how do you protect someone’s kidneys to avoid CIN? contrast induced nephropathy
hydration
why can a VQ scan miss a saddle embolus?
you are looking for mismatch (areas that are ventilated, but not profused)-you’ll be equal profusion to both lungs with this type of embolus…use a CTA
when would you use a VQ?
- pt has contrast allergy and you need the scan right away
- if CTA is not clear on whether there is a small one
how do you read a CXR?
- mediastinum and the heart
- lungs (back and forth with eyes over each lung field)
- bony structures
what is a spiculated mass?
looks like a sunburst
why do you use contrast on a lung CT?
be able to view the mediastinum more affectively and evaluate if there is mediastinal hilar LAD
which lesion do you biopsy in lung cancer?
highest stage lesion
which imaging should you use to look for metastasis?
PET/CT (although not good at looking at the brain) add MRI of the brain
how does a PET scan work?
evaluates sugar uptake (FDG uptake)
what is risk of pneumothorax in aCT FNA of the lung?
10-15%
what is an EBUS with TBNA?
endobronchial ultrasound with transbronchial
allows you to biopsy a lymphnode along the trachia
what is TBBX?
transbronchial biopsy (with superdimension bronchoscopy) allows you to biopsy very distal lesions
what disease makes your lungs look big?
COPD
what are the characterstics of COPD chest XR?
flattened diaphram
big lung fields
how will lung squish in a pneumothorax?
will squish medially
what is a deep sulcus sign?
sign of a pneumothorax
what it will look like in a supine patient
always know what about your CXR
what position the patient is in
what do you look for in sick pts with a portable chest xray?
deep sulcus sign
what is good to measure pulmonary pressure?
echo
how do you measure pulmonary artery pressure?
tricuspid regurgitant jet
how is pulmonary edema located in heart failure
centrally located (bat wing)
what is borhoff syndrome?
tear in the esophagus
pneumomediastinum
what is classic presentation of pericarditis?
URI sxs with CP radiating to the right shoulder
what is EKG reading of pericarditis
ST elevation
what does CT do to size of effusion?
always overestimates
what is in break pads?
asbestos
what is bronchiectasis
irreversibly enlarged airways
what indicates mesothelioma?
thickening or pleural nodularity on the medial pleura
what procedure is needed for an obstruction?
bronchoscopy
what causes a complete white out from a pleural effusion?
lung cancer
subcutaneous emphysema
air in the soft tissue
-worry about pneumothorax
what can cause pneumoperitoneum?
perforated ulcer
