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Post-Test All of the material covered in this test can be found on the previous pages. Answers are provided at the end of the test. 1) Opacification of what part of the lung will silhouette the left heart border? Left lower lobe Superior segment left lower lobe Right middle lobe Lingula 2) What is the most likely diagnosis on the following chest x-ray?

Radiology - Part 3 Post Test

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Page 1: Radiology - Part 3 Post Test

Post-Test

 All of the material covered in this test can be found on the previous pages. Answers are provided at the end of the test.

1)  Opacification of what part of the lung will silhouette the left heart border?

Left lower lobe

Superior segment left lower lobe

Right middle lobe

Lingula

2)  What is the most likely diagnosis on the following chest x-ray?

Page 2: Radiology - Part 3 Post Test

Atelectasis

Pulmonary edema

Bilateral pneumonia

Pneumothorax

Questions 3-7: Please refer to the following image.

Page 3: Radiology - Part 3 Post Test

3)  Identify the object labeled "3" in the above image.

Ascending aorta

Aortic arch

Aortopulmonary window

Right atrium

4)  Identify the object labeled "4" in the above image.

Ascending aorta

Right atrium

Right hilum

Right ventricle

5)  Identify the object labeled "5" in the above image.

Ascending aorta

Aortic arch

Left hilum

Mass in the left aortopulmonary window

6)  Identify the object labeled "6" in the above image.

Left ventricle

Aortic arch

Ascending aorta

Left pulmonary artery

7)  Identify the object labeled "7" in the above image.

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Aortic arch

Right atrium

Left ventricle

Left pulmonary artery

8)  The normal chest x-ray seen below is not technically adequate. Why?

The patient is rotated.

The radiograph is over penetrated.

The radiograph was performed during expiration.

The radiograph is under penetrated.

9)  Which of the following is not a characteristic of a technically adequate PA chest radiograph?

Thoracic spine disc spaces should be barely visible through the heart.

The osseous detail of the thoracic spine is always clearly visualized.

The clavicular heads should be equal distance from the spinous process of the thoracic vertebral bodies.

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Bronchovascular structures can usually be seen through the heart.

10)  Identify the abnormality shown in the image below.

Right middle lobe pneumonia

Right upper lobe pneumonia

Right lower lobe pneumonia

Right upper lobe atelectasis

11)  Admission PA and Lateral chest radiograph of a trauma patient with a left-sided pleural effusion  demonstrates what other notable abnormality ?

Page 6: Radiology - Part 3 Post Test

Right tension pneumothorax

Left pulmonary opacity representing pulmonary hemorrhage

Left pulmonary opacity representing pneumonia

Left pneumothorax

12)  Based on your findings, what lobe is involved in the above image?

Left upper lobe

Right middle lobe

Left lower lobe

None of the above

13)  Name the abnormality shown in the image below?

Page 7: Radiology - Part 3 Post Test

Left lower lobe atelectasis

Luftsichel sign

Hampton's hump

None of the above

14)  What other clinical finding(s) would you expect to find in a patient with the abnormality shown above?

Enlarged axillary lymph nodes

Hypoxia and dyspnea

Normal serum D-dimer

None of the above

15)  Identify the abnormality shown in the image below?

Page 8: Radiology - Part 3 Post Test

Bilateral basilar atelectasis

Right middle lobe pneumonia

Hampton's hump

Bilateral pleural effusions

16)  What study may be used to further evaluate the nature of the finding seen above?

Bilateral decubitus chest x-ray

Supine chest x-ray

Apical lordotic chest x-ray

None of the above

17)  Pneumonia causes volume loss or collapse of the affected lung parenchyma.

True

False

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18) A pneumothorax is best demonstrated by an upright expiratory chest x-ray.

True

False

19)  Identify the abnormality shown in the image below.

Large pleural effusion

Tension pneumothorax

Left lower lobe pneumonia

None of the above.

20)  The next step in diagnosis and treatment of the abnormality seen above is?

Admit and observe patient.

Perform chest CT scan.

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Immediate chest tube placement.

Thoracentesis to remove effusion.

21)  Why is prompt diagnosis and treatment of the above process important?

Patient will experience persistent shortness of breath.

Patient may expire secondary to hypoxia.

The contralateral lung may collapse if not treated.

Patient may expire secondary to decreased venous return to the heart.

22)  The image seen below is a magnified view of a lateral chest x-ray. The blue arrows indicate the left ribs and the red arrows indicate the right ribs. 

Which of the following statements is true?

The right ribs are further away from the cassette and therefore magnified less than the left ribs.

The lateral chest x-ray is obtained with the left chest against the film cassette which diminishes magnification of the heart and left ribs.

The left ribs are usually projected posterior to the right ribs on a true lateral chest x-ray.

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None of the above are true.

 

23)  Identify the bronchus labeled "23" in the image below.

Right mainstem bronchus

Right middle lobe bronchus

Bronchus intermedius

Right lower lobe bronchus

24)  Identify the bronchus labeled "24" in the image above.

Left upper lobe bronchus

Left middle lobe bronchus

Left lower lobe bronchus

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Lingular bronchus

 

25)  Identify the abnormality shown in the images below.

Right pleural effusion

Hydropneumothorax

Right basilar pneumothorax

Right lower lobe atelectasis

26) Which of the following statements is true when distinguishing between a pulmonary, pleural, and extrapleural mass?

Masses with acute margins to lung tissue indicate the process is pleural or extrapleural.

Masses with oblique margins to lung tissue indicate the process is pleural

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or extrapleural.

Rib destruction indicates pleural involvement and possibly the origin of the mass.

27)  What sign is seen in the image below?

Concave margin sign

Indistinct margin sign

Crescent sign

Silhouette sign

All of the above

28)  Identify the abnormality shown in the images below.

Page 14: Radiology - Part 3 Post Test

Hiatal hernia

Bochdalek hernia

Morgagni hernia

Eventration

29)  The following characteristics of calcification in a solitary pulmonary nodule would be considered benign except:

Central calcification

Stippled calcification

Irregular calcification

Complete calcification

 

30)  What finding is least consistent with lobar atelectasis?

Air bronchograms

Crowding of vascular markings

Expansion of other lobes

Page 15: Radiology - Part 3 Post Test

Elevation of the diaphragm

None of the above.

Post Test Answers

1) Opacification of what lobe of the lung will silhouette the left heart border?

2)What is the most likely diagnosis on the following chest x-ray?

Page 16: Radiology - Part 3 Post Test

Questions 3-7: Please refer to the following image.

3) Identify the object labeled "3" in the above image. Ascending aorta

4) Identify the object labeled "4" in the above image. Right atrium

5) Identify the object labeled "5" in the above image. Aortic arch

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6) Identify the object labeled "6" in the above image. Left pulmonary artery

7) Identify the object labeled "7" in the above image.  Left ventricle

8) The normal chest x-ray seen below is not technically adequate. Why?

9) Which of the following is not a characteristic of a technically adequate PA chest radiograph?

The osseous detail of the thoracic spine is always clearly visualized.

10) Identify the abnormality shown in the image below.

Page 18: Radiology - Part 3 Post Test

11) What abnormalities of the elbow can be observed in the image below?

The Left upper lobe opacity represents pulmonary hemorrhage. There is also a left pleural effusion seen best as a fluid level on the lateral view.

12) Based on your findings, what lobe is involved in the above image? Left upper lobe.

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13) Name the abnormality shown in the image below?

14) What other clinical finding(s) would you expect to find in a patient with the abnormality shown above? Hypoxia and dyspnea

15)  Identify the abnormality shown in the image below?

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16) What study may be used to further evaluate the nature of the finding seen above?

Bilateral decubitus chest x-ray

17) Pneumonia causes volume loss or collapse of the affected lung parenchyma.

False - The affected lung airspaces become filled with the infectious process and typically do not collapse.

18) A pneumothorax is best demonstrated by an upright expiratory chest x-ray.

True

19) Identify the abnormality shown in the image below.

The red arrows indicate the edge of the collapsed right lung.  Their is also significant shift of the mediastinum to the left.

20) The next step in diagnosis and treatment of the abnormality seen above

Page 21: Radiology - Part 3 Post Test

is? Immediate chest tube placement.

21) Why is prompt diagnosis and treatment of the above process important?

Patient may expire secondary to decreased venous return to the heart. The tension pneumothorax increases the intrathoracic pressure decreasing the venous return to the heart.

22)   The image seen below is a magnified view of a lateral chest x-ray. The blue arrows indicate the left ribs and the red arrows indicate the right ribs.  Which of the following statements is true?

The lateral chest x-ray is obtained with the left chest against the film cassette which diminishes magnification of the heart and left ribs. The right ribs are projected posterior to the left ribs in a true lateral view.

23) Identify the bronchus labeled "23" in the image below.

Page 22: Radiology - Part 3 Post Test

 The bronchus labeled "23" is the Bronchus intermedius.

24) Identify the bronchus labeled "24" in the image above.

 The bronchus labeled "24" is the Lingular bronchus.

25) Identify the abnormality shown in the images below.

Page 23: Radiology - Part 3 Post Test

 The air-fluid level seen in the right chest represents a hydropneumothorax. The red arrows demonstrate the pleural line of the pneumothorax.

26) Which of the following statements is true when distinguishing between a pulmonary, pleural, and extrapleural mass?

 Masses with oblique margins to lung tissue indicate the process is pleural or extrapleural.

27) What sign is seen in the image below?

Page 24: Radiology - Part 3 Post Test

 Silhouette sign. The right heart border is not seen due to airspace disease in the right middle lobe which has a radiodensity similar to the adjacent heart.

28) Identify the abnormality shown in the images below.

  Hiatal hernia demonstrated by the red arrows above.

29) The following characteristics of calcification in a solitary pulmonary nodule would be considered benign except: Irregular calcification.  Central, stippled, or complete calcification of a

Page 25: Radiology - Part 3 Post Test

solitary pulmonary nodule are considered  benign findings.

30) What finding is least consistent with lobar atelectasis? None of the above. All of the findings listed are characterictic of

atelectasis.