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Chest Flashcards

1
Q

Bizarre shaped apical predominant cysts in a female smoker?

A

Langerhans Cell Histiocytosis.

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2
Q

Pleural drop mets with heterogenous mediatstinal mass- adult?

A

Thymoma.

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3
Q

Infxn of lateral pharyngeal space and septic thrombosis of jugular vein. +/- septic pulmonary emboli.

A

Lemierre Syndrome

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4
Q

inferior border of the superior mediastinum?

A

oblique plane from the sternal-manubrial jxn

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5
Q

interstitial thickening and miliary calcified nodules

A

viral pna- varicella/chicken pox and rarely flu

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6
Q

Reverse halo sign

A

cryptogenic organizing pna

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7
Q

Causes of crazy paving

A

GGO w/ interlobular septal thickening and intralobular reticular thickening

Common causes: ARDS, PNA, pulmonary alveolar proteinosis (PAP)

Less common causes: drug-induced pneumonitis, radiation pneumonitis, diffuse pulmonary haemorrhage, Goodpasture, chronic eosinophilic pna, UIP w/ DAD, sarcoid… etc

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8
Q

Multiple AVMS in the lungs?

A

HHT

Hereditary hemorrhagic telengiectasia/Osler Weber Rendau syndrome

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9
Q

Panlobular emphsymetaous changes in a young person?

A

alpha 1 antitrypsin deficiency

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10
Q

Rasmussen aneurysm

A

TB cavity weakens pulmonary artery

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11
Q

Multifocal hypervascular lymphadenopathy in a patient with HIV?

A

Multicentric Castleman’s dz

Kaposi is legit ddx too

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12
Q

Thin-walled pulmonary cysts in a patient with Sjogren’s syndrome?

A

LIP

lymphocytic interstitial pneumonia

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13
Q

bilateral parenchymal opacities in a patient with hx of heroin overdose

A

heroin induced pulmonary edema

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14
Q

on a lateral view, which ribs are typically magnified?

A

R

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15
Q

Opacity in the Raider Triangle = ?

A

Aberrant right subclavian artery

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16
Q

poserior border of anterior mediastinum?

A

pericardium

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17
Q

on PA view of chest, a mass above the clavicals is located where?

A

posterior mediastinum

cervicothoracic sign

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18
Q

How many layers of pleura make azygous lobe?

A

4

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19
Q

air trapping or recurrent infxns in patient with variant tracheal anatomy?

A

pig bronchus/tracheal bronchus/bronchus suis

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20
Q

MC pulmonary veinous anatomic variation?

A

separate vein draining the RML- 30% of the time.

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21
Q

Volume loss of one- hemithorax and only one PA

A

proximal interruption of the pulm artery

(unilateral absence)

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22
Q

MC cause of PNA in AIDS patient

A

S. pneumo

lower lobes

can be sever in SS pts post splenectomy

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23
Q

PNA that can make abscess, bronchopna with patchy opacities

A

S. aureus

bilateral

endocarditis

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24
Q

hemorrhagic lymphadenitis, mediastinitis, hemothorax

mediastinal widening with pleural effusion

A

anthrax

bioterrorism

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25
Q

COPDers and people without spleens, bronchitis, sometimes B lower lobe pna

A

H. flu

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26
Q

ICUers on vents/CF/Primary Ciliary Dyskinesias

A

pseudomonas

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27
Q

COPDer around a crappy AC. peripheral sublobar airspace opacities

A

Legionella

x-ray tends to lag behind resolution of symptoms

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28
Q

aggro pna with rib osteo and chest wall invasion

A

actinomycosis: dental procedure gone bad, mandible osteo -> aspiration

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29
Q

Pulm findings in chronic GVHD?

A

lymphocytic infiltration of airways and obliterative bronchiolitis

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30
Q

pulmonary findings in early neutropenic BMT?

A

pulm edema, hemorrhage, drug-induced lung inj

fungal pna (invasive aspergillosis)

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31
Q

pulmonary findings in early BMT? 30-90days

A

PCP, CMV

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32
Q

pulmonary findings in late BMT? >90 days

A

bronchiolitis obliterans, cryptogenic organizing pna

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33
Q

AIDS infxns w/ ct >200

A

bacterial, TB

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34
Q

AIDS infxns w/ ct <200

A

PCP, atypical mycobateria

feeling funky- dancing the line before <100, so you take some PCP or you get atypical

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35
Q

AIDS infxns w/ ct <100

A

CMV, disseminated fungal, mycobacterial

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36
Q

pt with AIDS: what can a focal airspace opacity represent?

A

Bacterial infxn (s. pna MC)

TB if low CD4

If chronic- think lymphoma or kaposi

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37
Q

pt with AIDS: what can multi-focal opacities rep?

A

bacterial, fungal

38
Q

pt with AIDS: what doe GGOs rep?

A

THIS IS PCP

can be CMV if ct is <100

39
Q

what does PCP look like?

A

GGOs

peripheral sparing

30% of the time, cysts -> ptx

40
Q

flame shaped perihilar opacity in AIDS

A

kaposi sarc

41
Q

AIDS patient with cysts

42
Q

Which TB forms cavitate?

A

Post primary and primary progressive

43
Q

calcificed TB granuloma

A

Ghon lesion- sequela of primary TB

44
Q

Calcified TB granuloma + calcified hilar node

A

Ranke complex

healed primary TB

45
Q

old white man with COPD with cavitary lesion

A

MAC

looks like reactivation TB

46
Q

RML bronchiectasis and tree-in-bud opacities and bronchiectasis

A

Bronchiectactic MAC

“Lady Windermere” disease

47
Q

ill-defined, gg centrilobular nodules

A

Hypersensitivity pneumonitis/ hot-tub lung

48
Q

You are shown a fungus ball in an exisiting cavity

A

aspergilloma

normal immune

49
Q

consolidative nodule/mass with ground glass halo

and or air crescent sign

A

immune suppressed patient with invasive aspergillus

50
Q

upper lobe central sacular bronchiectasis with mucoid impaction (finger-in-glove)

A

hyper-immune patient/asthmatic with ABPA (allergic broncho-pulmonary aspergillosis)

51
Q

aggro fungal infxn with invades mediastinum, pleura, and chest wall

A

mucormycosis

52
Q

features of pulm measels?

A

multifocal ggo, small nodular opacities

53
Q

features of pulm influenza

A

coalescent LL opacity

54
Q

pulm features of SARS

A

LL predominant ggo’s

55
Q

pulm features of caricella

A

mult perpheral nodular opacities

56
Q

Mnemonic for cavitary lung lesion?

A

Cavity: cancer, usually squamous cell

Autoimmune: wegeners, rheumatoid, caplan syndrome

Vascular: septic emobli/bland emboli

Infxn: TB

Trauma: pneumatoceles

Young: congenital ccams and sequestration

57
Q

septic emboli after ENT surgery or oropharyngeal infxn

A

Lemierre Syndrome

fusobacterium necrophorum

58
Q

Exceptions to benign pulm nodule calcs?

A

hx of GI cancer

osteosarc

59
Q

Most suspicious morphology of pulm nodule?

A

part solid lesions with ground glass component

60
Q

lung CA that is central, assoc with smoking, cavitates

A

Squamous

can get ectopic PTH production

61
Q

lung CA that is central, central lymphadenopathy

A

Small cell

paraneoplastic: SIADH and ACTH

death sentence

62
Q

Lung CA usually peripheral, large

A

Large cell

bad prognosis

63
Q

lung CA that is peripheral, upper lobes, MC subtype overall, happens in setting of lung fibrosis

A

adenocarcinoma

64
Q

precursor of adenocarcinoma

A

atypical adenomatous hyperplasia of lung (AAH)

65
Q

adenocarcinoma in situ

A

less than 3 cm

MC is non-mucinous one

66
Q

minimally invasive adenocarcinoma (MIA)

A

<3cm. also <5mm stromal invasion.

if greater than 5mm, lepidic predominant adeno

67
Q

AIDS patient with lung nodules, pleural effusion, and lymphadenopathy

A

ARL/AIDS relatd pulmonary lymphoma

2nd MC lung tumor in AIDS to Kaposi

68
Q

Which sequestration presents in adolescence and which in infancy?

A

adol/adulthood: intralobar with rucurrent pnas (uaully LLL)

infancy: extralobar. assoc with CCAM, diaphram hernia, vert anomalies, congen heart dz, rarely gets infected

69
Q

LCH (langerhans cell histiocytosis)

A

young smokers

bizarre shaped cysts (initially nodules)

gets better if you quit smoking

spares costophrenic angles

70
Q

which cystic lung disease accompanies tuberous sclerosis?

A

LAM- you can be shown kidneys with mult AMLs

71
Q

LIP is associated with what other dz processes?

A

sjogrens and HIV in adults and HIV in kids

72
Q

AIDS + ground glass lungs

A

PCP (pneumocystis pneumonia)

73
Q

cavitation in the setting of silicaosis?

74
Q

Which ILD is most common with scleroderma?

75
Q

What are the stages of CHF?

A
  1. “Redistribution”= wedge pressure of 13-18-> cephalization, cardmeg
  2. “interstitial edema” = wedge pressure of 18-25 -> kerley, peribronch cuffing, indistinct pulm vasc
  3. “alveolar edema”= wedge of >25, airspace fluffy opacity, pleural effs
76
Q

air trapping on expiration at or after 6 months from lung transplant

A

chronic rejection/ bronchiolitis obliterans

77
Q

interlobular septal thickening and ground glass

A

crazy paving= pulmonary alveolar proteinosis

in real life, this can also be edema, hemorrhage, bronchoalveolar carcinoma, interstitial pna

tx with bronchoalveolar lavage

78
Q

diffuse thickening of the trachia that spares the posterior membrane

A

relapsing polychondritis

79
Q

circumferential thickening of th trachea- varying extent, without calcs

A

wegener’s

80
Q

tracheal pathology that spares posterior membrane- cartilagenous and osseous nodules within the submucosa of the tracheal and bronial walls

A

tracheobronchopathia osteochondroplastica (TBO)

81
Q

irregular focal/short segment thickening of the trachea and posterior membrane- calcs common

A

amyloidosis

82
Q

apical predominant bronchiectasis

A

CF

basilar is ciliary dyskinesia

83
Q

Mournier-Kuhn

A

ridic huge trachea

84
Q

Williams campbell syndrome

A

congenital cystic bronchiectasis in 4th-6th order bronchi

85
Q

what collagen vascular disease looks like UIP and COP?

86
Q

Which pulmonary path is related to sjogrens?

87
Q

shortness of breath when sitting up

A

hepatopulmonary syndrome

they’ll need to give you hx of liver disease

88
Q

randomly distributed nodules with cavitation (not infectious)

A

Wegener’s

89
Q

autoimmune pulmonary renal syndrome which resolves quickly- coaslescent airspace opacities (look like edema, but are hemorrhage)

A

goodpasture’s

90
Q

classic location for pericardial cyst

A

right anterior cardiophrenic angle

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