1. The document discusses various radiological signs seen on chest x-rays related to different disease processes and conditions. It provides descriptions of findings related to lung lesions, pleural diseases, pulmonary vascular abnormalities and other pathologies.
2. Examples of signs described include the appearance of mediastinal lesions, pleural effusions, lung opacities, findings associated with lobar collapse, and distributions of opacities related to specific conditions.
3. The document aims to aid in the interpretation of chest x-rays and teaching of radiological findings for different diseases. It covers topics such as cavitary lung lesions, mediastinal abnormalities, signs of pneumonia, and characteristics of vascular anomalies amongst other pathologies.
Right Paratracheal Stripe
Posterior wall of the bronchus intermedius
Left Paratracheal Stripe
Left subclavian artery border
Posterior-superior junction line
Right Paratracheal Stripe
Posterior wall of the bronchus intermedius
Left Paratracheal Stripe
Left subclavian artery border
Posterior-superior junction line
4 BASIC TYPES OF DENSITY - air , water /soft tissues, metal /bone , fat
Two substances of the same density, in direct contact, cannot be differentiated from each other on an x-ray.
This phenomenon, the loss of the normal radiographic silhouette (contour), due to loss of difference in density is called the silhouette sign.
4 BASIC TYPES OF DENSITY - air , water /soft tissues, metal /bone , fat
Two substances of the same density, in direct contact, cannot be differentiated from each other on an x-ray.
This phenomenon, the loss of the normal radiographic silhouette (contour), due to loss of difference in density is called the silhouette sign.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
4. Cavitary lung lesions
Loculated empyema
Hydropneumothorax
Esophageal obstruction
Mediastinal abscess
Hydropneumopericardium
Hiatal hernia
Chest wall abscess
Air Fluid Levels
in the following conditions:
5. • A mediastinal lesion should have a sharp
margin convex towards the lungs and its base
abutting the mediastinum .
Most disease processes will either increase
or decrease the density of the lung
parenchyma
6. • A pleural lesion should be seen as a homogenously
dense opacity abutting the pleural surface, without
air bronchogram.
• If the pleural lesion is free fluid, it will gravitate to
the dependant lung parts first to form a miniscus
(concavity) along its upper surface.
7. • An extra pleural lesion demonstrates a homogenous
density which makes obtuse angles with the chest
wall, or may appear similar to pleural disease.
8. • A lung opacity may be due to a mass or lung-
parenchymal opacification.
• Identification of clear margins vs indistinct or
diffuse opacification is important in making
the differentiation.
• If the diffuse opacification demonstrates
lucencies or air bronchogram within it, it is
most likely air space disease (consolidation).
9. Signs of lobar collapse
• Local increase in density due to non-aerated
lung.
• Decreased lung volume.
• Displacement of pulmonary fissures.
• Elevation of hemidiaphragm.
• Displacement of hila.
11. left upper lobe atelectasis following right upper lobectomy.
The left lung lacks a middle lobe and therefore a minor fissure, so left upper
lobe atelectasis presents a different picture from that of the right upper lobe
collapse.
The result is predominantly anterior shift of the upper lobe in left upper lobe
collapse, with loss of the left upper cardiac border. The expanded lower lobe
will migrate to a location both superior and posterior to the upper lobe in
order to occupy the vacated space.
As the lower lobe expands, the lower lobe artery shifts superiorly. The left
mainstem bronchus also rotates to a nearly horizontal position.
18. Lung mass
• of more than Clinical history and patient’s age .
• Mass borders .
• Comparison with previous examinations.
• Presence of calcifications.
• Associated adjacent rib erosions, pleural effusion,
hilar or mediastinal nodal enlargement.
• Presence of more than one mass.
19. Distribution of opacities
• Unifocal or multifocal.
• Lobar.
• Segmental.
• Perihilar.
• Peripheral.
• Upper, middle or lower zones.
20. Lung fields appear dark because of air.
Ninety-nine percent of the lung is air.
The pulmonary vasculature,
interstitium constitute 1% and give the
lacy lung pattern.
21. Normal Female . older, young
Note breast shadows
Look for asymmetry or missing breast (surgery)
Be aware of basal lung changes due to breast tissue.
Review lateral to evaluate basal changes.
22. Which lung is larger?
Which diaphragm is higher and why?
What is the normal size of the heart?
What is the normal size and shape of
the aorta?
25. Silouhette Adjacent lobe/segment
Right Diaphragm RLL/Basal segments
Right Heart margin RML/Medial segment
Ascending Aorta RUL/Anterior segment
Aortic knob LUL/Posterior segemnt
Left Heart margin Lingula/Inferior segment
Descending Aorta LLL/Superior and medial segments
Left Diaphragm LLL/Basal segments
26. Consolidation / Lingula
Density in left lower lung field
Loss of left heart silhouette
Diaphragmatic silhouette intact
No shift of mediastinum
Blunting of costophrenic angle
36. Unilateral Hyperlucent Lung
Peanut in Left Bronchus
Partial Airway Obstruction Left lung hyperlucent
Left lung stays hyperlucent on expiration
Mediastinal shift with respiration
39. Honeycombing
• Seen in end stage lung disease
• Indicative of diffuse interstitial fibrosis
• Due to bronchiolectasia
• Most of the time in bases
• Upper lobe distribution seen in eosinophilic
granuloma
44. Aspergilloma. Bilateral upper lobe disease
Long standing cavity due to sarcoidosis
Cavity containing round density
Crescent sign - semilunar air space above mass density
45. Aspergillosis
Solitary Pulmonary Nodule
Patient on steroids. Develops solitary pulmonary nodule with air bronchogram.
Short doubling time indicating inflammatory process. Air bronchogram indicating
that it is an alveolar process.
- On steroids (film below)
- Develops solitary pulmonary nodule within one month
- Air bronchogram in the density
FNAB: Aspergillus
Resolved with discontinuation of steroids
50. Tension Pneumothorax No vascular markings on
right
Shift of mediastinum to left
Deep sulcus
Atelectatic right lung
Increased haziness on left: Diversion of entire
cardiac output
53. Hilar Nodes
Note bilateral symmetrical hilar nodes and
para tracheal nodes.
A clear space between the nodes and heart,
identifies the nodes as hilar.
61. Aneurysm Arch of Aorta
Leaking Blood into Pleural Space
Mediastinal mass
Calcification of periphery evident along upper margin
Loss of silhouettes of
aortic knob
left heart margin
left diaphragm
Left pleural effusion
Tracheal indentation Old and New x rays
62. Aneurysm Arch of Aorta
"Mass" density
Extrapleural
Middle mediastinal mass
63. Aneurysm of Descending Aorta- Inhomogeneous cardiac density
Retrocardiac density
Extrapleural
64. Dissecting Aneurysm
Mediastinal widening
Inlet to outlet shadow on left side
Retrocardiac: Intact silhouette of left heart margin
Pulmonary artery overlay sign: Density behind left lower
lobe
Wavy margin
Lat view demonstrates increased density over spine
66. Bronchiectasis
• Normal appearing CXR in most
• Tubular shadows
• Tram line
• Gloved fingers
• Mucocele
• Ring shadows with thickened bronchial walls
• Air fluid levels
• Watch for dextrocardia
– Immotile cilia syndrome
• Diffuse lung fibrosis
– Due to recurrent infections
73. Right Sided Aortic Arch
Aortic knob missing on left and seen on right
Descending aorta missing on left and seen on right
Paravertebral line on right
74. Right Sided Aortic Arch
Aortic knob on right
Descending aorta on right
Paravertebral line
Right Sided Aortic Arch
Aortic knob on right
Descending aorta on right
Paravertebral line
76. Anterior Mediastinal Mass
Widened mediastinum
Loss of cardiac silhouette
Intact silouhette of descending aorta
Lateral view below.
This is a case of anaplastic carcinomaRetrosternal area is filled with mass density.
78. Pulmonary Embolism
. The primary purpose of a chest film
in suspected PE is to rule out other
diagnoses as a cause of dyspnea or
hypoxia. Most CXRs in patients with
PE are normal.
79. These are two PA fiilms demonstrating Hampton's
hump (rounded opacities) in patients with pulmonary
embolism
