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RSNA ICU Draft testing. JK Amorosa. 1. #1 What is the Interval change?. 1. Removal of Dobhoff feeding tube 2.Repositioning of Dobhoff to more appropriate position 3.Repositioning of Dobhoff which was initially in an appropriate position 4.Insertion of an endotracheal tube 5.No change. 2.

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1 what is the interval change
#1 What is the Interval change?

1. Removal of Dobhoff feeding tube

2.Repositioning of Dobhoff to more appropriate position

3.Repositioning of Dobhoff which was initially in an appropriate position

4.Insertion of an endotracheal tube

5.No change

2 what is the interval change
#2 What is the interval change?

1. Insertion of an orogastric tube

2.New RML consolidation

3.Removal of endotracheal tube

4.Insertion of a left chest tube

5.No change

3 what is the interval change
#3 What is the interval change?
  • 1. Insertion of a right PICC line
  • 2. Removal of an endotracheal tube and orogastric tube
  • 3. Insertion of a Swan-Ganz catheter
  • 4. New left chest tube
  • 5. No change
4 what is the interval change
#4 What is the interval change?

1.New right middle lobe consolidation

2.New right middle lobe atelectasis

3. New right pleural effusion

4.New right lower lobe atelectasis

5. No change

5 what is the interval change
#5 What is the interval change?

1.Removal of Left jugular line

2.Removal of Right jugular line

3. Removal of Impella LVAD

4.Right lower lobe atelectasis

5. No change

6 what is the interval change
#6 What is the interval change?

1.New right middle lobe consolidation

2.New right middle lobe atelectasis

3. New right pleural effusion

4.New right lower lobe atelectasis

5. No change

7 what is the interval change
#7 What is the interval change?
  • Insertion of new lead wire in right atrium
  • Fracture in lead wire
  • Insertion of new pacemaker generator
  • A and C
  • No change
8 what is the interval change
#8 What is the interval change?
  • RLL atelectasis
  • Fracture of pacer wire
  • New R PICC
  • L pneumothorax
  • No change
9 what is the interval change
#9 What is the interval change?
  • Removal of ET
  • Removal of pacemaker generator
  • A and B
  • B and C
  • No change
10 what is the interval change
#10 What is the interval change?
  • Removal of Swan-Ganz catheter
  • Insertion of aortic baloon
  • Removal of OG tube
  • Removal of ET
  • No change
12 in addition to a small ptx what is the interval change
#12 In addition to a small Ptx what is the interval change?
  • Insertion of ET
  • New L subclavian line
  • Repositioned L chest tube
  • All of the above
  • No change
13 what is the interval change
#13 What is the interval change?
  • Insertion of ET
  • New Swan-ganz catheter
14 what is the interval change
#14 What is the interval change?
  • Removal of left ventricular assist device
  • Removal of right chest tube
  • Removal of left chest tube
  • Removal of Swan-Ganz catheter
  • No change
15 what is the interval change
#15 What is the interval change?
  • Removal of pacemaker wire
  • New soft tissue swelling near right shoulder
  • New right pneumothorax
  • New left pneumothorax
  • No change
16 what is the next step
#16 What is the next step?
  • Call the nurse about low endotracheal tube
  • Call the nurse about a malpositioned right chest tube
  • Recommend STAT chest CT for lower lobe mass
  • Nothing needs to be done. Move on to the next case
what is the most appropriate next step
What is the most appropriate next step?
  • Dictate as no acute cardiopulmonary disease. Move on to the next case
  • Call nurse about possible thoracic aortic aneurysm
  • Call nurse about left pneumothorax
  • Call nurse about pneumoperitoneum
17 what is the interval change
#17 What is the interval change?
  • Resolution of CHF
  • New Swan-ganz catheter and aortic balloon pump in the correct position
  • New left pleural pigtail catheter
  • New Swan-ganz catheter and aortic balloon pump in the incorrect position
18 what is the interval change
#18 What is the interval change?
  • Resolurion of CHF pattern
  • New Swan-ganz catheter
  • New L pleural catheter
  • New Swan-ganz catheter and aortic baloon in the correct position
  • No change
19 what is the interval change
#19 What is the interval change?
  • New Swan-ganz catheter correctly positioned
  • Placement of additional pacer wire
  • New OG tube
  • New Swan-gans incorrectly positioned
  • No change
21 what is the interval change
#21 What is the interval change
  • Placement of Dobhoff feeding tube
  • New Swan-ganz catheter incorrectly positioned
  • New Swan-ganz catheter correctly positioned
  • New LLL atelectasis
  • No change
22 what is the interval change
#22 What is the interval change?
  • Insertion of OG tube
  • Removal of ET tube
  • New R PICC
  • Free air under diaphragm
  • No change
23 what is the interval change
#23 What is the interval change?
  • New right sided pneumothorax
  • Complete left lower lobe atelectasis
  • Complete left upper lobe atelectasis
  • New orogastric tube
  • No change
24 what is the interval change
#24 What is the interval change?
  • New RLL atelectasis
  • New left pleural effusion
  • New right pleural effusion
  • New pacemaker wire
  • No change
25 what is the interval change
#25 What is the interval change?
  • New right pleural effusion
  • New left sided pneumothorax
  • New RLL partial atelectasis
  • New right subclavian catheter
  • No change
26 what is the interval change
#26 What is the interval change?
  • New Swan-ganz catheter/removal of old Swan-ganz
  • Removal of endotracheal tube
  • Removal of orogastric tube
  • New transcutaneous pacemaker pad
  • No change
27 what is the interval change
#27 What is the interval change?
  • Removal of pericardial drain
  • Removal of mediastinal tube
  • New Swan-ganz catheter
  • Removal of R jugular line
  • No change
28 what is the interval change
#28 What is the interval change?
  • Removal of OG tube
  • Change in location of aortic baloon
  • New Swan-ganz catheter
  • New dialysis catheter
  • No change
29 what is the appropriate next step
#29 What is the appropriate next step?
  • Call nurse about R pneumothorax
  • Call nurse for repositioning L chest tube
  • Call nurse about widened mediastinum
  • Move onto next case
30 how can this patient be best treated
#30 How can this patient be best treated?
  • IV antibiotics
  • Placement of left chest tube
  • Repositioning of ET tube
  • Placement of OG tube
  • No treatment, congenital anomaly
31 what is the next step
#31 What is the next step?
  • Feed the patient
  • Remove wire from Dobhoff feeding tube
  • Call nurse about malpositioned Dobhoff feeding tube
  • Call nurse for repositioning of pH probe
  • No abnormality.ove onto next case
32 what is the next step
#32 What is the next step?
  • Feed the patient
  • Remove wire from Dobhoff feeding tube
  • Call nurse for repositioning Dobhoff feeding tube
  • Call nurse for repositioning of pH probe
  • No abnormality. Move on to the next case
40 pick the correct scenario
#40 Pick the correct scenario
  • Patient’s jewelry was not removed
  • IVC filter misplaced
  • Patient had a murmur and suffered a stroke from a lower extremity DVT 6 mo ago
  • Jewelry swallowed
41 what is the abnormality
#41 What is the abnormality?
  • R pneumothorax
  • L pneumothprax
  • LLL atelectasis
  • RLL atelectasis
  • Misplaced Swan –ganz catheter
42 what is the abnormality
#42 What is the abnormality?
  • Situs inversus
  • Double aortic arch
  • Double SVC
  • Patent foramen ovale
  • No abnormality
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