Radiology

Question 1

Where is atelectasis caused by aspiration most commonly seen?

Answer 1

posterior segment of the RUL or the superior segment of the RLL.

Question 2

Is anesthesia-induced bibasilar atelectasis typically visible on a CXR?

Answer 2

No

Question 3

Simple pneumothorax has a pleural line beyond which no vascular markings are seen. (T/F)

Answer 3

T

Question 4

What is a deep sulcus sign?

Answer 4

Seen with pneumothorax.

air collects in the anterior inferior thorax adjacent to the diaphragm. An abnormal lucency appears over the costophrenic angle on the affected side, sometimes even extending over the upper quadrant of the abdomen.

Question 5

What changes about the size of the thoracic cage on the ipsilateral side of pneumothorax? What changes about the intercostal spaces?

Answer 5

Gets larger

Become wider

Question 6

Which way does mediastinum shift with tension pneumo?

Answer 6

Contralateral side.

With tracheal deviation.

Question 7

What causes cardiogenic (hydrostatic) pulmonary edema?

Answer 7

LV failure usually

Question 8

Evidence of ARDS on CXR

Answer 8

BL pulmonary infiltrates

that cannot be explained by other causes such as fluid overload, cariogenic pulmonary edema, plural effusion, or lobar collapse

Question 9

3 stages of ARDS

Answer 9

Exudative
Proliferative
Fibrotic

Question 10

Briefly describe stage 1 of ARDS

Answer 10

Exudative.
Diffuse patchy infiltrates that appear about 12 hours after initial insult

Question 11

Briefly describe stage 2 of ARDS

Answer 11

Proliferative.
Alveolar infiltrates now seen with atelectasis and air bronchograms appear after 24 - 48 hours

Question 12

Briefly describe stage 3 of ARDS

Answer 12

Fibrotic.
There is complete alveolar consolidation

Question 13

What is Roentgen (R)

Answer 13

total dose administered

Question 14

What is radiation absorbed dose (Rad)

Answer 14

Total dose received at the tissue level

Question 15

What is Radiation equivalent (Rem)

Answer 15

Effective dose

Question 16

How many rem is the yearly max radiation exposure for adults?

Answer 16

5 rem

Question 17

How many rem is the yearly max radiation exposure for the fetus of a pregnant worker?

Answer 17

0.5 rem or 0.05 rem/month

Question 18

3 ways to limit radiation exposure

Answer 18

Distance
Duration
Shielding

Question 19

6 feet of air is equal to how many mm of lead?

Answer 19

2.5

Question 20

Radiation exposure obeys the inverse square law. What does that mean?

Answer 20

The amount of exposure is inversely proportional to the square of the distance of the source.

Question 21

Order in which how easily x-ray passes through lower density structures and less easily through higher density structures

Answer 21

Gas -> Fat -> Water (Soft tissue) -> Bone (metal)

Question 22

Best image quality is obtained when xray is taken with pt in what position?

Answer 22

Upright

Question 23

3 most common CXR views:

Answer 23

Posterior anterior: pass from patients back to the front
Anterior posterior: pass from patients front to the back
Lateral projection

Question 24

Is xray better on inspiration or expiration

Answer 24

Inspiration because it separates the soft tissues from vessels

Question 25

An adequate inspiratory effort is indicated by identifying the right hemidiaphragm at the ___ or ___ rib counted posteriorly.

Answer 25

9th 10th

Question 26

Size of the heart appears larger with PA or AP view

Answer 26

AP

Question 27

With either PA or AP view, the width of the heart should be less than what width of the thorax? (%)

Answer 27

50-60 %

Question 28

Which side of the diaphragm is higher on xray and why?

Answer 28

Right Due to the liver

Question 29

Should diaphragm look domed or flattened? Why?

Answer 29

Domed If flattened that is indicative of pneumothorax or COPD/asthma

Question 30

How should costophrenic angles appear on cxr?

Answer 30

SHARP not blunted

Question 31

What do Kerley A and B lines represent?

Answer 31

Interstitial pulmonary edema

Question 32

Fissure that separate lung lobes can be major or minor. Where are major fissures in the R and L lung?

Answer 32

R: Separates the lower lobe from the middle and upper L: Separates the upper and lower lobe

Question 33

Fissure that separate lung lobes can be major or minor. Where are minor fissures in the R and L lung?

Answer 33

Only in right lung. Separates middle and upper lobes in the right lung

Question 34

Is gastric bubble normal or abnormal finding?

Answer 34

Normal. It is seen under the left hemidiaphragm. Caused by gas in the fundus of the stomach

Question 35

Carina should be at what dermatome

Answer 35

T4-5

Question 36

How far above the carina is a porperly placed ETT?

Answer 36

4-5 cm above carina

Question 37

Where should the distal tip of a CVC reside?

Answer 37

Distal 1/3 of SVC If it was in the right atrium --> arrhythmias or puncture

Question 38

How many times more likely is it for a CVC to thrombose if it is in upper 1/3 of SVC

Answer 38

16x

Question 39

Target location of pulmonary artery catheter

Answer 39

West zone 3

Question 40

Where is pulse generator of a PPM placed?

Answer 40

SUBQ pocket on the left anterior chest wall

Question 41

Where should lead wires be embedded for a pacemaker?

Answer 41

Endocardium