ST Imaging Final Lecture Questions

A patient presents with a posterior mediastinal lesion What differential diagnosis is reasonable to entertain:

a. cardiac mass

b. teratoma

c. thymoma

d. neurogenic tumor

d. neurogenic tumor

What type of pneumothorax is particularly life threatening based on the risk of cardiorespiratory arrest due to mediastinal compression:

a. emphysematous

b. tension

c. trauma induced

d. spontaneous

b. tension

What imaging modality influences hydrogen protons resulting in high resolution depiction of soft tissue anatomy particularly useful outside the chest and abdomen:

a. magnetic resonance imaging

b. diagnostic ultrasound

c. nuclear imaging

d. computed tomography

a. magnetic resonance imaging

Bilateral hilar lymphadenopathy is suspicious of what pathology:

a. Pancoast tumor

b. Squamous cell carcinoma

c. Sarcoidosis

d. Aspergillosis

c. Sarcoidosis

What is a common contrast agent employed in MRI and CT to delineate vascular structures from surrounding soft tissues:

a. gadolinium

b. barium

c. technetium indium

a. gadolinium

All the following are patterns of lung disease EXCEPT:

a. infectious

b. mass

c. interstitial

d. airspace

a. infectious

Lesions in what space likely deviate the trachea:

a. Retrocardiac clear space

b. anterior mediastinum

c. cardiophrenic angles

d. costophrenic recesses

b. anterior mediastinum

The silhouette sign radiographically can be described as which of the following:

a. can see the bronchi amidst the lung parenchyma discreet

b. air collection at pleural space

c. blunting of costophrenic angles

d. a loss of a structures outline

d. a loss of a structures outline

If the cardiac silhouette is over 50 percent of the width of the thorax which of the following is NOT a considerable differential:

a. Anterior mediastinal mass

b. Pericardial effusion

c. Cardiomegaly

d. Increased inspiratory effort

d. Increased inspiratory effort

The horizontal fissure separates what two lobes of the right lung:

a. middle and lower

b. upper and middle

c. upper and lower

d. upper and lingula

b. upper and middle

Retrocardiac and retrosternal clear spaces are best assessed on what projection of the chest:

a. PA with inspiration

b. Apical lordotic

c. PA with expiration

d. Lateral

d. Lateral

How much fluid is needed to detect a pleural effusion on radiographs:

a. 100-200 mL

b. 250-600 mL

c. 10-50 mL

d. 50-100 mL

b. 250-600 mL

In general chest radiographic technique versus thoracic spine employs a lower mAs and higher kVp resulting in _____ contrast than thoracic spine films:

a. similar

b. higher

c. lower

c. lower

What is the optimal grid ratio to image the chest

a. 14:1

b. 12:1

c. 16:1

d. 10:1

c. 16:1

Rib fractures most commonly involve evenly distributed:

a. upper ribs 1-3

b. lower ribs 10-12

c. middle ribs 4-9

c. middle ribs 4-9

Air bronchograms are seen with which of the following lung findings:

a. cardiomegaly pneumothorax

b. posterior mediastinal masses

c. consolidation

c. consolidation

Chylothorax eludes to what type of fluid filling the pleural space:

a. blood

b. lymph

c. exudate

d. transudate

b. lymph

The most common cause of a lung mass in an older patient:

a. atelectasis

b. emphysema

c. lung carcinoma

d. aneurysm

c. lung carcinoma

To appropriately assess the cardiothoracic ratio how must the patient be positioned:

a. AP positioning at 72 inch FFD

b. PA positioning at 40 inch FFD

c. AP positioning at 40 inch FFD

d. PA positioning at 72 inch FFD

d. PA positioning at 72 inch FFD

What name sign is used in the presence of pleural rib and intercostal nerve lesions that lead to deflection of the pleura away from the chest wall:

a. silhouette

b. bulging fissure

c. cat under the rug

d. meniscus

c. cat under the rug

What subtype of atelectasis does NOT have air bronchograms:

a. Compressive

b. Cicatrisation

c. Resorptive

d. Passive

c. Resorptive

The cross sectional imaging modality of choice for chest and abdominal imaging is:

a. nuclear imaging

b. magnetic resonance imaging

c. computed tomography

d. ultrasound

c. computed tomography

A proper inspiratory effort for chest radiography is determined by the position of the diaphragm relative to the posterior ribs at what vertical landmark

a. Mid clavicular line

b. Sternoclavicular joint line

c. Acromial clavicular line

d. Mid axillary line

a. Mid clavicular line

Which hemidiaphragm is usually normally seen higher than the other:

a. right and left are even

b. right higher than left

c. left higher than right

b. right higher than left

What real time imaging modality can assess blood flow through vasculature using pulses of sound waves:

a. doppler ultrasound

b. computed tomography

c. magnetic resonance imaging

d. nuclear imaging

a. doppler ultrasound

What is the most common cause of pulmonary consolidation:

a. pulmonary malignancy

b. bronchial obstruction

c. infectious pneumonia

d. pulmonary hemorrhage

c. infectious pneumonia

What contrast agent is used in the gastrointestinal system to opacify tube like organs:

a. iodine

b. xenon

c. barium sulfate

d. gadolinium

c. barium sulfate

What characteristic of a solitary pulmonary lesion distinguishes a lesion as a nodule versus a mass:

a. density

b. location

c. size

d. patient age

c. size

Pleural plaques are commonly seen in:

a. pleural effusion

b. tuberculosis

c. asbestosis

d. intercostal schwannoma

c. asbestosis

Which of the following would not be a cause of diaphragm elevation:

a. phrenic nerve palsy

b. eventration

c. hepatomegaly

d. pleural effusion

d. pleural effusion

A RUL collapse would silhouette what anatomy:

a. right hemidiaphragm

b. right paratracheal stripe

c. aortic knob

d. right heart border

b. right paratracheal stripe

All the following are patterns of lung disease EXCEPT:

a. mass

b. airspace

c. infectious

d. interstitial

c. infectious

T/F: When differentiating primary and secondary lung disease primary has no underlying pathology while secondary does.

a. True

b. False

a. True

What imaging modality influences hydrogen protons resulting in high resolution depiction of soft tissue anatomy particularly useful outside the chest and abdomen:

a. computed tomography

b. nuclear imaging

c. diagnostic ultrasound

d. magnetic resonance imaging

d. magnetic resonance imaging

T/F: All cases of Mesothelioma arise from previous Asbestos exposure.

a. True

b. False

b. False

What type of pneumothorax is particularly life threatening based on the risk of cardiorespiratory arrest due to mediastinal compression?

a. trauma induced

b. tension

c. spontaneous

d. emphysematous

b. tension

When viewing a frontal chest radiograph the cardiac silhouette is over 50 percent of the thorax what are appropriate differentials select all that apply:

a. pleural thickening

b. pericardial effusion

c. poor inspiratory effort

d. cardiomegaly

b. pericardial effusion

c. poor inspiratory effort

d. cardiomegaly

The 5 Ts differential includes select all that apply:

a. Terrible Metastasis

b. Goiter

c. Teratoma

d. Abdominal Aortic Dissection

b. Goiter

c. Teratoma

What name sign is associated with LUL collapse:

a. Air bronchogram sign

b. Meniscus sign

c. Luftsichel sign

d. Cat under the rug sign

c. Luftsichel sign

What level indicates a proper inspiratory effort:

a. Rib 8-9 interspace midclavicular line

b. Rib 8-9 interspace acromioclavicular line

c. Rib 9-10 interspace midclavicular line

d. Rib 9-10 interspace acromioclavicular line

c. Rib 9-10 interspace midclavicular line

Match the appropriate silhouetted anatomy to the lobe collapse:

Right heart border

Right paratracheal stripe

Left hemidiaphragm

Right hemidiaphragm

Aortic knuckle

- RML

- LUL

- RUL

- LLL

- RLL

Right heart border; RML

Right paratracheal stripe; RUL

Left hemidiaphragm; LLL

Right hemidiaphragm; RLL

Aortic knuckle; LUL

Air bronchograms are seen in which subtypes of atelectasis select all that apply:

a. Obstructive

b. Cicatrisation

c. Compressive

d. Resorptive

b. Cicatrisation

c. Compressive

When imaging the chest CT is preferred over MRI why select all that apply :

a. Better for acute trauma situations

b. Faster scan time

c. Better soft tissue detail

d. Less motion artifact

a. Better for acute trauma situations

b. Faster scan time

d. Less motion artifact

Localizing a lesion to a specific lobe of the lung requires:

a. PA positioning at 72 inch FFD PA positioning at 40 inch FFD

b. Both PA positioning at 72 inch FFD and Lateral positioning at 72 inch FFD

c. PA positioning at 72 inch FFD and Lateral positioning at 40 inch FFD

b. Both PA positioning at 72 inch FFD and Lateral positioning at 72 inch FFD

Which of the following are subcategories of airspace disease select all that apply:

a. Nodular

b. Consolidation

c. Reticular

d. Atelectasis

b. Consolidation

d. Atelectasis

The horizontal fissure is made of what:

a. one layer of parietal pleura

b. one layer of visceral pleura

c. two layers of parietal pleura

d. two layers of visceral pleura

d. two layers of visceral pleura

What anatomy would barium be used to visualize:

a. esophagus

b. tumors

c. lung perfusion

d. vasculature

a. esophagus

T/F: Von Recklinghausen disease can present with rib notching.

a. True

b. False

a. True

Match the following diagnosis to the correct specialist:

Phrenic Nerve Mass

Cardiac Mass

Aortic Root Aneurysm

a. Vascular surgeon

b. Neurosurgeon

c. Cardiologist

Phrenic Nerve Mass; Neurosurgeon

Cardiac Mass; Cardiologist

Aortic Root Aneurysm; Vascular surgeon

A stone within a salivary gland or duct is termed:

a. cholelith

b. sialolith

c. tonsilolith

d. appendicolith

b. sialolith

What imaging modality is best to demonstrate cerebellar tonsillar ectopia?

a. MRI

b. Ultrasound

c. PET

d. CT

a. MRI

Zenker diverticulum is a posterior outpouching of what structure in the neck?

a. nasopharynx

b. epiglottis

c. hypopharynx

d. trachea

c. hypopharynx

What structure of the central nervous system is infratentorial and positioned in the posterior fossa of the skull?

a. Cauda Equina

b. Cerebellum

c. Cerebrum

d. Conus medullaris

b. Cerebellum

Which of the following lesions is often associated with an Arnold Chiari malformation?

a. disc protrusions

b. tethered cord

c. cord syrinx

d. cord ependymoma

c. cord syrinx

Magnification of the heart is inherently present with AP projections of the chest.

a. True

b. False

a. True

What is a normal cardiothoracic ratio of the thorax to the heart (thorax:heart) ?

a. 1:4

b. 2:1

c. 1:1

d. 1:3

b. 2:1

The carina is a landmark on which structure?

a. trachea

b. hilum

c. esophagus

d. carotid aa.

a. trachea

What radiographic density is most of the mediastinum?

a. water

b. bone

c. air

d. fat

a. water

What area is an important region to check on lateral radiographs to confirm an anterior mediastinal mass is actually in the anterior mediastinum?

a. retrocardiac clear space

b. prevertebral soft tissues

c. hilum

d. retrosternal clear space

d. retrosternal clear space

Anterior mediastinal masses ddx is:

a. 5 T's

b. Plastic Rags

c. Fog Machines

a. 5 T's

What advanced imaging modality is recommended for most cases of chest abnormalities requiring imaging follow-up?

a. CT

b. PET scan

c. MRI

d. Bone Scan

a. CT

What diagnosis is associated with the "potato nodes" or 'Garland' sign?

a. sarcoidosis

b. tuberculosis

c. lymphoma

d. teratoma

a. sarcoidosis

Which of the following is NOT apart of the 5 T's?

a. Terrible lymphoma

b. Thymoma

c. tuberculosis

d. Thyroid

e. Thoracic aortic aneurysm

f. Teratoma

c. tuberculosis

Normally aerated lungs will appear what density?

a. radiodense

b. radiolucent

b. radiolucent

Atelectasis is a subcategory of which radiographic pattern of lung disease?

a. interstitial

b. mass

c. nodular

d. airspace

d. airspace

What is the most common cause of pulmonary consolidation?

a. pulmonary hemorrhage

b. infectious pneumonia

c. pulmonary edema

d. pulmonary malignancy

b. infectious pneumonia

What is the only type of atelectasis lacking air bronchogram sign?

a. passive

b. contraction/fibrosis

c. resorptive

d. compressive

c. resorptive

Lobar collapse (atelectasis) of the right middle lobe would obscure the border of what anatomy?

a. left heart border

b. right heart border

c. left hemidiaphragm (dorsal)

d. right hemidiaphragm (dorsal)

b. right heart border

What is the primary feature distinguishing a pulmonary nodule from a mass?

a. size

b. location

c. density

d. calcification

a. size

Interstitial lung disease affect what pulmonary anatomy?

a. lymph nodes

b. airspaces

c. parenchyma

d. bronchi

c. parenchyma

Which of the following is not a differential for an anterior mediastinal mass?

a. Teratoma

b. Thoracic aneurysm

c. Thymoma

d. Non-neurogenic tumor

d. Non-neurogenic tumor

What is the most common posterior mediastinal mass?

a. Neurogenic tumor

b. Sympathetic tumor

c. Paraspinal abscess

d. Aneurysm

a. Neurogenic tumor

What is the most common cause of pneumothorax?

a. Traumatic

b. Primary spontaneous

c. Underlying lung disease

d. Iatrogenic

b. Primary spontaneous

T/F: Mediastinal shift is seen with all types of pneumothoraces.

a. True

b. False

b. False

Which costophrenic angle is the most gravity dependent?

a. Posterior

b. Anterior

c. Right

d. Left

a. Posterior

Which of the following is a benign pleural mass?

a. Fibroma

b. Mesothelioma

c. Lymphoma

d. Metastasis

a. Fibroma

Which of the following is a benign tumor of the ribs?

a. Osteosarcoma

b. Fibrous dysplasia

c. Metastasis

d. Ewing's

b. Fibrous dysplasia

Which of the following conditions gives a "ribbon rib" deformity?

a. Fibrous dysplasia

b. Neurofibromatosis type 1

c. Neurofibromatosis type 2

d. Paget's

b. Neurofibromatosis type 1

Choose the line of mensuration used to assess for cardiac shadow enlargement radiographically?

a. cardiothoracic ratio

b. gross cardiac measurement

c. cobbs angle

d. McNab's line

a. cardiothoracic ratio

The cardiac margins can be obscured radiographically at the cardiophrenic angles by which of the following findings?

a. hilar lesion

b. thyroid mass

c. pleural effusion

d. epicardial fat pads

d. epicardial fat pads

T/F: Cardiomegaly is a specific term used to describe cardiac enlargement due to congestive heart failure.

a. True

b. False

b. False

Identify the term used to describe fluid in the membrane surrounding the heart leading to an enlarged cardiac silhouette.

a. hydromediastinum

b. pulmonary effusion

c. pleural effusion

d. pericardial effusion

d. pericardial effusion

Focal or diffuse weakness of the diaphragm leading to abnormal contour is termed:

a. hernia

b. Mallory Weiss

c. leiomyoma

d. eventration

d. eventration

A chylothorax implies what type of material composing a pleural effusion?

a. lymph

b. blood

c. transudate

d. exudate

a. lymph

In relation to pleural effusions, what is the name sign given to describe the fluid tracking up the pleural wall?

a. mass effect

b. silhouette sign

c. meniscus sign

d. hampton hump

c. meniscus sign

What radiographic density would a pleural effusion exhibit?

a. fat

b. water

c. bone

d. air

b. water