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abnormal chest Flashcards

1
Q

consolidation

A

infiltrate or solid engorgement

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2
Q

congestive heart failure

A

hilar engorgement and increase heart size

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3
Q

pneumothorax

A

air in the pleural cavity

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4
Q

atelectasis

A

collapse of the lung due to obstruction

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5
Q

alveolar

A

air sacs

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6
Q

interstitial

A

spaces within a lung or tissue/spaces between alveoli

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7
Q

pleural effusion

A

fluid in the pleural cavity

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8
Q

patterns of disease

A
  1. diffuse
  2. focal
  3. lung volume
  4. pleural disease
  5. lymphadenopathy
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9
Q

two divisions of diffuse disease pattern

A

airspace disease and interstitial opacity

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10
Q

two divisions of focal disease patterns

A

nodules/masses

blebs/bullae/cysts/cavities

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11
Q

what will airspace disease look like

is it focal or diffuse

A

a confluent fluffy or hazy opacity resulting from fluid density in the alveoli

it is diffuse and can involve part or the whole lung

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12
Q

what is air bronchogram sign

what is it indicative of

A

indication of airspace disease

an air filled bronchus surrounded by an airless lung

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13
Q

if air bronchogram sign is present where is the lesion causing the issue

A

in the lung

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14
Q

describe what the airspace disease will look like on xray

A

hazy, fluffy, confluent opacities with indistinct margins and airbronchogram or silhouette sign

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15
Q

what is the acute DDx for air space opacity

A
  1. pneumonia
  2. pulmonary alveolar edema
  3. hemorrhage
  4. aspiration
  5. near-drowning
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16
Q

what is the DDx for chronic air space opacity

A
  1. bronchoalveolar cell carcinoma
  2. alveolar cell proteinosis
  3. sarcoidosis
  4. lymphoma
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17
Q

interstitial lung disease

A

development of particles in the interstitium

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18
Q

interstitium

A

connective tissue, lymphatics, blood vessels, and bronchi that surround and support airspaces

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19
Q

three characteristics of interstitial lung disease

A
  1. reticular, nodular, or reticulonodular pattern
  2. packets of disease surrounded by normal lung
  3. can be focal of diffuse
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20
Q

define the reticular/nodular pattern found in interstitual lung disease

A

small, well defined white nodules and lines that cna be fine, thin, lacy densities

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21
Q

description of interstitial opacities based on pattern

A
  1. reticular (too many lines)
  2. nodular (too many dots)
  3. reticulonodular (too many lines and dots)
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22
Q

DDx for interstitial opacities

A
  1. idiopathic interstitial pnemonia
  2. infection
  3. pulmonary edema from CHF
  4. idiopathic pulmonary fibrosis
  5. environmental factors
  6. hemorrhage
  7. sarcoidosis
  8. tumor/metastases
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23
Q

in what disease would a miliary pattern appear on xray

A

tuberculosis

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24
Q

distinguish between a nodule and mass

A

nodule is any pulmonary radiographic lesion that is sharply defined, discrete, nearly circular, and less that 3cm

a mass is larger than 3cm

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25
descriptive terms for a nodule or mass
1. single vs multiple 2. size 3. border defintion 4. calcification 5. location
26
characteristics of benign nodules
1. can be slow or fast growing 2. usually round and less than 4cm 3. usually found in non smokers under 35 4. can be calcified 5. well definded edges
27
characteristics of malignant nodules
1. steady, predictable growth 2. larger than 5cm 3. can be smooth round or ill defined depending on source
28
how will primary lung cancer look on xray
ill defined, speculated, lobulation
29
how will hematologic mets look on x ray
multiple smooth round lung nodules often variable in size
30
how will lymphatic mets look on xray
more like interstitial lung disease
31
what is snowball sign used to do elaborate on how
determine if a mass or nodule comes from the lung or surrounding tissue if the snow ball is round, it is in the lung, if the snow ball is flat it is in the surrounding tissue
32
atelecatsis three types
collapse or volume loss obstructuve, compressive, subsegmental
33
what will atelectasis look on xray
white tissue due to lack of air volume
34
obstructuve ateleactasis
blocked bronchus causes reabsorption of air in the alveoli distal to the obstruction leading to collapse
35
compressive atelectasis
passive compression of the lung due to pleural effusion, pneumothorax, or space occupying mass
36
subsegmental atelectasis
lung collapse of part of a lung usually caused by patients not taking deep breaths, often related to surgery or pleuritic chest pain
37
signs of atelectatsis
1. displacement of the interlobar fissure toward the collapsed lobe 2. increased density of the affected lung 3. shift of mobile structures in the thorax 4. overinflation of the ipsilateral lobes and/or contralateral lung
38
what three structures in the thorax can shift due to atelectasis
trachea, heart, lungs
39
why can the ipsilateral lobes/contralateral lungs overinflate due to atelecatsis
there will be an attempt to overcompensate due to volume loss
40
what is the most common mediastinal mass
lymphadenopathy
41
four common causes of lymphadenopathy
1. lymphoma 2. metastatic carcinoma 3. sarcoidosis 4. TB
42
how will lymphadenopathy present on xray
medialstinal widening and hilar prominence
43
commonalities between blebs, bullae, cysts, and cavities four points of variation between them
all air and or fluid containing lesions in the lung 1. size 2. location 3. wall composition 4. fluid content
44
blebs
very small blister like lesions that form in the visceral pleura, usually in the apices
45
can blebs always be seen on CXR? what sequla is associated with blebs
not usually spontaenous pneumo
46
bullae
less than 1cm cavitys associated with emphysema, only partially visable on CXR
47
where are bullae found? why are they only partiall visable on CXR
lung parechyma very thin wall
48
cysts location defining characteristic
cavities that can be congential or acquired through infection occur in the lung parenchyma and mediastinum thin walled but larger than bullae (\<3mm)
49
cavity location wall characteristic description often includes what
variable in size and shape lung parenchyma wall greater than 3mm white soft tissue density ring with an air density center air fluid level
50
causes of lung cysts
abscesses, TB, carcinoma
51
signs to look for to indicate pneumothorax
1. symmetrical 2. lung markings to periphery 3. white visceral lines and bones
52
signs to look for in pleural effusion
blunting of the costophrenic angle movement of opacity
53
what should you do if you suspect pleural effusion or lung infiltrate
move the patient effusion will move in response to gravity infiltrate wont
54
signs of COPD or emphysema
1. hyperinflation 2. flattened diaphragm 3. heart appears smaller
55
why are lungs hyper inflated in COPD/Emphysema
air trapping due to incomplete expiration
56
barrel chest is a sign of what
COPD emphysema
57
what usually causes pneumopericardium
direct wound
58
air bronchogram
59
air bronchogram
60
normal vs alveolar opacity
61
right upper lung opacity
62
right middle lobe opacity
63
interstitial lung disease vs normal lung
64
linear interstitial disease
65
nodular interstitial disease
66
reticular interstitial disease
67
reticulonodular interstitial disease
68
interstitial lung disease from advanced pulmonary fibrosis
69
reticular intestitial disease
70
milliary intertstitial disease
71
differentiate between air space disease and interstitial lung disease in term of location in the lung
there is no difference both diesease can be in any zone
72
differentiate between air space disease and interstitial lung disease in term of appearance on CXR
ASD: confluent shadows with air bronchogram ILD: linear/reticular/nodular shadows
73
differentiate between conditions that will cause air space disease and interstitial lung disease to show up on CXR
ASD: fluid, pus, blood, tumors ILD: fluid or inflammation leading to fibrosis
74
what are four examples of disease that can lead to fibrosis/interstitial lung disease
1. industrial lung disease 2. inflammation 3. sarcoidosis
75
76
what is the probability of malignancy if a malignant lung nodule is larger that 5cm
95%
77
calcified nodules
78
nodule
79
nodule
80
how will subsegmental atelectasis look different from other atelectasis on CXR
linear densities parallel to diaphragm seen at the lung bases
81
what is a common cause of subsegmental atelecatasis two conditions that would lead to this
patients who arent taking deep breaths post-op patients or patients with pleuritic chest pain
82
T/F a small, acute atelectasis will create a larger overinflation of the the contralateral lung
false, a large or chronic atelectasis will produce a larger compensation
83
atelectasis
84
lymphadenopathy
85
lymphadenopathy
86
cyst with an air fluid level
87
cyst
88
what will definitely be visable on CXR in the case of pneumothorax
a white viseceral line at the periphery
89
what are two structures that can mimic pneumothorax how can they be differientated from pneumo
overlapping skin folds scapular border follow the lung markings
90
what should be ordered if you are unsure if there is a pneumo but have high clinical suspicion
get an expiratory film
91
pneumothorax on expiration
92
pneumothorax on inspiration
93
tension pneumo
94
tension pneumo
95
pleural effusion
96
pleural effusion
97
pleural effusion
98
COPD
99
COPD
100
COPD
101
COPD
102
pneumopericardium
103
pericardial effusion
104
mediastinal widening

Radiology (14 decks)

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