Question 1

&#10;&#10;-Refer to the figure. Both radiographs of the chest are normal. Which patient was radiographed in a PA (posteroanterior) projection?&#10;A) Patient A&#10;B) Patient B

Accepted Answer

In a PA (posteroanterior) projection, the x-ray beam passes from the back to the front of the body. This projection typically results in a more accurate representation of the heart size and lung fields. The scapulae are moved out of the lung fields, and the clavicles are more horizontal, as seen in Patient A's radiograph.

Question 2

&#10;&#10;-Refer to the figure. You know which chest radiograph was made in an AP (anteroposterior) projection because of what factor?&#10;A) A reversal of the mediastinum&#10;B) An appearance of an enlarged heart in the cardiothoracic ratio&#10;C) Sharpening of the edges of the anatomic structures&#10;D) Less lung inflation

Accepted Answer

In an AP (anteroposterior) projection, the heart appears larger than it actually is due to the increased distance between the heart and the x-ray film. This projection can artificially enlarge the heart in the cardiothoracic ratio, distinguishing it from the more commonly used PA (posteroanterior) projection where the heart appears more true to its actual size.

Question 3

&#10;&#10;-The chest radiograph is useful to determine:&#10;A) The cause of a consolidation.&#10;B) If the pathological condition is cardiac or pulmonary in nature&#10;C) Subtle fractures in the thoracic spine&#10;D) Spinous process fractures at the cervicothoracic junction

Accepted Answer

Chest radiographs are primarily used to differentiate between cardiac and pulmonary conditions by evaluating the size and shape of the heart and the appearance of the lungs. They are not detailed enough to determine the specific cause of a consolidation, nor are they the best modality for identifying subtle fractures in the thoracic spine or spinous process fractures at the cervicothoracic junction, where more detailed imaging like CT or MRI would be preferred.

Question 4

&#10;&#10;-The value of the silhouette sign, which is a loss of a radiographic interface between air and soft tissue, is that it can localize a lesion:&#10;A) To one lobe of the lung&#10;B) To one chamber of the heart&#10;C) To one branch of the bronchial tree&#10;D) In the bony thorax

Accepted Answer

The silhouette sign helps localize a lesion to a specific lobe of the lung by identifying the loss of normal borders between structures of different radiographic densities, such as the heart and adjacent lung lobes.

Question 5

&#10;&#10;-Atelectasis is:&#10;A) A common postoperative complication caused by poor inspiratory effort&#10;B) Revealed as a lung field that is abnormally white because it is no longer filled with air&#10;C) A condition that responds well to physical therapy&#10;D) All of the above.

Accepted Answer

Atelectasis is indeed a common postoperative complication often resulting from poor inspiratory effort, can be identified on imaging as an area of increased opacity (or whiteness) due to loss of air in the lung tissue, and is a condition that can respond well to interventions such as physical therapy, which can include breathing exercises and techniques to re-expand the affected lung areas.

Question 6

&#10;&#10;-The lateral chest radiograph is often made as a second-level decision, based on findings obtained from the PA view, because the lateral view:&#10;A) Incurs more radiation exposure and less useful clinical information&#10;B) Demonstrates the same location of lesions as the PA view&#10;C) Demonstrates anatomic structures already seen on the lateral view of the thoracic spine&#10;D) Incurs less radiation and less resolution than the PA view

Accepted Answer

The lateral chest radiograph incurs more radiation exposure compared to the PA (posteroanterior) view and often provides less additional clinical information, making it a second-level decision based on findings from the PA view.

Question 7

&#10;&#10;-Radiographically, the primary finding of chronic obstructive pulmonary disease is hyperinflation of both lungs.

Accepted Answer

Chronic obstructive pulmonary disease (COPD) often leads to hyperinflation of the lungs, which can be seen radiographically as an increase in the size of the lung fields, flattening of the diaphragm, and increased retrosternal air space, among other signs.

Question 8

&#10;&#10;-Computed tomography pulmonary angiography (CTPA) is the current standard of care in the diagnosis of acute pulmonary embolism because of high accuracy, wide availability, and rapid turnaround time.

Accepted Answer

CTPA is considered the gold standard for diagnosing acute pulmonary embolism due to its high diagnostic accuracy, widespread availability in most hospitals, and the ability to quickly provide results, which is crucial for the timely management of this potentially life-threatening condition.

Question 9

&#10;&#10;-In this study, contrast is delivered into the left side of the heart to evaluate the coronary arteries. This study is included under a group of cardiac catheterization procedures that include both diagnostic evaluation and interventional treatment (e.g., balloon angioplasty,stent placement).&#10;A) Echocardiogram&#10;B) Coronary angiogram&#10;C) Pulmonary angiogram&#10;D) Magnetic resonance angiogram

Accepted Answer

A coronary angiogram involves the injection of a contrast dye into the coronary arteries (which supply blood to the heart) to visualize them on X-ray images. This procedure is a type of cardiac catheterization used for both diagnosing and treating heart conditions, such as blockages that may require balloon angioplasty or stent placement.

Question 10

&#10;&#10;-A patient with chest pain and shortness of breath is evaluated with a chest radiograph, which shows blunting of the costophrenic angles. This finding is called:&#10;A) Myocardial infarction&#10;B) Pneumonia&#10;C) Pleural effusion&#10;D) Aortic dissection

Accepted Answer

Blunting of the costophrenic angles on a chest radiograph is a classic sign of pleural effusion, which occurs when fluid accumulates in the pleural space surrounding the lungs.

Deck 10: The Chest Radiograph and Cardiopulmonary Imaging