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Respiratory > Radiology > Flashcards

Radiology Flashcards

1
Q

Identifying poor inspiration on chest x-rays

A

6 ribs aren’t visible

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2
Q

Anterior lobes visible on x-ray

A

Right upper and middle lobes

Left upper and lingula

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3
Q

Lesion behind oblique fissure vs in front

A

Lesion behind oblique fissure = Lower lobe

Lesion above oblique fissure = Upper lobe

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4
Q

Above horizontal fissure vs below

A

Above horizontal fissure = Right upper lobe

Below horizontal fissure = Right lower lobe

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5
Q

60 year old smoker, 2 stone weight loss, haemoptysis, cough, “second heart line” seen on chest x-ray, no diaphragm seen

A

Right lower lung collapse

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6
Q

Lung collapse features on x-ray

A

Mediastinum and trachea tend to shift in direction of collapse, lungs seen as white normally with compensatory inspiration of other lung. Elevation of ipsilateral hemidiaphragm

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7
Q

Lung collapse vs atelectasis

A

Atelectasis is a more generic term for ‘incomplete expansion’ which can be due to alveoli becoming deflated. Lung collapse is a subtype under. Atelectasis is used during partial collapse.

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8
Q

Right middle lobe collapse is seen easier on what type of x-ray

A

Easy to identify on lateral chest x-ray as a triangular opacity in the anterior aspect of chest overlying chest shadow

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9
Q

Features of right lower lobe collapse

A

Medial aspect of dome of right hemidiaphragm is lost, right hilum is depressed, right heart border is seen

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10
Q

Why is right heart border still seen in right lower lobe collapse

A

As the right heart border is contacted by the right middle lobe

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11
Q

Features of lower left lung collapse

A

Edge of collapse lung may create a double cardiac contour, left hilum is depressed, loss of ipsilateral hemidiaphragm outline

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12
Q

What is air bronchogram

A

The phenomenon of air-filled bronchi (dark) being made visible by opacification of surrounding alveoli (grey/white). Happen when something other than air fills the bronchi. This makes the tubular outline of airway visible.

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13
Q

What is lung consolidation

A

This occurs when air that usually fills the small airway in your lungs is replaced with something else. This may be by fluid or solids.

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14
Q

What is bilateral hilar lymphadenopathy

A

Enlargement of the lymph nodes of pulmonary hila

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15
Q

Anterior heart border on x-ray

A

Right atrium

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16
Q

Right middle lobe pneumonia

A

Right heart border isn’t very visible however the right diaphragm is visible

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17
Q

Lingular pneumonia

A

Causes left heart border to become obscured

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18
Q

Left heart border in x-ray is

A

Left ventricle

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19
Q

Left lower lobe collapse

A

Displaced left oblique fissure demarcates dense collapsed lobe. Medial part of left hemidiaphragm is obscured

20
Q

Left upper lobe collapse

A

Left oblique fissure is pulled anteriorly, well defined lobar edge is visible on lateral view. Left heart border gets obstructed with veil like opacity Trachea pulled to side of collapse

21
Q

Right upper lobe collapse

A

Trachea pulled to side of collapse. Right horizontal fissure gets displaced. Opague right upper lobe on anterior view

22
Q

Pleural effusion general features

A

Visible when filled with fluid (pleural effusion) or air (pneumothorax). Pleural fluid collects at the bases and gives a curved appearance of meniscus. May track into horizontal and oblique fissures obscuring features

23
Q

Pneumothorax

A

Dark crescent without lung markings bounded medially by lung edges. Often at lung apexes

24
Q

Diaphragm in tension pneumothorax

A

Often squashed down and mediastinal shift

25
Q

Common cause of pneumothorax

A

Iatrogenic

26
Q

Why is it easier for tubes and other foreign bodies to pass into the right main bronchus than left

A

As there’s a more obtuse angle and the right main bronchus is more straight compared to the left

27
Q

Where should the endotracheal tube (ET) be placed

A

2cm proximal to carina

28
Q

Inverted D sign on chest xray

A

Classic sign of loculated empyema

29
Q

Ultrasound vs CT scan for empyema

A

Ultrasound for empyma shows loculations whereas CT scan show’s presence of pleural effusion but not loculations

30
Q

Antibiotics for empyema?

A

Yes, broad spectrum IV such as Amoxicillin and Metronidazole initially. Oral antibiotics directed towards cultured bacteria for 14 days

31
Q

A young African man presents with a cough and night sweats. His chest x-ray shows dense consolidation in the right upper lobe with cavity formation.

A

This is Tuberculosis

32
Q

Hallmarks of asbestosis on CT scan

A

Large chunks of white - Calcium bilateral pleural plagues

33
Q

Sign on x ray doesn’t double in size less than 40 days or more than 400 days

A

Might be infection as cancer takes 40-400 days to double

34
Q

Advantage of PET-CT

A

Can detect nodal metastases, distant metastases, delineating tumour in an area of collapse. Metabolically active areas shown up as bright red

35
Q

Spiculated appearance on CT scan

A

Mostly seen in primary carcinoma

36
Q

Disadvantage of PET-CT

A

Can’t assess brain metastases as glucose doesn’t cross blood-brain barrier

37
Q

Can we ultrasound guide in pleural effusion removal

A

No as we can’t see past fluid using ultrasound

38
Q

Complications of CT biopsy

A

Pneumothorax, haemoptysis if a vessel is injured, air embolus in heart

39
Q

Importance of previous images

A

Can be used to compare changes, especially minute ones around the hilar

40
Q

Left elevated hemidiaphragm making a triangular shape

A

Left lower lobe collapse

41
Q

Young patient with tumour like sign on chest x-ray

A

Teratoma a possibility

42
Q

Narrow tube like lungs are often seen in

A

COPD patients

43
Q

Bilateral dark shadows indicative of

A

Pulmonary oedema, singular shadow maybe pneumonia

44
Q

What can V/Q scans be used for

A

Generally for PE but also COPD and cancer.

45
Q

V/Q scan over CT scan?

A

V/Q scan allows early detection of gas-exchange changes prior to structural change detection in CT
Also has lower dose of radiation

Respiratory (26 decks)

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