Practice and Review Exam: 145   ::

Description: Chest Radiology Practice Exam
Faculty: Les R Folio

1) Why should you have a systematic approach to the chest radiograph?

1. A methodical process and checklist helps avoid overlooking important findings 
2. The second (or 3rd, 4th) finding is the hardest finding: “satisfaction of search” 
3. You should learn to think through the patterns, locations, and process 
4. Provides a more scholarly approach create an informed differential list 
5. All of the above 

2) What is the first thing you should do each time you review any patient image?

1. Verify you have not violated HIPAA with the patient name written in your book 
2. Make sure your patient is enrolled in Tricare Prime before you spend time on it 
3. Verify that the name and medical record number match the patient you intend to review 
4. Compare the chest side to side and up and down 
5. Note adequacy of penetration and any technical defects 

3) What round and lucent structure is typically be found in the center of the lung fields on the lateral radiograph?

1. Trachea 
2. Heart 
3. Hilum 
4. Left mainstem bronchus  
5. All of the above 

4) What structure(s) are outlined in red on this image?

1. Ascending aorta, arch, and descending aorta 
2. Pulmonary artery trunk and left main pulmonary artery 
3. Azygous arch and vein 
4. Esophagus 

5) What structure(s) are outlined in blue on this image?

1. The azygous arch and vein 
2. The hemiazygous arch and vein 
3. The trachea and proximal bronchi 
4. The superior vena cava 

6) Which of the following are the areas of increasing lucency (darkening) seen on the lateral radiograph?

1. From center of the cardiac silhouette to sternum 
2. From center of cardiac silhouette to the costophrenic angles 
3. From the superior thoracic spine to inferior thoracic spine 
4. All of the above 
5. A and C from above (only) 

7) On the lateral radiograph, what edges should be seen when looking from heart upward to the sternum?

1. Pulmonary trunk 
2. Left pulmonary artery 
3. Ascending aorta 
4. All of the above 
5. None of the above 

8) Which of these steps is not required for pre-clinical review of chest radiographs?

1. Describe the type of exam you are reviewing (frontal and lateral chest shows….) 
2. Identify the finding(s) 
3. Define the finding(s) 
4. Categorize and prioritize a diagnostic list 
5. Conclude with one single definitive diagnosis 

9) What is the ideal location for the tip of an endotracheal tube?

1. Right mainstem bronchus 
2. Bronchus intermedius 
3. About 3-5 cm above the carina 
4. At the carina 
5. Around the T1 intervertebral disk space 

10) What is atelectasis?

1. Pleural effusion 
2. Volume loss 
3. Pneumothorax 
4. Consolidation 
5. Mass 

11) What is the ideal location for the tip of a central venous line, on the ICU radiograph?

1. In the right atrium 
2. In the proximal SVC 
3. In the brachiocephalic vein 
4. In the jugular vein 
5. Where the SVC enters the right atrium 

12) What does the "Deep sulcus sign" indicate?

1. RLL atelectasis 
2. Volume loss 
3. Hyperaeration 
4. Pneumothorax 
5. Pneumomediastinum 

13) Which of the following is most life-threatening?

1. Atelectasis 
2. Azygos lobe 
3. Reticulonodular pattern 
4. Tension pneumothorax 
5. Hydropneumothorax 

14) Which of the following terms is confusing and should NOT be used to describe lung parenchymal patterns seen on chest radiography?

1. Mass 
2. Opacity 
3. Infiltrate 
4. Interstitial thickening 
5. Air bronchogram 

15) Which of the following should not be included in the differential diagnosis for a posterior mediastinal mass?

1. Neurogenic lesions 
2. Morgagni hernia 
3. Esophageal lesions 
4. Cysts 
5. Bochdalek hernia 

16) Which of the following may be associated with middle mediastinal masses?

1. Esophagus 
2. Trachea, bronchi 
3. Lymph nodes 
4. Aorta 
5. All of the above 

17) Which of the following lesions should be included in the differential diagnosis for an anterior mediastinal mass?

1. Teratoma 
2. Lymphoma 
3. Tortuous vessels 
4. Thymoma 
5. All of the above 

18) A patient has a hydropneumothorax on an upright chest radiograph. Which of the following is NOT correct?

1. It is a pleural effusion combined with a pneumothorax on the same side 
2. It may create a straight edge from an air fluid level 
3. It will have a meniscus like any pleural effusion 
4. It may be caused by trauma, with blood as the fluid 
5. The imaging findings are a result of fluid properties, potential space, and gravity 

19) In diagnostic imaging, the mediastinum is divided up into the following areas EXCEPT:

1. Superior 
2. Middle 
3. Posterior 
4. Anterior 

20) All of the following are possible abnormalities associated with the pleura EXCEPT:

1. Mass 
2. Consolidation 
3. Thickening 
4. Fluid (pleural effusion) 
5. Air (pneumothorax) 

21) Which of the following vascular anomalies may appear as a mediastinal mass on the frontal and/or lateral chest radiograph?

1. Vascular ring 
2. Aberrant right subclavian artery 
3. Aberrant left subclavian artery 
4. Right aortic arch 
5. All of the above 

22) The vessels inside the lungs appear totally black (lucent) on a chest radiograph.

1. True 
2. False 

23) Which of the following are normal opacities that are seen WITHIN the lungs on a normal radiograph?

1. Pulmonary vessels 
2. Fissures 
3. Air bronchograms 
4. A and B  
5. All of the above  

24) The hilar shadows principally consist of the:

1. Major fissure 
2. Pulmonary veins 
3. Pulmonary arteries 
4. None of the above 

25) Vessels seen on end on the chest x-ray that are nearby to vessels branching in other directions should:

1. be much smaller than nearby vessels 
2. be of the same diameter of nearby vessels 
3. unrelated to nearby vessels 
4. All of the above 
5. None of the above