Diagnostic Focus in Imaging Studies - Respiratory Therapist Reviewer

The Diagnostic Imaging Studies section is a crucial component of the Respiratory Therapist Licensure Examination in the Philippines. This segment tests the examinee's ability to interpret and analyze imaging results, which is vital for accurate assessment and management of respiratory conditions. A strong understanding of various imaging modalities and their applications is essential for aspiring respiratory therapists.

Chest X-rays are the most common imaging tool in respiratory care. The ability to identify abnormalities such as pneumonia (indicated by lung opacities), pneumothorax (presence of air in the pleural space causing lung collapse), and pleural effusion (fluid accumulation in the pleural cavity) is essential. Mastery of recognizing these conditions is pivotal for clinical decision-making and immediate patient intervention.

CT Scans (Computed Tomography) offer more detailed cross-sectional images, making them invaluable in diagnosing complex pulmonary conditions like pulmonary embolism and interstitial lung diseases. Respiratory therapists must understand the indications for CT scans and the interpretation of findings to guide physicians in accurate diagnosis and appropriate treatment planning.

MRI (Magnetic Resonance Imaging) and Ultrasound are less frequently used in respiratory therapy but remain essential for specific cases. MRI provides detailed imaging without radiation exposure, particularly useful in assessing mediastinal and vascular abnormalities. Ultrasound, often portable, is valuable in detecting pleural effusion and guiding thoracentesis procedures.

The ability to interpret diagnostic imaging studies and integrate findings into clinical practice is a critical competency assessed in the licensure examination. Examinees are expected to understand the indications, limitations, and diagnostic significance of various imaging modalities to ensure comprehensive and high-quality respiratory care. Therefore, thorough preparation and review of these imaging studies are essential for success in the board exam and competent clinical practice.

RESPIRATORY THERAPIST REVIEWER

Welcome to our Respiratory Therapist Reviewer. In this session, you'll have the opportunity to test your understanding of key concepts in Imaging Studies. The quiz consists of multiple-choice questions covering various topics. Pay close attention to each question and select the best answer. After completing the exam, check the video or the answer key and explanations at the last part.

Chest X-ray Interpretation

1. Which of the following appears as a white (radiopaque) area on a chest X-ray?
A. Fluid or consolidation
B. Air in the lungs
C. Gas in the stomach
D. Normal lung tissue

2. A chest X-ray showing a “bat-wing” pattern is characteristic of which condition?
A. Pneumonia
B. Pulmonary edema
C. Pneumothorax
D. Tuberculosis

3. Which condition is indicated by a “blunting of the costophrenic angle” on a chest X-ray?

A. Pleural effusion
B. Pneumothorax
C. Pulmonary embolism
D. Emphysema

4. A collapsed lung (pneumothorax) on a chest X-ray appears as:
A. An area of increased radiopacity with air-fluid levels
B. A white-out of the entire lung field
C. A dark (radiolucent) area without lung markings
D. A consolidation in the lower lobes

5. A patient with tuberculosis (TB) is most likely to show what pattern on a chest X-ray?

A. Diffuse ground-glass opacities
B. Blunting of the costophrenic angles
C. Honeycombing in the lungs
D. Cavitary lesions in the upper lobes

6. Which view is most commonly used in a routine chest X-ray?
A. Anteroposterior (AP)
B. Posteroanterior (PA)
C. Lateral
D. Oblique

7. A "ground-glass opacity" on a chest X-ray is commonly associated with:

A. Interstitial lung disease
B. Pneumonia
C. Pulmonary embolism
D. All of the above

CT Scan Interpretation

8. What is the primary imaging modality for detecting pulmonary embolism?
A. CT Pulmonary Angiography (CTPA)
B. Chest X-ray
C. MRI
D. Ultrasound

9. Which lung condition is best diagnosed using high-resolution CT (HRCT)?
A. Pneumonia
B. Interstitial lung disease
C. Pleural effusion
D. Asthma

10. Which CT scan finding is characteristic of emphysema?

A. Honeycombing
B. Ground-glass opacities
C. Hyperinflated lungs with bullae
D. Pleural thickening

11. A “tree-in-bud” pattern on a CT scan suggests:
A. Bronchiolitis or tuberculosis
B. Pulmonary embolism
C. Pulmonary fibrosis
D. Pneumothorax

12. Which of the following is the hallmark CT finding in pulmonary fibrosis?
A. Tree-in-bud pattern
B. Honeycombing
C. Ground-glass opacities
D. Pleural effusion

13. Which of the following findings on a CT scan suggests bronchiectasis?

A. Dilated bronchi with thickened walls
B. Ground-glass opacities
C. Mediastinal shift
D. Bullous formations

14. Which condition is associated with a "crazy paving" pattern on high-resolution CT (HRCT)?
A. Interstitial lung disease
B. Pulmonary embolism
C. Pulmonary alveolar proteinosis
D. Tuberculosis

MRI and Ultrasound in Pulmonary Diagnosis

15. Which condition is best evaluated using lung ultrasound?
A. Pleural effusion
B. Pulmonary embolism
C. Tuberculosis
D. Interstitial lung disease

16. Why is MRI not commonly used for lung imaging?
A. MRI is too expensive
B. Lungs contain air, which limits MRI resolution
C. MRI uses ionizing radiation
D. MRI cannot differentiate soft tissues

17. Which imaging modality is preferred for detecting mediastinal tumors?

A. Chest X-ray
B. CT scan
C. MRI
D. Ultrasound

18. What is the primary advantage of ultrasound over CT for pleural effusion detection?
A. Higher sensitivity
B. Faster imaging
C. No radiation exposure
D. All of the above

19. Which lung pathology is best evaluated using MRI rather than CT?
A. Lung nodules
B. Pulmonary embolism
C. Mediastinal tumors
D. Pneumothorax

20. Why is MRI not commonly used for routine lung imaging?
A. It is too expensive
B. MRI has lower resolution for lung tissue due to air interference
C. MRI exposes the patient to radiation
D. MRI does not differentiate bone from soft tissue

21. Which of the following is best diagnosed using thoracic ultrasound?

A. Pulmonary embolism
B. Pleural effusion
C. Lung cancer
D. Bronchiectasis

22. Which ultrasound sign is indicative of a pneumothorax?
A. B-lines
B. Lung sliding
C. Barcode sign (Stratosphere sign)
D. Pleural thickening

23. What is the advantage of ultrasound over X-ray for diagnosing pleural effusion?
A. Can detect small amounts of fluid
B. Does not use radiation
C. Can be done at the bedside
D. All of the above

24. Advanced Imaging and Clinical Cases
Which of the following best describes the "Westermark sign" on a chest X-ray?
A. Hyperinflation of one lung
B. Bilateral pleural effusions
C. Ground-glass opacities
D. A wedge-shaped area of lung oligemia

25. Which imaging modality is most sensitive for detecting lung cancer?
A. Chest X-ray
B. CT scan
C. MRI
D. Ultrasound

26. Which of the following is a common radiographic sign of pneumonia on a chest X-ray?
A. Hyperinflation
B. Patchy or lobar consolidation
C. Air-fluid levels
D. Pleural effusion

27. Which condition would show a "Kerley B line" on a chest X-ray?
A. Pulmonary embolism
B. Pulmonary fibrosis
C. Pneumothorax
D. Congestive heart failure

28. A 65-year-old smoker presents with hemoptysis and weight loss. Which imaging modality is best for initial assessment?
A. Chest X-ray
B. Ultrasound
C. MRI
D. CT scan

29. Which finding suggests an acute pulmonary embolism on CT?
A. Hyperinflated lungs
B. Westermarck sign
C. Blunted costophrenic angle
D. Cavitary lesion

30. Which imaging modality is safest for pregnant patients needing lung evaluation?
A. CT scan
B. MRI
C. Ultrasound
D. X-ray

ANSWER KEY HERE