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Chest Imaging > Chapman & Nakielny > Flashcards

Chapman & Nakielny Flashcards

1
Q

What is the definition of bronchiectasis?

A

Permanent (localized or diffuse) airway dilatation and is more reliably identified on CT

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2
Q

What are the 3 most common causes of bronchiectasis?

A

Post-infective (TB, Mycobacterium, Chronic aspiration)
Traction bronchiectasis
Cystic fibrosis

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3
Q

What is a distinguishing finding of Mounier-Kuhn syndrome?

A

Grossly dilated trachea, often > 3cm

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4
Q

Name 3 differential diagnosis for increased density of one hemithorax with undisplaced mediastinum

A

Consolidation
Pleural effusion
Malignant pleural mesothelioma

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5
Q

Name 3 differential diagnosis for increased density of one hemithorax with mediastinal displacement away from the dense hemithorax

A

Large pleural effusion
Large intrathoracic tumor
Diaphragmatic hernia

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6
Q

What is the most common cause of increased density of one hemithorax with mediastinal displacement towards the dense hemithorax?

A

Atelectasis

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7
Q

Which pneumonia-causing organism has a high propensity for cavitation?

A

Klebsiella

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8
Q

The “bulging fissure” sign is associated with which organism?

A

Klebsiella

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9
Q

Coccidioidomycosis has a propensity for which lobes?

A

Multiple pulmonary nodules in the upper lobes, cavitation and calcification may be present

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10
Q

Which 2 conditions can present with bilateral pulmonary nodules with cavitations?

A

Wegeners granulomatosis

Rheumatoid nodules

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11
Q

The “water lily” sign is associated with what pathology?

A

Ruptured hydatid cyst, usually seen with the lower lobes

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12
Q

The “comet tail” sign is associated with what pathology?

A

Rounded atelectasis

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13
Q

In the setting of an apical mass, always look for associated _____

A

Adjacent rib destruction

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14
Q

Klebsiella pneumonia is more common in the _____ lobes

A

Upper lobes

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15
Q

What are 3 causes of post-infective pulmonary cysts?

A

Bacterial pneumonia
Pneumocystic jirovecii
Hydatid cyst

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16
Q

Lymphangioleiomyomatosis (LAM) is exclusively seen in what population?

A

Women of childbearing age

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17
Q

Sarcoidosis typically presents with what pattern of bilateral hilar enlargement?

A

Symmetrical and lobulated lymphadenopathy

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18
Q

Lymphoma typically presents with what pattern of bilateral hilar enlargement?

A

Asymmetrical

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19
Q

“Egg-shell” calcifications of lymph nodes are seen in which conditions?

A

Silicosis (approximately 5%)
Coal worker’s pneumoconiosis
Sarcoidosis (approximately 5%)
Lymphoma (1-9 years post therapy)

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20
Q

What are 3 causes of bilateral transudative pleural effusion?

A

Cardiac failure
Hepatic failure
Renal failure (especially nephrotic syndrome)

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21
Q

What are 4 causes of exudative pleural effusion?

A

Infection
Malignancy (primary/metastatic)
Collagen vascular disorder (eg. SLE, rheumatoid arthritis)
Pulmonary infarction

22
Q

Describe pleural effusion associated with pancreatitis

A

Predominantly left-sided
Acute/chronic/relapsing
Elevated amylase content

23
Q

Describe the other findings of pleural effusion associated with Meigs syndrome

A

Predominantly right-sided
Ascites
Benign ovarian tumor (typically fibroma)

24
Q

Stannosis is associated with inhalation of what kind of material?

A

Tin dust and fumes

25
Q

What is the most common cause of pleural calcification?

A

Asbestos exposure

26
Q

Describe the preferred location of pleural plaques associated with asbestosis exposure

A

Adjacent to anterior ribs
Along the superior margin of diaphragms
Usually bilateral

27
Q

What are 3 differential diagnosis for a focal pleural mass?

A

Loculated pleural effusion/empyema
Metastasis (eg. from breast/lung)
Malignant mesothelioma (usually diffuse but can be focal)

28
Q

Spontaneous pneumothorax are usually caused by what?

A

Ruptured blebs/bullae
M > F
More prevalent in tall, thin patients

29
Q

What is the most common cause of unilateral hemidiaphragm elevation?

A

Phrenic nerve palsy

30
Q

What is the most common cause of bilateral hemidiaphragm elevation?

A

Poor inspiration effort

31
Q

What is the most common benign rib lesion?

A

Fibrous dysplasia

32
Q

What is most likely to cause rib expansion and cortical thickening?

A

Pagets disease

33
Q

What is the most common cause of a focal rib lesion?

A

Healed rib fracture

34
Q

What has to be considered when there is a rib lesions?

A

Rib metastasis (eg. from lung, kidney, prostate, or breast)

35
Q

If a sternum fracture is present, what other fractures must be ruled out?

A

Thoracic spine fractures

36
Q

The “oreo cookie sign” is associated with what finding of the heart?

A

Pericardial effusion, seen on the lateral chest radiograph

37
Q

What is the most common primary cardiac tumor in adults?

A

Myxoma (benign)

38
Q

What is the most common primary cardiac neoplasm in children?

A

Rhabdomyoma

Presents in infancy/prenatal in most cases

39
Q

What is the most common location for a rhabdomyoma of the heart?

A

Left/Right ventricle > atrium

40
Q

Name 3 of the most common malignant tumors of the heart

A

Metastasis
Primary sarcoma (angiosarcoma is the most common)
Primary lymphoma

41
Q

Kawasaki disease is known to cause what?

A

Coronary artery aneurysms with/without stenosis

42
Q

Behcet disease and Hughes-Stovin syndrome are both known to cause what?

A

Pulmonary artery aneurysms

43
Q

Which part of the aorta is most commonly involved in an aneurysm associated with Marfans syndrome?

A

Ascending aorta

44
Q

Rhabdomyomas of the heart has a strong associating with which disease?

A

Tuberous sclerosis

45
Q

What are some causes of inferior surface rib notching?

A

Coarctation of the aorta
Proximal subclavian artery occlusion
Neurofibromatosis
Schwannoma

46
Q

What are some cause of superior surface rib notching?

A

Connective tissue disorders (eg. RA, SLE, Scleroderma, Marfans syndrome)
Hyperparathyroidism
Osteogenesis imperfecta

47
Q

Where would you see the “sail” sign of the thymus?

A

Radiographs of infants/young children
A triangular projection to one/both sides of the mediastinum (typically right-side)
Inconsistently seen after 2-3 years old

48
Q

What is the most common benign germ cell tumor of the mediastinum?

A

Teratomas (60%)

49
Q

What is the normal position of the cardiac apex?

A

Levocardia (left-side)

50
Q

What is a mesocardia?

A

Cardiac apex at the midline

51
Q

What is a dextrocardia?

A

Cardiac apex on the right-side

Chest Imaging (3 decks)

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