Chest

Question 2

Please Provide a Differential Diagnosis

Solitary Pulmonary Nodule (5 categories)

Answer 2

Malignant tumors

• Bronchogenic carcinoma
• Metastasis

Benign tumors

• Adenomas (carcinoid)
• Hamartomas

Infections

• Pneumonia
• TB
• Histoplasmosis
• Hydatid

Congenital

• Lung sequestration
• Bronchogenic cyst

Vascular

• Pulmonary infarction
• Hematoma
• AV malformation

Question 3

Please Provide a Differential Diagnosis

Pleural effusion (4 categories)

Answer 3

Transudative

• Cardiac failure
• Hepatic failure
• Nephrotic syndrome
• Meigs Salmon syndrome

Exudative

• Infection (subphrenic abscess)
• Malignancy
• Infarction
• Collagen vascular Disease
• Pancreatitis

Hemorrhagic

• Bronchogenic carcinoma
• Trauma (surgery)

Chylous

• Thoracic duct obstruction

Question 4

Please Provide a Differential Diagnosis

Bronchiectasis(4)

Answer 4

Childhood infections

• measles
• pertussis

Bronchial obstruction

• Foreign body
• Neoplasm
• Mucus plug
• Aspergillosis
• Chronic aspiration

Congenital

• Kartagener’s
• Williams Campbell

Immune deficiency

• (hypogamaglobulinemia)

Question 5

Please Provide a Differential Diagnosis

Honeycomb Lung(5/8)

Answer 5

Collagen disorders

• Rheumatoid (bases)
• Scleroderma (bases)
• Extrinsic allergic alveolitis (upper)

Sarcoidosis (spares apices)

Pneumoconioses

• Asbestosis
• Silicosis

Cystic bronchiectasis (lower/middle)

Cystic fibrosis

Langerhans cell histiocytosis (mid/upper)

Tuberous sclerosis

Question 6

Please Provide a Differential Diagnosis

Miliary Pattern (0.5-2mm)(5)

Answer 6

Miliary TB

Fungal diseases

• Histoplasmosis
• Coccodiomycosis
• Blastomycosis
• Cryptococcosis

Coal miners pneumoconiosis

Sarcoidosis

Acute extrinsic allergic alveolitis

Question 7

Please Provide a Differential Diagnosis

Large Miliary Pattern (2-5mm)(3)

Answer 7

Metastasis

Lymphoma (with lymphadenopathy)

Sarcoidosis (with lymphadenopathy)

Question 8

Please Provide a Differential Diagnosis

Multiple pulmonary nodules (>5mm)(5 categories)

Answer 8

Metastasis

Infections

• Staph. Aureus abscesses
• Coccidiomycosis
• Histoplasmosis
• Hydatid

Immunological

• Wegener’s (no ca++, cavitation 30-50%)
• RA nodules (no ca++, cavitation common)
• Caplan’s Syndrome (ca++ & cavitation)

Inhalational

• Progressive Massive fibrosis

Vascular

• AVM (33% multiple, rarely ca++)

Question 9

Please Provide a Differential Diagnosis

Localized calcification (4)

Answer 9

TB

Histoplasmosis

Coccidiomycosis

Blastomycosis

Question 10

Please Provide a Differential Diagnosis

Consolidative Pattern of Lung Disease

(5 categories)

Answer 10

Blood

• Trauma
• Infarct
• Vasculitis
• Goodpastures

Pus

• Pneumonia

Protein

• Alveolar proteinosis
• Mucus Plug

Water

• Cardiac Edema
• Renal failure
• Toxic Inhalation
• ARDS

Cells

• Bronchogenic carcinoma
• Lymphoma
• Mets

Question 11

Discoid Atelectasis

Answer 11

EPIC

• Embolus
• Pneumonia
• Inadequate Inspiration
• obstructing Carcinoma

Question 12

Pleural Calcification

Answer 12

HEATR

• Hemothorax
• Empyema
• Asbestosis
• TB, Talcosis
• Radiation

Question 13

Cavitating Lung Masses

Answer 13

CAVITY

• Carcinoma (squamous cell)
• Cystic Bronchiectasis
• Autoimmune (Wegeners, RA)
• Vascular (Emboli)
• Infection (TB, Hydatid, Klebsiella)
• Trauma
• Young (Sequestration, Hernia, Bronchogenic Cyst)

Question 14

Hyperlucent Lung

Answer 14

• Mastectomy
• Poland’s Syndrome
• Rotation
• Obstructive emphysema
  
  • Foreign body
  • Neoplasm
  • Inflammation
• Bullous emphysema
• Compensatory hyperinflation
• Pneumothorax
• Swyer-James (Macleod) Syndrome
• Congenital lobar emphysema

Question 15

Opacified Lung (Unilaterally)

Answer 15

• Pleural Effusion
  
  • Transudative
  • Exudative
  • Hemorrhagic
  • Chylous
• Collapse
• Post surgical (pneumonectomy)
• Consolidation
• Congenital Absence (rare)