Chest and Abdominal Radiographs

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Question 1 of 10

1. Question
In which of the following cases is there a clear indication for CXR?

Select one or more options.
- A 59 year old man with known hypertension, complaining of heavy central chest discomfort made worse by exertion
- A 19 year old asthmatic who came in complaining of increased wheeze and whose peak expiratory flow rate (PEFR), after treatment with a nebuliser, is now >75% best
- 31 year old construction worker who has fallen four metres from scaffolding, with obvious head and lower limb injuries
- A 28 year old footballer, kneed in the ribs, who has pain and tenderness of the right lateral ribs but good air entry on auscultation
- A 71 year old heavy smoker who complains of cough and haemoptysis
Question 2 of 10

2. Question
Looking at the x-ray below, which of the following statements are true? (Select all that apply)

Click on the x-ray to enlarge.
- This is a rotated film
- Part of the lung field has not been included on the film
- Heart size is not accurately determined from this type of film
- The patient has taken an adequate breath in
- The patient has had previous surgery to the chest
Question 3 of 10

3. Question
A 40-year-old man attends complaining of pleuritic left chest pain and breathlessness. He has recently had symptoms of influenza. His temperature is 37.7o, pulse 102, BP 140/80, RR 20 and SaO2 on air 92%. Looking at the image, which statement is true?

Click on the x-ray to enlarge.
- The film is under penetrated
- The film is suggestive of a pulmonary embolus
- The film shows a left sided effusion
- The film shows left sided lung collapse
- The film shows a left sided consolidation
Question 4 of 10

4. Question
A 50-year-old heavy smoker is brought in complaining of severe increased shortness of breath and a non-productive cough. Pulse 112, BP 105/62, RR 24, SaO2 89% on room air, temperature 36.9o. Looking at the chest x-ray, which one of the following statements is true?

Click on the x-ray to enlarge.
- The film shows a mass at the right hilum
- There is hyperinflation and diaphragmatic flattening
- The artefact on the right side is an ECG monitoring lead
- There is a right sided pneumothorax
- There is clear evidence of an infective cause for the symptoms
Question 5 of 10

5. Question
An elderly gentleman complains of breathlessness on exertion. Looking at the x-ray, which of the following statements are true?

Click on the x-ray to enlarge.

Select one or more options.
- There is cardiomegally
- There is evidence of exposure to asbestos in the past
- There is pneumoperitoneum
- There is a right sided effusion
- There is an old fracture of the right humerus
Question 6 of 10

6. Question
A young man is brought in. He is a pedestrian who has been hit by a car. His GCS is 5, pulse 114, BP 118/64 and SaO2 92% on high flow oxygen. He is assessed and treated by the trauma team and his chest x-ray is shown.

Looking at the x-ray, which of the following statements is true?

Click on the x-ray to enlarge.
- There is no obvious bony injury
- The patient now requires intubation for airway protection
- The left lung shadowing is probably due to lung collapse
- The chest drain has been inserted too low, in the 8th intercostal space
- CT thorax is indicated as it may demonstrate injuries not detected on plain x-ray
Question 7 of 10

7. Question
You are handed over a patient by a colleague. It is a young student with colicky abdominal pains and vomiting for 24 hours. One of his housemates had similar symptoms two days earlier. There is no haematemesis and his bowels opened normally yesterday. He has mild epigastric tenderness but no rebound or guarding is elicited. He is otherwise fit and well.

Looking at the x-rays, which one of the following statements is true?

(Click on the x-ray to enlarge)
- The erect chest x-ray shows free gas, indicating a perforated viscus
- You would prefer an erect abdominal film to rule out obstruction
- There is evidence of faecal loading on the abdominal film
- There was no clear indication to perform these radiographs given the clinical history
- There is mucosal oedema of the ascending colon
Question 8 of 10

8. Question
A confused elderly lady is brought in from a nursing home with a history of severe abdominal pain, vomiting and distension of the abdomen. Looking at the abdominal x-ray, which one of the following statements is true?

Click on the x-ray to enlarge.
- There is isolated small bowel obstruction
- There is large bowel obstruction due to faecal impaction
- This is a sigmoid volvulus
- This is a caecal volvulus
- The appearance of the bowel is within normal limits
Question 9 of 10

9. Question
A 46-year-old man attends with a history of abdominal pain and vomiting. He last had his bowels open five days ago. Looking at his abdominal film (upper and lower) which of the following statements is true?

Click on the x-ray to enlarge.
- The patient may have a history of previous abdominal surgery
- The likely cause of this appearance is obstruction due to tumour
- The transverse colon appears distended
- The likely cause is infectious
- The x-ray shows gallstone ileus
Question 10 of 10

10. Question
A 75-year-old man presents with abdominal pain. It is central but radiates to the left loin. He has a history of hypertension and angina. The pain is constant but he has not vomited and his bowels are opening normally. He is tachycardic and pale with a BP of 100/70. Looking at his abdominal x-ray, which of the following statements are true? (Select all that apply)

Click on the x-ray to enlarge.
- The bowel gas pattern is unremarkable
- There are left side ureteric stones visible
- There is degenerative change in the lumbar spine
- Renal calcification is shown
- There is vascular calcification suspicious of an aortic aneurysm