Labs/X-rays/ECG Lecture Flashcards
(105 cards)
1
Q
ALT vs AST
A
ALT elevated before AST
2
Q
Alka phosphatase
A
increases in liver and bone disease
3
Q
Wilson’s disease
A
Copper issues
4
Q
Xrays blocked by
A
denser tissues like bone
5
Q
Lungs fields look _____on xray
A
Black
6
Q
Water fields look ______
A
Black
7
Q
BLood on xray look
A
white, light gray
8
Q
Fat on xray
A
Gray
9
Q
You should be able to see
A
9-10 posteriorly
6-7 anteriorly
10
Q
Motion on CXR
A
Blurry
11
Q
Hold breath
A
to expands lungs for better picture
12
Q
Most chest PA
A
posterior to Anterior
Through back to film
13
Q
Heart closer to heart
A
PA
14
Q
Magnifies heart
A
AP
15
Q
PA best when
A
Standing
16
Q
Spinous processes aligned with
A
Center of the sternum
17
Q
Best xray is
A
PA
18
Q
Overexposed xray
A
Looks really dark
19
Q
Underexposed (underpenetrated)
A
Looks really white
20
Q
Have to be able to differentiate
A
vertebral bodies
21
Q
Cardiac silhouette should be
A
less than 50% of diameter of chest in PA
22
Q
Cardiac silhouette should be (AP)
A
Less than 60%
23
Q
RIght is usually a little higher due to
A
liver
24
Q
Normal Carina angle =
A
60-100°
25
ETT
* S/b 5-7cm above carina
| * Carina usually @ T4/T5
26
Non-ionizing
Ultrasound MRI
27
Ionizing
Xray, CT, nuclear med scans,
28
CT mostly for 2 parts
Chest and ABdomen
29
MRI mostly for
Head, Neck , spinal cord and extremities
30
MRI how it works
beam waves scatter water molecules.
| no damage to the body
31
Routes of administration contrast
IV
Oral
Rectal
32
FOR CT iodinated contrast
High osmolarity , more side effects
33
CT iodinated contrast non-ionic :
low osmolality, less side effects ($
34
Barium: non-water soluble suspension
Used for GI Tract assessment:
35
Types of Barium
Swallow study
Small bowel
BE
36
___________can be used in place of barium if
| perforated bowel, or barium allergy)
(Gastrografin
37
When to use IV Contrast:
solid organs
| vascular structures
38
When to use Barium
Barium: GI tract assessment
39
CONTRAINDICATIONS to Constract
* Anaphylaxsis
| * Nephropathy
40
ANaphylaxis
pt.s with atopic disease such as asthma, eczema, allergic
rhinitis (food allergies) are at higher risks – Iodine is not a proven allergen. Allergies to shellfish do
not increase risk of reaction to IV contrast any more than that of other
allergies.
41
Common Signs/Symptoms for ordering Exams:
Cough
SOB
Hemoptysis
Trauma
42
Reading check
```
Date
Name
Left and Right marker
Quality – rotation, inspiration, exposure
Soft tissue
Bones
Organs
Airway
```
43
ABCDEFGHI
```
Assessment of quality
Bones/soft tissues
Cardiac
Diaphragm
Effusions
Fields, fissures,foreign bodies
Great vessels/gastric bubble
Hila/mediastinum
Impression
```
44
Assess lung fields for ?
```
• Infiltrates
• Increased interstitial markings
• Masses
• Absence of normal margins
• Air bronchograms
• Phenomenon of air-filled bronchi (dark) being made
visible by the opacification of surrounding alveoli (grey/white)
• Increased vascularity
```
45
Air Bronchospasm
• Air-filled bronchi (dark) made visible by opacification of surrounding alveoli consolidation
46
Alveolar:
* Fluffy rounded densities (Consolidation)
* Air spaces filled with fluid, blood, pus (pneumonia)
* protein or cells (tumor)
47
Interstitial
* Linear or nodular densities
| * Supportive tissue around/between alveoli
48
Chloride range
95-105
49
Cr
0.6-1.2
50
AST normal range
• 8-40 units/L
51
• ALT normal range
• 10-40 units/L
52
• Alk Phos normal range
• 35-150 units/L
53
• Albumin normal range
• 6-8 g/dL
54
Common causes of elevated Liver enzymes:
Tylenol, Statins, Antifungals
55
Common causes of elevated Liver enzymes:
* Etoh
* Hepatitis
* Fatty Liver/Obesity
* Hemochromatosis/Wilson’s Disease
56
Film turns-____ where xrays strike
black
57
Less dense xray
more beam, xray way blacker
58
Denser object xray
less beam striking, xray whiter
59
How many anterior ribs to qualify as a good film
6
60
• Spinous processes aligned with center of sternum between clavicles? What are you assessing?
• Rotation
61
• Preferred view for CXR
PA – energy penetrates thru pts back onto film
62
In PA where does energy penetrate
energy penetrates thru pts back onto film
63
If spine is not visible, the film is
underexposed or under penetrated (too white)
64
____view makes heart appear larger than it really is
AP
65
For MRI, contrast used
Gadolinium
66
Aortic knob
The first knob on the of the left side of the aortic arch
67
Measure knob from the
Lateral border of air in the trachea to the edge of the aortic knob
68
Aortic knob should measure
<35 mm
69
Air bronchograms is a phenomenon
• Phenomenon of air-filled bronchi (dark) being made
| visible by the opacification of surrounding alveoli (grey/white)
70
Air-filled bronchi (dark) made visible by opacification of surrounding alveoli consolidation
Air Bronchogram
71
Alveolar air sacs
Radiolucent; may contain blood, mucous, tumor or edema
72
Interstitial disease
RADIODENSE vessels, lymphatics, bronchi, CT tissue
73
Tuberculosis • Almost always affects :
* posterior segments of upper lobes
| * superior segments of lower lobes
74
• Patchy bilateral opacification of upper lobes with cavitation (Left)
Tuberculosis
75
* Kerley A Lines
| * From____To____
Hila to periphery
76
• Dilated lymphatic channels
Kerley A lines
77
Interstitial - Reticular Patterns Fine
• 1-2mm = pulmonary edema
78
Interstitial - Reticular Patterns • Medium
• 3-10mm = pulmonary fibrosis
79
Interstitial - Reticular Patterns Coarse
• >10mm = sarcoidosis
80
Hyperinflated Lungs
Emphysema (COPD)
81
• “Flat” Diaphragm
Emphysema (COPD)
82
• Narrow Heart Shadow
Emphysema (COPD)
83
• Increased Retrosternal clear space
| Barrel Chest
Emphysema (COPD)
84
Partial filling of air spaces with exudate or transudate
Ground Glass Opacities
85
Associated pulmonary edema, infections (including cytomegalovirus and Pneumocystis carinii pneumonia)
Ground Glass Opacities
86
Sarcoidosis -
Bilateral Hilar Enlargement
87
• Hilar (lung roots) mainly consist of the
major bronchi and the pulmonary veins and arteries
88
Nodes are seen clearly with Spiral CT
Sarcoidosis
89
Solitary Pulmonary Nodule
If < 3cm =
If > 3cm =
Nodule
| Mass
90
Solitary Pulmonary Nodule CT – if calcified,
likely benign, otherwise…
91
Solitary Pulmonary Nodule, PET/FDG – if hot, likely _______ next step is _______
likely malignant
| Order Biopsy
92
Atelectasis
collapse of lung tissue affecting part or all of one lung.
Results from alveoli collapse or plug.
• loss of volume
93
Elevation of hemidiaphragm
Atelectasis
94
Crowding of vessels & bronchial tree in the volume loss
Atelectasis
95
• Overaeration of opposite lung or other lobes
Atelectasis
96
• Increase in density
Atelectasis
97
Collapsed lung
Pneumothorax
98
Absent Vascular markings
Pneumothorax
99
Mediastinal shift
Pneumothorax
100
For assessment of valves and chambers of the Heart
| clots, myxomas
Echocardiograms
101
Pneumoperitoneum
•Abnormal presence of air or gas in peritoneal cavity –
| potential space within abdominal cavity
102
•Often during laparoscopic procedures.
Pneumoperitoneum
103
• Note pulmonary vascular congestion
CHF
104
• Enlarged Heart shadow
CHF
105
U wave associated with
* Hypokalemia
* Hypercalcemia
* Digitalis
