Chest I

Question 1

definition of

Atelectasis

Answer 1

(collapse) is loss of lung volume due to decreased aeration.

Question 2

types of atelectasis

Answer 2

compressive, obstructive, contractive (ARDS, lung fibrosis)

ARDS = acute respirator distress syndrome

Question 3

describe signs of atelectasis by X ray [4]

Answer 3

1. rib crowding
2. high dome of the affected side
3. triangular shaped obacity (wedge-shaped)
4. inverted S sign
   By hakim:
5. Displacement of the fissure
6. Vascular crowdding
7. Elevation kf diaphragm
8. Ipsilateral Midastinal shiftting
9. Overinflated adjacent or contralateral lobe
10. Hilar displacement

Question 4

in case o atelectasis what is the next step

Answer 4

CT to discover the cause

Question 5

DDs of obstructive atelectasis

Answer 5

forign body aspiration (young), tumors (old)

Question 6

definition of

consalidaton

Answer 6

filling of the alveoli with a liquid like substance (blood, pus, water, cells)

Question 7

describe the consalidation radiologically

Answer 7

condense area and air bronchogram

Question 8

acute symtoms + consalidation = ?

Answer 8

Pneumonia

Question 9

waht is the cause of consalidation if it not treated by antibiotic

Answer 9

it may be tumor

Question 10

types of cavitary lesion in the lung:

just mention the main 4 forms

Answer 10

cavitary lesion
1. with air-fluid level
2. with irregular wall
3. with mobile fungal ball
4. multiple

Question 11

DDs of

cavitary lesion with air-fluid level

Answer 11

lung abscess, TB, pneumonia or squamus cell carcinoma

Question 12

DDs of

cavitary lesion with irregular speculated margin

Answer 12

~squamus cell carcinoma

Question 13

DDs of

multiple cavitary lesion

Answer 13

1. septic emboli from: endocardaitis or Wegener granulomatosis.
2. metastasis: squamous cell carcinoma (male) or uterine carcinosarcoma (female)

Question 14

special cavitation in pulmonary fungal infection

Answer 14

fungal ball (move with gravity)
pulmonary myocytoma (aspergilloma)
and crescent sign

Question 15

tumor of the plura

Answer 15

mesothelioma

Question 16

sign of empyema

Answer 16

split pleural sign + enhanced CT

Question 17

signs of tension pneumothorax by x ray:

Answer 17

1. loss of lung marks (lung collapse)
2. mediastinal sheft
3. flat diaphragm
4. hazy opposite lung (due to high blood supply)
5. increase intercostal spaces

treated by chest tube

Question 18

signs of pulmonary effusion by x ray:

Answer 18

1. opacity in the lower zone
2. oplitiration of:
   * the dome of daphrgm
   * (R/L) heart border
   * costo-phrinic angle
   * cardiophrenic angle
3. c spaped angle
   maybe uni or bilateral

Question 19

if there are signs of trauma (fracture, bullet), the pulmonary effusion is probably ____

Answer 19

hemothorax

Question 20

shape of opacity due to plural effusion:

mention three shapes/forms

Answer 20

1. c shaped –> plural effusion
2. air fluid level –> hydropneumothorax
3. encysted (bi convex) –> colliction in the fissure

Question 21

CT of mesothelioma

Answer 21

circumferential , nodular, thick, enhanced soft tissue (mass)

Question 22

multiple level reb fracture called

Answer 22

flail chest

Question 23

DDs of

bilateral nodular opacity in the hilum

Answer 23

hilar LN enlargement
1) lymphoma 2) sarcaidosis 3) TB

Question 24

air-fluid level in the mediastinum

Answer 24

(stomach) hiatus hernia

Question 25

air between diaphragm and liver

Answer 25

perforated viscus (perforated peptic ulcer) (pneumoperitoneum)

Question 26

crescent sign you can see it in which cases

Answer 26

1. funal ball 2. pneumoperitoneum

Question 27

how the pulmonary embolizm appeares radiologically

Answer 27

**filling defect** normally the both main branches of pulmonary vein should be completely opacifyed by contrast

Question 28

# spot diagnosis tearing pain

Answer 28

aortic disection --line inside the aorta