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Imaging (clinical anatomy) > Chest imaging > Flashcards

Chest imaging Flashcards

1
Q

What symptoms indicate CXR?

A
  1. Acute SOB
  2. Chronic cough >3w
  3. haemoptysis
  4. Sudden onset pleuritic chest pain
  5. chronic chest pain
  6. peripheral oedema
  7. productive cough
  8. sx’s of infection in someone immunocomp. / requires abx (homeless, elderly, IVDU, RIB FRACTURE…)
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2
Q

What signs indicate CXR?

A
  1. decreased or absent breath sounds
  2. added sounds: creps or crackles
  3. hyper/hyporesonant percussion
  4. respiratory distress
  5. tracheal tug / deviation (TREAT FIRST)
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3
Q

How might someone present w/ lung malignancy?

A

Acute: sudden onset SOB, pneumonia, dramatic haemoptysis

chronic: cough, small haemoptysis, hoarse voice, gradually ^ SOB/decreased exercise tolerance, gradual weight loss

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4
Q

Give some CXR features of lung malignancy

A

opaque lesion!!

other: pleural effusion, consolidation (secondary), collapse, satellite mets, cavitation, rib lesions, pleural plaques, hilar lymphadenopathy

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5
Q

How might someone with tension pneumothorax present?

A

ACUTELY UNWELL

signs of chest trauma (penetrating)

deviated trachea, Sudden SOB, respiratory distress (tachypnoeic, hypotensive, bradycardic [decreased CO + venous return])

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6
Q

What CXR signs would you see in tension pneumothorax?

A

Trachea deviated, absent lung markings, mediastinal shift (E.g. cardiac nuchal)

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7
Q

What CXR signs would you see in tension pneumothorax?

A

Trachea deviated, absent lung markings, mediastinal shift (E.g. aortic nuchal, shifted heart borders)

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8
Q

When would you request further imaging if you suspect lung malignancy?

A
  1. If CXR equivocal
  2. CXR shows lesion
  3. CXR shows no improvement after Abx
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9
Q

what is High resolution CT good for?

A

Bronchiectasis and pulmonary fribrosis

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10
Q

What are the different types of CT (not including normal CT)?

A

CTPA

HRCT

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11
Q

What further imaging would you do in CONFIRMED lung malignancy?

A

CT chest (furtehr evaluate + guide Rx)

CT abdomen (staging)

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12
Q

What are the symptomatic indications for imaging heart (echo)?

A

SYMPTOMS:

  1. breathless
  2. forthy sputum
  3. chest pain
  4. syncope
  5. palpitations
  6. Uncontrolled HTN
  7. Post-MI!!!!!!!!!!!!!

Signs:
palpitations O/E or ecg, heart murmur, signs of HF

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13
Q

What are the imaging modalities of choice for the heart and lungs?

A

Heart: CXR + ECHO (1st line)

Lungs: CXR + CT

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14
Q

When is CXR used to image the heart?

A

ONLY when HF suspected (ECHO is 1st line)

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15
Q

What 5 signs do you see on CXR of heart failure?

A 
Cardiomegaly
Kerley B lines (interstitial oedema)
pleural effusion
Prominent upper lobe vessels
Alveolar oedema (pulmonary oedema) = bat wings
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16
Q

What are the advantages of ECHO?

A

Non-invasive, cheap, non-ionising, REAL TIME FUNCTIONAL imaging, portable

17
Q

what are the disadvantages of ECHO?

A

poorer resolution than other modalities, obese, requires skilled person/intepretor

18
Q

What are some symptoms of HF?

A

Orthopnoea, paroxysmal nocturnal dyspnoea, peripheral swelling, SOB, decreased exercise, ascites

19
Q

Why would you CT the heart?

A
  • Coronary artery disease (CT angiography) or just XR coronary angiography
  • Assess masses picked up on ECHO
  • Assess pericardium
  • If MRI contraindicated
20
Q

Why would you use MRI to image the heart?

A
  1. assess cardiac function
  2. MR angiography
  3. gadolinium enhanced MR (ischaemic damage)
21
Q

What are 3 ways you can image the heart using nuclear medicine?

A

(((Gadolinium MRI –> ischaemic damage (SMALLER AREAS PICKED UP) –> GADOLINIUM ISN’T NUCLEAR/))))

  1. gated cardiac blood pool imaging (RBCs labelled w/ T99 –> assess LV function more accurately)
  2. SPECT: single photon emission CT (heart - T99 attached sestemibe) –> assess blood flow / myocardial perfusion in the heart
  3. FDG-PET –> ischaemic damage
22
Q

What information can you get from echocardiography?

A

wall thickness, valve function, masses, structural wall defects, wall abnormalities (post-mi), valve function, ejection fractions

23
Q

What can you use gadolinium MRI for?

A

Heart - ischaemia

Brain - SOL

24
Q

How can contrast be used to image the heart?

A

Gadolinium MRI

Imaging (clinical anatomy) (19 decks)

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