You are on page 1of 20

1. In this view of the x-ray, theoretically where can the horizontal fissure be found?

A. Medial portion of lung on the left


B. Inferior portion of the lung on the right
C. Medial portion of the lung on the right
D. Inferior portion of the lung on the left
Ans:
D
The view given is AP
AP vs PA

AP PA
Vertebral body configuration Mickey mouse due to neural Mongolian hat transverse
foramina process
Scapular deflection Hands on hips Hands raised above head
(otherwise scapula will block
the film)
Gastric bubble Absent Present

Memory Device: The wHORe is always right. (Horizontal and Oblique Fissure is found in the right lung,
which is found on your left
2. Identify the view shown
a. Lateral
b. Decubitus
c. Apicolordotic
d. None of the above
Ans: Decubitus
3. In the area pointed in the view, which of the following structures CANNOT be found in this area of the
mediastinium?
a. Lymph node
b. Internal Thoracic
c. Vagus nerve
d. Artery
Ans: Vagus Nerve
Vagus nerve only crosses the middle and posterior mediastinium.
4. The CT Scan shown above shows the bifurcation of the right upper lobe. What pair of segments are
involved in this bifurcation?
A. Anterior; Apicoposterior
B. Posterior; Apical
C. Anterior; Apical
D. Posterior; Anterior
Ans: C
The bifurcation of the right upper lobe (The Whale Shape) shows the apical and anterior lobes of the right
lung.
5. The heart chamber pointed receives blood from the
A. Left atrium
B. Pulmonary veins
C. Pulmonary trunk
D. Right atrium
Ans: B
The structure pointed is the LEFT ATRIUM, which receives blood from the pulmonary veins.
6. Arrange the following branches from the LEAST likely to be occluded in CAD to the MOST likely to
be occluded. (HINT: The angiogram shows NONE OF THE RIGHT CORONARY ARTERY
BRANCHES)
a. Orange, Green, Blue
b. Blue, Green, Orange
c. Blue, Orange, Green
d. NOTA
Answer: B
Orange Arrow: Anterior interventricular aka Left Anterior descending Artery
Green Arrow: Circumflex artery
Blue Arrow: Left coronary artery

Coronary Arteries in order of likelihood of occlusion (ARCLP)


Anterior interventricular branch
Right coronary artery
Circumflex artery
Left coronary artery
Posterior interventricular artery
7. Which of the following is NOT A POSSIBLE mammogram of Angelina Jolie?
A. Left
B. Center
C. Right
D. None of the above
D. None of the above
Angelina Jolie had mastectomy (removal of the breast)
If she still had breasts however, it would not be B since she is already over 40 years old. Mammograms
SHOULD NOT be requested for patients <30 years old due to the presence of glands.
8. When the lung on the right is percussed, the sound can be described as:
a. Dull
b. Resonant
c. Hyperesonant
d. Flat
Answer: C
The lung on the right side of the plate is the LEFT LUNG (remember that X-rays are taken with the
patient facing you)
The patient has Pneumothorax, as evidenced by the absence of the bronchial tree.
The following table shows the percussion and the possible sounds that can be heard when percussing:

Sound Cause Diagnosis


Resonant Normal Normal
Hyperesonant Too much air Pneumothorax
Dull Fluid accumulation Hemothorax, chylothorax,
pleural effusion
Flat Solid Pneumonia, mass
9. Which of the following statements is not true about this patient?
A. Possible complication of thoracic duct ligation
B. Possible effect of rib fracture
C. Unlikely to be due to mass
D. All of the above are true
B. Possibly the result of fracture
If the patient has hydrothorax/pleural effusion, Decubitus view will show the fluid moving towards the
ipsilateral side of the cavity. While B can cause hydrothorax/hemothorax, it is unlikely because in the first
place, the plates dont show any fractures.
10. In relation to the pointed area, which of the following is NOT an effect of mass emanating from it?
a. Klumpkes palsy
b. Scapular winging
c. Anhidrosis
d. Ptosis
B. Scapular winging
Mass emanating from the area (bronchogenic carcinoma aka Pancoasts Syndrome) has the following
effects:
Damage to the lower brachial plexus -> Klumpkes palsy
Damage to the sympathetic trunk -> Horners syndrome -> Miosis, Ptosis, Anhidrosis and Enopthalmos