Diagnostic Processes in Medicine

Question 1

What are the indications for plain film radiography?

Answer 1

Work up variety of problems
Inexpensive, widely available
Bones easily visible
Cortical disruptions can be readily seen

Question 2

What are the contraindications for plain film radiography?

Answer 2

Patient stable enough to travel to department
Patient must be able to stand for some studies
Patient must remain still
Might not be the best study for your diagnosis

Question 3

What is least dense on plain film radiography?

Answer 3

Air

Question 4

What is most dense on plain film radiography?

Answer 4

Metal

Question 5

How does air appearance on plain film?

Answer 5

Dark

Question 6

How does metal appear on plain film?

Answer 6

Very bright

Question 7

What is the preferred view for heart size?

Answer 7

PA

Question 8

Where are the hands placed during a PA chest x-ray?

Answer 8

On hips to move scapula away from lungs

Question 9

What is a contraindication for CXR plain film?

Answer 9

Patient not able to take and hold a deep breath

Question 10

What are in the indications for abdominal plain film?

Answer 10

Obstruction (air/fluid levels)
Perforation (free air under diaphragm)
Tube placement (NGT)
Foreign bodies
Trauma
Stones

Question 11

Tinkling sound on abdominal PE is indicative of what?

Answer 11

Bowel obstruction

Question 12

String of pearls sign is indicative of what on abdominal plain film?

Answer 12

Air fluid levels

Question 13

What are the indications for extremity plain films?

Answer 13

Injury/fracture to bones
Focal lesions like tumors, infections of joint spaces, arthritis and dislocations
Soft tissue injury

Question 14

What are contraindications for extremity plain films?

Answer 14

Patient unstable
Life-threatening injuries
Other studies are better
You are ordering a CT or MRI

Question 15

What is the HU of water?

Answer 15

Zero

Question 16

What is a hounsfield unit?

Answer 16

Absorption value of x-ray beam assigned to tissue imaged

Question 17

What is the HU of fluid/simple ascites?

Answer 17

0-20 HU, acute blood 40-60 HU

Question 18

What are the different CT windows?

Answer 18

Subdural window
Brain window
Bone window

Question 19

Include appendix if you are just ordering what CT?

Answer 19

Abdominal CT

Question 20

Include kidneys if you are just ordering what CT?

Answer 20

Pelvis

Question 21

What is the slice thickness on CT?

Answer 21

Submillimeter-10mm

Question 22

Abdominal non-contrasted studies should be used for what?

Answer 22

Renal colic (stone protocol)
Intra-abdominal fat

Question 23

Abdominal IV contrast studies should be used for what?

Answer 23

Opacifies solid organs, the bowel wall, vascular structures

Aortic dissection

Question 24

Abdominal IV enteric contrast should be used for what?

Answer 24

Opacifing bowel lumen