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Internal Medicine

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Harsh Sura
Nader Guma

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Nader Guma
Amna Khan


Symmetric diffuse, bilateral pulmonary infiltrates with mediastinal and bilateral hilar lymphadenopathy. DDx?


Harsh Sura
Nader Guma

Sarcoidosis

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Harsh Sura
Israr Khan
Nader Guma

Thank you, in addition to the pneumomediastinum and SQ emphysema, there is also a pneumothorax on the right side and a chest tube is needed since this patient is on the ventilator. @Everyone

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Large peripancreatic retroperitoneal fluid collections with gas formation representing necrotizing pancreatitis.

Harsh Sura
Nader Guma

80-year-old male who had a second- and third-degree burn injury was found to have an automated platelet's count of 980,000 while a manual analysis revealed it is 165,000. This is a heat-induced fragmentation of RBCS causing a false automated reading of the platelets.



Sundus Basheer
Seif Hayek
Israr Khan
Shafaq Taj

Shafaq Taj

Nader Guma
Seif Hayek

Probe location (zone L3): 4th-10th intercostal spaces, between the anterior & posterior axillary lines.

Transducer Type & Placement

Phased Array or Curvilinear

The footprint is perpendicular to the skin with the marker pointing cephalad

Amna Khan
Harsh Sura
Israr Khan
Manar  Ismail

Lung Sliding

Pleural line is found below the chest wall

Movement of pleura with breathing will generate the “lung sliding” sign

• Represents the sliding of the visceral pleura against the parietal pleura

• Using Color Flow (CF) can help identify the pleural line and its movement


Manar  Ismail
Mazen Kherallah
Omar Taleb
Nader Guma

Bat Sign: This sign is formed by the shadows of two ribs and the pleural line (looks like a bat flying towards you)

Manar  Ismail
Mazen Kherallah
Nader Guma

Comet Tail Artifact/B Lines

• Vertical lines, extending from the pleural line to the edge of the screen without fading

• Synchronized with lung sliding

• When present they will usually overshadow the A lines

• Represents thickening interlobular septa and extravascular lung water as in alveolar interstitial disease (pulmonary edema, ARDS...)


Desmond Boakye Tanoh
Apoorva Pandharpurkar
Sadia Usmani
Seif Hayek

A Lines

Can be part of the normal lung signs

Represents normal artifact repetition(s) of the pleural line

Intervals between the A lines are equal to the distance between the skin and the original pleural line

When present without lung sliding, it may indicate the presence of pneumothorax

Desmond Boakye Tanoh
Harsh Sura
Apoorva Pandharpurkar