Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RRC DDx 2 > Chest > Flashcards

Chest Flashcards

1
Q

Cystic lung disease

A

LAM
LIP
LCH (late stage)
Light chain deposition disease (very rare)
Cystic metastases (e.g. sarcoma)
Pneumatocele from prior infection (pneumocystis, S.aureus, coccidioidomycosis; should resolve over time and not be so numerous as true cystic lung disease)
Birt-Hogg-Dube (very rare)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Centrilobular ground glass nodules

A 
HP
RB
Follicular bronchiolitis
Pulmonary capillary hemangiomatosis (cause of PAH)
Plexiform arteriopathy (must have PAH)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Localized multifocal tree-in-bud nodularity

A

Infectious bronchiolitis (endobronchial spread of infection)
Aspiration
Endobronchial spread of malignancy
Mucous impaction/inflammatory secretions in underlying congenital airway disorders: CF, PCD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Diffuse centrilobular tree-in-bud nodularity

A 
Infectious panbronchiolitis (endobronchial spread of infection) - airway
Inhalational panbronchiolitis (toxic/chemical) - airway
Foreign body granulomatosis - vascular
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Acute pure ground glass opacity

A
  1. Pulmonary edema (noncardiogenic)
  2. Hemorrhage (vasculitis-GPA; illicit drugs-cocaine/crack, meth)
  3. Infection (immunocompromised-PJP; viral-HSV, CMV, COVID; atypical-mycoPLASMA, chlamydia, legionella) – NOT CAP (staph/strep), mycobacteria, fungal
  4. Subacute HP
  5. Drug reaction (results in pulmonary edema, hemorrhage, pneumonitis)
  6. (Acute eosinophilic pneumonia: young females, poor prognosis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Chronic pure ground glass opacity

A
  1. Cellular NSIP (patchy, peripheral, peribronchovascular)
  2. DIP (usually lower zone involvement; smokers)
  3. LIP (classic also has cystic lung dz + hx CTD e.g. Sjogren’s)
  4. Chronic HP (especially if upper lobe fibrosis)
  5. Malignancy (adenocarcinoma spectrum of disease)
  6. Organizing pneumonia (peripheral or peribronchovascular - rare)
  7. Chronic eosinophilic pneumonia (peripheral)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Crazy paving - acute

A
  1. Pulmonary edema (cardiogenic, illicit drugs)
  2. Hemorrhage (vasculitis-GPA, Churg Strauss (EGPA), SLE, Goodpasture; illicit drugs-cocaine/crack; anticoagulants)
  3. Infection (immunocompromised-PJP; viral-HSV, CMV, COVID; atypical-mycoPLASMA, chlamydia, legionella)
  4. Drug reaction
  5. Acute eosinophilic pneumonia
  6. (ARDS (AIP/DAD) – if in ICU)

(Similar to acute GGO DDx except:

  • cardiogenic pulmonary edema vs. noncardiogenic
  • no subacute HP)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Crazy paving - chronic

A
  1. Pulmonary alveolar proteinosis
  2. Chronic pulmonary edema (cardiogenic)
  3. Lipoid pneumonia
  4. Invasive adenocarcinoma (NOT adenocarcinoma spectrum)
  5. Fibrotic NSIP (peripheral or peribronchovascular, e.g. not patchy or diffuse)
  6. Organizing pneumonia (peripheral or peribronchovascular)
  7. Chronic eosinophilic pneumonia (peripheral)
  8. (Alveolar sarcoidosis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Mosaic attenuation

A 
If hyperattenuating areas are abnormal - GGO DDx
If hypoattenuating areas are abnormal (vessels in abN lucent areas are too few in number or small in caliber) - “Mosaic perfusion”
1. Airway causes (abnormal ventilation -> reflex vasoconstriction)
*Small airway*
• Bronchiolitis obliterans
• Asthma
• COPD
• HP
• Chronic bronchitis/small airway infection/mucus plugging
*Large airway* 
• CF
• Bronchiectasis
2. Small vessel (vascular obstruction)
-Chronic PE
-Pulmonary arterial hypertension
-Vasculitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Multiple large nodules/opacities

A
  1. Malignancy (metastasis, multifocal primary bronchogenic carcinoma, lymphoma, Kaposi sarcoma)
  2. Atypical infection (fungal, mycobacteria)
  3. Wegener/GPA
  4. Sarcoidosis
  5. Organizing pneumonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Multifocal mass-like air space opacities

A
  1. Malignancy (metastasis, multifocal primary bronchogenic carcinoma, lymphoma, Kaposi sarcoma)
  2. Atypical infection (fungal, mycobacteria)
  3. Wegener/GPA
  4. Sarcoidosis
  5. Organizing pneumonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Multiple peribronchovascular opacities/consolidation

A
  1. Bronchopneumonia (bacterial, viral, mycobacterial, fungal)
  2. Aspiration
  3. Lymphoma/lymphoproliferative disorder
  4. Multifocal adenocarcinoma
  5. Organizing pneumonia
  6. Wegener/GPA
  7. Sarcoidosis
  8. Kaposi sarcoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Reverse halo sign/atoll sign

A 
Organizing pneumonia (classic)
Vasculitis: Wegener/GPA
Pulmonary infarction
Fungal (S.American paracoccidioidomycosis, Zygomycosis/mucormycosis)
COVID
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Halo sign

A 
Invasive fungus (aspergillosis-classic; mucormycosis)
Septic emboli
Hemorrhagic metastases
Viral: CMV, HSV
Vasculitis: Wegener/GPA
Organizing pneumonia (rare)
Eosinophilic pneumonia (rare)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Perilymphatic nodules

3 locations: subpleural, peribronchovascular, septal

A

Lymphangitic carcinomatosis
Lymphoma
Sarcoidosis
Silicosis & coal worker pneumoconiosis

Kaposi sarcoma (rare)
Lymphoid interstitial pneumonitis (rare) 
Amyloidosis (rare)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Miliary pulmonary nodules (on CXR)

A

Disseminated mycobacterial/fungal infection
Hematogenous metastases – papillary thyroid, pancreas, renal cell, melanoma
Pneumoconiosis – silicosis/CWP
Sarcoidosis

Miliary PJP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Bronchiectasis

A 
Postinfectious
- Bacterial: Pseudomonas, staph, pertussis
- Mycobacterial: TB, MAC
- Viral
- Mycoplasma
Immunodeficiency
- Congenital: SCID, hypogammaglobulinemia
- Acquired: HIV
Mucociliary clearance abnormality
- Cystic fibrosis (abnormal mucus)
- Primary ciliary dyskinesia (abnormal cilia)
- Young syndrome
Bronchial obstruction
- Bronchial atresia
- Endobronchial tumour
- Foreign body
- Chronic aspiration
Bronchial wall abnormality
- Mounier-Kuhn (1st-4th order)
- Williams-Campbell (4th-6th order)
Immune reactions
- ABPA
- Asthma
- Lung transplant rejection
- Graft vs. host disease
Systemic disease
- Alpha 1 antitrypsin deficiency
- Collagen vascular disease
- IBD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Organizing pneumonia/constrictive bronchiolitis causes

A

Post infectious: viral, bacterial, mycoplasma, PJP
Post toxic/inhalational injury: smoke, NO2
Connective tissue disorder: Sjogren, rheumatoid arthritis, SLE, scleroderma
Post transplant: lung, heart, heart-lung, bone marrow
Drug reaction: amiodarone, bleomycin, cyclophosphamide, methotrexate, nitrofurantoin
Idiopathic (i.e. COP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Reticulonodular opacities on CXR

A

Bronchiectasis/bronchial wall thickening
Emphysema/smoking-related changes with superimposed acute airspace disease
Langerhans cell histiocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Peripheral airspace disease / reverse batwing

A

Organizing pneumonia
Chronic eosinophilic pneumonia
Sequela of extensive pulmonary thromboembolic disease / pulmonary infarcts

(Infection: COVID)
(Vasculitis)
(Multifocal adenocarcinoma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Focal interlobular septal thickening

A

Lymphangitic carcinomatosis
Lymphoma
Kaposi sarcoma
Sarcoidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Mediastinal adenopathy

A 
Lymphoma
Metastasis
Infection – mycobacterial/fungal
Sarcoidosis
(Castleman, etc.)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Irregular opacity diffuse lung disease – “Dog’s breakfast DDx”

A 
Diffuse malignancy
- Multifocal primary 
- Disseminated pulmonary lymphoma
- Not metastasis
Atypical disseminated infection
Organizing pneumonia
24
Q

Cavitary lesion

A

Cavitary neoplasm – metastasis, primary bronchogenic cancer, invasive adenocarcinoma, lymphoma
Infection – mycobacterial/fungal, septic emboli, nocardia/actinomyces
Vasculitis – Wegener

Rheumatoid arthritis
Tracheobronchopapillomatosis (peribronchovascular)
Langerhans cell histiocytosis

If solitary cavitary lesion, add: congenital (sequestration, CPAM, bronchogenic cyst)

25
Q

Pulmonary necrosis without abscess formation

A

Necrotic malignancy – melanoma, colorectal, etc.
Necrotic infection – mycobacterial/fungal, Actinomycosis, Nocardia
Vasculitis – Wegener

26
Q

Upper lung zone predominant fibrosis/honeycombing

A 
Chronic hypersensitivity pneumonitis
Sarcoidosis
UIP in atypical distribution
Fibrosing organizing pneumonia/DAD
TB
Ankylosing spondylitis
27
Q

Fibrotic NSIP pattern of lung injury

A

Connective tissue disorders
Drug toxicity
Idiopathic

Sequela of hypersensitivity pneumonitis
Consequence of prior diffuse alveolar damage

28
Q

Headcheese

A

HP
Smoking + DIP
Mycoplasma

29
Q

Wandering opacities

A 
Vasculitis (Churg-Strauss)
Acute eosinophilic pneumonia
Organizing pneumonia
If ground glass:
- HP
- DIP
30
Q

Multiple calcified pulmonary nodules

A

Calcified pulmonary metastases
Histoplasmosis
Silicosis
Healed varicella pneumonia

31
Q

Calcified pulmonary metastases

A 
Papillary thyroid carcinoma 
Osteosarcoma
Chondrosarcoma
Synovial sarcoma
Giant cell tumour
Adenocarcinoma: colon, ovary, breast
Treated choriocarcinoma
32
Q

Persistent airspace opacity

A

Suboptimally treated pneumonia / atypical infection
Post-obstructive pneumonia
Malignancy: invasive adenocarcinoma, lymphoma
Chronic eosinophilic pneumonia
Organizing pneumonia

33
Q

Unilateral pulmonary edema

A

Mitral valve regurgitation
Re-expansion pulmonary edema
Pulmonary vein stenosis

34
Q

Random nodules

A 
Mycobacterial/fungal infection
Hematogenous metastases (papillary thyroid, pancreatic, RCC, melanoma)
35
Q

Lower lung fibrosis

A

UIP
Fibrotic NSIP
Asbestosis

36
Q

Chronic ground glass + lung cysts

A

PJP
LIP
DIP

37
Q

Endobronchial lesions

A

Malignant primary (SCC, carcinoid, adenoid cystic, mucoepidermoid)
Mets (CKMB – colon, kidney, melanoma, breast) / lymphoma
Papilloma
Non-neoplastic (mucous plug, foreign body)

38
Q

Tracheal wall thickening

A

Sparing posterior membrane
- Relapsing polychondritis
- Tracheobronchopathia osteochondroplastica
Circumferential long segment (amyloid, GPA, TB, sarcoid, malignancy/SCC)
Circumferential short segment (post-intubation, malignancy/SCC)

39
Q

UIP causes

A

Connective tissue disease (esp. RA)
Asbestosis
Drug reaction
Idiopathic pulmonary fibrosis

40
Q

NSIP causes (requires subpleural sparing to come down hard)

A 
Connective tissue disease (esp. scleroderma)
HP (as a cause of fibrotic NSIP)
Drug toxicity
Consequence of DAD
Idiopathic
41
Q

Drugs that cause lung injury

A 
ABC MN
Amiodarone
Bleomycin
Cyclophosphamide
Methotrexate
Nitrofurantoin
42
Q

Anterior mediastinal mass

A

Tumour of thymic origin (thymoma / thymic Ca, thymolipoma)
Germ cell tumor
Lymphoma or other causes of adenopathy, such as metastases or infection
Goiter
Aneurysm

43
Q

Solid middle mediastinal mass

A

Neoplasm (esophagus, cardiac / pericardial, vagal / phrenic nerves)
Adenopathy
Varices / aneurysm

44
Q

Cystic middle mediastinal mass

A

Cyst (foregut duplication, bronchogenic, pericardial, neurenteric)
Collection
Echinococcus
Pancreatic pseudocyst

45
Q

Posterior mediastinal mass

A

Primary neoplasm (PNST, ganglio-neuro-blastoma spectrum, sarcoma)
Metastatic LAD / lymphoma
Paraspinal collection (abscess / phlegmon in discitis/osteomyelitis, hematoma)
Neurenteric cyst / meningocele
Extramedullary hematopoiesis

46
Q

Fat containing anterior mediastinal mass

A

Teratoma
Thymolipoma
Liposarcoma

47
Q

Cardiophrenic angle mass

A 
Pericardial fat pad
Pericardial cyst
Diaphragmatic hernia
Adenopathy
Mediastinal masses
48
Q

Low density adenopathy

A

Necrotic malignant adenopathy
Lymphoma
Infection: Mycobacterial / fungal
Whipple’s disease

49
Q

High density adenopathy

A

Hypervascular metastases
Castleman’s disease
Kaposi’s

50
Q

Calcified adenopathy

A 
Prior granulomatous infection
Sarcoidosis
Pneumoconioses
Papillary thyroid cancer mets
Treated lymphoma
Fibrosing mediastinitis
51
Q

Pleural mass

A

Mesothelioma
Mets / lymphoma
Solitary fibrous tumor

52
Q

Unilateral hyperlucent lung

A

Chest wall (mastectomy, Poland syndrome)
Pleura (pneumothorax in supine patient)
Pulmonary artery (unilateral pulmonary artery obstruction / interruption)
Airways (bronchial obstruction / dysplasia)
Parenchyma (Swyer-James, congenital lobar overinflation, compensatory hyperinflation)

53
Q

Unilateral hyperdense lung

A

Unilateral effusion in supine patient

Upper lobe atelectasis

54
Q

Chest wall mass

A

Primary neoplasm (pleural, osseous, soft tissue)
Mets / myeloma / lymphoma
Collection
Invasive infection (nocardia / actinomyces / mycobacterial / fungal)

55
Q

Unilateral effusion

A

PE (also peripheral opacity or subsegmental atelectasis)
Malignancy
Pneumonia

RRC DDx 2 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions