Chest

Question 1

Hemoptysis

Answer 1

Congenital: Cystic fibrosis (bronchiactasis)

Noeplastic

Infectious: TB, acute bronchitis,..

Inflammatory: Chronic bronchitis, Bronchiectasis

Idiopathic

Question 2

Cystic Anterior Mediastinal Mass

4 C

N

Inf

Answer 2

Pure cysts (no wall or enhancing rim):

• pericardial(RT)
• thymic(LT, no fat plane with thym)
• bronchogenic (thn wll, @carina / cntrl brnch)
• loculated effusion (other findings)

cystic neoplasm

abscess

Question 3

End of vessel nodules

Answer 3

Infection: Septic emboli

Vascular:

• vasculitis: Wegners
• AVM’s

Neopl: Mets

Question 4

Tracheobronchomegaly

DDx

Answer 4

1. Mounier-Kuhn syndrome

Abscent elastic fibers trachea, 1st to 4th order bronchi

Usually sporadic idiopathic

Tracheal diameter > 27 mm in men and > 23 mm in women

Recurrent pulmonary infections; bronchiectasis

Corrugated trachea, best on lateral
Airways dilate on inspiration, collapse on expiration
Hyperinflation and emphysema
Thinning of the tracheal wall

2. Ehlers-Danlos syndrome
   Inherited connective tissue disorder
   One subtype has tracheal and bronchial dilation
   Pulmonary artery stenoses, bronchiectasis, thin-walled cavitary lesions, cysts
3. Cutis laxa (generalized elastolysis)
   Hereditary connective tissue disorder
   Autosomal recessive
   Premature aging, loose skin and subcutaneous tissue
   Tracheobronchomegaly, panacinar emphysema, bronchiectasis, aortic aneurysms
4. Mechanical ventilation in preterm neonate
5. Upper lobe or diffuse pulmonary fibrosisAnkylosing spondylitis
   Sarcoidosis
6. Immune deficiency states and recurrent childhood infections
   Ataxia telangiectasia
   Bruton-type agammaglobulinemia

Question 5

Bronchiectasis

DDx (Etiologic)

Answer 5

Congenital
Tracheobroncomalacia (e.g. Mounier-Kuhn)
Williams Cambpell syndrome - 4th generation and distal

Post inflammatory
Post infectious:
Congenital:
1ry ciliary dyskinesia
Immunodeficiency

    Infections
         TB, MAI, Measules, Pertussis, Viral

 _Post toxic_
       Aspiration (also gastric acid)

 _Immunologic_
       ABPA and Asthma

Post obstructive
Neoplasm, Foreign body, Broncholith, Lymphnode

Fibrotic
IPF, Sarcoid

Question 6

Diffuse airway thickening

Large 3 common - 4 less - 2 rare

Small 3 comon

Answer 6

Large
Neoplastic disease
Acute bronchitis
Chronic bronchitis

Amyloidosis
Sarcoidosis
Wegners
Relapsing polychondritis

Laryngeal papillomatosis
Tracheopathis Osteochondroplastica

Small
Asthma
Sarcoidosis
Bronchiolitis

Question 7

Bronchiolitis Obliterans

DDx (etiology)

Answer 7

Infection: RSV, Adeno, Myco

Inflammatory
Toxic inhalation : Ammonia, Chlorine, Acid
Aspiration: also gastric acid

Post transplant

Collagen vascular disease

Idiopathic

Question 8

Chronic airspace disease

Answer 8

Adenocarcinoma in situ (BAC)

Lymphoma

Alveolar sarcoidosis

Chronic eosinophilic pneumonia

Alveolar proteinosis

COP

Question 9

Bibasilar Interstitial markings on CXr

“BAASS”

Answer 9

1. Bronchiectasis
2. Aspiration
3. Asbestosis
4. Sickle Cell Disease
5. Scleroderma

Question 10

Lung CAVITY

Answer 10

C- Carcinoma: Squamous most common

A- Autoimmune: Wegener’s, Rheumatoid nodules

V- Vascular: Emboli (septic or non septic)

I- Infection: Abscess, Bacterial, Fungal, TB, Pneumatocele

T- **Trauma: **Pulmonary laceration

Y- Young (congenital): CCAM, Sequestration, Bronchogenic cyst

Question 11

Slow growing lung nodules

Answer 11

Granulomas

Sarcoidosis
Amyloidosis

RA

Benign mets: Leiomyomas
BALT
Thyroid mets-follicular