DI Midterm Exam Material Flashcards
(142 cards)
1
Q
T/F: Pneumomediastinum may result in dyspnea
A
False
1
Q
If you see an enlargement in this region, what should your top two differentials be?
A
Tracheobronchial lymphadenopathy and Left atrial enlargement
2
Q
T/F: Ring Shadows (donuts) are often associated with a bronchial pattern
A
True
Bronchial pattern: donuts and tram lines
3
Q
T/F: Hepatic veins have a hyperechoic wall on ultrasound
A
False
Hepatic veins have an isoechoic wall
3
Q
This is a sagittal image of the left kidney. Which side is cranial?
A
That one.
3
Q
What view would be best for evaluating lesions in the right lung lobes?
A
Left Lateral
- In small animals, lung lesions generally are detected best in the non-dependent lung because the “up” lung is better aerated and therefore provides better contrast of lesions*
- Keep in mind, other lesions (not in the lung) generally are best seen on the “down” side because they are not distorted by magnification*
3
Q
What echocardiographic modality would you use to measure wall thickness during systole and diastole?
A
M Mode
4
Q
Name the MR sequence that nulls signal from free fluid (i.e. CSF):
A
FLAIR
_FL_uid _A_ttenuated _I_nversion _R_ecovery
4
Q
Is sternal lymphadenopathy present in this patient?
A
Yes.
Note the enlargement of the sternal lymph node
4
Q
T/F: Ascites is commonly associated with mitral valve insufficiency
A
False
That is false
5
Q
Is the circled lesion more likely in the lung or the mediastinum?
A
Lung
Note the acute angle to the body wall. If the lesion was in the lung you would not have such an acute angle
5
Q
With which radiographic view is mediastinal shift best visualized?
A
VD/DV
5
Q
Doppler measurements should be taken with the patient in ______ lateral recumbency
A
LEFT
5
Q
If you see a “bow-legged cowboy sign” on a DV view, what is your DDx?
A
left atrial enlargement
6
Q
Identify the lymphatic structure indicated by the number 3:
A
Tracheobronchial
6
Q
T/F: Diaphragmatic hernias cause caudal displacement of the gastric axis
A
False
Diaphragmatic hernias cause cranial displacement of the gastric axis
7
Q
Long-axis left ventricular outflow view.
Identify the structure indicated by the number 2
A
right atrium
8
Q
T/F: An overexposed radiograph is too light
A
False
An overexposed radiograph is too dark. Either kVp or mAs is too high.
8
Q
T/F: If you suspect a lesion in the right lung of a dog, a left lateral thoracic radiograph should be made
A
True
8
Q
What diagnostic imaging modalities might you use if you suspect a diaphragmatic hernia?
A
Radiographs, Ultrasound, Barium Study
RUB the hernia…
…creep
9
Q
T/F: Atelectasis is associated with normal to increased size of the lung lobe
A
False
- Atelectasis is associated with decreased size of the lung lobe*
- Consolidation is associated with normal to increased size of the lung lobe*
11
Q
This presentation is most often associated with _______ insufficiency
A
mitral insufficiency
Turbulent flow (regurgitation); often bright and a mixture of colors
11
Q
T/F: Mammary adenocarcinomas are typically associated with mediastinal lymphadenopathy
A
False
12
Q
T/F: Tracheobronchial lymphadenopathy is an example of a cranioventral disease
A
False
Tracheobronchial lymphadenopathy is an example of a dorsal disease
12
T/F: Pneumothorax may progress to pneumomediastinum
**No!**
*Pneumomediastinum may progress to pneumothorax, but not the other way around*
13
When using **grids** for radiographs, how should you adjust the mAs?
**Increase mAs**
The grid 'intercepts' scatter from patient before it reaches film. You need 2x-3x more photons when grid is used (higher mAs) due to absorption of primary beam by lead
13
If you suspect a **right lung lesion**, what radiographic views would you take for the dog? What about a horse?
Dog: **R → L**
Horse: **L → R**
14
Which has better contrast resolution: **flat panel** or **film**?
**Flat panel**
14
Identify the cardiac abnormality:
**Pericardial Effusion**
14
T/F: The **cranial vena cava** is normally visible radiographically in the mediastinum
**False**
15
T/F: Decreased mAs would contribute to increased film blackness
**False**
*Increased* mAs would increase film blackness
15
T/F: A diagnosis of cardiac failure can not be based on echocardiology alone
**True**
16
Are mediastinal masses typically more evident in a **lateral view** or a **ventrodorsal view**?
**ventrodorsal (VD) view**
18
T/F: The **esophagus** is normally visible on survey radiographs
**FALSE**
*The esophagus is normally _not_ visible on survey radiographs*
19
What is the most common **vascular ring anomaly**?
**Persistent right fourth aortic arch**
20
If the distance between the film and the x-ray source decreases from 40" to 30", how much does radiation intensity at the film change?
**By 402/302**
Intensity of radiation (x-rays/unit area) decreases with the square of the distance from the source
21
Identify the structure indicated by the red star:
**caudal vena cava**
22
This "scalloping" appearance of the lung margins indicates:
**pleural effusion**
24
Identify the lymphatic structure indicated by the number 2:
**Cranial Mediastinal**
28
For thoracic radiographs, what should your mAs and kVp settings be?
high kVp, low mAs
30
\_\_\_\_\_\_\_\_\_ is the extent to which a film, image plate or flat panel can be over and underexposed and still acheive an acceptable result
**Exposure latitude**
32
Identify the structure indicated by the red star:
**right middle lung lobe**
33
Is **pneumomediastinum** present in this radiograph?
**Yes**
*Normally all of the tubular structures arent so readily visible, but in the case of pneumomediastinum gas acts as a contrast agent and allows for visualization of structures that would normally be undetected*
34
Is this radiograph *under-exposed* or *over-exposed*?
**Over-exposed**
*To correct this radiograph, you could decrease the mAs or decrease the kVp*
35
The number of x-rays produced in a radiograph is quantified as:
**mAs**
36
T/F: Doubling the mAs doubles the amount of x-rays produced
**True**
37
Of the many structures present in the mediastinum of the normal thorax, only a few structures are seen radiographically.
## Footnote
**Name 'em, biatch!**
* ****_H_**eart**
* ****_A_**orta**
* ****_T_**rachea**
* ****_T_**hymus** (young animals)
* ****_C_**audal vena cava**
* ****_O_**ccasionally Esophagus** (left lateral)
## Footnote
*"**_H_**ere **_A_**re **_T_**he **_T_**hings **_C_**ommonly **_O_**bserved" in the mediastinum*
38
T/F: Border effacement is often associated with a **bronchial pattern**
**False**
*Border effacement is associated with alveolar patterns*
40
T/F: The diaphragm attaches to the ventral aspect of L3-L4
**True**
41
**Pectus excavatum**: detected or not detected?
**Detected**
*Pectus excavatum is dorsal displacement of the sternum. It often results in narrowing of the thorax and is often associated with respiratory and CV anomalies*
42
A change of kVp by _______ is equivalent to halving or doubling mAs
**16-20%**
43
Identify the lymphatic structure indicated by the number 1:
**Sternal**
44
If you see an interstitial pattern, is that considered airway or non-airway disease?
**Non-airway**
45
T/F: **Grids** are often used in radiography when the patient is less than 10 cm thick
**False**
*Grids are often used in radiography when the patient is _more than 10 cm thick_. (Thicker patients create more scatter)*
46
Which one of these radiographs is normal?
What do you observe in the abnormal one?
**B is normal**
*In A, you can observe **air bronchogram** (this is indicative of an _alveolar pattern_) - there is air in the bronchus and the alveoli are filled with fluid. You can also observe border effacement, sillhouetting of the cranial margin of the heart.*
48
*Long-axis left ventricular outflow view.*
Identify the structure indicated by the number 1
**right ventricle**
48
For interlobar fissures to be visualized radiographically when pleural effusion is present, how must the x-ray beam strike the fissures?
**Tangentially**
50
Is a **bronchial lung pattern** detected in this image?
**No**
51
T/F: **Tracheal Stripe Sign** is indicative of a pathological process
**Not always**
*_General anesthesia_ may result in signs that mimic megaesophagus and aspiration pneumonia*
52
Identify the structure indicated by the red star:
**cranial mediastinum**
52
Note the **V-sign** on this radiograph. What is this indicative of?
**Megaesophagus**
*On the VD view, when the enlarged esophagus is gas-filled, the left and right walls of the esophagus are sometimes visible as two soft tissue stripes that converge at the esophageal hiatus of the diaphragm*
53
T/F: Pneumomediastinum does not result in dyspnea
**True**
55
For abdominal radiographs, what should your mAs and kVp settings be?
low kVp, high mAs
55
Radiographically, what do you expect to see with a **bronchial pattern**?
**ring shadows (donuts)** and **tram lines**
## Footnote
*You should also see increased conspicuity of the bronchial tree*
55
**atelectasis** or **consolidation**?
**Atelectasis**
*Note the shift of the heart toward the rib (mediastinal shift), as well as less volume of the lung on the left hand side*
57
What three structures are visualized in this image?
**aorta, pulmonary artery, and left atria**
*When you see the Mercedes Benz sign, that indicates the aorta, pulmonary artery, and left atria*
58
Identify the cardiac abnormality in this ultrasound view:
**Dilated Cardiomyopathy (DCM)**
59
Are x-rays **positively** or **negatively** charged?
**Negatively charged**
60
Right parasternal short axis view. What valve is indicated by the arrow?
**Aortic valve**
60
Creation of an opacity in a radiograph by overlapping of structures in the patient is termed:
**summation effect**
60
Is **air bronchogram** present in this image?
Yeah.
61
Name the MR sequence that nulls signal from fat:
**STIR**
***_S_**hort **_T_**au **_I_**nversion **_R_**ecovery*
62
T/F: On the dorsal ventral view of the thorax of a dog, the pulmonary arteries are positioned lateral relative to the pulmonary veins
**False**
*Pulmonary veins are _ventral and central_*
63
Identify the artifact:
**mirror image artifact**
64
There is moderate pleural effusion in this patient.
Is this a DV view or a VD view?
**VD**
* The fluid is falling away from the heart, so the heart is visible*
* In a DV view, the view of the heart would be blocked by fluid*
65
There are two types of **hiatal hernias**. Which of the two is most common?
**Sliding hiatal hernia**
*The other type is paraesophageal hiatal hernia*
67
What are 'the 5 opacities' in radiology?
Air, Fat, Water, Bone, Metal
## Footnote
***_A_**lways **_F_**ind **_W_**ater **_B_**efore **_M_**eandering*
68
\_\_\_\_\_\_\_\_\_\_\_ is the range of light intensities a medium can capture
**Contrast Optimization**
69
Is **pneumomediastinum** detected in this image?
**No**
69
Identify the cardiac abnormality:
**Hypertrophic Cardiomyopathy**
*Note the thickening of the left ventricular walls*
70
T/F: The **caudal vena cava** is normally visible radiographically in the mediastinum
**True**
72
Alveolar pattern right middle lung lobe: **detected** or **not detected**?
**Detected**
72
Hemothorax: **detected** or **not detected**?
**Detected**
73
What is the most common secondary thoracic lesion resulting from megaesophagus?
**Aspiration Pneumonia**
74
T/F: Fluid often accumulates in the esophagus in the right lateral view
**False**
*Fluid often accumulates in the esophagus in the _left_ lateral view*
76
If you see **air bronchogram** on a radiograph, you should know it is a(n) _________ pattern
**alveolar pattern**
77
T/F: X-rays are devoid of mass
**True**
79
Name four characteristics of **alveolar patterns** on radiographs:
1. Air bronchograms
2. Border effacement
3. Lobar distribution
4. Labile
81
Identify the structure indicated by the red star:
**trachea**
83
T/F: An **underexposed** radiograph is too **light**
**True**
Either kVp or mAs is too low
84
In which radiographic view are hiatal hernias best visualized?
**Left Lateral**
85
Note the kink in the trachea on this VD view. This presentation is fairly characteristic for:
**Persistent right fourth aortic arch**
87
T/F: Tracheoesophageal stripe sign indicates tracheal pathology
**False**
*Tracheoesophageal stripe sign indicates gas in the esophagus*
88
What lung pattern is observed in this radiograph?
**Alveolar**
* Note the soft tissue opacity. Alveolar pattern is the only one that has this.*
* (Top DDx in this case would be pneumonia)*
89
T/F: MRI is the modality of choice to visualize bone
**Hell no.**
*MRI doesn't show bone, mutha f\*\*\*a*
90
T/F: Increased soft tissue opacity is observed with both **atelectasis** and **consolidation**
**True**
91
In which view is gas or fluid accumulation in the esophagus most visible?
**left lateral**
93
From what species was this radiograph taken?
**Cat**
*Note the oblique lines in the caudal third of the esophagus due to a change to smooth muscle fibers - "herring bone pattern"*
93
What is the most common cause of diaphragmatic hernias?
**Trauma!**
95
What thoracic lymph node would most likely be increased due to infection of the peritoneal space - peritonitis?
**Sternal**
96
What layer of the duodenum is the thickest/most hyperechoic?
**Mucosal layer**
97
What artifact is shown here?
**Slice Thickness Artifact**
99
T/F: Enlargement of the tracheobronchial lymph nodes may cause elevation of the tracheal bifurcation, depression of the tracheal bifurcation, or no change in tracheal bifurcation position
**True**
100
To decrease error % when measuring flow velocity, it is important to keep the doppler at a \_\_\_o angle
**22o**
101
What **alveolar pattern** characteristic is indicated by the arrows in this radiograph?
**Air bronchogram**
102
*Long-axis left ventricular outflow view.*
Identify the structure indicated by the number 3
**left ventricle**
103
Regarding ultrasound, is image resolution better with higher frequency or lower frequency?
**higher frequency**
*Image resolution is better with higher frequency and smaller wavelength*
104
Which view is more useful for determining whether a lesion is in the lung or the mediastinum: DV/VD or lateral?
**DV or VD**
105
T/F: **Pyothorax** is a common cause of unilateral distributions of pleural fluid
**True**
106
T/F: **Sternal lymphadenopathy** is an example of a cranioventral disease
**True**
107
T/F: A diagnosis of cardiac failure can be based on echocardiology alone
**False!**
109
Is **pneumothorax** detected in this image?
**No**
110
Is this image a film radiograph, digital radiograph, CT, or MRI?
**CT**
111
T/F: The mediastinum is a closed space
**False**
112
What echocardiographic modality would you use to determine normal and abnormal blood flow in the heart?
**Doppler**
113
T/F: **Portal veins** have a hy**_per_**echoic wall on ultrasound
**True**
114
Is tracheoesophageal stripe sign present in this radiograph?
**Yes**.
## Footnote
*This indicates gas in the esophagus. This does NOT indicate tracheal pathology*
115
Identify the artifact. Where is this most likely to be observed?
**Slice Thickness Artifact**
*Seen at curved surfaces, such as the urinary or gall bladder*
116
Bow-legged cowboy sign: **detected** or **not detected**?
**Detected**
117
This characteristic 'wagon wheel' appearance is characteristic for what portion of the intestine?
**Ileum**
119
Which view is this?
**Left lateral**
120
**Roentgen Signs** are six standard terms used to describe changes in a structure in a radiograph.
What are the Roentgen Signs?
1. Size
2. Shape
3. Number
4. Location
5. Margination
6. Opacity
122
What's going on in the lungs?!
**pulmonary osseous metaplasia**
*(mineralization)*
123
Which is more hyperechoic: **spleen** or **liver**?
**Spleen**
* Order of increasing echogenicity:*
* (hypoechoic) **_M_**edulla - **_C_**ortex - **_L_**iver - **_S_**pleen - **_P_**rostate (hyperechoic)*
* "My cat loves sunny places"*
125
Is **aortic insufficiency** detected in this image?
**Yes**
* Blue = away; red = toward*
* This image should show all **blue** as blood should be from **_from_ the LV _into_ the aorta***
126
T/F: Regarding pleural effusion: the space between lungs, and the lung and thoracic wall is radiolucent
**False**
127
Red arrow: **nodule** or **blood vessel**?
**Nodule**
The ones with the blue shit around them are blood vessels. The green nonsense is a bronchus
128
There is moderate pleural effusion in this patient.
Is this a DV view or a VD view?
**DV**
*The fluid is blocking the view of the heart because it is between the lung and the pleural wall. The heart would be visible in a VD view*
129
Holy shit, is that a lung nodule?!
**No, calm down.**
*It's a tick.*
130
What pulmonary structure is indicated by "3"?
**right pulmonary artery**
131
The renal cortex is ______ when compared with the renal medulla
(hyperechoic, hypoechoic, anechoic, isoechoic)
The renal cortex is **_hyperechoic_** when compared with the renal medulla
132
The relative increase in echogenicity in the far field adjacent to an anechoic round structure is called:
**acoustic enhancement**
133
The spleen is ______ to the liver in the normal dog
(hyperechoic, hypoechoic, anechoic, isoechoic)
The spleen is **_hyperechoic_** to the liver in the normal dog
134
The image shows ultrasound image of two intestinal loops. What artifact is indicated by the red star?
**Dirty Acoustic Shadowing**
135
What two layers of the intestines are **hy**_po_**echoic**?
**Mucosa** and **Muscularis**
136
Pictured below is a sagittal sonogram of the liver. Identify the normal anatomic structure indicated by the red arrow:
**Portal vein**
137
The ultrasound probe is positioned on the ventral aspect of the abdomen with the patient in dorsal recumbency. What artifact is present here?
**Mirror Image Artifact**
138
Aortic insufficiency?
Yes.
139
What is the primary purpose of this piece of equipment in animal radiography?
**Protect against scattered x-rays**
And to make a fashion statement
140
If you set the kVp at 100, the mA at 50, and the time at 0.20 seconds, what is the mAs?
**10**
141
Lateral thoracic radiograph of an adult dog. What is the identity of the linear opacity indicated by the arrow?
**pulmonary artery**
142
Is pneumothorax detected in this image?
**NO!**
Pneumomediastinum is though
