Post-Test

All of the material covered in this test can be found on the previous pages.
Answers are provided at the end of the test.

1) Opacification of what part of the lung will silhouette the left heart border?

Left lower lobe

Superior segment left lower lobe
Right middle lobe
Lingula

2) What is the most likely diagnosis on the following chest x-ray?

Atelectasis
Pulmonary edema
Bilateral pneumonia
Pneumothorax

Questions 3-7: Please refer to the following image.

3) Identify the object labeled "3" in the above image.

Ascending aorta
Aortic arch
Aortopulmonary window
Right atrium

4) Identify the object labeled "4" in the above image.

Ascending aorta
Right atrium
Right hilum
Right ventricle

5) Identify the object labeled "5" in the above image.

Ascending aorta
Aortic arch
Left hilum
Mass in the left aortopulmonary window

6) Identify the object labeled "6" in the above image.

Left ventricle
Aortic arch
Ascending aorta
Left pulmonary artery

7) Identify the object labeled "7" in the above image.

Aortic arch
 Right atrium
Left ventricle
Left pulmonary artery

8) The normal chest x-ray seen below is not technically adequate. Why?

The patient is rotated.

The radiograph is over penetrated.
The radiograph was performed during expiration.
The radiograph is under penetrated.

9) Which of the following is not a characteristic of a technically adequate PA

chest radiograph?

Thoracic spine disc spaces should be barely visible through the heart.
The osseous detail of the thoracic spine is always clearly visualized.
The clavicular heads should be equal distance from the spinous process of
the thoracic vertebral bodies.
Bronchovascular structures can usually be seen through the heart.
 10) Identify the abnormality shown in the image below.

Right middle lobe pneumonia

Right upper lobe pneumonia
Right lower lobe pneumonia
Right upper lobe atelectasis

11) Admission PA and Lateral chest radiograph of a trauma patient with a left-
sided pleural effusion demonstrates what other notable abnormality ?
Right tension pneumothorax
Left pulmonary opacity representing pulmonary hemorrhage
Left pulmonary opacity representing pneumonia
Left pneumothorax

12) Based on your findings, what lobe is involved in the above image?

Left upper lobe

Right middle lobe
Left lower lobe
None of the above

13) Name the abnormality shown in the image below?

 Left lower lobe atelectasis
Luftsichel sign
Hampton's hump
None of the above

14) What other clinical finding(s) would you expect to find in a patient with
the abnormality shown above?

Enlarged axillary lymph nodes

Hypoxia and dyspnea
Normal serum D-dimer
None of the above

15) Identify the abnormality shown in the image below?

 Bilateral basilar atelectasis
Right middle lobe pneumonia
Hampton's hump
Bilateral pleural effusions

16) What study may be used to further evaluate the nature of the finding
seen above?

Bilateral decubitus chest x-ray

Supine chest x-ray
Apical lordotic chest x-ray
None of the above

17) Pneumonia causes volume loss or collapse of the affected lung

parenchyma.

True
False
18) A pneumothorax is best demonstrated by an upright expiratory chest x-ray.

True
False

19) Identify the abnormality shown in the image below.

Large pleural effusion

Tension pneumothorax
Left lower lobe pneumonia
None of the above.

20) The next step in diagnosis and treatment of the abnormality seen above
is?

Admit and observe patient.

Perform chest CT scan.
Immediate chest tube placement.
Thoracentesis to remove effusion.
 21) Why is prompt diagnosis and treatment of the above process
important?

Patient will experience persistent shortness of breath.

Patient may expire secondary to hypoxia.
The contralateral lung may collapse if not treated.
Patient may expire secondary to decreased venous return to the heart.

22) The image seen below is a magnified view of a lateral chest x-ray. The
blue arrows indicate the left ribs and the red arrows indicate the right ribs.
Which of the following statements is true?

The right ribs are further away from the cassette and therefore magnified
less than the left ribs.
The lateral chest x-ray is obtained with the left chest against the film
cassette which diminishes magnification of the heart and left ribs.
The left ribs are usually projected posterior to the right ribs on a true lateral
chest x-ray.
None of the above are true.
 23) Identify the bronchus labeled "23" in the image below.

Right mainstem bronchus

Right middle lobe bronchus
Bronchus intermedius
Right lower lobe bronchus

24) Identify the bronchus labeled "24" in the image above.

Left upper lobe bronchus

Left middle lobe bronchus
Left lower lobe bronchus
Lingular bronchus

25) Identify the abnormality shown in the images below.

 Right pleural effusion
Hydropneumothorax
Right basilar pneumothorax
Right lower lobe atelectasis

26) Which of the following statements is true when distinguishing between a

pulmonary, pleural, and extrapleural mass?

Masses with acute margins to lung tissue indicate the process is pleural or
extrapleural.
Masses with oblique margins to lung tissue indicate the process is pleural
or extrapleural.
Rib destruction indicates pleural involvement and possibly the origin of the
mass.
 27) What sign is seen in the image below?

Concave margin sign

Indistinct margin sign
Crescent sign
Silhouette sign
All of the above

28) Identify the abnormality shown in the images below.

 Hiatal hernia
Bochdalek hernia
Morgagni hernia
Eventration

29) The following characteristics of calcification in a solitary pulmonary

nodule would be considered benign except:

Central calcification
Stippled calcification
Irregular calcification
Complete calcification

30) What finding is least consistent with lobar atelectasis?

Air bronchograms
Crowding of vascular markings
Expansion of other lobes
Elevation of the diaphragm
 None of the above.

Post Test Answers

1) Opacification of what lobe of the lung will silhouette the left heart border?

2)What is the most likely diagnosis on the following chest x-ray?

Questions 3-7: Please refer to the following image.

3) Identify the object labeled "3" in the above image. Ascending aorta

4) Identify the object labeled "4" in the above image. Right atrium

5) Identify the object labeled "5" in the above image. Aortic arch

6) Identify the object labeled "6" in the above image. Left pulmonary artery

7) Identify the object labeled "7" in the above image. Left ventricle

8) The normal chest x-ray seen below is not technically adequate. Why?
9) Which of the following is not a characteristic of a technically adequate PA
chest radiograph?

The osseous detail of the thoracic spine is always clearly visualized.

10) Identify the abnormality shown in the image below.

11) What abnormalities of the elbow can be observed in the image below?
The Left upper lobe opacity represents pulmonary hemorrhage. There is
also a left pleural effusion seen best as a fluid level on the lateral view.

12) Based on your findings, what lobe is involved in the above image? Left
upper lobe.

13) Name the abnormality shown in the image below?

14) What other clinical finding(s) would you expect to find in a patient with the
abnormality shown above?
Hypoxia and dyspnea

15) Identify the abnormality shown in the image below?

16) What study may be used to further evaluate the nature of the finding seen
above?

Bilateral decubitus chest x-ray

17) Pneumonia causes volume loss or collapse of the affected lung

parenchyma.

False - The affected lung airspaces become filled with the infectious process
and typically do not collapse.

18) A pneumothorax is best demonstrated by an upright expiratory chest x-

ray.

True

19) Identify the abnormality shown in the image below.

The red arrows indicate the edge of the collapsed right lung. Their is also
significant shift of the mediastinum to the left.

20) The next step in diagnosis and treatment of the abnormality seen above
is?
Immediate chest tube placement.

21) Why is prompt diagnosis and treatment of the above process important?

Patient may expire secondary to decreased venous return to the heart.

The tension pneumothorax increases the intrathoracic pressure decreasing
the venous return to the heart.

22) The image seen below is a magnified view of a lateral chest x-ray. The
blue arrows indicate the left ribs and the red arrows indicate the right ribs.
Which of the following statements is true?
The lateral chest x-ray is obtained with the left chest against the film
cassette which diminishes magnification of the heart and left ribs. The
right ribs are projected posterior to the left ribs in a true lateral view.

23) Identify the bronchus labeled "23" in the image below.

The bronchus labeled "23" is the Bronchus intermedius.

24) Identify the bronchus labeled "24" in the image above.

The bronchus labeled "24" is the Lingular bronchus.

25) Identify the abnormality shown in the images below.

The air-fluid level seen in the right chest represents a

hydropneumothorax. The red arrows demonstrate the pleural line of the
pneumothorax.

26) Which of the following statements is true when distinguishing between a

pulmonary, pleural, and extrapleural mass?

Masses with oblique margins to lung tissue indicate the process is

pleural or extrapleural.

27) What sign is seen in the image below?

 Silhouette sign. The right heart border is not seen due to airspace disease
in the right middle lobe which has a radiodensity similar to the adjacent heart.

28) Identify the abnormality shown in the images below.

Hiatal hernia demonstrated by the red arrows above.

29) The following characteristics of calcification in a solitary pulmonary nodule

would be considered benign except:
Irregular calcification. Central, stippled, or complete calcification of a
solitary pulmonary nodule are considered benign findings.

30) What finding is least consistent with lobar atelectasis?

None of the above. All of the findings listed are characterictic of
atelectasis.