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top 3 differentials > chest and cardiac imaging > Flashcards

chest and cardiac imaging Flashcards

1
Q

solitary pulmonary nodule

A

granuloma-central/diffuse/popcorn/lamellated calcification
neoplasm
hamartoma-30% calcify, 60% show macroscopic fat

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2
Q

multiple pulmonary nodules

A

metastases (random, lower lobes). Cannonball classically RCC/choriocarcinoma
tb, histoplasmosis, coccidoidomycosis
septic emboli - may sow “feeding vessel sign” also seen with mets
GPA (Wegener) -cANCA
RA

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3
Q

pulmonary mass/nodule with cavitation

A 
Tb
Fungal disease
SCC
Septic emboli
GPA, RA

“CAVITY” mneumonic:
Cancer (SCC)
Autoimmune (sarcoid, GPA) also Angioinvasive Aspergillus
Vascular (septic emboli/bland emboli
Infection (staph, Tb)
Trauma (pneumatocoele)
Youth (CPAM, sequestration, bronchogenic cyst)

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4
Q

miliary pulmonary nodules

A 
tb
histoplasmosis
metastases
healed varicella
pneumoconioses (these are more correctly perilymphatic and centrilobular)
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5
Q

centrilobular pulmonary nodules

A 
HP
RB ILD
infectious bronchiolitis -especially consider Tb and MAI (lingula and RML - "lady windermere")
endobronchial tumour spread
pneumoconioses
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6
Q

cystic lung disease

A

Emphysema (mimic, these are not actually cysts)
LAM - uniform round cysts
LCH - nodules and irregular cysts, subpleural sparing
PJP
LIP - sjogrens/AIDs, GGO, CL nodules and cysts

I would add:
DIP
Birt-Hogg-Dube: bilateral renal oncocytomas and chromophobe RCCs, cutaneous fibrofolliculomas and lower zone, subpleural, lentiform cysts

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7
Q

lower lobe ILD

A

UIP pattern ILD - IPF, CTD (RA) -straight edge sign and anterior upper lobe sign are suggestive of CTD, amiodarone, chronic HP

NSIP - collagen vascular disease (SLE, scleroderma), drug induced, idiopathic

Asbestosis

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8
Q

upper lobe ILD

A 
Complicated Silicosis, CWP
Complicated Sarcoidosis
Tb, CF, ABPA
Ankylosing Spondylitis
LCH
Chronic HSP
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9
Q

Unilateral hyperlucent lung

A

Inhaled FB and air trapping
PE: Westermark sign (Other PE signs: Fleishner/Hampton hump)
Pneumothorax
Chest wall: mastetomy/Poland
Swyer-James-MacLeod: obliterative bronchiolitis post mycoplasma: small hyperlucent lung with diminished vascularity
Asthma

I confuse:
A. Swyer-James: : obliterative bronchiolitis post mycoplasma: small hyperlucent lung with diminished vascularity
B. Congenital lobar overinflation: enlarged, hyperlucent, oligaemic lung with mass effect in neonate
C. Bronchial atresia: hyperlucent lobe with finger-in-glove mucocoele

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10
Q

Anterior mediastinal mass

A

lymphoma, germ cell tumour, thymic epithelial neoplasm, thyroid lesion

thymic sepctrum includes hyperplasia (signal drop out), thymoma, invasive thymoma and thymic carcinoma
pericardial cyst, thymic cyst

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11
Q

Middle mediastinal mass

A

lymphadenopathy
calcified: sarcoid, silicosis, treated lymphoma, Tb, less commonly papillary thyroid, mucinous adenocarcinoma or osteosarcoma mets

vascular abnormality
foregut duplication cyst
hiatal hernia

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12
Q

posterior mediastinal mass

A

paraganglioma
nerve sheath tumour in adult: sch/NF/MNST
sympathetic ganglion cell tumour in child: ganlgioneurome/ganglioneuroblastoma/neuroblastoma
oesophageal duplication cyst/bronchogenic cyst
neurenteric cyst
lymphoma
extramedllary haematopoiesis
mediastinal haematoma
lateral thoracic meningocoele

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13
Q

chronic air space disease

A

OP - peripheral migratory GGO/consolidation, atoll/arcade, nodules “reverse batwing
cancer esp. adenocarcinoma
PAP
EP - chronic, UZ, peripheral consolidation “reverse batwing”
Lipoid pneumonia

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14
Q

Peripheral air-space disease

A

EP - chronic, UZ, peripheral consolidation “reverse batwing”
OP - peripheral migratory GGO/consolidation, atoll/arcade, nodules “reverse batwing
Embolic disease
Contusion

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15
Q

GGO

A 
oedema
infection esp atypicals e.g. CMV, PJP
ARDS (normal heart size, no effusion)
haemorrhage - trauma, vasculitis
PAP
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16
Q

Hilar Lymphadenopathy

A

Hodgkin Lymphoma
Sarcoidosis

Infection
Metastasis
Pneumoconioses

17
Q

Calcified Pleural Disease

A

Asbestos exposure
Fibrothorax post empyema, haemothorax
Talc pleurodesis

18
Q

Bronchiectasis

A

Post infectious, CF, ABPA, obstructie lesion and primary ciliary dyskinesia

Capt. Kangaroo has Mounier Kuhn:

CF, congenital cystic nronchiectasis (Willams campbell)
ABPA
Prior infection
Tb
Kartageners/PCD
Mounier Kuhn

and obstructing lesion

19
Q

Perilymphatic nodules

A

Sarcoidosis, silicosis, CWP
lymphangitic carcinomatosis
Lymphoproliferative disorder/LIP

20
Q

Pleural mass

A

Solitary pulmonary nodule -pedunculated, HPOA, hypoglycaemia
Mesothelioma
Metastasis
Empyema (empyema necessitans: Tb, actinomyces, nocardia)

21
Q

HIV related lung disease

A

PJP CD4<200
CMV
LIP (GGO and centrilobular nodules) and Lymphoma
TB/histoplasmosis
Kaposi Sarcoma (nearly all have skin involvement)
Invasive aspergillus - air crescent indicative of healing

22
Q

Abnormal LV contour/calcification

A

true aneurysm - wide neck, anterior
false aneurysm (contained rupture) - narrow neck, posterior, surgically managed
pericardial cyst or mass
pericardial calcification: tb, rheumatic fever, uraemia, pericarditis, haemocardium

23
Q

Cardiac Mass

A

Thrombus - most common
Mets - most common malignancy: melanoma/leukaemia/lymphoma
Myxoma - LA, most common primary, pedunculated
Rhabdomyoma - TS, children, IV septum
Lipoma/fibroma
Angiosarcoma/pleiomorphic undifferentiated sarcoma/liposarcoma

24
Q

Delayed myocardial enhancement

A 
Infarct - initially subendocardial
myocarditis (mid-wall)
sarcoid
amyloid
neoplasm
25
Q

Cardiac fat

A

lipoma (RA)
lipomatous hypertrophy of the IA septum -spares fossa ovalis
arrythmogenic RV dysplasia

26
Q

Coronary Artery Disease

A

atheroscleosis: >50% significant
coronary artery aneurysm: iatrogenic, kawasaki
anomalous coronary arteries: pulmonary arterial origin and interarterial course are significant
Dissection: FMD, postpartum, CTD, iatrogenic

27
Q

Aortic valve disease

A

stenosis: bicuspid, degenerative
regurgitation: root dilatation (marfan), RhF

28
Q

Chest Wall Mass

A 
Askin tumour/Ewing sarcoma
Metastasis
Lipoma
Rib tumour: osteochondroma, chondrosarcoma
Empyema necessitans
elastofiboma dorsi
29
Q

Enlarged cardiac silhouette

A

Cardiomegally: cardiomyopathy, valvular disease
Pericardial effusion
Mediastinal mass

30
Q

Acute aortic syndrome

A

IMH
PAU
Dissection

top 3 differentials (6 decks)

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