Respiratory Radiology

Question 1

What are the findings of a normal chest xray?

Answer 1

normal bone markings with overlying soft tissue

heart

central vascular and airway markings

parenchyma and air

Question 2

Which pattern of pneumonia shows a “tree-in-bud” pattern?

Answer 2

bronchopneumonia

Question 3

Which pattern of pneumonia shows a lobar delineation?

What will you see on pathology?

Answer 3

lobar pneumonia

Red hepatization

Question 4

What pathogen causes a bulging fissure?

Answer 4

Klebsiella

Question 5

Which bacteria are more likely to cause a lobar pneumonia?

Answer 5

S. Pneumoniae

S. Aureus

Gram -

Question 6

Which bacteria are more likely to cause abscess?

(often seen with lobar PNA)

Answer 6

Klebsiella

S. aureus

Anaerobes

Question 7

Which disease shows an abnormal dilatation and extension of airway spaces into peripheral fields?

Answer 7

Bronchiectasis

Question 8

what is the diagnosis in someone with situs inversus with dextrocardia?

Answer 8

primary ciliary dyskinesia

(Kartagener syndrome)

Question 9

What causes Bat Wing infiltrates?

Answer 9

Pulmonary edema (hydrostatic-2’ to HF)

Pneumonias (viral)

HSN pneumonitis

Inhalation injury

Question 10

Anything favoring (proximal or distal) vascular or airway involvement will cause Bat Wing infiltrates?

Answer 10

Proximal

Question 11

Anything favoring (central or peripheral) involvement leads to Reverse Bat Wing?

What specific condition can cause reverse bat wing?

Answer 11

Peripheral

Interstitial Pulmonary Fibrosis/Sarcoidosis

Question 12

Why does HSN pneumonitis cause bat-wing on xray?

Why does Sarcoidosis cause reverse bat-wing on xray?

Answer 12

Because it follows airways

Because it follows lymphatics

Question 13

What conditions cause White Out?

Answer 13

ARDS (most common)

Severe pneumonia

Severe Atelectasis

Diffuse hemorrhage

Malignancy

Question 14

Histoplasmosis shows what kind of nodularity?

Answer 14

diffuse or laminated

Question 15

Hamartomas show what type of nodularity?

Answer 15

popcorn

Question 16

If you see a laminated, diffuse nodule on XR, what is likely?

Answer 16

old granulomas

Question 17

What are the two charcteristics to look for if worried about malignancy?

Answer 17

tumor characteristics

patient characteristics

Question 18

what specific factors should be considered when deciding if a lesion should be biopsied?

Answer 18

age

smoker

size

growth

solid

lack of calcification

Question 19

What malignancies can look like pneumonia and be bilateral?

Answer 19

mucinous adenocarcinoma

adenocarcinoma in situ

Question 20

What malignancy has a ground glass appearance?

Answer 20

adenocarcinoma in situ

Question 21

What malignancy has bubble lucencies?

Answer 21

invasive adenocarcinoma

Question 22

What malignancy shows cavitation?

Answer 22

squamous cell carcinoma

Question 23

What causes wedge-shaped atelectasis?

Answer 23

Resorption (which is from an obstruction)

obstruction can be foriegn body, mucus, tumor

Question 24

What cancers may cause wedge-shaped atelectasis?

Answer 24

squamous carcinoma

carcinoid tumor

Question 25

A patient will have a more obvious tension PTX on XR when (inhaling or exhaling) ?

Answer 25

exhaling

Question 26

A primary PTX is due to a limited introduction of air into which space?

Answer 26

thoracic space

usually due to 1’ lung pathology

Question 27

tension PTX us due to what?

Answer 27

“one-way” unchecked accumulation of air

usually from chest wall trauma

causes mass effect with midline shift

Question 28

Alveolar processes are more likely to show what?

Answer 28

ground glass or diffuse “white out”