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jihuygu jihuygu
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Posts: 601
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6 years ago
A 49-year-old COPD patient arrives to the ER complaining of shortness of breath (SOB) and difficulty breathing. The physical examination reveals bilateral coarse crackles throughout the lung fields, pedal edema, and hepatomegaly.
 
  The chest x-ray shows bilateral fluffy infiltrates with a bat's wing configuration. What clinical condition you may suspect on this patient?
  a. Acute coronary syndrome
  b. COPD exacerbation
  c. Hypertensive crisis
  d. Left heart failure



Q. 2  Which of the following are common radiographic findings seen in patients with volume loss due to atelectasis?
 
  1. Elevation of the hemidiaphragm
  2. Narrowing of the space between the ribs
  3. Increase in the retrosternal airspace
  4. Shift of the mediastinum
  a. 1 only
  b. 3 only
  c. 1, 2, and 4 only
  d. 3 and 4 only



Q. 3  Which of the following findings on the chest radiograph is considered a secondary sign of em-physema?
 
  a. Flattening of the diaphragm
  b. Widening of the cardiac shadow
  c. Narrowing of the space between the ribs
  d. Blunting of the costophrenic angle



Q. 4  How many solitary pulmonary nodules (SPNs) would be encountered for every 1000 routine chest radiographs?
 
  a. 1 or 2
  b. 10 to 15
  c. 30 to 40
  d. 80 to 100
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wrote...
6 years ago
(Answer to Q. 1)  ANS: D
The term bat's wing appearance is applied to the predominance of edema in the hilar regions of both lungs with progressively less edema in the more peripheral areas of the lungs. Left heart failure and CHF will cause congestion of the pulmonary vessels leading to pulmonary edema throughout the lung fields.

(Answer to Q. 2)  ANS: C
This can be seen by elevation of the diaphragm on the side of the atelectasis, a shift of the medi-astinum toward the atelectasis, and poor expansion of the chest causing narrowing of the space between the ribs. If the collapsed segment of the lung is in the upper lobe, the hilum will be dis-placed upward and the minor fissure on the right will be displaced upward.

(Answer to Q. 3)  ANS: A
In patients with chronic obstructive pulmonary disease, there may also be an increase in the an-teroposterior diameter of the chest, with associated enlargement of the retrosternal and retrocar-diac airspaces and flattening of the hemidiaphragms.

(Answer to Q. 4)  ANS: A
One or two SPNs are encountered in every 1000 chest radiographs.
wrote...
6 years ago
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