RCA Midterm Review Study Guide

What is the kVp range for a chest x-ray?

100-140 kVp

What are the TWO standard views of a chest x-ray?

PA; lateral

What are the THREE accessory views of chest x-rays?

Lateral decubitus; apical lordotic; expiration

What are the FIVE emergency indications for chest CT?

Chest trauma; aortic dissection; aneurysm; pulmonary embolism; post-surgical complications

What's the main indication for a V/Q Scan?

Pulmonary embolism

What's the radionuclide for PET?

F-18 fluorodeoxyglucose (FDG)

What are FIVE indications of lung diagnostic ultrasound?

Pleural Effusion; pneumothorax; pneumonia; pulmonary edema; asthma/ COPD

Trachea x-ray

Aortic knob x-ray

Right atrium x-ray

Left ventricle x-ray

Right & Left pulmonary arteries x-ray

Hemidiaphragm x-ray

Pectus excavatum

Pectus carinatum

Costochondral calcification

Right sided aortic arch

Azygos fissure

Thymus gland

Eventration

Most common congenital sternal abnormality?

Pectus excavatum

What is the normal Haller Index?

<2.0

How do you calculate the Haller Index?

Maximum transverse diameter / Minimum AP distance

What is the most common form of pulmonary sequestration?

Intralobar

What kind of shunt is created by an arteriovenous malformation?

R —> L shunt

Which side is more common in eventration? _____________

Right

What is the diferential diagnosis for total eventration? (Hint: PEAS)

Phrenic nerve palsy; eventration; atelectasis; subpulmonic effusion

Which TWO pathologies are most commonly seen with air bronchogram sign?

Pneumonia; pulmonary edema

What is the Humpton Hump sign?

Lung infarction

What is the most common pathology associated with a butterly (bat wing) opacification?

Pulmonary edema

What issure is classically afected by a bulging fissure sign?

Horizontal (minor)

What pathology is most commonly seen with a reverse halo (atoll) sign?

Crytogenic organizing pneumonia

What forms a gloved inger sign on chest CT?

Dilated bronchi filled with mucus (mucoid impaction)

Definition of crazy paving sign

Scattered or diffuse ground glass attenuation with superimposed interlobular septal septal thickening and intralobular lines

Definition of tree-in-bud sign.

Small centrilobular nodules connected to multiple branching linear structures of similar caliber orginating from a single stalk

What's in a consolidation?

fluid; pus; blood; cells; protein

What's the most common lung infection in the western world?

pneumonia

What's the leading lethal chest infection worldwide?

Tuberculosis

What are the THREE types of Tuberculosis?

Primary; post-primary (reactivation); miliary

TWO categories of pulmonary edema.

Cardiogenic; non-cardiogenic

T or F : Radiation-induced lung disease respects anatomical boundaries.

False

What is the associated lymphadenopathy sign with sarcoidosis?

1-2-3 sign

What is the skin rash that is associated with sarcoidosis and coccidioidomycosis?

Erythema nodosum

Which inflammatory arthritis demonstrates interstitial thickening and nodules with or without cavitation?

Rheumatoid arthritis

Which inlammatory arthritis can develop apical ibrosis?

ankylosing fibrosis

What THREE lung diseases can develop chronic obstructive pulmonary disease (COPD)?

Emphysema; chronic bronchitis; chronic asthma

What is the most common underlying etiology of COPD/Emphysema?

Smoking

What are the THREE structural types of emphysema?

Centrilobular; Panlobular; paraseptal

Which one of the structural types of emphysema is most common?

Centrilobular

What chest etiology can be associated with a history of an atopic disorder, such as eczema?

Asthma

What is the most common genetic disorder of the chest and abdomen affecting the European population?

Cystic fibrosis

What are the THREE structural types of bronchiectasis?

Cylindrical; varicose; cystic

What are the FIVE types of atelectasis?

Resorptive (obstructive); passive (relaxation); compressive; cicatrisation; adhesive

What are the TWO DIRECT signs of atelectasis?

fissures displacement; crowding of pulmonary vasculature or air bronchogram signs

The issure is PULLED TOWARD / PUSHED AWAY the afected lobe in atelectasis.

PULLED TOWARD

5. What are the FIVE INDIRECT signs of atelectasis?

opacification; compensatory expansion of contralateral lung; displacement of heart, medistinum, trachea, and hilum toward affected side; elevation of ipsilateral hemidiaphragm; rib crowding on affected side

What is the most common reason for a Golden's S Sign?

Bronchogenic carcinoma with atelectasis

What lobe and fissure are involved in Golden's S sign?

Upper right lobe and horizontal fissure

What are the FOUR etiologies of pneumothoraces?

spontaneous (primary and secondary); post-traumatic; post- infectious; iatrogenic

What is the diference between primary and secondary spontaneous pneumothorax?

Primary = no underlying lung disease and secondary = underlying lung disease

The mediastinum and trachea are PUSHED AWAY / PULLED TOWARD the afected side in a TENSION pneumothorax.

PUSHED AWAY

What sign is associated with a pneumothorax on imaging?

White pleural line

What TWO features are the most reliable indications of benignancy on imaging?

calcification; growth

When comparing size of a SPN, what should you always do (if available)?

Compare with previous imaging, if available

A newly discovered SPN should undergo a _________

CT

Most malignancies will double in size in less than ______ days.

500

The growth rate in most benign lesions are ____________ days.

>500

What size diferentiates a nodule from a mass?

30 mm

What are the FIVE granulomatous diseases that were covered in this class?

tuberculosis; sarcoidosis; histoplasmosis; blastomycosis; coccidiodomycosis

Where is histoplasmosis endemic?

Mississippi and Ohio River valleys

Where is coccidioidomycosis endemic?

Southwestern US and Mexico

What is the most common organism to cause round pneumonia in pediatric patients?

Streptococcus pneumoniae

What is the most common benign lung neoplasm?

Hamatoma

What are the pathologic types of bronchogenic carcinoma?

Adenocarcinoma; Squamous cell; small cell (oat cell); large cell

Which pathological type of bronchogenic carcinoma is most common?

adenocarcinoma

What TWO syndromes are associated with apical lung tumors?

pancoast; horners

. What are the THREE features of Horner syndrome?

Ptosis; miosis; anhidrosis

What primary carcinoma is most common to metastasize to the lungs?

lung

What are the TWO patterns of pulmonary metastasis?

cannonball; snowstorm

DDx for anterior mediastinum

5 Ts (teratoma, thyroid goiter (substernal), thymoma, ascending aortic aneurysm, lymphoma)

DDx for middle mediastinum

aortic arch aneurysm, lymphadenopathy, hiatal hernias, psudomediastinum

DDx for posterior mediastinum

Descending AAA, paraspinal abscess, neurogenic tumor, bone tumor/ infection, lymphadenopathy

What is the hilum overlay sign?

A mediastinal mass will silhouette the hilar vessels at the level of the hila

What is the cervicothoracic sign?

Lesion above clavicle lies posterior; lesion at or below clavicle lies anterior

What anterior compartment mass has teeth?

Teratoma

What anterior compartment mass is associated with myasthenia gravis?

Thymoma

What anterior compartment mass is associated with a goiter?

Substernal thyroid goiter

What TWO pathologies can be found in any or all the mediastinal compartments?

aortic aneurysm; lymphadenopathy

What type of hiatal hernia is most common?

Sliding

What is pneumomediastinum?

Air in the mediastinum from various etiologies

What is the most common neurogenic tumor in the posterior mediastinum?

Schwannoma

What malignancy is associated with asbestos exposure?

Malignant mesothelioma

What is the most common primary carcinoma metastasize to the pleura?

Lung

What radiologic inding is the most frequent manifestation of pleural metastases?

pleural effusion

What is the most common location of a vanishing tumor?

horizontal fissure

What extrapleural mass is associated with a rib fracture?

Hematoma

What TWO pathologies most commonly form pleural effusions?

congestive heart failure; malignancy

What sign is associated with pleural effusions?

meniscus sign (blunting of the costophrenic angles)

What is the most common underlying etiology of atherosclerosis?

Hypertension

What is the most common segment of the aorta affected in an aneurysm?

Ascending aorta