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Lung Ultrasound - Final Quiz

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The document provides details about a registrar training workshop final quiz on lung ultrasound. It includes 9 cases with ultrasound images of the right and left lungs and two possible chest x-ray images to choose from for each case. For each case, trainees are asked to identify their findings for each region of the lungs on ultrasound and choose the correct chest x-ray. The document also provides background information on common ultrasound lung findings like A-lines, B-lines, and hepatization.

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Final Quiz Registrar training workshop
But first a recap
Lung Ultrasound - Final Quiz
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)
B- lines 際際滷 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.
Wet PLUS= B lines with thick wrinkly pleura. c pattern
Sub pleural abnormality = small collapse May indicate small PE, mets or infection. 際際滷s with respiration. Suggest refer to German papers for subgrouping.
Hepatisation (wet OR dry) Hepatisation generally indicates major collapse/consolidation.
And there are other less frequent findings.. curtain & jelly fish sign
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.
Case 4 RIGHT LUNG
Case 4 LEFT LUNG
XRAY A
XRAY B
Case 5 RIGHT LUNG
Case 5 LEFT LUNG
XRAY A
XRAY B
Case 6 RIGHT LUNG
Case 6 LEFT LUNG
XRAY A
XRAY B
CASE 7 RIGHT LUNG
Case 7 LEFT LUNG
XRAY A
XRAY B
Case 8- RIGHT LUNG
Case 8 LEFT LUNG
Case 8 Bonus slide
XRAY A
XRAY B
Case 9- RIGHT LUNG
Case 9 LEFT LUNG
XRAY A
Case 9 Bonus slide. XRAY B
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.
Case 9- bonus video BNP = 100

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Lung Ultrasound - Final Quiz

Editor's Notes

  • #9: Hepatisation is simply an appearance that is liver-like on ultrasound, usually caused by consolidation of the lung abutting the pleural surface. Be aware that anterior view appearances may normal whilst still seeing hepatisation in the posterior, lower views.
  • #10: Note the curtain sign, where the lowest portion of the lung slides across obscuring the diaphragm This shows you the lowest point of the lung, which we call a physiological lung point. It also indicates that this side of the chest is being ventilated (if you are checking endotracheal tube placement)