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Radiology > abnormal chest > Flashcards

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
Q

descriptive terms for a nodule or mass

A
  1. single vs multiple
  2. size
  3. border defintion
  4. calcification
  5. location
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26
Q

characteristics of benign nodules

A
  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
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27
Q

characteristics of malignant nodules

A
  1. steady, predictable growth
  2. larger than 5cm
  3. can be smooth round or ill defined depending on source
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28
Q

how will primary lung cancer look on xray

A

ill defined, speculated, lobulation

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29
Q

how will hematologic mets look on x ray

A

multiple smooth round lung nodules often variable in size

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30
Q

how will lymphatic mets look on xray

A

more like interstitial lung disease

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31
Q

what is snowball sign used to do

elaborate on how

A

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

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32
Q

atelecatsis

three types

A

collapse or volume loss

obstructuve, compressive, subsegmental

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33
Q

what will atelectasis look on xray

A

white tissue due to lack of air volume

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34
Q

obstructuve ateleactasis

A

blocked bronchus causes reabsorption of air in the alveoli distal to the obstruction leading to collapse

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35
Q

compressive atelectasis

A

passive compression of the lung due to pleural effusion, pneumothorax, or space occupying mass

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36
Q

subsegmental atelectasis

A

lung collapse of part of a lung usually caused by patients not taking deep breaths, often related to surgery or pleuritic chest pain

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37
Q

signs of atelectatsis

A
  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
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38
Q

what three structures in the thorax can shift due to atelectasis

A

trachea, heart, lungs

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39
Q

why can the ipsilateral lobes/contralateral lungs overinflate due to atelecatsis

A

there will be an attempt to overcompensate due to volume loss

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40
Q

what is the most common mediastinal mass

A

lymphadenopathy

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41
Q

four common causes of lymphadenopathy

A
  1. lymphoma
  2. metastatic carcinoma
  3. sarcoidosis
  4. TB
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42
Q

how will lymphadenopathy present on xray

A

medialstinal widening and hilar prominence

43
Q

commonalities between blebs, bullae, cysts, and cavities

four points of variation between them

A

all air and or fluid containing lesions in the lung

  1. size
  2. location
  3. wall composition
  4. fluid content
44
Q

blebs

A

very small blister like lesions that form in the visceral pleura, usually in the apices

45
Q

can blebs always be seen on CXR?

what sequla is associated with blebs

A

not usually

spontaenous pneumo

46
Q

bullae

A

less than 1cm cavitys associated with emphysema, only partially visable on CXR

47
Q

where are bullae found?

why are they only partiall visable on CXR

A

lung parechyma

very thin wall

48
Q

cysts

location

defining characteristic

A

cavities that can be congential or acquired through infection

occur in the lung parenchyma and mediastinum

thin walled but larger than bullae (<3mm)

49
Q

cavity

location

wall characteristic

description

often includes what

A

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
Q

causes of lung cysts

A

abscesses, TB, carcinoma

51
Q

signs to look for to indicate pneumothorax

A
  1. symmetrical
  2. lung markings to periphery
  3. white visceral lines and bones
52
Q

signs to look for in pleural effusion

A

blunting of the costophrenic angle

movement of opacity

53
Q

what should you do if you suspect pleural effusion or lung infiltrate

A

move the patient effusion will move in response to gravity infiltrate wont

54
Q

signs of COPD or emphysema

A
  1. hyperinflation
  2. flattened diaphragm
  3. heart appears smaller
55
Q

why are lungs hyper inflated in COPD/Emphysema

A

air trapping due to incomplete expiration

56
Q

barrel chest is a sign of what

A

COPD emphysema

57
Q

what usually causes pneumopericardium

A

direct wound

58
Q
A

air bronchogram

59
Q
A

air bronchogram

60
Q
A

normal vs alveolar opacity

61
Q
A

right upper lung opacity

62
Q
A

right middle lobe opacity

63
Q
A

interstitial lung disease vs normal lung

64
Q
A

linear interstitial disease

65
Q
A

nodular interstitial disease

66
Q
A

reticular interstitial disease

67
Q
A

reticulonodular interstitial disease

68
Q
A

interstitial lung disease from advanced pulmonary fibrosis

69
Q
A

reticular intestitial disease

70
Q
A

milliary intertstitial disease

71
Q

differentiate between air space disease and interstitial lung disease in term of location in the lung

A

there is no difference both diesease can be in any zone

72
Q

differentiate between air space disease and interstitial lung disease in term of appearance on CXR

A

ASD: confluent shadows with air bronchogram

ILD: linear/reticular/nodular shadows

73
Q

differentiate between conditions that will cause air space disease and interstitial lung disease to show up on CXR

A

ASD: fluid, pus, blood, tumors

ILD: fluid or inflammation leading to fibrosis

74
Q

what are four examples of disease that can lead to fibrosis/interstitial lung disease

A
  1. industrial lung disease
  2. inflammation
  3. sarcoidosis
75
Q
A
76
Q

what is the probability of malignancy if a malignant lung nodule is larger that 5cm

A

95%

77
Q
A

calcified nodules

78
Q
A

nodule

79
Q
A

nodule

80
Q

how will subsegmental atelectasis look different from other atelectasis on CXR

A

linear densities parallel to diaphragm seen at the lung bases

81
Q

what is a common cause of subsegmental atelecatasis

two conditions that would lead to this

A

patients who arent taking deep breaths

post-op patients or patients with pleuritic chest pain

82
Q

T/F a small, acute atelectasis will create a larger overinflation of the the contralateral lung

A

false, a large or chronic atelectasis will produce a larger compensation

83
Q
A

atelectasis

84
Q
A

lymphadenopathy

85
Q
A

lymphadenopathy

86
Q
A

cyst with an air fluid level

87
Q
A

cyst

88
Q

what will definitely be visable on CXR in the case of pneumothorax

A

a white viseceral line at the periphery

89
Q

what are two structures that can mimic pneumothorax

how can they be differientated from pneumo

A

overlapping skin folds

scapular border

follow the lung markings

90
Q

what should be ordered if you are unsure if there is a pneumo but have high clinical suspicion

A

get an expiratory film

91
Q
A

pneumothorax on expiration

92
Q
A

pneumothorax on inspiration

93
Q
A

tension pneumo

94
Q
A

tension pneumo

95
Q
A

pleural effusion

96
Q
A

pleural effusion

97
Q
A

pleural effusion

98
Q
A

COPD

99
Q
A

COPD

100
Q
A

COPD

101
Q
A

COPD

102
Q
A

pneumopericardium

103
Q
A

pericardial effusion

104
Q
A

mediastinal widening

Radiology (14 decks)

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