Self Assessment Quiz - Cardiovascular Radiology

Case 1 (questions 1-3)

Question 1 - Single Best Answer

What is the significant x-ray finding on the above film?

A) Central alveolar edema with cephalization of blood vessels
B) Widened superior mediastinum
C) Focal alveolar density in the right middle lobe

Question 2 - Single Best Answer

Which of the following is the most likely diagnosis?

A) Congestive heart failure
B) Thoracic aortic aneurysm
C) Lobar pneumonia

Question 3 - Single Best Answer

Which of the following scenarios is most likely?

A) 45 yo unrestrained driver in an high speed accident.
B) 60 yo with a history of myocardial infarction presenting with orthopnea and shortness of breath
C) 55 yo alcoholic with productive green sputum, fever and chills.

Case 2 (questions 4-7)

Question 4 - Single Best Answer

What is the significant x-ray finding on the above PA CXR?

A) Area of homogenous increased density in the left lung base with obscured left diaphragm
B) Widened superior mediastinum
C) Cephalization or redistribution of blood flow into the upper lobes
D) Right middle lobe alveolar density obscuring the right heart border

Question 5 - Single Best Answer

Which of the following is the most likely diagnosis?

A) Left pleural effusion
B) Thoracic aortic aneurysm
C) Congestive heart failure
D) Lobar pneumonia

Question 6 - Single Best Answer

The above image is from the same patient as in questions #4 and #5. What is the position of the patient in the above film?

A) Upright
B) Supine
C) Right lateral decubitus
D) Left lateral decubitus

Question 7 - Single Best Answer

Which of the following are causes of a pleural effusion?

A) Fractured rib
B) CHF
C) Tumor
D) Tuberculosis infection
E) All of the above

Case 3 (questions 8-9)

Question 8 - Single Best Answer

What is the most significant x-ray finding on the above film?

A) Blunting of right costophrenic angle
B) Central alveolar edema with cephalization of blood vessels
C) Widened superior mediastinum

Question 9 - Single Best Answer

Which of the following is the most likely diagnosis?

A) Right pleural effusion
B) Congestive heart failure
C) Thoracic aortic aneurysm

Case 4 (questions 10-12)

Question 10 - Single Best Answer

What is the significant x-ray finding on the above films?

A) Blunting of right costophrenic angle
B) Enlarged heart shadow

Question 11 - Single Best Answer

What is the differential diagnosis for the above CXR finding?

A) Pericardial effusion
B) Left ventricular hypertrophy
C) Cardiomyopathy
D) All of the above

Question 12 - Single Best Answer

What clinical signs would be most likely in a patient with a pericardial effusion?

A) Paradoxical pulse
B) Muffled heart sounds
C) Friction rubs
D) All of the above

65 yo male with a harsh crescendo-decrescendo systolic murmur radiating to carotids presented to the ER with complaints of chest pain. On the cxr's above, which valve appears to be calcified? (Click on lateral view for better image)