PAEA Surgery End Of Rotation (EOR) Practice Exam

What finding on chest X-ray is associated with aortic dissection?

1. Widened mediastinum

2. Bulging diaphragms

3. Blunting of costophrenic angles

4. Pleural effusion

The correct answer is: Widened mediastinum

Widened mediastinum is a classic radiographic finding associated with aortic dissection. This occurs due to the separation of the layers of the aorta, which leads to an increase in the mediastinal space because of the hematoma that can form in the mediastinum itself. When a dissection occurs, the aorta may tear, allowing blood to accumulate in the surrounding tissues. The resulting increase in the width of the mediastinum is a significant indicator that clinicians look for when assessing a patient suspected of having an aortic dissection. In contrast, bulging diaphragms, blunting of costophrenic angles, and pleural effusion are findings that are not specifically associated with aortic dissection. These findings can occur in various conditions such as pulmonary disease or heart failure, but they do not indicate the presence of aortic dissection. Thus, recognizing a widened mediastinum on a chest X-ray is crucial for prompt diagnosis and management of this potentially life-threatening condition.