CXR Common Pathologies Flashcards

1
Q

How does pneumonia show on CXR?

A

dense or patchy consolidation

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2
Q

What can you confuse pneumonia with?

A

in lower zones hard to distinguish from effusion (mention in differentials)

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3
Q

How do you know which lobes are affected by the pneumonia?

A

loss of clarity of borders indicates lobes affected

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4
Q

If diaphragm border is affected which lobe has pneumonia?

A

left or right lower lobe

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5
Q

If the right heart border is not as clear which lobe is affected by pneumonia?

A

RML

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6
Q

If the left heart border is not as clear which lobe is affected by pneumonia?

A

linguila

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7
Q

How would you describe a pleural effusion?

A

a homogenous opacification of (right middle and lower zones) of chest

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8
Q

What are the 4 features of a pleural effusion?

A
  1. Loss of costophrenic angle
  2. Homogenous opacification
  3. Fluid level (manifests as meniscus)
  4. Exudates vs Transudates
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9
Q

When is it a transudate?

A

bilateral effusion

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10
Q

When is it an exudate?

A

unilateral effusion

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11
Q

How do you really determine if it is an exudate or transudate?

A

pleural aspiration

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12
Q

How can you tell if pneumothroax and which side?

A
  1. trachea central
  2. darker and less vasculature
  3. loss of lung markings in peripheral lung field
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13
Q

How can you tell if tension penumothorax?

A
  1. tracheal/mediastinal deviation away from pneumothorax (darker side)
  2. Flattening of ipsilateral dome of diaphragm
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14
Q

How do you treat tension pneumothorax?

A

immediately (insert cannula into 2 ICS)

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15
Q

What could the 4 causes of a single coin lesion be?

A
  1. Malignancy
  2. Infection
  3. Infarction
  4. Inflammation
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16
Q

What could the malignancy causes of a single coin lesion be?

A
  1. bronchial

2. single pulmonary metastasis

17
Q

What could the infection causes of a single coin lesion be?

A
  1. pneumonia
  2. abscess
  3. TB
  4. hydatid cyst
18
Q

What are the inflammatory causes of a single coin lesion?

A

rheumatoid nodule

19
Q

What are the two types of causes for hilar lymphadenopathy?

A
  1. Neoplastic

2. Infective

20
Q

What are the neoplastic causes of hilar lymphadenopathy?

A
  1. Spread from bronchial cancer

2. Lymphoma

21
Q

What are the infective causes of hilar lymphadenopathy?

A

TB

22
Q

What are the inflammatory causes of bilateral hilar lymphadenopathy?

A

sarcoidosis

23
Q

What are the tumour causes of bilateral hilar lympahdenopathy?

A
  1. mets
  2. bronchial cancer
  3. lymphoma
24
Q

What are the infection causes of bilateral hilar lymphadenopathy?

A
  1. tb
  2. aids
  3. recurrent chest infection
25
Q

What are the features of heart failure on a CXR?

A
  1. Patchy heterogenous opacification bilaterally (sparing of upper lobes)
  2. Cardiac borders blunted and cardiomegaly
  3. Cardiophrenic angle and costophrenic angle blunted
  4. Bat wings (type peri-hilar haziness)
26
Q

What is an ABCDEF description of heart failure?

A
  • A: alveolar (interstitial) shadowing
  • B: Kerley B lines
  • C: cardiomegaly (cardiothoracic ration >50%)
  • D: upper lobe diversion (prominent upper lobe vasculature)
  • E: effusion
  • F: fluid in horizontal fissure
27
Q

What are Kerley B lines?

A

little white horizontal dashes usually in lateral lower edge

28
Q

How migh interstitial lung disease (pulmonasry fibrosis) show up on CXR?

A

diffuse bilateral reticular shadowing

29
Q

How does surgical empysema show up on CXR>

A

air between skin and subcart tissue

30
Q

What is surgical emphysema usually caused by?

A

trauma

31
Q

What latrogenic trauma can cause surgical emphysema?

A
  1. chest drains
  2. surgery
  3. thoracotomy
32
Q

What blunt trauma can cause surgical emphysema?

A
  1. stab

2. gunshot wound

33
Q

How can you determine pneuoperitoneum?

A

patient usually needs to have sat upright for more than 15 mins to allow air to rise

34
Q

What are the causes of pneumoperitoneum?

A
  1. laparoscopic surgery

2. perforated viscus

35
Q

What are causes of enlarged heart?

A
  1. Congestive cardiac failure
  2. Pericardial effusion
  3. Cardiomyopathy
36
Q

What does a right sided pleural effusion to mediastinum?

A

pushes mediastinum to left

37
Q

What does a right sided tension pneumothorax do to the mediastinum?

A

pushes mediastinum to left

38
Q

What does a right-sided lung collapse + pneumonectomy do to mediastinum?

A

pulls the mediastinum to right