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1041 RCA
1041 Thoracic Radiograph
| Question | Answer |
|---|---|
| what is the most common cause of lobar atelectasis? | Bronchial obstruction |
| Which of the following is false regarding the visualization of air bronchiogram on the chest film? | They are the hallmark of alveolar consolidation |
| Which abnormality may appear to be present on the chest xray but is simply due to abnormal rotation of the patient during production of the film? | Widended mediastinum |
| Blunting of a costophrenic angles seen on the posteroanterior or lateral chest film typically indicates | excess plural fluid |
| Which of the following are common radiographic findings seen in patients with volume loss due to atelectasis? 1. Elevation of the hemidiaphragm 2. Narrowing of the space between the ribs 3. Increase in the retrosternal airspace 4. Shift of the mediast | 1, 2, and 4 only |
| What is the optimal position of the tip of an intra-aortic balloon pump? | 2 cm above the carina |
| Which of the following statements best describe the typical findings on a chest radiograph for a patient with interstitial lung disease? | Diffuse bilateral infiltrates |
| Radiographically, into how many compartments is the mediastinum divided? | Three |
| Which of the following statements is false regarding the use of the chest x-ray to detect a pneumothorax? | The standard chest film is of limited use in detecting a pneumothorax. |
| What is indicated by the presence of gas bubbles within the pleural fluid without prior surgery or needle insertion? | Empyema |
| Which of the following statements is false regarding the use of ultrasound to image the chest? | It is useful to image lung tissue. |
| What is the optimal position of the endotracheal tube following intubation as seen on the chest radiograph? | 3 to 5 cm above the carina |
| What type of imaging is most useful for diagnosing idiopathic pulmonary fibrosis? | HRCT |
| Which of the following structures in the chest is typically examined using MRI? 1. Lung parenchyma 2. Hilar structures 3. Large vessels in the lung 4. Structures in the mediastinum | 2, 3, and 4 only |
| What term is used to describe the predominance of edema in the hilar regions of both lungs with progressively less edema in the more peripheral areas of the lungs as seen on the chest film? | Bat's wing |
| Which chest x-ray view is best used to identify excess pleural fluid? | Lateral decubitus |
| In what pulmonary condition does the chest radiograph often "lag behind" the clinical status of the patient? | Pneumonia |
| What is the earliest sign of a left-sided pleural effusion on an upright chest radiograph? | An increased distance between the inferior margin of the left lung and the stomach gas bubble |
| Which of the following findings on the chest radiograph is considered a secondary sign of emphysema? | Flattening of the diaphragm |
| An air-fluid level in the pleural space typically indicates | hydropneumothorax. |
| Which of the following is not a typical cause of atelectasis? Question options: | Hepatomegaly |
| Your patient just had an anteroposterior chest film taken. When you view the film, what may be a consideration? | The heart may appear larger than it really is. |
| The right heart shadow is not visible on your patient's chest radiograph. Which of the following pathologies may explain this? | Right middle lobe pneumonia |
| What is the most common cause of cephalization as seen on the upright chest film? | Left heart failure |
| Which of the following is a major limitation of magnetic resonance imaging (MRI) of the chest? | Cannot be used in patients with pacemakers. |
| Which of the following forms of radiologic assessment is most useful for studying the distribution of ventilation and perfusion and the effects that diseases may have on these two important functions? | Lung scanning |
| Which of the following views is used to see whether free fluid (pleural effusion or blood) is present in the chest in the left pleural region? | Lateral decubitus view |
| What is the significance of the silhouette sign? | It helps determine whether an infiltrate is in contact with a heart border. |
| What breathing instruction is a patient given immediately before an anteroposterior (AP) or posteroanterior (PA) chest radiograph? | Take a deep breath |
| Radiographic signs of consolidation include which of the following? 1. Lobar distribution 2. Minimal loss of volume 3. Homogenous density late in the process 4. A low shift of the diaphragm | 1, 2, and 3 |
| A lateral decubitus view is able to detect as little as _____ mL of the pleural fluid. | 25 to 50 |
| A male patient who is standing upright with his back to the x-ray tube, his anterior thorax pressed against a metal cassette containing the film, and his arms positioned out of the way is positioned for what x-ray view? | PA view |
| On a PA film, what number of posterior ribs visible above the diaphragm indicates a good inspiratory effort? | 10 |
| Which of the following tissues will look radiolucent on a chest radiograph? | lungs |
| The presence of the characteristic "signet sign" in a computed tomography (CT) scan is consistent with which of the following diseases? | Bronchiectasis |
| As a patient who is being positioned for a chest x-ray is moved closer to the source of the x-rays, what happens to the shadows of anatomic structures seen on the chest film? | They get larger. |
| Which of the following views is most helpful in identifying a pneumothorax? | Expiratory view |
| A portable film is ordered immediately after a patient is intubated in the emergency department. Which of the following distances confirms proper placement of the endotracheal tube? | 3 to 5 cm above the carina |
| Which of the following radiologic findings are consistent with lobar atelectasis? 1. Collapse of lung tissue 2. Shift in hilar structures toward the area of atelectasis 3. Hemidiaphragm elevation 4. Shift in hilar structures away from the area of atel | 1, 2, and 3 |
| Which of the following studies is gradually replacing scanning for the diagnosis of pulmonary embolus? | CT angiography |
| Which of the following structures will result in the most radiopaque shadow on the chest radiograph? Question options: | Ribs |
| In the standard posteroanterior chest film, the heart shadow should be less than what proportion of the chest width? | 50% |
| What imaging technique would be most useful to determine which patients with emphysema may benefit from lung volume reduction surgery? | Chest HRCT |
| Which of the following is a major limitation of magnetic resonance imaging (MRI) of the chest? | Cannot be used in patients with pacemakers. |
| In which of the following would loculation of pleural fluid be as likely to occur? 1. Empyema 2. Exudative fluid 3. Hemothorax 4. Congestive heart failure | 1, 2, and 3 only |
| What are the two most common reasons for placing a chest tube? | Pneumothorax and empyema |
| What is the best imaging technique for examining mediastinal masses? | Chest CT |
| In which of the following situations is obtaining a chest radiograph least useful? | When the static pressure drops by 2 cm H2O during CMV |
| Which of the following are typical causes of pulmonary edema as seen on the chest radiograph? 1. Left heart failure 2. Renal failure 3. Cor pulmonale 4. Fluid overload | 1, 2, and 4 only |
| What is the most common cause of cephalization as seen on the upright chest film? | left heart failure |
| Your patient just had an anteroposterior chest film taken. When you view the film, what may be a consideration? | The heart may appear larger than it really is |
| What is the most common cause of pulmonary fibrosis? | unknown |
| Computed tomography (CT) scanning of the chest would be least useful for which of the following? | To evaluate patients with asthma |
| What term is used to describe the shadows seen on the chest film when the alveoli fill with pus, fluid, or blood? | Infiltrates |
| Which radiographic view of the chest allows the physician to read the best quality film? | Posteroanterior |
| Which of the following is least likely to cause pneumomediastinum? | Pericarditis |
| Which of the following is the most common type of interstitial lung disease? | Sarcoidosis |
| A 49-year-old COPD patient arrives to the ER complaining of shortness of breath (SOB) and difficulty breathing. The physical examination reveals bilateral coarse crackles throughout the lung fields, pedal edema, and hepatomegaly. The chest x-ray shows bil | Left heart failure |
| What problem exists when interpreting an overexposed chest film? | There is difficulty in seeing the peripheral blood vessels. |
| Which of the following is not a typical cause of atelectasis? | Pleurisy |
| CT angiography is most often used to evaluate the patient for which of the following conditions? | Pulmonary emboli |
| The right heart shadow is not visible on your patient's chest radiograph. Which of the following pathologies may explain this? | Right middle lobe pneumonia |
| Which of the following statements is false regarding the recognition and treatment of a tension pneumothorax as seen on the chest radiograph? | The patient should be intubated |
| Which of the following diseases are typically evaluated using high-resolution CT? 1. Emphysema 2. Asthma 3. Bronchiectasis 4. Interstitial lung disease | 1, 3, and 4 only |
| A high-resolution CAT scan of a 62-year-old smoker has revealed several nodules on the right lung. Which of the following procedures would you suggest to assess the "malignancy" of these nodules? | Positron emission tomography |
| Which of the following statements are considered an indication for obtaining a radiograph? 1. Determine the appropriate therapy. 2. Evaluate the effectiveness of treatment. 3. Detect alterations of the lung caused by pathologic processes. 4. Diagnose | 1, 2, and 3 |
| Which of the following views provides less cardiac magnification and a sharper view of the left lower lobe? | Left lateral view |
| The casting of a white shadow on a film is consistent with which of the following situations? | Less exposed film |
| Which of the following radiologic findings are consistent with lobar atelectasis? 1. Collapse of lung tissue 2. Shift in hilar structures toward the area of atelectasis 3. Hemidiaphragm elevation 4. Shift in hilar structures away from the area of atel | 1 and 4 |
| Which of the following terms defines high-density tissues on the x-ray film? | Radiopaque |
| Which of the following would suggest that a patient has congestive heart failure (CHF)? | Increased cardiothoracic ratio |
| In which of the following areas has magnetic resonance imaging (MRI) demonstrated superiority over CT scanning? | Evaluation of the hila |
| During what type of procedure is the risk of exposure to scatter radiation the greatest? | Performing or assisting during fluoroscopy |
| To minimize the magnification associated with portable films, how far should the patient and the film be from the source of the x-rays in a conventional chest x-ray? | 6 feet |
| Which of the following are typical findings of a small pleural effusion? 1. Blunting of the costophrenic angle 2. A small meniscus sign 3. A partially obscured diaphragm 4. Complete whiteout of the affected side | 1, 2, and 3 |
| The presence of "hot spots" in a positron emission tomography (PET) scan is indicative of: | metabolically active tumor or infection |
| Which of the following tissues represent the four distinct densities recognized in the x-ray (from higher to lower density)? | Bone, water, fat, air |
| Which of the following clinical or chest x-ray findings is consistent with hyperinflation caused by obstructive lung disease? | Large retrosternal space |
| Which of the following studies is gradually replacing scanning for the diagnosis of pulmonary embolus? | CT angiography |
| AP portable films are obtained to evaluate which of the following? 1. Lung status 2. Lung tumor growth 3. Line and tubing positions 4. Results of invasive therapeutic procedures | 1, 3, and 4 |
| trachae shift in midline | pneumothorax, hemothorax, significant atelectasis |
| obliterated costophrenic angle (blunted) | pleural effusion |
| flattened diaphram | COPD, significant air trapping |
| radiolucent | normal |
| fluffy infiltrates | pulmonary edema |
| wedge-shaped infiltrates | pulmonary embolus |
| air bronchogram | pneumonia |
| butterfly or bat wing pattern | pulmonary edema |
| plate-like or patchy infiltrates | Atelectasis |
| scattered patchy infiltrates | ARDS |
| ground glass or honey comb | ARDS\IRDS |
| Reticulogranular or granular pattern | ARDS/IRDS |
| concave superior interface | pleural effusion |
| Kerley B Lines (WAP) | interstitial pulmonary edema and CHF |
Created by:
jlmarti1988