Deck 6: Chest

Question 1

In this AP projection the arrow indicates:

A) a normal arch of aorta.
B) a dilated pulmonary trunk.
C) an enlarged tracheobronchial lymph node.
D) a trachea shifted to left due to mass effect.

Answer 1

a normal arch of aorta.

Question 2

This portable AP chest radiograph shows a patient with:

A) acute pulmonary edema.
B) left lower lobe pneumonia without pleural effusion.
C) a left pleural effusion.
D) bronchogenic carcinoma in the lingula of the left upper lobe.

Answer 2

a left pleural effusion.

Question 3

What condition does the image depict?

A) Pneumothorax
B) Pleural effusion
C) Bacterial pneumonia
D) Congestive heart failure

Answer 3

Bacterial pneumonia

Question 4

This image includes a classic radiographic finding. What is the name of this radiologic sign, and what is the most likely disease?

A) Reticulonodular pattern; interstitial lung disease
B) Silhouette sign; pneumonia
C) Cephalization of the pulmonary vascular pattern; congestive heart failure
D) Silhouette sign; metastatic malignancy

Question 5

This frontal radiograph suggests an increase in lung density associated with an apparent silhouette sign along the right border of the heart. However, after a lateral view was also examined, the radiologist concluded that the patient's lungs were normal. Why?

A) The radiograph is an AP rather than the normal PA view.
B) The patient has fibrous granulomas.
C) The patient has pectus excavatum.
D) The patient is recovering from heart bypass surgery.

Question 6

Based on the image, what does this patient likely have?

A) Left lower lung atelectasis
B) Perforated left hemidiaphragm
C) Left pleural effusion
D) Paraspinal mass

Question 7

This patient is suffering from which symptoms?

A) Fever and cough
B) Trauma and limited air exchange on the left
C) Abdominal pain; preoperative radiograph
D) Known metastatic diseases and mediastinal adenopathy

Question 8

This image shows a child with:

A) allergies and enlarged adenoids causing snoring.
B) an (potentially fatal) acute epiglottitis.
C) failure to thrive and chronic dysphagia.
D) a viral illness that will respond readily to conservative treatment.

Question 9

The axial CT shown depicts that this patient has which disease?

A) Emphysema
B) Interstitial lung disease
C) Nodular lung disease
D) Pneumothorax

Question 10

Based on the image, what treatment will the patient likely receive?

A) Chemotherapy
B) Cardiac transplant
C) Surgery
D) Antibiotics

Question 11

The red arrows in this image highlight a finding that is associated with:

A) congestive heart failure.
B) pneumonia.
C) silicosis.
D) emphysema.

Question 12

The maximum transverse diameter of the heart in a PA view should be no more than what percentage of the transverse diameter of the inner margin of the rib cage at the level of the highest point of the diaphragm to be considered normal in size?

A) 20%
B) 33%
C) 50%
D) 75%

Question 13

In examining a PA chest radiograph:

A) you should use the search pattern described by the American College of Radiology.
B) you should examine peripheral structures before more central structures.
C) you should examine superficial structures before internal structures.
D) you should use a search pattern that best suits you and one that is consistent in examining and searching for all structures.

Question 14

A blunted costophrenic (costodiaphragmatic) sulcus on a PA view is most commonly associated with:

A) pleural effusion.
B) interstitial lung disease.
C) pneumothorax.
D) emphysema.

Question 15

Which of the following statements about evaluating rib fractures is NOT true?

A) Multiple views may be required to find a nondisplaced fracture.
B) All rib fractures identified on radiographs should be followed up with CT.
C) Fractures of the first rib and an "apical cap" suggest vascular injury.
D) A flail chest refers to multiple fractures within each of three or more adjacent ribs, or three anterior ribs and sternum or costal cartilages.

Question 16

The key finding on a chest radiograph leading to the diagnosis of a pneumothorax is:

A) visibility of the visceral pleura.
B) visibility of the parietal pleura.
C) increased radiolucency of the lung.
D) decreased radiolucency of the lung.

Question 17

Which of the following statements regarding pneumonia is CORRECT?

A) Bacterial and viral pneumonia typically are both associated with airspace opacification (consolidation).
B) Bacterial pneumonia is more typically associated with airspace opacity (consolidation) than viral pneumonia.
C) Viral pneumonia typically is associated with greater pulmonary opacity than bacterial pneumonia.
D) Neither viral nor pulmonary pneumonia have common patterns of abnormal radiographic densities.

Question 18

Croup is associated with which radiological sign?

A) Tram track
B) Air bronchogram
C) Peribronchial cuffing
D) Steeple sign

Question 19

High-resolution computed tomography (HRCT) is fundamental in evaluating and diagnosing:

A) interstitial lung disease.
B) mediastinal adenopathy.
C) congestive heart failure.
D) bronchogenic carcinoma.

Question 20

Which of the following statements is NOT true for the imaging of rib metastases?

A) Radiographs will always show increased density in the rib.
B) Radiographs will always show decreased density in the rib.
C) Radionuclide bone scans will typically show foci of increased activity.
D) MRI is the procedure of choice.

Question 21

Which of the following is NOT true for CCTA (cardiac or coronary CT arteriography)?

A) It is the modality of choice after a radiographic diagnosis of cardiomegaly.
B) It is less expensive than cardiac catheterization.
C) It is very sensitive for coronary artery disease.
D) It requires the IV injection of iodinated contrast material

Question 22

The goal of a frontal chest radiograph in the setting of acute chest pain is to determine:

A) the location of a coronary infarction.
B) if there is a non-cardiac explanation for the chest pain.
C) the coronary artery dominance pattern.
D) whether the internal mammary artery can be used for coronary bypass.

Question 23

Cephalization of the veins of the lungs is associated with all of the following EXCEPT:

A) bronchial pneumonia.
B) congestive heart failure.
C) Kerley-B lines.
D) Batwing type of pulmonary opacification.