Thoracic

Question 1

Recite the light’s criteria for exudative effusion

Answer 1

EXUDATIVE if

1. Pleural protein/serum protein >0.5
2. Pleural LDH/Serum LDH >0.6
3. Pleural LDH > 2/3 of the upper limit of serum LDH

Question 2

What is the mainstay CXR view in the evaluation of pleural effusion

Answer 2

CXR PA

Question 3

What is the volume of effusion which presents with CP angle blunting?

Answer 3

200 to 500mL

Question 4

Diagnostic modality that is able to characterize pleural effusion and detect septations

Answer 4

Chest UTZ

Question 5

What diagnostic modality can be used for unclear etiology of pleural effusion

Answer 5

Throacoscopy/VATS

Question 6

[Etiology based on the color of pleural fluid]

black

Answer 6

aspergillus

Question 7

[Etiology based on the color of pleural fluid]

chocolate sauce

Answer 7

Anaerobic liver abscess

Question 8

[Etiology based on the color of pleural fluid]

yellow-greenish

Answer 8

Rheumatoid

Question 9

[Stage of Empyema]

swelling of pleura, presence of discharge, thin exudative fluid

Answer 9

Stage I

Question 10

[Stage of Empyema]

Heavy fibrin deposit with turbid or purulent fluid; fibrin layer becomes heavier and pleural fluid is grossly turbid/purulent

Answer 10

Stage II

Question 11

[Stage of Empyema]

loculations are seen during this stage

Answer 11

Stage II

transitional stage

Question 12

[Stage of Empyema]

thick pus; presence of fibroblast and capillaries with lung trapping

Answer 12

Stage III

Question 13

___ refers to the condition where there is dissection of pus into the chest wall

Answer 13

Empyema necessatatis

Question 14

What are the clinical factors that favor a benign solitary pulmonary nodule

Answer 14

1. Age <40
2. Nonsmoker
3. No history of malignant disease
4. Previous history of TB, Wegener granulomatosis
5. Lives in area endemic for histoplasmosis
6. Immunosuppressed
7. Nodule size is unchanged for 2 years or more

Question 15

What are the clinical factors in favor of malignant solitary pulmonary nodule

Answer 15

1. Age >40 years
2. History of cigarette smoking >20-25 years
3. Previous history of malignant disease
4. Family history of lung CA
5. Presence of cough, hemoptysis
6. Presence of constitutional symptoms

Question 16

What are the radiologic features that favor a benign SPN?

Answer 16

1. Stability for 2 years
2. Diameter <3cm
3. Well-defined border
4. Heavier density
5. Specific patterns for calcifications

Question 17

What are the radiographic features that favor malignant SPN?

Answer 17

1. Evidence of growth of the lesion within 2 years or less
2. Volume doubling time 1-8 months
3. Size >3cm
4. Irregular contours and margins
5. Umbilication of border

Question 18

What is the range of Hounsfield unit that is most suspicious for malignancy

Answer 18

50 to 150

Low HU unit

High HU unit = generally benign

Question 19

What are reliable signs suggesting that the lesion is benign based on CT

Answer 19

1. Dense central core of calcification
2. Laminated pattern with calcium in concentric layers
3. Popcorn type o calcification

Question 20

What is the most appropriate approach for diagnosis of indeterminate SPN

Answer 20

Invasive methonds

1. Video assisted thoracoscopic surgery
2. Open lung biopsy

Question 21

[Paraneoplastic syndromes]

SIADH

Answer 21

Small cell lung CA

Question 22

[Paraneoplastic syndromes]

Hypercalcemia

Answer 22

Squamous cell Ca

Question 23

___ triangle where the brachial artery and subclavian artery pass through this space

Answer 23

interscalene triangle

Question 24

Prior to entering the subcoracoid space, the subclavian vein and artery, and brachial plexus pass through this space

Answer 24

Costoclavicular triangle

Question 25

Most common location of abdominal aortic aneurysm

Answer 25

Infrarenal aorta

Question 26

What is the most important predictor of AAA?

Answer 26

size of the aneurysm

Question 27

What is the preferred imaging study used to screen AAA because of its high sensitivity and specificity?

Answer 27

Abdominal UTZ

Question 28

What imaging modality is preferred to detect and measure the diameter of an AAA?

Answer 28

CT Aortogram (abdominal CT)

Question 29

What is the recommended screening for AAA for both sexes?

Answer 29

1. Men >65 years old

Question 30

What is the recommended screening for AAA in patient's with history of ruptured AAA?

Answer 30

55 years old in both men and women

Question 31

Repair of asymptomatic AAA is reserved for ___ diameter

Answer 31

5 to 5.5cm in diameter

Question 32

Where is the most common location of thoracic aortic aneurysm?

Answer 32

1. Aortic root or ascending aortic aneurysm

Question 33

What are the CXR findings suggestive of Thoracis AA?

Answer 33

1. Widened mediastinum 2. Prominent aortic knob 3. Displaced trachea

Question 34

What imaging modality that is widely used for detection of aortic dissection?

Answer 34

Transesophageal echocardiography