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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
COPDers and people without spleens, bronchitis, sometimes B lower lobe pna
H. flu
26
ICUers on vents/CF/Primary Ciliary Dyskinesias
pseudomonas
27
COPDer around a crappy AC. peripheral sublobar airspace opacities
Legionella x-ray tends to lag behind resolution of symptoms
28
aggro pna with rib osteo and chest wall invasion
actinomycosis: dental procedure gone bad, mandible osteo -\> aspiration
29
Pulm findings in chronic GVHD?
lymphocytic infiltration of airways and obliterative bronchiolitis
30
pulmonary findings in early neutropenic BMT?
pulm edema, hemorrhage, drug-induced lung inj fungal pna (invasive aspergillosis)
31
pulmonary findings in early BMT? 30-90days
PCP, CMV
32
pulmonary findings in late BMT? \>90 days
bronchiolitis obliterans, cryptogenic organizing pna
33
AIDS infxns w/ ct \>200
bacterial, TB
34
AIDS infxns w/ ct \<200
PCP, atypical mycobateria feeling *funky*- dancing the line before \<100, so you take some PCP or you get atypical
35
AIDS infxns w/ ct \<100
CMV, disseminated fungal, mycobacterial
36
pt with AIDS: what can a focal airspace opacity represent?
Bacterial infxn (s. pna MC) TB if low CD4 If chronic- think lymphoma or kaposi
37
pt with AIDS: what can multi-focal opacities rep?
bacterial, fungal
38
pt with AIDS: what doe GGOs rep?
THIS IS PCP can be CMV if ct is \<100
39
what does PCP look like?
GGOs peripheral sparing 30% of the time, cysts -\> ptx
40
flame shaped perihilar opacity in AIDS
kaposi sarc
41
AIDS patient with cysts
LIP
42
Which TB forms cavitate?
Post primary and primary progressive
43
calcificed TB granuloma
Ghon lesion- sequela of primary TB
44
Calcified TB granuloma + calcified hilar node
Ranke complex healed primary TB
45
old white man with COPD with cavitary lesion
MAC looks like reactivation TB
46
RML bronchiectasis and tree-in-bud opacities and bronchiectasis
Bronchiectactic MAC "Lady Windermere" disease
47
ill-defined, gg centrilobular nodules
Hypersensitivity pneumonitis/ hot-tub lung
48
You are shown a fungus ball in an exisiting cavity
aspergilloma normal immune
49
consolidative nodule/mass with ground glass halo and or air crescent sign
immune suppressed patient with invasive aspergillus
50
upper lobe central sacular bronchiectasis with mucoid impaction (finger-in-glove)
hyper-immune patient/asthmatic with ABPA (allergic broncho-pulmonary aspergillosis)
51
aggro fungal infxn with invades mediastinum, pleura, and chest wall
mucormycosis
52
features of pulm measels?
multifocal ggo, small nodular opacities
53
features of pulm influenza
coalescent LL opacity
54
pulm features of SARS
LL predominant ggo's
55
pulm features of caricella
mult perpheral nodular opacities
56
Mnemonic for cavitary lung lesion?
**C**avity: cancer, usually squamous cell **A**utoimmune: wegeners, rheumatoid, caplan syndrome **V**ascular: septic emobli/bland emboli **I**nfxn: TB **T**rauma: pneumatoceles **Y**oung: congenital ccams and sequestration
57
septic emboli after ENT surgery or oropharyngeal infxn
Lemierre Syndrome *fusobacterium necrophorum*
58
Exceptions to benign pulm nodule calcs?
hx of GI cancer osteosarc
59
*Mos*t suspicious morphology of pulm nodule?
part solid lesions with ground glass component
60
lung CA that is central, assoc with smoking, cavitates
Squamous can get ectopic PTH production
61
lung CA that is central, central lymphadenopathy
Small cell paraneoplastic: SIADH and ACTH death sentence
62
Lung CA usually peripheral, large
Large cell bad prognosis
63
lung CA that is peripheral, upper lobes, MC subtype overall, happens in setting of lung fibrosis
adenocarcinoma
64
precursor of adenocarcinoma
atypical adenomatous hyperplasia of lung (AAH)
65
adenocarcinoma in situ
less than 3 cm MC is non-mucinous one
66
minimally invasive adenocarcinoma (MIA)
\<3cm. also \<5mm stromal invasion. if greater than 5mm, lepidic predominant adeno
67
AIDS patient with lung nodules, pleural effusion, and lymphadenopathy
ARL/AIDS relatd pulmonary lymphoma 2nd MC lung tumor in AIDS to Kaposi
68
Which sequestration presents in adolescence and which in infancy?
adol/adulthood: intralobar with rucurrent pnas (uaully LLL) infancy: extralobar. assoc with CCAM, diaphram hernia, vert anomalies, congen heart dz, rarely gets infected
69
LCH (langerhans cell histiocytosis)
young smokers bizarre shaped cysts (initially nodules) gets better if you quit smoking spares costophrenic angles
70
which cystic lung disease accompanies tuberous sclerosis?
LAM- you can be shown kidneys with mult AMLs
71
LIP is associated with what other dz processes?
sjogrens and HIV in adults and HIV in kids
72
AIDS + ground glass lungs
PCP (pneumocystis pneumonia)
73
cavitation in the setting of silicaosis?
TB
74
Which ILD is most common with scleroderma?
NSIP
75
What are the stages of CHF?
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
air trapping on expiration at or after 6 months from lung transplant
chronic rejection/ bronchiolitis obliterans
77
interlobular septal thickening and ground glass
crazy paving= pulmonary alveolar proteinosis in real life, this can also be edema, hemorrhage, bronchoalveolar carcinoma, interstitial pna tx with bronchoalveolar lavage
78
diffuse thickening of the trachia that spares the posterior membrane
relapsing polychondritis
79
circumferential thickening of th trachea- varying extent, without calcs
wegener's
80
tracheal pathology that spares posterior membrane- cartilagenous and osseous nodules within the submucosa of the tracheal and bronial walls
tracheobronchopathia osteochondroplastica (TBO)
81
irregular focal/short segment thickening of the trachea and posterior membrane- calcs common
amyloidosis
82
apical predominant bronchiectasis
CF basilar is ciliary dyskinesia
83
Mournier-Kuhn
ridic huge trachea
84
Williams campbell syndrome
congenital cystic bronchiectasis in 4th-6th order bronchi
85
what collagen vascular disease looks like UIP and COP?
RA.
86
Which pulmonary path is related to sjogrens?
LIP
87
shortness of breath when sitting up
hepatopulmonary syndrome they'll need to give you hx of liver disease
88
randomly distributed nodules with cavitation (not infectious)
Wegener's
89
autoimmune pulmonary renal syndrome which resolves quickly- coaslescent airspace opacities (look like edema, but are hemorrhage)
goodpasture's
90
classic location for pericardial cyst
right anterior cardiophrenic angle

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