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SUMRAD > CHEST Pathology > Flashcards

CHEST Pathology Flashcards

1
Q

This XRay shows enlarged heart w/ upper apical prominent pulmonary vz? What is this pathology?

A

CHF w/ cephalization
Intersital edema- bilateral
Alveolar-if really bad- bronchograms

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2
Q

This XRay has K B lines, fluid in fissures, pleural effusion, perobroncihal cuffy and cardiolmegaly? What does this indicate?

A

Cardiogenic Pulmonary edema

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3
Q

This XRay has effusion with normal size heart? What does this indicate?

A 
NON cardiogenic pulmonary edema
Drowning
Fluid overload -ARF
High altitude PE
OD-heroin
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4
Q

What are sign of Late CHF?

A

Alveolar

Bil fluffy patchy, bat wing, pleural effusion

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5
Q

What are signs of early CHF?

A 
Interstitial
Fluid in fissures
KBlines
Pleural effusion
Peribronchial cuffing, teeny donuts
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6
Q

What pulls structure to same side when there is volume loss in the lung?

A

Atelectasis
fissures displaced
Atelectasis +effusion= ominous tumor+effusion

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7
Q

What is discoid plate-like, elevated hemidiaphragm, seen in post op, post trauma?

A

Sub segmental ateltectasis

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8
Q

On CT may see wisp of a lung d/t effusion or penumothorax?

A

Compressive atelectasis

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9
Q

Tumor, peanuts, mucus plug, misplaced ET tube may cause this? Xray look like
OPACIFIED area
Fissure, heart, hemidiaphragm displaced
RUL- inverted triangle, d/t fissure moved up
RLL, LLL- triangle sitting on medial 1/2 of diaphragm, pulling down minor/major
Spine sign Lateral film
LUL-tenting of diaphragm, opacified hilum
Major fissure shifted forward on Lat film
RML- Triangle, silhouetting R heart

A

Obstructive atelectasis

Lobar collapse d/t block of bronchus

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10
Q

What follows a hemithorax, pseudotumor. Comet tailing on CT, sticking to pleura?

A

Round atelectasis
Lung cannot expand after pleural effusion
Stuck in scar tissue

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11
Q

What is lucent area on one side of lungs with no markings?

A

Complete pneumothorax

Check close to spine

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12
Q

Pt is afebrile with pleuritic chest pain? What should be observed carefully?

A

Incomplete pneumothorax
Look for thin white line paralleling thoracic curvature
Absent lung markings
SCAN peripherally and apices

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13
Q

What are structures not to get confused with for pneumothorax?

A

Ignore scapula, curves opposite of thoracic, BIL
Bullous, round, curves opposite
skin fold- lung field distal
Poss lung markings

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14
Q

What can be requested to see PNEumothorax?

A

Expiratory film
LLD
Deep sulcus sign-supine, displaces costophrenic angle superiorly
CT-small thorax

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15
Q

What is characteristic of meniscus sign, blunted costophrenic angles, structure move away?

A

Pleural effusion

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16
Q

What type of effusion is lemon shaped, seen in the minor fissure?

A

Round effusion

17
Q

What is an apparent hemi diaphragm w/o meniscus?

A

Subpulmonic effusion
Edema- air space, infx, tissue
Effusion- between spaces

18
Q

Are perfect horizontal lines normal, what do they indicate?

A

Hydropneumothorax

Air+fluid in pleural space-gunshot

19
Q

What is lucent space btwn diaphragm and liver?

A

Pneumoperitoneum
bowel perforation
R side MC seen 1st

20
Q

What does a ruptured trachea, alveolus, emphysema bleb, mechanical ventilation, trauma, all lead to?

A

Pneumomediastinum
Lucent around heart+great vessels
May see continuous diaphragm sign- lucency under heart

21
Q

What cause free air post mediastinum, and push heart superiorly in CXR?

A

Hiatal Hernia
Painless
Superior stomach pushes through diaphragm

22
Q

Pt c/c SOB, hx of smoking, w/ retractions? What would his CXR look like?

A 
Darker, 
HYPERinflated
Flattened diaphragm
Narrow cardiac silouette
Large retrosternal space-Lateral
Blunted angles
Bullae on CT-alien llik
23
Q

What are special about pulmonary mass or nodule?

A 
They make mediastinum and hilar region wider
Cause Lobar atelectasis
Mass obstructive PNA
Malignant effusion exudative
Chest wall mass
Mets all over
24
Q

Which two nodule are central and faster?

A

Small cell- Central ACT, SIADH
Squamous cell- central obstructive
S-speed

25
Q

Which two nodules are peripheral and slower?

A

Adenocarcioma- solitary

Large cell- DX of exclusion

26
Q

What imaging is best for staging and DX?

A

CT
PET, fluoroscopy
Biopsy

27
Q

What conditions make a heart look bigger than 50% of thoracic cavity on PA! film only?

A 
Magnification, AP, apical lordotic
Rotation
Squishing, preg, obese, expiration
Pectus excavatum, kyphosis
Pericardial effusion
28
Q

What are Gold standard imaging for PE DX?

A 
#1CT w/ contrast
VQ if cannot do contrast
Pulmonary angiogram
29
Q

What are signs of PE on CXR?

A

Atelectasis
Effusion
Elevated Hemidiaphragm
Hamptons Hump- wedge shaped ipsilateral on pleura space
Westermarks sign- triangle like observed by vessels. CT vessels disappear
Golden S

30
Q

How can you distinguish btwn diff TBs?

A

Primary is Upper Lobar + Ipsilateral hilar adenophathy/wide

31
Q

What is MC TB in the apical upper lobes, superior LL, cavitation, hilar adenophathy, w/ effusion?

A

Reactivation

32
Q

What is innumerable 1mm nodules on CXR and starry night on CT?

A

Miliary TB-primary or reactive

33
Q

What are the terrible 4t of Ant. Mediastinal Mass? Restrosternal Latera?

A

Thyroid
Terrible Lymphoma
Thymoma
Teratoma

34
Q

What is DDX C.A.L for Medial Mediastinal Mass?

A

Cancer
Aortic Aneurysm
Lymphadenopathy

35
Q

What is DDX P.A.N for Post mediastinal Mass?

A

Aortic aneurysm

Neurogenic tumor

36
Q

Pt hs FH of aorta ruptures. Their c/c is chest and back pain, ripping. What may be seen on Xray?

A

Aortic Aneurysm
Wide mediastinum
Tortuous aorta
L pleural effusion

37
Q

Which ribs are commonly fractured?

A

Rib 4-9
Check for pneumothorax
Pulmonary contusion missed as aveloar/airspace dz

38
Q

Damage to spleen is caused by which rib?

A

Ribs 10-12

39
Q

Which ribs are uncommonly fractured and may cause other tissue damage?

A

Rib 1-3

SUMRAD (13 decks)

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