2. Chest

1Which of the following statements about taking a routine chest x-ray are true?
  • (a) It is normally taken in expiration
  • (b) It is normally taken as an anteroposterior view
  • (c) It is normally taken as a posteroanterior view
  • (d) It is hazy when the patient has taken a deep inspiration
2On a normal chest x-ray, which of the following statements are true?
  • (a) The dome of the right hemidiaphragm lies at the level of the anterior end of the sixth rib
  • (b) The trachea usually lies to the left of the midline
  • (c) The contours of the breast shadows are not seen
  • (d) Usually about two-thirds of the heart lies to the right of the midline
3Concerning the technique of chest CT, which of the following statements are true?
  • (a) Non-contrast CT is used to diagnose pulmonary emboli
  • (b) The lungs and mediastinum are viewed on the same window settings
  • (c) Blood clot in an aneurysm can be delineated on non-contrast CT
  • (d) High resolution CT (HRCT) allows evaluation of bronchial walls
4Radiopharmaceuticals are used in which of the following settings?
  • (a) Kyrpton-81 in a perfusion scan
  • (b) Xenon-133 in a ventilation scan
  • (c) 18-F fluorodeoxyglucose (FDG) to diagnose parenchymal lung disease
  • (d) 18F FDG to diagnose air-space consolidation
5Which of the following statements are true?
  • (a) Loss of the normal cardiac silhouette indicates pathology in the anterior chest
  • (b) Endobronchial lesions are readily seen as a ring shadow
  • (c) Air-space shadowing is seen as an air–fluid level
  • (d) An extrapleural mass is diagnosed by the typically round shape and narrow pleural base
  • (e) None of the above
6In patients with consolidation, which of the following statements are correct?
  • (a) Pulmonary infarction can be differentiated from pneumonia
  • (b) Air bronchograms are a diagnostic feature of air-space consolidation
  • (c) Lobar consolidation is seen as multiple ill-defined opacities
  • (d) The silhouette sign is rarely seen
7Which of the following statements concerning signs of infection in the lung are true?
  • (a) Lobar consolidation is usually due to bacterial pneumonia
  • (b) Cavitation is not seen
  • (c) Air–fluid levels in an abscess are only seen on CT
  • (d) Pleural effusions are not seen
8Which of the following statements about pulmonary collapse are true?
  • (a) It results in a compensatory pleural effusion
  • (b) Pulmonary collapse of the right upper lobe causes the trachea to be deviated to the right
  • (c) Pulmonary collapse of the right middle lobe results in a silhouette sign at the left heart border
  • (d) Pulmonary collapse of the left lower lobe usually has a very ill-defined border
9Which of the following statements are true concerning lung nodules?
  • (a) The presence of substantial calcification within a nodule virtually rules out malignancy
  • (b) Destruction of an adjacent rib may be seen in the case of a large hamartoma
  • (c) Cavitation in a lung nodule is diagnostic of lung cancer
  • (d) Spiculation is a diagnostic characteristic of a hamartoma
10Which of the following statements are true?
  • (a) Lymphangitis carcinomatosis is predominant in the upper zones
  • (b) Usual interstitial pneumonia is predominant in the lung peripheries
  • (c) Lung nodules in sarcoidosis are typically 1–2 cm in diameter
  • (d) The term asbestosis refers to diffuse pleural thickening
11Which of the following statements regarding the presence of increased transradiancy of one lung are true?
  • (a) It may be due to an inhaled foreign body
  • (b) It may be due to Pneumocystis carinii pneumonia
  • (c) It may be due to a chylous pleural effusion
  • (d) It may be miliary tuberculosis
12Which of the following disease are NOT associated with exposure to asbestos?
  • (a) Calcified pleural plaques
  • (b) Mesothelioma
  • (c) Lung cancer
  • (d) Sarcoidosis
13Causes of septal lines on a chest x-ray include which of the following?
  • (a) Interstitial pulmonary oedema
  • (b) Wegener’s granulomatosis
  • (c) Lymphangitis carcinomatosis
  • (d) Pneumocystis carinii pneumonia
14Widespread small pulmomary calcifications occur in which of the following?
  • (a) Metastases from squamous cell carcinoma
  • (b) Tuberculosis
  • (c) Sarcoidosis
  • (d) Pulmonary haemosiderosis
15Which of the following statements are true regarding cavitating nodules?
  • (a) Rheumatoid nodules in the lung do not cavitate
  • (b) Cavitating metastases to the lung are usually from squamous cell carcinomas
  • (c) Cavitating nodules may occur in Wegener’s granulomatosis
  • (d) Cavitation typically occurs in nodules secondary to sarcoidosis
16Which of the following statements regarding mediastinal masses are correct?
  • (a) A thyroid mass is the most frequent cause of a superior mediastinal mass
  • (b) Lymphadenopathy does not occur in the posterior mediastinum
  • (c) Calcification is suggestive of malignant lymphadenopathy
  • (d) Thymomas typically cause pressure deformity of adjacent ribs
17Regarding hilar nodal enlargement on a chest x-ray, which of the following statements are true?
  • (a) Sarcoidosis can be excluded unless there is bilateral enlargement
  • (b) It typically occurs in lobar pneumonia
  • (c) Tuberculosis is the most common cause of unilateral enlargement in children
  • (d) Bilateral enlargement typically occurs in carcinoma of the bronchus
18Which of the following statements are true regarding lung fibrosis?
  • (a) Radiation fibrosis typically occurs a few weeks after exposure
  • (b) When due to sarcoidosis, lung fibrosis is usually located in a subpleural, peripheral location
  • (c) It can occur secondary to Pneumocystis carinii infection in an immunocompromised patient
  • (d) When seen in association with pleural calcification, lung fibrosis is suggestive of rheumatoid arthritis
  • (e) None of the above