RADIOGRAPHY CARDIOLOGY

Question 1

How can you tell a RVE from LVE

Answer 1

RV will obscure the retrostermal space on a lateral view
LV will obscure downward towards the diaphragm (spine space is opaque now)

Question 2

Comon causes of LVE

Answer 2

Aortic stenosis, HTN , CHF

Question 3

Common causes of RVE

Answer 3

pulmonary stenosis, tetralogy of Farllot

Question 4

RVE vs LVE in comparison to the lower part of the retrosternal space on Lateral view

Answer 4

RVE will fill the lower retrosternal space
LVE will spare the lower retrosternal space and project downward toward the diaphragm

Question 5

In what infant heart abnormality do you see a concave waist line almost like a boot?

Answer 5

Tetrology of farllot

Question 6

RVE vs LVE in comparison to the spine and diaphragm

Answer 6

LVE will take over the black part of the spine and blend with the diaphragm
RVE will not touch the spine and remain away from this area

Question 7

patient presents with mitral insuficiency and CXR shows double shadow on the right side of heart . Which chamber is enlarged?

Answer 7

LAE

Question 8

first clue for LAE

Answer 8

straightening of the cardiac waistline
followed by the double-shadowing

Question 9

What is a classic sign seen in Tetrology of Fallot on a CXR PA view?

Answer 9

RVE - seen as the boot shape

Question 10

What 3 characteristics are seen in Rheumatic fever ?

Answer 10

-straight line on the waist line of heart
-double shadow
-splaying of the carina (bigger angle)

Question 11

When does pericardial effusion occur
how many mL is to much ?

Answer 11

when >250 mL spill into the pericardium

Question 12

what shape would a Pericardial effusion show? and how to confirm

Answer 12

shapeless heart projecting equally on both sides like a water balloon , needs ECHO

Question 13

Rapid deceleration motor vehicle accidents are a common cause of?

Answer 13

aortic trauma (will look wide at the arch and also know everything will move forward)

Question 14

LAE as seen on PA and lateral view

Answer 14

PA–> stright line on wasit, double shadown
Lateral–> displacemen of esophagus

Question 15

what are the 5 components of Pulmonary interstitial Edema seen in CHF?
hint ME.KFC

Answer 15

Markings (acentúate)
Effusions
Keyley B lines
Fissures (think b/cfluid here)
Cuffing (recall this is also seen with interstitial pneumonias -vital pneumonias)

Question 16

what componets are seen with Pulmonary alverolar edema as seen in CHF

Answer 16

Bat-wing densities in the center (outer 1/3 spared)
Cephalization– upper vessels will look more prominent

Question 17

what is an abnormal find with CHF that can raise a concern for weird mass?

Answer 17

pseudotumor (fluid gets trapped makes it look like a tumor

Question 18

another name for fluid in inter-lobular septa

Answer 18

Kerley B lines (horizontal lines seen)

Question 19

what is the greatest concern with Aneurism

Answer 19

dissection (can tear apart)

Question 20

How to rule out an aneurysm which also over interpreted?

Answer 20

widening of the mediastinum

Question 21

Clinical presentation of an aortic Aneurysm or dissection

Answer 21

abrupt tearing chest pain, hypotension, unequal peripheral pulses

Question 22

Where do most aortic dissections begin and can have be treated surgically urgently

Answer 22

Ascending Aorta

Question 23

Gold standard for Aortic Aneurysms

Answer 23

Contrast-enhanced CT showing long or globular shape

Question 24

types of Aortic dissections?

Answer 24

Type A– at ascending aorta seen on right side of the heart – need Sx asap since it can result in MI
Type B – descending aorta–can wait until it gets bad

Question 25

How does a case of Aortic dissection present? On CXR

Answer 25

-Tearing pain
-CXR: wide mediastinum, left pleural effusion, LVE if patient is HTN

Question 26

What patient is at most risk for Aortic dissection ?

Answer 26

Long hx of HTN

Question 27

Conditions that predispose Dissections?

Answer 27

ATHEROSCLEROSIS, Marfan syndrone, Ehler danlos, Syphyllis crack coccaine , trauma

Question 28

Aortoc aneurysm clinical finds on HTN patient

Answer 28

sudden searing chest pain radiation to the back , abdomen or neck

Question 29

most common cause of trauma to the aorta

Answer 29

Deceleration injuries

Question 30

What would you see on an Aortic Trauma CXR and on CT

Answer 30

CXR-Wide mediastinum
CT-A- demonstrates intimal flap, contour abnormalities, hematomas
Most pts die before they reach the hospital unless it is an incomplete tear.