Blue Team - Lung Ultrasound Quiz

1. Final Quiz
Registrar training workshop

2. But first a recap

4. A lines do not define pathology
A lines may exist in normal lungs, pntx(if there is no sliding), COPD or PE
Make sure probe is perpendicular to lung surface (not skin surface)

5. B- lines
Slide briskly from thin pleura
edge.
Extend to bottom of field.
Three per field = ‘wet field’.
Two wet fields per side
suggests CCF- particularly if
symmetrical
FLASH APO is often apical,
subclinical is laterobasal.

6. Wet PLUS= B lines with thick
wrinkly pleura.
‘c pattern’

7. Sub pleural abnormality =
small collapse
May indicate small PE, mets or
infection.
Slides with respiration. Suggest
refer to German papers for
subgrouping.

8. Hepatisation (wet OR dry)
Hepatisation generally indicates major
collapse/consolidation.

9. And there are other less frequent
findings…..
‘curtain’ & ‘jelly fish’ sign

10. Quiz instruction
 Right lung, 4 regions, on first slide
 Left lung, 4 regions, on second slide
 Choose between subsequent CXR (A or B)
 Added extras later on.

11. Case 4 RIGHT LUNG

12. Case 4 LEFT LUNG

13. XRAY A

14. XRAY B

15. Case 5 RIGHT LUNG

16. Case 5 LEFT LUNG

17. XRAY A

18. XRAY B

19. Case 6 RIGHT LUNG

20. Case 6 LEFT LUNG

21. XRAY A

22. XRAY B

23. CASE 7 – RIGHT LUNG

24. Case 7 – LEFT LUNG

25. XRAY A

26. XRAY B

27. Case 8- RIGHT LUNG

28. Case 8 – LEFT LUNG

29. Case 8 Bonus slide

30. XRAY A

31. XRAY B

32. Case 9- RIGHT LUNG

33. Case 9 –LEFT LUNG

34. XRAY A

35. Case 9 – Bonus slide.
XRAY B

36. Xray report.
CHEST (AP/ERECT)
History:
IHT from Esk. SOB. Treated as pneumonia. Bilateral chest xray
changes. Acute deterioration overnight, treated as APO.
Findings:
The heart appears moderately enlarged but the cardiac and
mediastinal outline appears otherwise normal. There is bilateral
alveolar shadowing throughout both lung fields with pulmonary
venous congestion, and appearances are in keeping with acute
pulmonary oedema but may also be due to infection. No pleural
effusions are visible.

37. Case 9- bonus video
BNP = 100