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Chest Imaging > Airways disease and emphysema > Flashcards

Airways disease and emphysema Flashcards

1
Q

normal pattern of tracheal branching in pigs, consists of an accessory bronchus to all or a portion of the right upper lobe that arises from the lateral tracheal wall within 2cm of tracheal carina

A

tracheal bronchus or bronchus suis

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2
Q

tracheal bronchus most often supplies what lung segment

A

right upper lobe

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3
Q

characterized by atresia of a segmental or subsegmental bronchus with a normal distal airway

A

bronchial atresia

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4
Q

caused by congenital or acquired abnormalities of the elastic membrane or cartilaginous rings of the trachea

A

focal tracheal dilatation

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5
Q

aka paratracheal air cysts, which may be congenital or acquired

A

tracheoceles

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6
Q

tracheoceles occur almost exclusively in the______ trachea because the pressure gradient from the extrathoracic trachea to the atmosphere with the Valsalva maneuver favors their formation in this region

A

cervical

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7
Q

circular lucencies along the right posterolateral trachea at the thoracic inlet in CT may represent

A

tracheoceles

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8
Q

most common cause of extrinsic mass effect on the trachea is a

A

tortuous or dilated aortic arch or brachiocephalic artery

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9
Q

Presents as a typical hourglass deformity of trachea on frontal radiography

A

Tracheal stenosis

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10
Q

Patients with extrathoracic tracheomalacia, most often at the site of a prior tracheostomy, demonstrate tracheal narrowing on inspiration or expiration?

A

Inspiration

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11
Q

Patients with intrathoracic tracheomalacia usually from prior endotracheal intubation, have tracheal narrowing on inspiration or expiration?

A

Expiration

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12
Q

This entity can produce a necrotizing granulomatous inflammation of the tracheal and central bronchi, leading to focal cervical narrowing, or in advanced disease, narrowing of the entire length of trachea. Its diagnosis is made by radiographic demonstration of tracheal narrowing in association with upper airway and renal involvment and characteristic findings on biopsy

A

Granulomatosis with polyangitis

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13
Q

Endotracheal and endobronchial tb are usually associated with

A

Cavitary tb

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14
Q

tracheal scleroma is a chronic granulomatous disorder caused by infection with

A

Klebsiella rhinoscleromatis

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15
Q

diffuse tracheal narrowing may be seen with what tracheal conditions

A

saber-shealth trachea, amyloidosis, tracheobronchopathia, osteochondroplastica, relapsing polychondritis, GPA or tracheal scleroma

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16
Q

can cause diffuse tracheal narrowing but is mostly seen in the cervical trachea

A

GPA or tracheal scleroma

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17
Q

rare condition in which there is incomplete septation of the cartilage rings, producing a long segment tracheal narrowing or “napkin ring” trachea

A

congenital tracheal stenosis

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18
Q

congenital tracheal stenosis is often associated with other congenital cardiovascular anomalies in particular,

A

anomalous origin of left PA from right PA (PA sling)

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19
Q

a fixed deformity of the intrathoracic trachea in which the coronal diameter is diminished to less than 2/3 of the sagittal diameter

A

saber-sheath trachea

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20
Q

saber sheath trachea commonly affects

A

older men with COPD

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21
Q

causes mass-like circumferential deposits that irregularly narrow the tracheal lumen seen in CT. It is characterized by deposition of a fibrillar protein polysaccharide complex in various organs

A

amyloidosis

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22
Q

rare disorder characterized by the presence of multiple submucosal osseous and cartilaginous deposits within the trachea abd central bronchi or elderly men. the lesions arise as enchondromas from the tracheal and bronchial cartilage, and then project internally to produce nodular submucosal deposits that irregularly narrow the tracheal tumen and have a characteristic appearance and feel on bronchoscopy

A

tracheobronchopathia osteochondroplastica

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23
Q

helpful feature in tracheobronchopathia osteochondroplastica that distinguishes this from tracheobronchial amyloid

A

calcified plaques that can be seen involving the anterior and lateral walls of trachea, with sparing of membranous posterior walls of the trachea which lacks cartilage

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24
Q

common associated finding in saber-sheath trachea

A

upper lobe emphysema

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25
Q

systemic autoimmune disorder that commonly affects the cartilage of the earlobes, nose, larynx, tracheobronchial tree, joints and large elastic arteries

A

relapsing polychondritis

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26
Q

early in the disease, tracheal wall inflammation associated with cartilage destruction leads to an abnormally compliant and dilated trachea. Later in the disease, fibrosis leads to diffuse fixed narrowing of trachal lumen

A

relapsing polychondritis

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27
Q

diagnosis is made by noting recurrent inflammation at two or more cartilaginous sites, most commonly the pinnae of the ear (producing cauliflower ears) and the bridge of the nose (producing saddle nose deformity)

A

relapsing polychondritis

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28
Q

congenital disorder of the elastic and smooth muscle components of the tracheal wall

A

tracheobronchomegaly (Mounier-Kuhn syndrome)

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29
Q

tracheobronchomegaly is associated with

A

ehler-danlos syndrome

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30
Q

In tracheobronchomegaly, trachea and central bronchi meaures

A

Greater than 3.0 and 2.5 cm respectively in coronal diameter

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31
Q

Congenital or acquired defect of tracheal cartilage causing soft ess of tracheal cartilage rings and a tendency for airway collapse

A

Tracheobronchomalacia

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32
Q

Congenital disorders most often associated with tracheobronchomalacia

A

Relapsing polychondritis, ehler danlos syndrome, mucopolysaccharidosis

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33
Q

May result from prolonged intubation, prior tracheostomy and extrinsic tracheal compression by mediastinal masses and vascular anomalies

A

Tracheobronchomegaly

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34
Q

Excessive airway collapse of trachea on expiration, seen best on dynamic expiratory CT using low dose CT acquisition performed during forced expiratory maneuver are imaging features of

A

Tracheobronchomegaly

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35
Q

A reduction in the cross-sectional area of the trachea exceeding 50% on the expiratory CT, particularly if there is a crescentic “frown-like” configuration to the trachea in cross section should suggest what diagnosis

A

Tracheobronchomegaly

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36
Q

“Lunate”-shaped trachea, in which the coronal diameter of the trachea exceeds the sagittal diameter on axial CT obtained at normal inspiration

A

Tracheobronchomegaly

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37
Q

Tracheal and bronchial fractures generally involve what part of bronchial tree

A

Proximal main bronchi (80%) or distal trachea (15%) within 2cm from the carina

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38
Q

Most common form of tracheal and bronchial injury

A

Horizontal laceration or transection parallel to the tracheo bronchial cartilage

39
Q

Presence of calcified material within the tracheobronchial tree, develops from the erosion of a calcified peribronchial lymph node into the bronchial lumen

A

Broncholithiasis

40
Q

Broncholiths may occlude the airway and lead to

A

Bronchiectasis, obstructive atelectasis or pneumonia

41
Q

Diseases known collectively as COPD include

A

Asthma, chronic bronchitis, bronchiectasis and emphysema

42
Q

Common pathophysiology in COPD

A

Obstruction to expiratory airflow

43
Q

Airway disorder charcterized by rapid onset of bronchial narrowing with spontaneous resolution or improvement as a result of therapy

A

Asthma

44
Q

Radiographic findings in uncomplicated asthma are primarily the result of

A

Diffuse airway narrowing

45
Q

Results from excessive production of IgE following exposure to antigenic stimuli, resulting in bronchial smooth muscle contraction, bronchial wall inflammation, excessive mucus production

A

Asthma

46
Q

Hyperinflation producing increased lung volume, flattening or inversion of the diaphragm, attenuation of the peripheral vascular markings and prominence of retrosternal airspace is the result of

A

Expiratory air trapping

47
Q

Bronchial wall inflammation and thickening appear radiographically as

A

Peribronchial cuffing and tram tracking

48
Q

Defined as the excess production and expectoration of sputum that occurs on most days for atleast 3 consecutive months in at leasr 2 consecutive years

A

Chronic bronchitis

49
Q

Commonly affected lobes in chronic bronchitis

A

Lower lobe bronchi

50
Q

Abnormal permanent dilatation of bronchi

A

Bronchiectasis

51
Q

3 morphologic groups of bronchiectasis

A

Cylindrical, varicose, cystic (saccular)

52
Q

Type of bronchiectais Characterized by mild diffuse dilatation of the bronchi

A

Cylindrical

53
Q

Cystic bronchial dilatation interrupted by focal areas of narrowing, an appearance that has been likened to a string of pearls

A

Varicose bronchiectasis

54
Q

Appears as clusters of bronchi with marked localized saccular dilatation

A

Cystic bronchiectasis

55
Q

Characteristic appearance of multiple peripheral thin-walled cysts, with or without air-fluid levels that tend to cluster together in the distribution of a bronchovascular bundle is seen in

A

Ctstic bronchiectasis

56
Q

Bronchiectatic changes are usually central or peripheral?

A

Peripheral

57
Q

Central bronchiectasis is seen only in

A

Allergic bronchopulmonary aspergillosis, cystic fibrosis, bronchial atresia, acquired central bronchial obstruction

58
Q

Triad of kartagener syndrome

A

Sinusitis, situs inversus, bronchiectasis

59
Q

Post infectious bronchiectasis results from severe childhood pneumonia, usually from what organisms or viruses

A

Adenovirus, measles, pertussis

60
Q

Allergic bronchopulmonary aspergillosis represents a hypersensitivity reaction to aspergillus antigens and is characterized clinically by

A

Asthma, blood eosinophilia, bronchiectasis, with mucus plugging and circulating antibodies to aspergillus antigen

61
Q

Term used to describe the effect of severe pulmonary fibrosis on the peripheral airways

A

Traction bronchiectasis

62
Q

Traction bronchiectasis occurs commonly in what lobes

A

Upper lobes

63
Q

Defined as an abnormal, permanent enlargement of the airspaces distal to the terminal bronchiole, accompanied by destruction of alveolar walls and without obvious fibrosis

A

Emphysema

64
Q

Most common emphysema and is characterized by airspace distension in the central portion of the lobule, with sparing of the more distal portions of the lobule

A

Centrilobular emphysema

65
Q

Centrilobular emphysema affects what lobe

A

Upper lobes more than the lower lobes

66
Q

Results in uniform distention of the airspaces throughout the substance of the lobule, from the central respiratory bronchioles to the peripheral alveolar sacs and alveoli

A

Panlobular emphysema

67
Q

Panlobular emphysema has predilection to what lobe

A

Lower lobes

68
Q

Seen as selective distention of peripheral airspaces adjacent to interlobular septa, with sparing of the centrilobular region. It is most often seen in the immediate subpleural regions of upper lobes

A

Paraseptal emphysema

69
Q

Type of emphysema that may coalesce to form apical bullae; rupture of these bullae into the pleural space may give rise to spontaneous pneumothoraces

A

Paraseptal emphysema

70
Q

Refers to destruction of lung tissue associated with fibrosis that bears no consistent relationship to a given portion of the lobules

A

Paracicatricial or irregular emphysema

71
Q

Form of emphysema that is most often seen in association with old granulomatous inflammation

A

Paracicatricial or irregular emphysema

72
Q

Deficiency of serum protein alpha 1 antitrypsin (alpha 1 antiprotease inhibitor) and the development of what form of emphysema is well established

A

Panlobular emphysema

73
Q

Functional hallmarks of emphysema

A

Decreased airflow and diffusing capacity

74
Q

Most important plain radiographic finding and reflects the loss of lung elastic recoil

A

Hyperinflation

75
Q

In emphysema, loss of pulmonary capillary bed; associated chronic hypoxemia causes increased pulmonary vascular resistance manifests as

A

Enlarged central PAs; right heart enlargement (centrilobular)

76
Q

In emphysema, presence of increased peripheral vascular markings (centrilobular) is due to

A

Small airways disease, increased pulmonary vascularity

77
Q

treatment for emphysema

A

lung volume reduction surgery

78
Q

this surgical procedure specifically benefits those with mostly upper lobe emphysema and low exercise capacity prior to surgery

A

lung volume reduction surgery

79
Q

alterantive treatment for patients with emphysema, particularly younger patients with alpha 1 antitrypsin deficiency is

A

single or double lung transplantation

80
Q

thin walled cystic spaces that exceed 1 cm in diameter and are found within the lung parenchyma

A

bullae

81
Q

most often represent confluent areas of emphysematous lung and may be seen as part of generalized emphysema

A

bullae

82
Q

rare cause of lung cysts or bullae is ____, which is an autosomal dominant disorder characterized by skin fibrofolliculomas, malignant renal tumors, and thin-walled lung cysts, the latter predisposing to spontaneous pneumothorax

A

Birt-Hogg-Dube syndrome

83
Q

an accelerated form of paraseptal emphysema seen in young adult men; can also be associated with primary bullous disease

A

vanishing lung syndrome

84
Q

non-cartilage bearing bronchioles with a luminal diamter of <2 mm

A

small airways disease

85
Q

direct signs of small airway disease include

A

centrilobular nodules, centrilobular tree-in-bud opacities

86
Q

indirect CT signs of small airways disease include

A

proximal bronchial dilatation, hyperlucent regions due to expiratory air trapping

87
Q

pneumocystic jiroveci produce what opacities

A

geographic ground-glass opacification

88
Q

refers to an inflammation of the small airways

A

bronchiolitis

89
Q

infectious bronchiolitis in children are due to

A

RSV or adenovirus

90
Q

form of bronchiolitis which reflecs a form of diffuse lymphoid hyperplasia of peribronchiolar lymphoid follicles of unclear clinical significance seen in patients with RA or sjogren syndrome

A

follicular bronchiolitis

91
Q

aka bronchiolitis obliterans, is a subacute disease characterized pathologically by a mononuclear cell inflammatory process within the walls of respiratory bronchiles that leads to the formation of granulation tissue which plugs small airways

A

constrictive bronchiolitis

92
Q

because postinfectious bronchiolitis obliterans affects the lungs asymmetrically and usually occyrs during a period of lung growth and development, the affected lung is typically small and hyperlucent and the ipsilateral PA is hypoplastic. These findings describe what syndrome

A

Swyer-James syndrome

93
Q

rare form of constrictive bronchiolitis which is seen in middle-aged women who demonstrate severe airflow limitation and CT findings of air trapping with bronchial thickening and dilatation in association with one or multiple small nodules representing neuroendocrine cell tumorlets or inf the nodules are > 5 mm diameter, carcinoid tumors

A

diffuse idiopathic pulmonary neuroendocrine cell hyperplasia

Chest Imaging (9 decks)

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