Resp: Test 2 : 13. Maki: The Pleura And The Mediastinum

Front 1

Back 1

1. aortic knob
2.aortopulmonic window

Front 2

what is going on in this child?

Back 2

thymic hyperplasia

Front 3

if you had a CXR of a child and you thought they may have a thymic hyperplasia, what should be your next move?

Back 3

CT of the chest

Front 4

the most common thing seen in CT as a superior or anterior mediastinal tumor is what?

**

Back 4

substernal thyroid (goiter)

Front 5

what is the pathology?

Back 5

teratoma

Front 6

which diaphragm is higher?

Back 6

right

Front 7

what is the sniff test? (normal finding, and abnormal

Back 7

normally both diaphragms go down

but in diaphragmatic paralysis there is paradoxical motion, where the diaphragms go up (due to negative pressure)

Front 8

Herniation of Bachdelek: 3 traits

(probably not on test)

Back 8

Big

in Babies

in the Back

(more commonly on left side)

Front 9

Herniation of Morgagni

Back 9

right sided anterior herniation of the diaphragm

Front 10

Hiatal hernia... 2 types (describe both, and which is most common)

***

Back 10

Paraesophageal: fundus of stomach is herniated into the chest, esophagus in the normal area

Sliding: most common, whole stomach and esophagus are in the chest

Front 11

this person was given a sniff test...what is going on?

Back 11

sniff test with paradoxical movement of left hemidiaphragm

Front 12

as you go down the spinal cord in a lateral view what should happen to its appearance?

Back 12

it gets darker

Front 13

what is going on here

Back 13

right diaphragmatic leaflets

tension pneumothorax (hole in visceral pleura)

left lung starts to look 'dirty' because it is getting all the blood

Front 14

best view to see a tension pneumothorax?

Back 14

PA

Front 15

if you suspect a pneumothorax on a normal CXR what should be your next step?

**

Back 15

upright expiratory chest film

Front 16

Back 16

just wanted to show this

Front 17

Back 17

again just look at this

Front 18

Back 18

effusion

Front 19

Back 19

Front 20

2 important diagnoses?

Back 20

mediastinal shift left

pleural effusion

Front 21

TEST

Back 21

pneumothorax that has collected inferiorlly

Front 22

This PA chest was performed
In expiration….Why?
***

Back 22

suspected pneumothorax

this is an expiratory chest film

Front 23

Pneumothorax
COPD
CHF
Consolidation

Back 23

COPD

Front 24

bacterial will cause a alveolar or interstitial CXR?

Back 24

predominantly alveolar

Front 25

viral/mycoplasma will cause a alveolar or interstitial CXR?

Back 25

interstitial

Front 26

fungal will cause a alveolar or interstitial CXR?

Back 26

actually it is combination

TRICK QUESTION!

Front 27

Apical-posterior segments are filled up in what type of pneumonia?

Back 27

reactivation TB

Front 28

posterior segment of upper lobes that are lighting up on CXR is normally caused by what?

Back 28

aspiration in supine position

Front 29

Expansion or bowing of fissures is caused by?

Back 29

Klebsiella

Front 30

if you see rapid spread or abcess on CXR what is the likely cause?

Back 30

staph

Front 31

in a neutropenic pt, what type of findings might you see in a pt who has pneumonia on CXR?

Back 31

may have no findings in a neutropenic patient (limited inflam. response)

Front 32

what can make pneumonia look worse?

Back 32

hydration

Front 33

when a pt has pneumonia, and you take an Xray right at the beginning, what might you find?

Back 33

X-rays may lag the onset and the resolution of pneumonia

so you might not see much

Front 34

what sign

Back 34

silhouette sign

Front 35

sign and where?

Back 35

silhouette sign of lingula

Front 36

cause of this pneumonia?

Back 36

anthrax

see widened mediastinum

Front 37

if this person had TB, what would you call this?

Back 37

Renkie Complex (Ghon lesion)

Front 38

lung cancer LEAST commonly associated with cigs?

in what sex?

Back 38

adenocarcinoma

women

Front 39

what percent of primary lung tumors are malignant?

Back 39

90

Front 40

when you see a CT of someone's chest it goes down to the adrenal glands...Why?

***TEST

Back 40

hypervascular

one of the first places to see a metastatic deposit

Front 41

what type of cancer may have air bronchograms?

Back 41

adenocarcinoma

Front 42

what can be seen on this CXR?

Back 42

metastatic lesions

Front 43

Birth control pills
Pregnancy (during and after)
Surgery
Trauma
Malignancy
Immobilization
Cross country car or airplane trips

are all what? ***

Back 43

risk factors for PE

Front 44

where do PEs most often occur?

***

Back 44

bilateral and in lower lungs

Front 45

what will cause tumor emboli?

Back 45

renal cancer

Front 46

what is the method of choice to find a PE?

***

Back 46

CT

Front 47

Westermark sign

Back 47

clot so big it blocks the blood going to a lung segment

refers to dilation of the pulmonary artery proximal to an embolism with collapse of distal vessels

Front 48

you give a VQ scan. It shows a normal ventilation, but the perfusion is lacking...what does this show?

Back 48

PE

Front 49

If you see V/Q Mismatch, what is going on?

***TEST

Back 49

PE

(note: asthma and COPD do that too...so make sure they don't have a history of either or your V/Q mismatch isn't as helpful)

Front 50

d-dimer does what?

Back 50

measures the clotting in the blood

shows PE

Front 51

THERE WILL BE A CT FROM LECTURE ON THERE

Back 51

look at them

Front 52

what is the triple rule out? what does this show?

Back 52

Triple Rule out:
Aoritc dissection
PE
Coronary Artery occlusion

this is PE (i think)

Front 53

what does this show? what causes it?

Back 53

Wedge shaped peripheral defect, infarct due to PE