Aquifer – Radiology EXAM AND PRACTICE EXAM NEWEST
ACTUAL EXAM COMPLETE 200 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+
Window vs. Reconstruction on CT? - CORRECT ANSWER
Reconstructions - processing of the raw CT data allows for
better resolution of the structures [higher resolution and
higher contrast]
Reconstruction can be done in 3D (ortho) or in a linear way
too (vascular)
What is the total range of hounsfield units availabe? -
CORRECT ANSWER -1000 (air) to +1000 (metal) [so range is
2000]
What does a typical computer display show for greyscale
range? What can the human eye actually distinguish? -
CORRECT ANSWER 256shades (that means each shade of
grey covers ~8HU)
The can only distinguish 17 shades of grey
What is a good way to check diaphragm flattening? -
CORRECT ANSWER Look at the lateral film
Diaphragm will be flat like you can set a ruler down on the
edge
What can a poor inspiration/hypoinflation appear like? -
CORRECT ANSWER consolidation or PNA
,How to look at the lung fields? - CORRECT ANSWER Sweep
or a zig zag down the lung field (both in PA and lateral
views)
look for focal, diffuse, BL asymmetrical, interstital/vasc
markings, lucencies (cavity/bullae/PTX),
compare upper and lower and L/R zones
Middle
lower zones
Which hilum should always appear higher on the radiograph?
- CORRECT ANSWER The LEFT sided hilum should be higher -
if its not its pathological
What to look for with the heart? - CORRECT ANSWER Size of
the heart - the cadiac:thoracic cavity ratio
LA
LV
What mediastinal lines should be observed on PA film? -
CORRECT ANSWER R paratracheal line
Azygous area
Azygoesophageal line
Paraaortic line (all the way down)
If you can see these you need to figure out the reason why
How to look at the bones on Xray? - CORRECT ANSWER
Quadrant method [above and below the ribs] (the middle
lung section you just
,also go down the spine looking for abnormalities, mets, or
collapse
When should you START looking at OLD films? - CORRECT
ANSWER AFTER you have COMPLETELY evaluated the new
scan
What are the ACR appropriateness criteria? - CORRECT
ANSWER The aim is to provide continuously updated
evidence-based algorithms that ensure the safest, most
cost-effective, and most efficient path to radiological
diagnosis or intervention matched to specific variants of
clinical presentations.
Federal LAW requires referring physicians to consult
Appropriate Use Criteria (AUC), such as ACR
Appropriateness Criteria, prior to ordering advanced imaging
services (ADIS), including CT, MR, nuclear medicine, and
PET, for Medicare patients.
How are appropriateness criteria divided/staged? - CORRECT
ANSWER Older appropriateness rating tables used a
numerical rating scale: • Usually Appropriate = 9, 8, or 7 •
May be Appropriate = 6, 5, or 4 • Usually Not Appropriate = 3,
2, or 1
Newer appropriateness rating tables simply use the three
categories: • Usually Appropriate (Green cells in the table) •
May be Appropriate (Yellow cells in the table) • Usually Not
Appropriate (Red cells in the table)
, What lobe of lung is seen at the apicies? - CORRECT ANSWER
The R and L upper lobes
What is the silhouette sign? - CORRECT ANSWER The visual
interface between structures of different density.
Its actually when a silhouette is LOST that we say its a
"silhouette sign"
What is spine sign? - CORRECT ANSWER When the combined
density of the vertebrae and some source of
fluid/consolidation make the vertebrae look MORE dense
[just like ice over water accentuates the ice appearing like
they have increased density even though they still the same
ice]
What are cases in which spine sign occur? - CORRECT
ANSWER Spine sign - vertebral bodies should be relative
lucent (black) above the diaphragm on lateral projection.
-Lateral x-ray goes through spine + pneumonia and vertebra
will appear whiter (fewer x-rays reach detector since some
are absorbed in the pneumonia)
- Helpful sign for detection of lower lobe pneumonia. - - Very
useful for detecting LLL pneumonia behind the heart.
- If vertebral bodies appear more dense (whiter) above the
level of diaphragm, and part of one of the diaphragms is
obscured → spine sign → sign of lower lobe pneumonia
- There are other causes for the spine to appear whiter (such
as a blastic bone metastasis).
ACTUAL EXAM COMPLETE 200 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+
Window vs. Reconstruction on CT? - CORRECT ANSWER
Reconstructions - processing of the raw CT data allows for
better resolution of the structures [higher resolution and
higher contrast]
Reconstruction can be done in 3D (ortho) or in a linear way
too (vascular)
What is the total range of hounsfield units availabe? -
CORRECT ANSWER -1000 (air) to +1000 (metal) [so range is
2000]
What does a typical computer display show for greyscale
range? What can the human eye actually distinguish? -
CORRECT ANSWER 256shades (that means each shade of
grey covers ~8HU)
The can only distinguish 17 shades of grey
What is a good way to check diaphragm flattening? -
CORRECT ANSWER Look at the lateral film
Diaphragm will be flat like you can set a ruler down on the
edge
What can a poor inspiration/hypoinflation appear like? -
CORRECT ANSWER consolidation or PNA
,How to look at the lung fields? - CORRECT ANSWER Sweep
or a zig zag down the lung field (both in PA and lateral
views)
look for focal, diffuse, BL asymmetrical, interstital/vasc
markings, lucencies (cavity/bullae/PTX),
compare upper and lower and L/R zones
Middle
lower zones
Which hilum should always appear higher on the radiograph?
- CORRECT ANSWER The LEFT sided hilum should be higher -
if its not its pathological
What to look for with the heart? - CORRECT ANSWER Size of
the heart - the cadiac:thoracic cavity ratio
LA
LV
What mediastinal lines should be observed on PA film? -
CORRECT ANSWER R paratracheal line
Azygous area
Azygoesophageal line
Paraaortic line (all the way down)
If you can see these you need to figure out the reason why
How to look at the bones on Xray? - CORRECT ANSWER
Quadrant method [above and below the ribs] (the middle
lung section you just
,also go down the spine looking for abnormalities, mets, or
collapse
When should you START looking at OLD films? - CORRECT
ANSWER AFTER you have COMPLETELY evaluated the new
scan
What are the ACR appropriateness criteria? - CORRECT
ANSWER The aim is to provide continuously updated
evidence-based algorithms that ensure the safest, most
cost-effective, and most efficient path to radiological
diagnosis or intervention matched to specific variants of
clinical presentations.
Federal LAW requires referring physicians to consult
Appropriate Use Criteria (AUC), such as ACR
Appropriateness Criteria, prior to ordering advanced imaging
services (ADIS), including CT, MR, nuclear medicine, and
PET, for Medicare patients.
How are appropriateness criteria divided/staged? - CORRECT
ANSWER Older appropriateness rating tables used a
numerical rating scale: • Usually Appropriate = 9, 8, or 7 •
May be Appropriate = 6, 5, or 4 • Usually Not Appropriate = 3,
2, or 1
Newer appropriateness rating tables simply use the three
categories: • Usually Appropriate (Green cells in the table) •
May be Appropriate (Yellow cells in the table) • Usually Not
Appropriate (Red cells in the table)
, What lobe of lung is seen at the apicies? - CORRECT ANSWER
The R and L upper lobes
What is the silhouette sign? - CORRECT ANSWER The visual
interface between structures of different density.
Its actually when a silhouette is LOST that we say its a
"silhouette sign"
What is spine sign? - CORRECT ANSWER When the combined
density of the vertebrae and some source of
fluid/consolidation make the vertebrae look MORE dense
[just like ice over water accentuates the ice appearing like
they have increased density even though they still the same
ice]
What are cases in which spine sign occur? - CORRECT
ANSWER Spine sign - vertebral bodies should be relative
lucent (black) above the diaphragm on lateral projection.
-Lateral x-ray goes through spine + pneumonia and vertebra
will appear whiter (fewer x-rays reach detector since some
are absorbed in the pneumonia)
- Helpful sign for detection of lower lobe pneumonia. - - Very
useful for detecting LLL pneumonia behind the heart.
- If vertebral bodies appear more dense (whiter) above the
level of diaphragm, and part of one of the diaphragms is
obscured → spine sign → sign of lower lobe pneumonia
- There are other causes for the spine to appear whiter (such
as a blastic bone metastasis).
