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ST Radiology > Exam 2 - Thoracic > Flashcards

Exam 2 - Thoracic Flashcards

0
Q

Pattern of Pneumonia:

  • Starts in peripheral alveoli
  • Bacterial
  • Airspace pattern, Silhouette sign, Air bronchogram sign
A

Lobar pneumonia

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1
Q

MC infectious disease in the world

A

Pneumonia

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2
Q

MC cause of Lobar pneumonia

A

Streptococcus pneumonia

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3
Q

Pattern of Pneumonia:

  • Starts in mucosa of bronchi & bronchioles; spreads to alveoli
  • Viral pneumonia
A

Interstitial/Lobular pneumonia

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4
Q

MC Cause of Bronchopneumonia (segmental)

A

Staphylococcus aureus

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5
Q

MC type of pneumonia in post-primary (reactivation) TB

A

Cavitary Pneumonia

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6
Q

TB that is MC in children

  • Little or no symptoms
  • MC in upper lobes
  • Ranke (primary) complex: hilar lymph node calcification + ghon tubercle
A

Primary TB

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7
Q

TB that is MC in adults as reactivation or continuation of primary disease

  • Cavitation is common
  • Possible pleural effusion
  • MC right side of posterior & apical segments of upper lobes
A

Post-Primary (Reinfective) TB

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8
Q

Type of TB that is due to hematogenous dissemination

  • uncommon
  • small nodules scattered thru-out both lungs
A

Miliary TB

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9
Q

Air in pleural space

- parietal pleura is intact while visceral pleura retracts toward hilum with the collapsing lung

A

Pneumothorax

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10
Q

Air that has dissected into the pleurae, small, and not seen on a film. If it ruptures –> spontaneous pneumothorax

A

Blem

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11
Q

With tension pneumothorax, mediastinal shifts _____ d/t fluid

A

Away

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12
Q

What is the best view to view Pneumothorax

A

PA Chest with Expiration

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13
Q

Key clinical sign for recognizing Subcutaneous Emphysema

A

Crackles upon palpation

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14
Q

MC Anterior Mediastinal Masses

A
  • Lymphoma (T-cells) — MC
  • Thymoma — 2nd MC
  • Teratoma
  • Substernal Thyroid
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15
Q

Thymic hyperplasia in adults is due to:

A
  1. High does cortisone therapy
  2. Chemotherapy
  3. Myasthenia Gravis
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16
Q
  • aka Coin Lesion
  • Nodule: 3cm
  • Water Density
A

Solitary Pulmonary Nodule (SPN)

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17
Q

What are some things that can mimic an SPN:

A
  • Clothing, screen, film artifacts (water on inside)
  • Skin or chest wall lesions (moles, nipples, etc)
  • Hair artifacts
  • Bone lesions
  • Healing rib fractures
  • Pleural or mediastinal lesions
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18
Q

How does the size of a SPN determine if it’s benign or malignant?

A

Rarely Malignant: 5cm

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19
Q

3 MC types of pulmonary scars:

A
  1. TB
  2. Histoplasmosis
  3. Coccidiomycosis
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20
Q

MC benign lung tumor

A

Hamartoma

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21
Q

MC primary lung tumor

A

Bronchial Carcinoid Tumor aka Bronchial Adenoma

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22
Q

Nodule or mass with irregular borders

  • 50% are lobulate
  • 16% cavitate
  • Pleural tail / Comet tail (99% chance malignant)
A

Bronchogenic Carcinoma

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23
Q

MC cell type of a Pancoast Tumor

  • MC to cause airway obstruction
  • Usually central
A

Squamous Bronchogenic Carcinoma

24
Q

MC cell type of small peripheral bronchi

- slow growth = large when discovered

A

Adenocarcinoma

25
Q

Metastasizes quickly to regional lymph nodes

- most aggressive & worst prognosis

A

Small Cell / Oat Cell

26
Q

Grows the quickest

  • periphery
  • large size
  • pleural effusion & pleural involvement are common
A

Large Cell Carcinoma

27
Q

Mass in the lung apex

A

Pancoast Tumor

superior sulcus tumor

28
Q

Best view to see Pancoast Tumor

A

Apical Lordotic View

29
Q

What are the MC cell types for Pancoast Tumor

A

MC = Squamous cell

2nd MC = Adenocarcinoma

30
Q

MC spread of Metastatic Lung Disease

- single/multiple well defined nodules

A

Blood (MC) — Hematogenous

31
Q

Spread of Metastatic Lung Disease

- Reticular nodular interstitial pattern, very small nodules

A

Lymphatic

32
Q

A chronic irreversible dilation of the airspaces distal to the terminal bronchiole with associated destruction of their walls

A

Emphysema

33
Q

Radiographic findings of Emphysema

A
  • Sagittal dimension of chest increased
  • Low flat diaphragm
  • Pseudoblunting of costophrenic angles
  • Heart: small, vertical, elongated
  • Retrosternal clear space > 4.5cm
  • Horizontal anterior ribs & increased intercostal spaces
  • Hyperlucent lungs
  • Loss of vascular markings in periphery
34
Q

MC fungal disease in USA

  • Mississippi & Ohio valleys, Appalachian Mts
  • bird & bat excremate in dirt
  • pulmonary changes similar to TB
A

Histoplasmosis (h.capsulatum)

35
Q

Saprophytic fungus that abides in dirt, but is often airborne

  • Endemic SW USA (desert)
  • San Juanquin Valley fever
A

Coccidiomycosis (c.immitis)

36
Q

Collection of air within the visceral pleura

Dissection of air from the lung into the interstitium, then along septal lines and into the pleura

A

Bleb

37
Q
  • Chronic bronchitis, smoking
  • Due to recurrent inflammation, scarring & fibrosing
  • Bronchovasicular structures/markings have irregular/accentuated contour
A

Dirty Chest

38
Q

A group of more than 200 disorders characterized by inflammation of the pulmonary interstitium & related structures
- Only about 15% have identifiable cause, most of which are due to environmental exposure to certain agents

A

Interstitial Lung Disease

39
Q
  • Increased risk of mesothelioma (mc pleural based tumor)
  • XRay: interstitial pattern, linear opacities start in lung base & move to apex, pleural effusion
  • MC cause of plaques & calcification
  • Starts over the domes of the diaphragm
  • MC cause of pulmonary fibrosis
A

Asbestosis

fibrogenic pneumoconiosis

40
Q

Fibrogenic Pneumoconiosis

  • Rock drilling, mining, foundries, etc
  • XRay: Silicon Nodules, Egg-Shell calcification of Lymph Nodes
A

Silicosis

41
Q

Fibrogenic Pneumoconiosis:

- Caplan’s Syndrome: pneumoconiosis & RA

A

Coal Workers

42
Q

Which conditions are non-fibrogenic pneumoconiosis?

A

Siderosis
Baritosis
Stannosis

43
Q

Iron oxide, welders

A

Siderosis

44
Q

Due to inhaled organic dusts

A

Extrinsic Allergic Alveolitis

45
Q

Moldy sugar cane

A

Bagassosis

46
Q

Bird excreta (pigeon)

A

Bird Fanciers Lung

47
Q

Moldy hay

A

Farmers Lung

48
Q

Redwood dust

A

Sequoiosis

49
Q

Cotton Dust

A

Byssinosis

50
Q

MC Primary tumor of pleura

A

Pleural Mesothelioma

51
Q

3 reasons for enlarged heart:

A
  1. Cardiomegaly
  2. Pericardial Effusion
  3. Extra-cardiac causes that mimic
52
Q

MC benign tumor of the heart

A

Myxoma

75% in left atrium

53
Q

4 Key Radiographic signs:

  • Thickening of interlobular septa (Kerley B Lines)
  • Peribronchial Cuffing
  • Fluid in the fissures
  • Pleural Effusion
A

Pulmonary Interstitial Edema

54
Q

3 Key radiographic signs:

  • Fluffy, indistinct, patchy airspace densities
  • Bat wing/butterfly wing appearance ***
  • Pleural effusion
A

Pulmonary Alveolar Edema

55
Q

These key signs indicate what:

  1. Kerley’s Lines
  2. Fluid in Fissure
  3. Peribronchial Cuffing
  4. Pleural Effusion
  5. “Viking Horn Sign” (cephalization of blood flow)
A

Pulmonary Edema asso w/ CHF

56
Q

Thoracic aorta in aging patient

A
  • Loss of elasticity: slight elongation & dilation
  • Ascending arch more convex at upper right heart border
  • Transverse arch bc prominent
57
Q

Thoracic Aortic Aneurysm is MC

A

descending

58
Q

Congenital syndrome due to cilia dyskinesia

- Situs inversus: all organs transposed

A

Kartagener Syndrome

ST Radiology (3 decks)

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