Here is a set of multiple-choice questions (MCQs) based on the TCV definition of Pulmonary Embolism (PE), integrating insights from reputable sources.
Question 1:
What is the most common cause of a pulmonary embolism (PE)?
A. Amniotic fluid embolism
B. Air embolism
C. Fat embolism
D. Deep vein thrombosis (DVT)
Correct Answer: D. Deep vein thrombosis (DVT)
Reference: The majority of PEs originate from thrombi in the deep veins of the lower extremities. (Radiopaedia)
Question 2:
Which of the following is an abnormal finding indicating significant right heart strain in pulmonary embolism?
A. Reflux of contrast into the inferior vena cava (IVC)
B. Reflux of contrast into hepatic veins
C. Bowing of the interventricular septum toward the right ventricle
D. Azygos vein size less than 7 mm
Correct Answer: B. Reflux of contrast into hepatic veins
Reference: Reflux into the hepatic veins is abnormal and indicates elevated right-sided pressures. (Fleischner Society Glossary)
Question 3:
Which of the following imaging findings is most characteristic of acute pulmonary embolism?
A. Eccentric filling defects with vessel wall thickening
B. Central filling defects with vessel enlargement
C. Calcified thrombi in pulmonary arteries
D. Wedge-shaped subpleural opacity
Correct Answer: B. Central filling defects with vessel enlargement
Reference: Acute emboli typically present as central filling defects, often with vessel dilation, on CT pulmonary angiography. (Radiopaedia)
Question 4:
What does the “feeding vessel” sign in pulmonary embolism indicate?
A. Thrombus occlusion in the main pulmonary artery
B. A vessel leading to a lesion, suggesting embolism or vascular abnormality
C. Recanalization of a chronic embolus
D. Peribronchial thickening from inflammatory processes
Correct Answer: B. A vessel leading to a lesion, suggesting embolism or vascular abnormality
Reference: The feeding vessel sign is seen as a prominent vessel leading to an affected lung region, indicating embolism.
Question 5:
What is the role of dual-energy CT in the evaluation of pulmonary embolism?
A. Identifying perfusion defects with iodine maps
B. Measuring right ventricular wall thickness
C. Detecting chronic thromboembolic pulmonary hypertension (CTEPH)
D. Visualizing small peripheral emboli directly
Correct Answer: A. Identifying perfusion defects with iodine maps
Reference: Dual-energy CT with iodine maps identifies areas of reduced perfusion, complementing standard CTPA findings. (Fleischner Society Glossary)
Question 6:
Which of the following features helps distinguish chronic pulmonary embolism from acute pulmonary embolism?
A. Vessel enlargement and sharply demarcated filling defects
B. Calcification of thrombi and web-like structures in pulmonary arteries
C. Reflux of contrast into hepatic veins
D. Ground-glass opacity on CT
Correct Answer: B. Calcification of thrombi and web-like structures in pulmonary arteries
Reference: Chronic PE is characterized by fibrotic or calcified thrombi and web-like intravascular structures. (Radiopaedia)
Question 7:
What are the primary sources of oxygenation in the lungs, relevant to pulmonary infarction?
A. Pulmonary veins and arteries
B. Alveoli, pulmonary arteries, and bronchial arteries
C. Pulmonary capillaries and venules
D. Systemic arteries and lymphatic vessels
Correct Answer: B. Alveoli, pulmonary arteries, and bronchial arteries
Reference: The lung?s dual blood supply reduces the risk of infarction unless collateral flow is compromised. (Radiopaedia)
Question 8:
What imaging feature on CT pulmonary angiography (CTPA) suggests right heart strain?
A. RV/LV ratio >1
B. Thickening of pulmonary artery walls
C. Ground-glass opacity in peripheral lung zones
D. Pleural effusion without vascular findings
Correct Answer: A. RV/LV ratio >1
Reference: Right ventricular dilation with an RV/LV ratio >1 is a classic sign of right heart strain in PE. (Fleischner Society Glossary)
Question 9:
What is the clinical significance of occlusive vs. non-occlusive emboli?
A. Non-occlusive emboli do not require treatment.
B. Occlusive emboli are more likely to cause severe perfusion defects and hemodynamic instability.
C. Non-occlusive emboli are more likely to result in infarction.
D. Occlusive emboli always lead to pulmonary infarction.
Correct Answer: B. Occlusive emboli are more likely to cause severe perfusion defects and hemodynamic instability.
Reference: Occlusive thrombi completely block the vessel lumen, causing more severe consequences. (RadiologyKey)
Question 10:
Which of the following is a hallmark finding on chest X-ray (CXR) in pulmonary embolism?
A. Normal appearance
B. Hampton hump (wedge-shaped opacity)
C. Bilateral pleural effusions
D. Central mediastinal widening
Correct Answer: B. Hampton hump (wedge-shaped opacity)
Reference: The Hampton hump is a classic but uncommon finding, representing infarction in PE. (Radiopaedia)