xray images Flashcards
65 year old smoker presents with 4 weeks of hemoptysis and progressive dyspnea
Total white out of R hemithorax
with deviation of trachea towards affected side
Marked atelectasis/collaped R lung
in this case who is a smoker with hemoptysis the most likeley cause is a endobronchial tumor
23 year old women recently retruned from Africa presenting with 4 weeks of cough, intermittent fever and weight loss
no wob
dullness to percussion
crackles in R lung base
film has opacity has RL lobe with air bronchogram
on lat film pt has spine sign
possible r paratracheal lymphadenopathy
RLL lobar pneumonia
caused by community acquired pneumonia (ie) strep pneumoniae)
due to recent travel and cachexia with duration of symptoms, also consider Tuberculosis
38 yo man with history of IV drug abuse presented to ER with fever and a new heart murmur, suspected to be secondary to endocarditis who delveloped progressive hypotension and resp distress over the first 12 hrs post admission
intubated, critically ill, febrile, hypotensive, diffuse loud crackles bilat
tachycardic, 3/6 systolic murmur at RUSB, 2/6 diastolic murmur at LLSB
technically poor film quality due to
1) significant multiaxial rotation
2) suboptimal penetration/contrast
3) inferior portion of thorax not included
findings
diffuse bilat patchy alveolar opacities
probable bilat effusions
non-cardiogenic pulmonary edema due to the following
normal cardiac size
regional distribution of opacities relatively patchy
air bronchograms which are common
No peribronchial cuffing
no kerley B lines seen
68 year old man presents to ER 2 days ago with dyspnea, 15kg weight loss, found to have a large left pleural effusion which was drained via chest tube. He initially felt improved but then abruptly developed severe shortness of breath and hypotension
in severe resp distress
hypotensive 74/52
Tachypenic 45
SPO2 86% on 10 L via face mask
absent breath sounds and hyperrensonance throughout l hemithorax
L large pneumothorax
L sided chest tube appears to be extrathoracic
Righward shift of mediastinum
which caused a
R sided tension pneumothorax secondary to technical problem with chest tube
pt also has innumerable tiny pulmonary nodules throughout R lung - metastatic disease is possible
76 year old women with 1 week od progressive dyspnea and bilat leg swelling. surgery 30 years ago for some heart valve surgery been on coumadin since
in mild resp discomfort
tachycardic 110
BP 145/100
RR 24
SPO2 94% on RA
irregularly irregular rhythm 2/6
systolic murmur at apex
elevated JVP
findings
Cardiomegaly
splaying of the carinal angle - L atrial enlargement
sternotomy wires
artificial heart valve (starr-edwards caged ball valve)
mitral valve that had been replaced
small right pleural effusion
Mild bilat perihilar alveolar opacities
most likely
CHF exacerbation
45 yo man with alcohol dependence presents with 2 weeks of productive cough and high fevers
acutely unwell
febrile
HR 125
SPO2 96% on RA
BP 110/66
SPO2 96% on RA
CTA bilat
alcohol makes him more prone to aspiration
cavitary lung lesion with air fluid level in the RLL (you can distinguish that it is in the RLL insead of RML in the lateral film because it is more posterior)
impression
Pneumonia with cavitation
vs lung abscess
vs tuberculosis
vs. solitary lung metastasis
55 yer old non smoker
no pmh
2 months of progressive dyspnea
well appearing
SPO2 90% on RA
diffuse bilat fine crackles
Intersitial opacities
-relatively sharp margin
reticular pattern
widened mediastinum - but pt is rotated
area circled is susupicious for aortic aneurysm or maybe arifact from rotation
idopathic pulmonary fibrosis
vs. Chronic hypersensitivity pneumonitis
Bilat enlarged Hila probably due to pulmonary hypertension
in a immune compromised pt
innunmerable bilat pulmonary nodules of varied size, most prevalent in mid lung zone
consistant with but not diagnostic of fungal pneumonia
mildly reduced lung volumes
lungs otherwise clear
cardiac silhouette unremarkable
colon interposed between liver and diaphragm
low lung volumes and incidental finding of Chilaiditis sign
what type of film is this?
what do they have?
Lordotic film
inferior displacement of L hilum
obscured descending aorta with a triagular retrocardiac and retromediastinal opacity
hyperlucency of L lung compared to Right
this person has a LLL collapse
what is this?
Round pneumonia
what is this
Hemithorax
what is abnormal here?
Mediastinal widening
which image has normal thymus and which has pneumonia
L is a normal thymus
R is pneumonia
which pic shows what process?
L shows atelectasis
R shows neuroblastoma
Label the cardiac ultrasound structures
1) Interventricular septum
2) LV
3) Descending aorta
4) MV
5) RV
6) AV
7) LA
