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chest FRCR > Chest > Flashcards

Chest Flashcards

1
Q

When is pancoast’s tumour unresectable? (4)

What type of lung cancer?

A
  1. Brachial plexus involvement above T1 (C8 or higher).
  2. Diaphragm paralysis (C3,4 and 5): phrenic nerve compression from lung cancer. Test: sniff test.
  3. > 50% vertebral body involvement.
  4. Distal nodes/mets

Non small cell lung cancer (Squamous cell)

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2
Q

Name the different types of pathology with thymus (4)

A
  1. Rebound thymus secondary to stress/chemo
  2. Cysts
  3. Thymoma (non invasive –> invasive (+/- calcification)
  4. Thymolipoma- fat and soft tissue
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3
Q

What are the associations with thymoma? (3)

A
  1. Myasthenia Gravis
  2. Pure red cell aplasia
  3. Hypogammaglubinaemia
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4
Q

Name the anterior mediastinal masses: (4)

A
  1. Thymoma
  2. Teratoma
  3. Thyroid
  4. Terrible lymphoma
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5
Q

Most common teratoma in anterior mediastinum:

A

Germ cell tumour

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6
Q

What is the appearance of teratoma?

A

Cystic mass + fat +/- calcification ?teeth

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7
Q

What is the most common location for pericardial cyst?

A

Right anterior cardiophrenic angle.

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8
Q

Name the posterior mediastinal masses: (2 and then 7)

A

a) Neurogenic: -

  • Schwannoma -
  • Neurofibroma -
  • Peripheral nerve sheath tumour

b) BM -

  • Extra medullary haematopoiesis -
  • CML -
  • Myelofibrosis -
  • Thalasaemia
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9
Q

Name the middle mediastinal masses: (4)

A
  1. Lymphadenopathy
  2. Bronchogenic cyst
  3. Fibrosing mediastinitis
  4. Mediastinal lipomatosis- Obesity/cushing/ streroid
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10
Q

What are the causes of lipoid pneumonia?

A

a) Exogenous- aspiration of oil
b) Endogenous- more common- secondary to post obstructive processes ie Fat density in consolidation

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11
Q

Re Pulmonary alveolar proteinosis-PAP

a) What are they at increased risk?
b) Appearances?
c) Treatment?

A

a) increased risk of Nocardia infection- brain abscess
b) Crazy paving with septal thickening and GGO
c) Bronchoalveolar lavage

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12
Q

What are the three stages of congestive cardiac failure?

A
  1. Redistribution: cardiomegaly, UL vessel diversion
  2. Interstitial oedema: Kerley lines, peribronchial cuffing
  3. Alveolar oedema: airspace fluffy opacity
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13
Q

What are the DDx for crazy paving? (5) ie septal thickening and GG

A
  1. PAP
  2. Oedema
  3. Haemorrhage
  4. BAC
  5. Acute interstitial pneumonia
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14
Q

What differentiates a benign from malignant nodule? (3)

A

Malignant:

  1. Spiculated margin
  2. Air bronchogram through nodule- usu adenocarcinoma in situ
  3. Partially solid lesion with GG component

Benign:

  1. Fat
  2. Rapid doubling time
  3. Slow doubling time
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15
Q

Re Squamous cell lung cancer:

  1. where is it located?
  2. Ectopic ?
  3. Example
A
  1. It is centrally located +/- cavitation
  2. Ectopic PTH
  3. Pancoast tumour (NSCLC)
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16
Q

What type is a pancoast tumour?

A

Squamous cell

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17
Q

Re Small cell lung cancer:

  1. Location
  2. Paraneoplastic
A
  1. Central, near main lobarbronchi
  2. Paraneoplastic ACTH/SIADH
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18
Q

Where is large cell lung cancer usually located?

A

It is usually peripheral.

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19
Q

What is a Lambert Eaton syndrome?

A

Proximal muscle weakness secondary to ACh near NMJ.

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20
Q

Where is the predominance of NSIP?

A

Lower lobes, posterior and peripheral predominance with sparring of the immediate subpleural spaces.

immediate subpleural sparing - a relatively specific sign

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21
Q

What causes NSIP? (3)

it is important to carefully scrutinise the images, looking for findings such as joint or bony changes, oesophageal dilatation, pleural and pericardial effusion, etc. as it has been mentioned earlier NSIP pattern is also associated with many other conditions.

A
  1. Collagen vascular disease
  2. Drug reaction
  3. Hypersensitivity pneumonitis
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22
Q

What is the histology in UIP?

A

Heterogenous

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23
Q

List the differences between NSIP and UIP:

A

NSIP:

  1. Homogenous histology.
  2. GG and micronodules.
  3. Most common in scleroderma.

UIP:

  1. Heterogenous histology
  2. Honeycombing and traction bronchiectasis
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24
Q

RB-ILD- Smoking related

  1. Predominance?
  2. When to call it?
A
  1. UL- apical centrilobular GG nodules
  2. Resp bronchiolitis and symptoms.
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25
Q

DIP- smoking related- end spectrum of RB-ILD Appearances?

A

More diffuse GGO with patchy/subpleural distribution mainly in the lower lobes with some small cystic spaces.

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26
Q

What is Hughes Stovin syndrome?

A

This is a PA aneurysm similar or is Behcet. They get recurrent thrombophlebitis and PAA and rupture.

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27
Q

What is a Behcet?

A

Genital and mouth ulcers. Turkish descent Aorta thickening PAA

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28
Q

What is sarcoid staging?

A

0- Normal

1- Hilar/mediastinal nodes only

  1. Nodes + parenchymal disease
  2. Parenchymal disease
  3. END STAGE- FIBROSIS
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29
Q

Name the signs associated with sarcoid: (3)

A

a) 1,2,3 : biliateral hilar and right paratracheal nodes
b) Lambda sign: Same as 123 but in Gallium scan
c) CT Galaxy sign- UL masses with satellite nodules.

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30
Q

What is sarcoid?

Define Location?

Biochemical?

A

It is a non caseating granulomas.

Perilymphatic nodules with UL predominance.

Raised ACE and Ca

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31
Q

List DDx for reverse halo (ATOL) sign: (5)

A
  1. COP- CLASSIC
  2. Fungal pneumonia
  3. TB
  4. Wegeners
  5. Pulmonary infarct
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32
Q

List DDx for halo sign (5)

A
  1. Invasive aspergillosis- CLASSIC
  2. Other Fungus
  3. Haemorrhagic mets including melanoma
  4. Wegeners
  5. BAC
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33
Q

Re hypersensitivity pneumonitis

What is it caused by? BUZZWORD?

A

This is caused by inhaled organic antigen. (farmers lung, bird, mushroom, paint and etc)

BUZZWORD: HEAD CHEESE- mix of everything:

GG/consolidation/ air trapping

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34
Q

Re organising pneumonia

What is a COP?

What are the causes? (4)

Treatment?

What is the main DDx?

A

When cause is not known: COP: Reverse halo sign

Causes of organising pneumonia:

  1. Idiopathic,
  2. Collagen vascular disease
  3. Drugs (amiodarone)
  4. Infection

Treatment: steroid with good prognosis.- No fibrosis.

DDx: Chronic eosinophilic pneumonia

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35
Q

Re Chronic eosinophilic pneumonia

What is it?

DDx?

CT?

A

Peripheral eosinophilia +/- asthma Looks similar to COP

CT: peripheral GGO/consolidation UL

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36
Q

What is a Caplan syndrome?

A

RA with UL lung nodules which can cavitate +/- pleural effusion.

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37
Q

Re Ankylosing spondylosis: - Which lobes?

A
  • UL fibrobullous disease Usually unilateral first –> Bilateral
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38
Q

1) What is a shrinking lung syndrome?
2) What condition is associated with shrinking lung?
3) Causes?

A

1) Loss of volume in both lungs with lupus.
2) Shrinking lung for SLE
3) Diaphragm dysfunction/ pleuritic chest pain- present with pleuritis +/- pleural effusion.

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39
Q

Re Granulomatous Wegeners:(AKA Granulomatosis with polyangitis)

a) Which organs are affected?
b) Appearance?
c) Markers?

A

a)

  1. Upper tract/ sinuses
  2. Lungs
  3. Kidneys

b) Nodules with cavitation +/- GG secondary to haemorrhage.
c) cANCA +ve in 90 %

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40
Q

Causes of pulmonary hypertension:

ie; PA pressure > 25 mmHg

A
  1. Primary- idiopathic, uncommon
  2. Secondary: -
  • Chronic PE -
  • Right sided heart strain -
  • Lung parenchymal disease-
  • Fibrosis and emphysema
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41
Q

Define pulmonary veno-occlusive disease

A

PA HTN with normal wedge pressure.

The normal wedge pressure differentiates it from post cap causes such as: - LA myxoma - MS- mitral stenosis - PV stenosis.

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42
Q

What is an extra pleural haematoma?

A

If there is damage to the parietal pleural: Haemothorax If parietal pleura is intact : Extrapleural haematoma Persistent fluid collection after drain. There could be displacement of the extrapleural fat.

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43
Q

Re Fat embolism: - RF - Triad/ organs affected - Timing?

A
  • After long bone fracture or IM rod placement. -
  1. Affects brain (changed mental state),
  2. skin (rash) and
  3. lung (SOB). -

Timing 1-2 days after #

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44
Q

Re Pseudomonas:

Appearance:

Typical patient group:

A

Patchy opacification with abscess formation

ICU patients on ventilators/ CF and PCD

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45
Q

Re Legionella Appearance:

Typical patient group:

A

Peripheral and subpleural airspace opacity.

Cavities in immunocompromised patients.

COPD and crappy air conditions X rays tend to lag behind resolution of symptoms.

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46
Q

Re Anthrax: Appearance

A

Haemorrhagic lymphadenitis, mediastinitis and haemothorax. Mediastinal widening with pleural effusionin setting of bioterrorism.

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47
Q

Re Klebsiella:

Appearance

Typical patient group:

What colour sputum?

A

BULGING fissure Pleural effusion with empyema and cavity

Alcoholic and NH resident

Current jelly sputum.

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48
Q

What are the 3 main differences between empyema and abscess?

A

Empyema: Abscess: -

Lentiform - Round -

Split pleural sign - Claw sign-acute angle w pleura -

Treated with chest drain -Not tx with drain risk of fistula

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49
Q

Define empyema necessitans:

A

Extension of empyema into chest wall and soft tissue. It is classically seen with TB or Actinomyces.

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50
Q

Types of diaphragmatic hernia: (2)

A

Back and Left: Bochdalek

Anterior and Right: Morgagni

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51
Q

DDx for pleural calcification: (5)

A
  1. Asbestos
  2. Old haemothorax
  3. Old infection
  4. TB
  5. Extraskeletal osteosarcoma.
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52
Q

Re Mesothelioma: -

What is it associated with? - Buzzword

A

Associated with asbestos exposure

*** Pleural Rind***

If direct invasion and extension into fissure, then highly suggestive.

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53
Q

Re Fibrous tumour of pleura

What is it?

What is it associated with?

A

This is a solitary tumour arising from visceral pleura

It is not associated with smoking/asbestos

It is associated with

  1. hypoglycaemia,
  2. hypertrophic osteoarthropathy
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54
Q

Pleural mets:

A
  1. Adenocarcinoma- most likely: - Lung - Breast -
  2. Lymphoma
  3. Pleural effusion
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55
Q

Lupus

A

Pleural and pericardial effusion

Fibrosis is uncommon but instead they will get shrinking lung.

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56
Q

Scleroderma

Location

GI symtoms

A

NSIP > UIP

LL

Patulous fluid filled oesophagus

57
Q

Rheumatoid arthritis

Location and appearance

A

LL

Similar to UIP/COP

Reticulation and honey combing with consolidative opacities: organising pneumonia. Pleural effusion.

CAPLAN SYNDROME (RA + Nodules)

58
Q

Sjogren What type of cystic lung disease?

A

LIP cystic lung disease

Extensive GGO and scattered thin walled cysts.

59
Q

DDx for lung cavity: 6

A
  1. Cancer- usu squamous cell
  2. Autoimmune- Wegener’s/RA
  3. Vascular- septic emboli
  4. Infection-TB
  5. Trauma- Pneumatocele
  6. Young- congenital- CCAMS. sequestration
60
Q

Re Lemierre syndrome -

Define -

Bacterial agent

A

Jugular vein thrombosis with septic emboli classically after oropharyngeal infection or recent ENT surgery

Caused by Fusobacterium Necrophorum.

61
Q

Non TB mycobacteria

A
  1. Cavitary: old white male smoker-
  2. Bronchiectatic - lady windermere: RML and lingula bronchiectasis
  3. HIV, CD4 <100,
  4. Hypersensitivity pneumonitis- hot tub lung
62
Q

Aspergillus types:

A
  1. Fungal ball: aspergilloma in existing cavity-NOT invasive
  2. Immunocompromised- Invasive asp. - Halo sign- INVASIVE - Air crescent- healing
  3. Hyperimmune- asthma/ ABPA/CF UL central saccular bronchiectasis with mucoid impaction-finger in glove.
63
Q

What would count as stage 3B cancer? (3)

3B is non resectable.

A

3B = T4 or N3 : NOT RESECTABLE

  1. Supraclavicular, scalene or contralateral med/hilar adenopathy
  2. Same lung but different lobes.
  3. Malignant pleural effusion.
64
Q

Bronchopleural fistula went wrong…

A

In fistula the space is filled with air as opposed to fluid.

Diagnosis by Xe NM scan: Xe detected in pneumonectomy space.

65
Q

Subtypes of adenocarcinoma:

A
  1. Atypical adenocarcinoma Hyperplasia- AAH
  2. Adenocarcinoma in situ- ACIS
  3. Minimally invasive adenocarcinoma-MIA
66
Q

T3 vs T4 vs M1

A

T3: Two in the same lobe

T4: two in different lobes but same lung

M1: two in different lungs

67
Q

Wagerers or granulomatosis polyangitis

A

Circumferential thickening- focal or long segment -

No calcification -

Subglottic involvement - Sinuses and lungs - nasal perforation and cavity -

cANCA positive 90%

68
Q

TBO TracheoBronchopathia Osteochondroplasia

A
  • Spares the posterior membrane. - Cartillaginous and osseous nodules within submucosa of trachea and bronchial wall.

Classically affects the lower 2/3 of trachea.

69
Q

Relapsing polychondritis

A
  • Spares the posterior membrane.
  • Diffuse thickening of the trachea -

No calcification -

Characterised by recurrent cartilage inflammation and recurrent pneumonia.

70
Q

Post intubation stenosis

A

Focal subglottic circumferential stenosis with hour glass configuration

71
Q

HSP - Age group - Symptoms

A

Most common in children (4-11yrs)

Systemic disease affecting GI: -

  • Intussuception: Doughnut sign -
  • Pain - Blood - Diarrhoea Thumbprinting and
  • Massive skin oedema
72
Q

Churg Strauss -

Define -

Appearances -

Marker

A

D: Necrotising pulmonary vasculitis (part of eosinophilic lung consolidation spectrum). Eosinophilia and asthma

Peripheral lung consolidation and GGO- transient

Cavitation is rare-

Ddx: Wagerers

pANCA +ve 75%

73
Q

Microscopic polyangitis -

Which organs are affected -

Marker

A

Affects kidneys and lungs

Diffuse pulmonary haemorrhage in 1/3 of cases

pANCA positive 80%

74
Q

Behcet

A

Mouth and genital ulcers in turkish descent

Thickening of aorta and PAA

75
Q

Buergers

Strongly associated with…

What size vessels are affected?

BUZZWORD

A
  • Strong association with smoking -

Small and medium vessels in arms < legs -

Extensive arterial occlusive disease and development of corkscrew collateral vessels.

BUZZWORD: AUTO AMPUTATION

76
Q

Name large and medium vessel vasculitis

A
  • Large: -
    • Takayasu- young asian girl -
    • Giant cell- crutches- SCA, Ax and brachial -
    • Cogans syndrome: Paeds with ear and eye symphonies and aortitis
  • Medium: -
    • PAN- renal micro aneurysm-
    • HepB -
    • Kawasaki- coronary artery aneurysm
77
Q

Name small vessel vasculitis

A
  • ANCA +ve: -
    • Wegeners- nasal septum erosion and cavity -
    • Churg Strauss- Transient peripheral lung consolidation -Micro polyangitis- Diffuse pull haemorrhage
  • ANCA -ve: -
    • HSP:Intussception and scrotal oedema -
    • Behcet: PAA -
    • Buergers- male smoker
78
Q

Hand angio in exam…

A
  • Ulnar artery involved? -
    • YES: HHS -
    • NO: Fingers out: Buergers- corkscrew collateral
79
Q

Kaposi in lung vs lymphoma -NM

A
  • Thallium: - Kaposi and lymphoma: Positive
  • Gallium: -
    • Kaposi Negative -
    • Lymphoma: Positive
80
Q

Lymphoma in lung (4)

A
  1. Primary : NHL and maltoma No extra thoracic disease for 3/12
  2. Secondary: NHL and HL
  3. PTLD- BMT or organ Tx, B cell lymphoma, associated with EBV
  4. AIDS related lymphoma, secondary most common cancer in AIDS - NHL associated with EBV- CD4< 100 - Affecting: CNS/ Lung/ Bone/ Liver/ Bowel
81
Q

Kaposi sarcoma

CD4?

BUZZWORD

NM

A
  • Most common lung tumour in AIDS.
  • CD4 < 200 -
  • Tracheobronchial and peripheral lung affected -
  • Bloody effusion.
  • BUZZWORD: Flame shaped
  • Thallium +ve and Gallium -ve
82
Q

Bronchial atresia

Which segment is most likely affected?

Buzzword appearance?

A
  • Most likely involves apical posterior segment of LUL.
  • Blind ending bronchus filled with mucus: finger in glove.
  • Distal lung hyper inflated from collateral drift and air trapping.
83
Q

AVM

Name 2 conditions

location? What type of shunt?

when treated?

A
  • Think of HHT/ Osler weber Rendu
  • Usually in lower lobes- more blood flow: R-L shunt : stroke and brain abscess
  • Treated when > 3mm
84
Q

Swyer James

A
  • Unilateral lucent lung post viral infections in childhood- post infectious - Obliterative bronchiolitis
  • Size of affected lobe is smaller
  • Not hyper expanded.
85
Q

Poland

A

Unilateral absence of pectoral muscles- Unilateral hyper lucent chest

Can have limb issues

86
Q

Vanishing lung syndrome/ Giant bollous emphysema

  • Location?
  • 20% have ……….
A
  • Resulting from avascular necrosis of lung parenchyma and hyperinflation UL,
  • young male
  • Bollous disease occupying 1/3 of hemithorax
  • 20% have alpha 1 antitrypsin deficiency
87
Q

Saber sheath trachea

Side-to-side narrowing of the intrathoracic trachea. It is longer (anterior-posterior) than it is wide (side-to-side).

A

Diffuse coronal narrowing of trachea sparring the extra thoracic portion

  • pathognomonic for COPD.

The sagittal:coronal diameter is over 2:1 and the extra-thoracic portion of the trachea is not narrowed. The supporting tracheal cartilage is usually thickened and densely calcified

88
Q

Extra lobar sequestration

A
  • 25% -
  • Has its own pleural cover -
  • Systemic venous drainage -
  • Infancy with resp compromise, associated with: -
    • CCAM -
    • Diaph hernia -
    • Pulmonary hypoplasia -
    • Heart disease -
    • Vertebral anomaly
89
Q

Sequestration types:

A
  1. Intralobar- adolscence and adulthood with recurrent pneumonia
  2. Exralobar: Infancy with resp compromise
90
Q

Intralobar sequestration

A
  • 75% -
  • Most common in LLL post segment-
  • uncommon in UL. -
  • Recurrent infection -
  • No pleural cover -
  • Pulmonary venous drainage.
91
Q

Signs of PE on CXR (4)

A
  1. Westermak sign- regional oligaemia
  2. Fleishner sign: enlarged pulm artery
  3. Hamptons hump: peripheral wedge shaped opacity
  4. Pleural effusion
92
Q

Acute vs chronic PE (3)

A

Acute vs chronic:

  1. Central vs peripheral
  2. Venous dilatation vs shrunken vein collateral
  3. Perivenous soft tissue oedema vs calc within thrombi and venous wall.
93
Q

What is considered as low probability for PE on VQ scan? (2)

A
  1. Triple matched defect in MIDDLE and UPPER lung.
  2. Stripe sign: Perfusion defect with rim of surrounding normal perfused lung.
94
Q

What is considered as INTERMEDIATE probability for PE on VQ scan?

A
  1. Triple matched defect in the LOWER zones
  2. Single moderate matched VQ with normal CXR
95
Q

What is considered as HIGH probability for PE on VQ scan?

A

Four moderate segmental defects

96
Q

Bronchial tree blood supply:

A

Bronchial arteries:

  • 2 left sided from the aorta and
  • the single right side from the right 3rd posterior intercostal artery.
97
Q

Opacity in the Raider triangle is……

A

aberrant RSCA

98
Q

Pacemaker wire goes through this valve, terminating in …..ventricle

A

TV and right ventricle

A biventricular pacemaker with its three wires in appropriate positions:

  1. right ventricle
  2. right atrium
  3. coronary sinus pacing the left ventricle
99
Q

Most superior valve is

A

PV

100
Q

Obtuse margin with the lung, the lesion is in the

A

mediastinum

101
Q

The differential diagnosis for ground glass in a central distribution (4)

A
  1. Pulmonary edema.
  2. Alveolar hemorrhage.
  3. Pneumocys s jiroveci pneumonia- PCP
  4. Alveolar proteinosis.
102
Q

The differential diagnosis for peripheral consolidation or ground glass (4)

A
  1. Organizing pneumonia.
  2. Chronic eosinophilic pneumonia, typically with an UL predominance.
  3. Atypical or viral pneumonia.
  4. Pulmonary edema.
103
Q

the differential diagnosis for smooth interlobular septal thickening is identical to the differential for central ground glass: (4)

A
  1. Pulmonary oedema - by far the most common cause of smooth interlobular septal thickening .
  2. Pulmonary alveolar proteinosis- PAP
  3. Pulmonary hemorrhage.
  4. Atypical pneumonia, especially PCP
104
Q

Nodular, irregular, or asymmetric septal thickening DDx (2)

A
  1. Lymphangitis carcinomatosis
  2. Sarcoid
105
Q

What is crazy paving?

A

Septal thickening and GGO

106
Q

Ddx for crazy paving: (7)

A
  1. Alveolar proteinosis.
  2. Pneumocys s jiroveci pneumonia.
  3. Organizing pneumonia.
  4. bronchioloalveolar carcinoma, mucinous subtype.
  5. Lipoid pneumonia,
  6. Acute respiratory distress syndrome.
  7. Pulmonary hemorrhage.
107
Q

Lung cysts and AIDS

A

LIP

108
Q

Lung cysts and GGO and Pneumothorax

A

PCP

109
Q

Hyper vascular LN

A

Castlemans Kaposi

110
Q

Flame shaped perihilar opacity

A

Kaposi sarcoma

Th201: usually positive in both lymphoma and Kaposi sarcoma

Ga67: usually negative in Kaposi sarcoma but positive in lymphoma and infection

111
Q

Patient with TB and AIDS started on HAART therapy, now doing worse

A

Immune reconstitution inflammatory syndrome

112
Q

Ghon lesion

A

calcified TB granuloma

113
Q

Ranke complex

A

Calcified TB granuloma AND calcified hilar node. Healed primary TB

114
Q

Fungal infection in impaired patient. Invading the mediastinum, pleura and chest wall. Reversed halo sign

A

Mucormycosis

115
Q

Feeding vessel sign ddx

A
  1. Septic emboli
  2. Haematogenous mets
116
Q

Pseudocavitation/bubble like licences and fried egg appearances and it is usually cold on PET

A

MIA- Minimally invasive adenocarcinoma

117
Q

Cannonball metastases (2)

A
  1. RCC
  2. Choriocarcinoma
118
Q

Causes of Lymphangitis carcinomatosis (4)

A
  1. Breast
  2. Stomach
  3. Pancreas
  4. Prostate
119
Q

Which side of the heart is affected by chest and GI carcinoid tumours?

A
  • Chest : Left sided
  • GI: Right sided
120
Q

Test to diagnose chest carcinoid

A

Octreotide

121
Q

AIDS patient with lung nodules, pleural effusion and lymphadenopathy

A

AIDS-related pulmonary lymphoma (NHL) CD4 < 100

122
Q

CD4 count in kaposi sarcoma

A

< 200

123
Q

Most common hepatic neoplasm in AIDS

A

Kaposi Sarcoma

124
Q

KS vs Lymphoma

A

KS: Thallium positive, Gallium negative

Lymphoma: Thallium positive, Galium positive

125
Q

Diagnosis? Macroscopic fat and popcorn calcification

A

Hamartoma

They can be hot on PET, they are still benign

126
Q

Buzzword: Central dot sign

A

Centrilobular emphysema , UL

127
Q

This type of emphysema is associated with alpha 1 antitrypsin and ritalin lung

A

pan lobular LL - ie The entire lung appears darker with attenuation of bronchovascular markings. The lung volumes are increased and distinct spaces of low attenuation may not be seen.

128
Q

Ddx egg shell Ca (4)

A
  1. Sarcoid
  2. Silicosis
  3. Coal worker
  4. Histoplasmosis
129
Q

Perilymphatic nodular pattern ddx

A
    1. Sarcoid
  2. . Silicosis
  3. LC
130
Q

Random nodular pattern ddx

A
  1. Miliary TB
  2. Mets
  3. Fungal
131
Q

Centrilobular nodular pattern ddx

A
  1. Infection
  2. Rb-ILD
  3. Hypersensitivity pneumonitis
132
Q

CF vs PCD

A

CF:

  1. Abnormal mucus, cilia cannot move
  2. Normal sperm, absent vas deferens
  3. UL bronchiectasis

PCD:

  1. Normal mucus. cilia don’t move
  2. abnormal sperm , normal vas deferens
  3. LL Bronchiectasis
133
Q

William Campbell Syndrome

A

congenital cystic bronchiectasis from deficiency of cartilage in 4-6th order bronchi

134
Q

massive dilation of trachea > 3cm

A

Mounter Kuhn or tracheobronchomegaly

135
Q

PLEURAL CA++ DDX

A
  1. old haemothorax
  2. old infection
  3. TB
  4. Extra-skeletal osteosarcoma
136
Q

Function of Intra-aortic balloon pump

A
  1. decreases LV afterload through a vacuum effect, decreasing myocardial oxygen requirements, and
  2. increases myocardial perfusion (during diastole)
137
Q

Location of IABP

A
  • in the proximal descending aorta, just below the origin of the left subclavian artery/ LSCA
  • This ideally results in the balloon terminating just above the splanchnic vessels
138
Q

Tracheobronchial injury is most common at what location and what does it cause?

A
  • usu within 2cm of carina.
  • It causes pneumomediastinum rather than pneumothorax.

chest FRCR (3 decks)

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