TEST 2

Question 1

important obscured/invisible structures on CXR

Answer 1

-sternum
-esophagus
-spine
-pleura
-fissures
-aorta

Question 2

common cause of tracheal deviation

Answer 2

-Atelectasis- mucus plug
-Pneumothorax-trachea deviates away
-Aortic Aneurysm
-Compressing Mass/Tumor
-more fluid on a side -> trachea deviates towards the higher pressure
-Note borders
-Irregular tends to be malignant
-Regular tends to be benign lesions

Question 3

why do chest xray with abdominal pathology

Answer 3

-upright
-chest disease can mimic abdominal
-pleural effusions

Question 4

viewing fluid

Answer 4

-upright
-lateral
-supine and prone is bad
-Bowel and other organ structures:
-gas pattern
-Bones
-Calcifications

Question 5

alignment

Answer 5

-look at pelvic rami
-spine orientation

-diaphragms/xiphoid to pubic symphysis

Question 6

small bowel

Answer 6

-<3cm
-central
-lines span the width of the bowel
-valvulae conniventes
-diff dx- younger, acute, surgery

Question 7

large bowel

Answer 7

-haustra
-MC- colon tumor (MC left colon)
-volvulus, diverticulitis (uncommon), intussusception (from tumor), hernia

Question 8

Local inflammation

Answer 8

-pancreatitis, cholecystitis, appendicitis, start of SBO

Question 9

volvulus

Answer 9

-MC sigmoid
-can be cecum

Question 10

generalized gas pattern

Answer 10

-surgery or electrolytes
-sepsis
-infection
-dead bowel

Question 11

extraluminal air MC location

Answer 11

-intraperitoneal (pneumoperitoneum)
-retroperitoneal air
-air in bowel wall (pneumatosis intestinalis)
-air in biliary system (pneumobilia)

Question 12

signs of free intraperitoneal air

Answer 12

-air beneath diaphragm
-visualization of both sides of bowel wall
-visualization of falciform ligament

Question 13

cecal volvulus

Answer 13

-congenital -> young
-incomplete dorsal mesenteric fixation of cecum or ascending colon -assoc with abnormally elongated mesentery distal to this area of absent mesentery
-N/V/C

Question 14

sigmoid volvulus

Answer 14

-chronic constipation
-high roughage diet
-surgery
-blood supply can be cut off -> generalized gas pattern
-pencil stool or none
-roundworm infestation
-megacolon (often due to chagas dz)

Question 15

esophagram

Answer 15

-hiatus hernia
-epigastric pain
-globus hystericus- throat pain
-persistent vomiting
-fistula
-cant pass endoscope

Question 16

achalasia

Answer 16

-dilated and stenosed

Question 17

esophageal web

Answer 17

-plummer vinson syndrome
-chronic iron deficiency
-squamous cell carcinoma assoc
-barium swallow
-tx- dilation

Question 18

esophageal tumor

Answer 18

-jagged
-dark spot on esophagus -> barium doesnt light it up
-grey shades change

Question 19

barium enema indications

Answer 19

-Lower GI Bleeding
-Iron deficiency anemia
-Chronic diarrhea
-Screening
-Colon Cancer
-Assess inflammatory bowel disease
-Intussusception

Question 20

polyp

Answer 20

-smooth
-symmetric

Question 21

apple core lesion

Answer 21

-ridged
-colon tumor
-need a CT with contrast -> grows its own vasculature

Question 22

3,6,9

Answer 22

-small bowel
-large
-cecum

Question 23

pneumotosis intestinalis

Answer 23

-air escapes to intestinal wall
-infection
-necrotizing enteral colitis
-dilated bowel

Question 24

biliary tree

Answer 24

-infection by gas forming organisms- emphysematous cholangitis
-incompetant sphincter of oddi
-recent surgery
-you should not see any change darkness

Question 25

cholecystitis

Answer 25

-pancreatitis
-ileus -> obstruction from inflammation from infection
-gall stones cause back up -> pancreatitis -> gas builds up

Question 26

CT image

Answer 26

-(-1000) to (+1000) measured in Hounsfield units
-measures density
-water = 0
-air= -1000
bone= 1000

Question 27

CT types

Answer 27

-4th generation- stationary-rotate -> 2-10s
-5th generation/spiral/helical- stationary-rotate, 30s -> multiplanar reformation- OVERLAPPING IMAGES IN SINGLE ACQUISITION
-multislice- very fast (head to toe in 10s) -> screenings (colon, broncho, angio

Question 28

CT contraindications

Answer 28

-NONE
-allergy to iodinated contrast - consideration

Question 29

windowing

Answer 29

-grey level mapping
-contrast enhancement
-CT greyscale manipulated to see particular structure better
-1. mediastinal or soft tissue
-2. lung
-3. bone

Question 30

post processing

Answer 30

-additional manipulation of raw data
-demonstrate pathology
-without repeating study **
-dont have to reexpose to radiation

Question 31

orientation of CT

Answer 31

-right and left are switched
-top is anterior
-bottom is posterior
-supine

Question 32

atelectasis

Answer 32

-rib crowding
-bronchiograms
-tracheal deviation
-displaced fissure