Radiology

Question 1

What is the benefit of identifying lung patterns?

Answer 1

Narrow differential list

Question 2

Name the common lung patterns

Answer 2

Alveolar
Interstitial (Structured v Unstructured)
Bronchial
Vascular

Question 3

Describe the appearance of an alveolar pattern

Answer 3

Homogenous, uniform opacity that varies from solid and opaque to faint or “wispy”

Question 4

What radiographic signs often accompany an alveolar pattern?

Answer 4

Lobar sign
Silhouette effect/border effacement
Air bronchogram

Question 5

What is a lobar sign?

Answer 5

Interface between fluid filled lung and gas filled lung

Question 6

What is an air bronchogram?

Answer 6

Lucency within the airways surrounded by fluid within the alveoli

Question 7

Alveolar patterns are considered the ________ pattern

Answer 7

Dominant

Question 8

What are some differential diagnoses for an alveolar pattern?

Answer 8

Pneumonia - aspiration, bronchopneumonia, hematogenous

Edema - cardiogenic versus non-cardiogenic

Hemorrhage - trauma, coagulopathy

Question 9

What is atelectasis? How does it appear on radiographs?

Answer 9

Atelectasis = collapse of alveoli

Cardiac shift to collapsed side

Question 10

You have a patient in-hospital who has developed a cough and elevated respiratory rate. You immediately pull the patient from its kennel and take radiographs. You notice an atelectic lung.

What non-pathologic cause could be contributing to this change?

Answer 10

Atelectasis is common in patients that have been in prolonged recumbency

Allow them to take a few breaths to re-inflate and retake radiograph

Question 11

Linear interstitial patterns are also called ___________

Answer 11

Unstructured

Question 12

How does a linear interstitial pattern appear?

Answer 12

Increased hazy, linear opacities

Question 13

Using vasculature, how can we differentiate an alveolar pattern from an interstitial pattern?

Answer 13

Vasculature is smudged but remains visible in a linear interstitial pattern while you cannot visualize vasculature in an alveolar pattern

Question 14

How can we artificially create a linear interstitial pattern?

Answer 14

Underexposed radiograph
Expiratory radiograph

Question 15

What are some causes of a linear interstitial pattern?

Answer 15

Artifact
Geriatric change
Pulmonary edema
Hemorrhage
Pneumonia
Neoplasia
Fibrosis

Question 16

A nodular interstitial pattern is also called _______

Answer 16

Structured

Question 17

What characterizes a nodular interstitial pattern?

Answer 17

Relatively circumscribed nodules/masses

Can be singular or multiple of varying sizes

Question 18

What does a bronchial pattern look like?

Answer 18

End-on thickened bronchi - “donuts”

Longitudinal thickened bronchi - “railroad tracks”

Question 19

What causes a bronchial pattern?

Answer 19

Thickened bronchial walls

DDX - Bronchitis (chronic), feline asthma, pulmonary parasites

Question 20

What is a vascular pattern?

Answer 20

Changes in vessel size, shape, or contour

Question 21

Pulmonary veins are ______ and ______

Answer 21

Ventral and central

Question 22

What are some causes of a pulmonary vascular pattern?

Answer 22

Heartworm disease - artery > vein

L to R Shunts (Pulmonary overperfusion) - artery and vein enlarged

Venous congestion (L sided HF) - vein > artery

Question 23

What are important things to analyze when looking at radiographs of a vomiting patient?

Answer 23

Location
Gas patterns
Intraluminal contents
Diameter

Question 24

How does an increased BCS affect SI location?

Answer 24

SI more centrally located in obese patients

Question 25

What should a normal SI’s gas pattern look like?

Answer 25

Smooth, homogenous

Question 26

What is the normal appearance of the colon?

Answer 26

Gassy w/ more ST opaque material

Question 27

Is it normal for SI to be located more in the right side of the abdomen?

Answer 27

Yes - normal variation

Question 28

Describe how a linear foreign body might appear on a radiograph

Answer 28

Plication of the bowel “Commas”

Question 29

What is the normal canine SI diameter?

Answer 29

<1.6x height of L5 body

Question 30

SI diameter >____x height of L5 body is suggestive of obstructive disease

Answer 30

2x

Question 31

What is the normal feline SI diameter?

Answer 31

Less than or equal to 12mm

Question 32

What is ileus?

Answer 32

Failure of passage of intestinal contents thru bowel lumen

Question 33

What are the two types of ileus?

Answer 33

Paralytic Obstructive

Question 34

How does paralytic ileus appear?

Answer 34

Mild generalized dilation 1 population of bowel

Question 35

Name some causes of paralytic ileus (there are so many, just try and name a few - basically anything that causes the bowel to not want to contract)

Answer 35

Peritonitis Post-op abdomen Enteritis Pain Anticholinergic drugs Sedation/anesthesia Dysautonomia GDV and mesenteric volvulus Electrolyte imbalance

Question 36

How does pancreatitis result in focal paralytic ileus?

Answer 36

Anatomical relationship between pancreas and duodenum Inflamed R limb of pancreas can lead to inflammation and hypomotility of the duodenum

Question 37

Describe obstructive ileus

Answer 37

Dramatic dilation Portion of bowel cranial to obstruction will be dilated 2 populations of bowel (one dilated, one normal)

Question 38

Name some causes of obstructive ileus

Answer 38

FB Intussusception (Puppies!) Stricture Neoplasia Hernia Adhesions