsy localization of pulmonary masses.

44
Q

Explain the use of PET-CT in diagnosing solitary pulmonary nodules.

A

o PET-CT is highly sensitive for detecting malignancy in solitary pulmonary nodules (SPN) larger than 1 cm. It uses radioactive tracers to highlight metabolic activity, as cancer cells typically exhibit increased glucose metabolism. PET-CT can differentiate between benign and malignant nodules, aiding in treatment decisions.

45
Q

Discuss the causes and radiographic features of pleural abnormalities, including effusions and pneumothorax.

A

o Pleural Effusion:
 Fluid accumulation in the pleural space. Radiographically, it appears as blunted costophrenic angles and fluid level on upright films. Large effusions can cause lung compression.
o Pneumothorax:
 Air in the pleural space leads to lung collapse. Radiographically, there is a visible pleural line with absent lung markings beyond it, and the lung appears smaller.

46
Q

How does the silhouette sign help in diagnosing lung pathologies on a chest radiograph?

A

o The silhouette sign refers to the loss of normal borders between structures of different densities, such as the heart and lungs. It helps localize pathologies:
 Loss of the right heart border suggests right middle lobe disease.
 Loss of the left diaphragm border points to left lower lobe pathology.
 It is useful in diagnosing conditions like pneumonia and pleural effusion.

47
Q

What radiological signs would indicate a pulmonary embolism, and how do they appear on imaging?

A
  • Radiological Signs: Pulmonary embolism may be subtle on plain chest radiographs. However, wedge-shaped consolidation or infarct (Hampton’s hump) can indicate a pulmonary infarction. In CT pulmonary angiography (the gold standard), a filling defect in the pulmonary arteries is a clear sign of embolism. Sometimes, pleural-based consolidation or cavitation can be seen if the embolism leads to infarction.
48
Q

Describe the comet tail sign and its significance in diagnosing rounded atelectasis.

A
  • Comet Tail Sign: The comet tail sign refers to a swirling appearance of blood vessels and bronchi curving around a pleural-based lesion, creating a “tail” effect. This is a characteristic sign of rounded atelectasis, a type of lung collapse where the lung tissue folds upon itself, often due to pleural disease or fibrosis. It is commonly seen in asbestosis and other fibrotic pleural conditions.
49
Q

Explain the importance of silhouette sign in chest radiography and its diagnostic value.

A
  • Silhouette Sign: The silhouette sign occurs when two structures of similar density (e.g., the heart and a consolidation in the adjacent lung lobe) lose their usual sharp interface, making it difficult to distinguish them on a radiograph. It helps localize pathology; for example, if the heart border is obscured, it suggests consolidation in the adjacent lung lobe (e.g., right middle lobe or left upper lobe pneumonia).
50
Q

What are the characteristic radiographic signs of bronchopneumonia, and how does it differ from lobar pneumonia?

A
  • Bronchopneumonia: Radiographically presents with multifocal, ill-defined, patchy areas of consolidation. It begins in the airways and spreads into the adjacent alveoli, leading to a more diffuse and bilateral pattern. It does not typically respect lobar boundaries.
  • Lobar Pneumonia: In contrast, lobar pneumonia shows a more uniform, well-defined consolidation affecting an entire lobe of the lung and usually presents with the air bronchogram sign.
51
Q

Plain Chest Radiograph

A

PA (Posteroanterior) and lateral views.
Check diaphragm, heart size and position, mediastinum, hilar shadows, lungs, ribs, clavicles, and soft tissues

52
Q

Computed Tomography (CT)

A
  • Useful for mediastinal masses, lymph node enlargement, mass localization, bronchiectasis, and parenchymal diseases like fibrosing alveolitis.
53
Q

Radionuclide Lung Scanning

A
  • Perfusion scan: Tc-99m injected, showing blood flow.
    • Ventilation scan: Radioactive gas (xenon or krypton) is inhaled, and distribution is imaged.
54
Q

Pulmonary Angiography

A
  • Used to visualize pulmonary arteries and veins.
55
Q

Ultrasound

A

Effective for pleural masses and effusions; can guide biopsies

56
Q

MRI

A

Limited use, helpful in lung cancers and neural tumors

57
Q

Types and Conditions of Abnormalities:

  1. Air-space Filling/Consolidation:
    o Cause: Replacement of air in alveoli by fluids (transudate, pus, blood, or tumor cells).
    o Signs: Ill-defined homogenous opacity, silhouette sign, air bronchogram.
    o Radiographic Appearance: Dense, white lung areas, possible air-bronchogram.
A

Causes and Radiographic Signs:
1. Consolidation:
o Cause: Pneumonia, hemorrhage, tumors.
o Radiographic Appearance: Opacities, air bronchograms, no volume loss.

**Lobar Consolidation:
- Typically seen in lobar pneumonia.
- Example: Pulmonary edema (cardiogenic vs non-cardiogenic).

58
Q

Types and Conditions of Abnormalities:

  1. Interstitial:
    o Cause: Diseases affecting the lung interstitium (fibrosis, edema).
    o Signs: Reticular or cystic patterns on HRCT; reticulation on CXR. Reticular patterns can indicate diseases like usual interstitial pneumonia (UIP).
    o Radiographic Appearance: Honeycombing in fibrosis; cysts with thin walls.
A

Causes and Radiographic Signs:
2. Interstitial Disease:
o Cause: Pulmonary fibrosis, edema, infections.
o Radiographic Appearance: Reticular patterns, honeycombing (fibrosis), cysts.

59
Q

Types and Conditions of Abnormalities:

  1. Nodular or Mass:
    o Cause: Solitary or multiple pulmonary nodules, lung cancers, metastases.
    o Signs: Solitary nodules (≤3 cm), multiple well-defined masses.
    o Radiographic Appearance: Cannon-ball pattern (metastases), PET-CT used for diagnosis.
A

Causes and Radiographic Signs:
o Cause: Cancer, metastasis.
o Radiographic Appearance: Solitary well-defined nodules, multiple masses.

60
Q

Types and Conditions of Abnormalities:

  1. Atelectasis:
    o Cause: Airway obstruction, lung compression, or fluid accumulation.
    o Signs: Volume loss, displacement of diaphragm or mediastinum, opacity without air-bronchogram.
    o Radiographic Appearance: Collapsed lobes, sharply defined opacities.
A

Causes and Radiographic Signs:
3. Atelectasis:
o Cause: Tumor, foreign body, pleural effusion.
o Radiographic Appearance: Volume loss, sharp opacity, tracheal shift.

61
Q

Types and Conditions of Abnormalities:

  1. Pleural Abnormalities:
    o Cause: Pleural effusion, pneumothorax, pleural masses.
    o Signs: Blunted costophrenic angles, displacement of structures.
    o Radiographic Appearance: Effusions appear as dense areas with fluid level.
A
62
Q

Types and Conditions of Abnormalities:

  1. Bone Abnormalities:
    o Cause: Fractures or lesions involving ribs or clavicles.
    o Signs: Rib fractures or misalignments.
    o Radiographic Appearance: Discontinuities or deformities in rib structure.
A
63
Q

Key Signs:
1. Air Bronchogram:
o Visible bronchi in consolidated lung tissue.
2. Silhouette Sign:
o Loss of normal lung-soft tissue boundaries.
3. Kerley B Lines:
o Short, horizontal lines near the pleura, indicative of interstitial edema.
4. Comet Tail Sign:
o Swirling of vessels around a mass, typically in rounded atelectasis.

A

Radiographic Pathology (1 decks)

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