Chest pathologies

Question 1

Cystic Fibrosis

Answer 1

Inherited disease of the exocrine glands in which heavy mucus causes progressive clogging of the bronchi and bronchioles.

R/A- increased thickening of lung markings, increased radiodensities and hyperinflation of the lungs as they’re overworked.

Question 2

Pleural Effusion

Answer 2

Abnormal accumulation of fluid in pleural space. Hemothorax (blood), empyema (pus), chylothorax (chyle), hydrothorax (serous fluid).

R/A- blunting of costophrenic angles, 400ml of fluid to be seen on xray, fluid within fissures, opacity

Question 3

Pneumothorax

Answer 3

Accumulation of air in pleural space. SOB. Chest pain. Absence of lung markings.

1) Traumatic = rib puncture/gun wound/knife wound
2) Tension = medical emergency. Without release air becomes trapped, mediastinal shift (away), can be potentially fatal.
3) Primary Spontaneous = common in young, tall, slender males. Idiopathic/spontaneous
4) Secondary Spontaneous = secondary to underlying pathology

Question 4

Cardiomegaly

Answer 4

Abnormal enlargement of heart. May be a result of CAD (coronary artery disease), or increased blood pressure, Look at CTR (cardio thoracic ratio) where the heart is 50% or more than the width of thoracic cavity it is deemed as cardiomegaly. Can lead to CHF.

Question 5

Emphysema

Answer 5

Irreversible & chronic lung disease. Spectrum of COPD, exclusively related to smoking. The alveoli air spaces become enlarged, destruct & lose elasticity.

R/A- Bulla (distended alveoli throughout lungs), hyperinflated lungs, barrel chest, decreased lung markings, flattened diaphragms.

Question 6

CHF (Congestive Heart Failure)

Answer 6

Heart cannot pump out the same amount of blood it is receiving. Leads to cardiomegaly.

Increased fluid levels, vascular redistribution, Kerly B lines.
LVF = gumboot sign, pulmonary oedema
RVF = Peripheral oedema

Question 7

TB (Tuberculosis)

Answer 7

Caused by inhalation of droplets containing mycobacterium tuberculosis. Airborne.

Primary = sits in lower lobes
Secondary = upper lobes
Miliary = tiny little focal lesions throughout

Question 8

Pneumonia

Answer 8

Inflammation of the lungs resulting in accumulation of fluid. Increased radiodensities.
4 types:
1) Aspiration Pneumonia
2) Bronchopneumonia
3) Lobar pneumonia
4) Viral (interstitial) pneumonia