Radiology - Respiratory Test 2

Front 1

On a PA film, what structure forms the right margin of the superior mediastinum?

Back 1

Superior Vena Cava

Front 2

What structure forms the left margin of the superior mediastinum?

Back 2

left subclavian artery

Front 3

what is the most common mass

Back 3

thyroid goiter in the substernal area

Front 4

how much fluid do you need in order to see it on CXR

Back 4

300cc

Front 5

a child that has an abnormal CXR with a widen mediastinum would lead you to think?

Back 5

thymic enlargement --
"sail sign" on the right side for the thymus

Front 6

if the trachea is bowed what do you think?

Back 6

think that there is a mass present -- asymmetry leads you to think of a superior/anterior mediastinal mass (4 T's)

Front 7

what is commonly seen below and above the diaphragm?

Back 7

lymphoma -- dont usually have calcification

-- can have a more benign course -- dont cause a problem right away

Front 8

if there is paradoxical movement of the diaphragm with the sniff test what does that lead you to think?

Back 8

paralysis of the phrenic nerve
-- do an inspiration and expiration CXR -- see paralysis of L hemidiaphragm if the diaphragm is higher on inspiration

Front 9

what are the two hiatal hernias and which one is more dangerous?

Back 9

sliding (99%) and paraesophageal which is rare but more dangerous

Front 10

if you see a double density towards the back near the spine what do you think?

Back 10

bachdelek hernia -- double density due to extra tissue from the hernia

Front 11

what happens with a pneumothorax?

Back 11

there is potential space -- theres a hole with filling

Front 12

if you see an empyema on CXR what do you do>

Back 12

if they are there long enough you need to surgically remove them -- can be due to infection

Front 13

where do you find mesothelioma?

Back 13

parietal pleura

Front 14

when do you see a "meniscus sign"

Back 14

when there is plueral effusion
-- silhouette sign present

Front 15

** what do you do to look for effusion/

Back 15

do a decubitus view with the suspected side down
-- high hemidiaphragm suggest effusion

Front 16

where do you look if you suspect a pneumothorax? where do you look if you suspect pleural effusion?

Back 16

pneumothorax -- apical
pleural effusion -- base of the lungs

Front 17

how can you exclude malignancy?

Back 17

look for calcification in the tumor

Front 18

when can you have abscess formation?

Back 18

with long standing pneumonia

Front 19

what are the most common causes for diffuse alveolar pneumonia (2)?

Back 19

1- pneumocystis
2- CMV

Front 20

what group of individuals have a problem with aspergillosis?

Back 20

asthmatics

Front 21

Not all air space disease is pneumonia -- what can cause a pulmonary hemorrhage?

Back 21

good pastures syndrome -- bilateral cloudy appearance
-- life span at this point is 6 months

Front 22

what is the most common benign lung tumor?

Back 22

hamartoma

Front 23

what three tissue elements are involved with primary lung tumors?

Back 23

(1) bronchial epithelium
(2) glandular epithelium
(3) undifferentiated

Front 24

what type of tumor is found in the bronchial?

Back 24

squamous cell (35%) -- central -- obstructing

Front 25

what type of tumor is found glandular?

Back 25

adenocarcinma -- peripheral -- mid to upper lung zones

Front 26

how do you stage lung tumors

Back 26

TNM system

Front 27

where does metastasis usually occur?

Back 27

adrenal glands, liver, bone, and brain

Front 28

metastasis to the lungs can be nodular or interstitial. if you have nodular where is it from? if you have interstitial where is it from?

Back 28

nodular = colon, sarcoma, trophoblastic, kidney

interstitial = breast, prostate, and stomach

Front 29

what diagnostic tool can be used to look for metastatic disease

Back 29

PET scan

Front 30

what is an example of an upper lobe tumor? What type of people can this be seen in?

Back 30

superior vena cava syndrome
-- presentaiton --> smoker that cant get good drainage (face appears swollen)

Front 31

which tumor has cavitation associated with it?

Back 31

squamous cell

Front 32

where do thromboemboli originate?

Back 32

deep veins of the thigh, pelvic veins, right atrium

Front 33

where do thromboemboli travel?

Back 33

inferior vena cava, right atrium, right ventricle, pulmonary arteries to the mid and lower lungs

Front 34

what are 3 things that can happen with thromboembolism?

Back 34

(1) thromboembolism without infarction or necrosis -- nearly impossible to detect with imaging
(2) thromboembolism with infarction but without necrosis -- clot in segmental or subsegmental branch, collateral circulation
(3) thromboembolism with infarction and necrosis -- large pulmonary arteries, underlying lung disase, permanent tissue destriction

Front 35

should you do a CXR (PA and lateral) if you suspect a PE

Back 35

NO! its useless because CXR will usually be negative

Front 36

what is the fleishner's sign?

Back 36

enlargement of the right interlobar pulmonary artery (associated with PE)

Front 37

normal CXR, perfusion scan shows one or more defects, normal ventilation

High, intermediate, or low probability of a PE

Back 37

HIGH

Front 38

CXR is normal/abnormal, perfusion scan shows defects not corresponding to the CXR, ventilation defects not corresponding to perfusion defect

High, intermediate, or low probability of a PE

Back 38

intermediate

Front 39

Normal CXR or COPD, perfusion and ventilation defects match and there is normal perfusion

High, intermediate, or low probability of a PE?

Back 39

LOW

Front 40

what is a wedge like defect associated with?

Back 40

PE -- hampton hump