X-Ray

Question 1

Difference between acute and chronic extrinsic allergic alveolitis on X ray (5)

Answer 1

Acute: just diffuse micronodular interstitial pattern
Chronic:
- Esp. upper lobe
- Loss of lung volume
- Honeycomb lung (alveolar destruction - dense fibrosis)
- Chronic interstitial inflammation

Question 2

Simple coal worker’s pneumoconiosis

Answer 2

Small, round opacities in the upper zones

Question 3

Complicated coal workers’ pneumoconiosis/progressive massive fibrosis (4)

Answer 3

• Large, round fibrotic nodules
• > 10mm
• Usually upper zones
• Maybe infected by TB

Question 4

Pleural effusion (5)

Answer 4

• Tracheal deviation away
• Fluid level (from bottom)
• Costophrenic angle blunting
• Well defined border between lung and effusion: meniscus (lateral to medial slope like a dip)
• More bright opacification

Question 5

What does a bronchopneumonia chest xray show? (2)

Answer 5

• Infiltrate

- Patchy consolidation

Question 6

Sign of abdo peritonitus/perforation on chest x ray?

Answer 6

Free gas below diaphragm

Question 7

ARDS

Answer 7

Bilateral widespread infiltrate

Question 8

Collapse (3)

Answer 8

• Uniform soft tissue densitiy (pure white)
• Structures move into space = volume loss
• No meniscus sign

Question 9

Pulmonary oedema/HF (3)

Answer 9

• Pulmonary veonus congestion
• Increased cardio-thoracic ratio
• Pleural effusion

Question 10

Lobar puenmonia (6)

Answer 10

• Heart border obliteration
• Lobar pattern
• Consolidation (non uniform tissue density)
• No meniscus
• No shift of mediastinum

Question 11

COPD/asthma excerbation maybe (6)

Answer 11

• Hyperinflation :
• More than 8 anterior ribs
• Flat hemidiaphargm
• Bunting of costophrenic angle
• Decreased lung markings : lucent areas = empyhesema

Question 12

Puenmothorax

Answer 12

• Decreased vascular markings around outer lung fields
• White line=edge of normal
• Look around hilia

Question 13

Pulmonary fibrosis (2)

Answer 13

• Lines and dots shadowing

- Irregular in lower zones