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Clin Med 1 - Exam 3 > Focal and Multifocal Lung Diseases > Flashcards

Focal and Multifocal Lung Diseases Flashcards

1
Q

Most common cause of bacterial pneumonia

A

Strep pneumoniae (85%)

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2
Q

Pulmonary infiltrates seen on a chest x-ray that have a sharp, clean border suggests this condition

A

Radiation pneumonitis

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3
Q

Radiation pneumonitis typically shows up this long after exposure

A

1-6 months after radiation

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4
Q

This focal pulmonary infiltrate looks like pneumonia on chest x-ray, but the patient will have NO symptoms (no fever, chills, or elevated WBCs)

A

Alveolar cell carcinoma

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5
Q

Since malignancy can hide in lung infiltrates, imaging should be repeated after this much time to get resolution

A

6 weeks to 3 months

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6
Q

Aspiration of an oily substance can lead to lipoid pneumonia. Diagnosis of which can be confirmed with this test

A

Oil red O stain

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7
Q

Describe the process that commonly leads to lung lobe torsion

A

Lungs are moved aside during CABG surgery

Torsion obstructs blood flow

Post-op, patient gets perfusion-reperfusion injury

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8
Q

Most common cause of endemic fungal pneumonia (in the midwest)

A

Histoplasmosis

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9
Q

Tuberculosis infiltrates typically show on chest x-ray with this appearance and in this area of the lungs

A

Cavitations

In upper lung zones

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10
Q

This multifocal pulmonary infiltrate looks like pneumonia but has more hemoptysis and is common in immunosuppressed patients

A

Invasive aspergillosis

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11
Q

Bulky hilar and mediastinal adenopathy is associated with this multifocal pulmonary infiltrate

A

Hodgkin’s lymphoma

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12
Q

In what way might viral pneumonia appear differently to bacterial pneumonia on chest x-ray?

A

Viral follows airways, so looks more streaky on chest x-rays

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13
Q

Drugs (3) that can induce simple eosinophilic pneumonia

A

Nitrofurantoin

Cocaine

Amiodarone

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14
Q

Simple eosinophilic pneumonia typically shows up in these areas of the lungs

A

Lower lung fields

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15
Q

Pneumonia caused by a worm would show this unique result on a CBC with differential

A

Eosinophils >60%

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16
Q

Which patients are most at risk of chronic eosinophilic pneumonia?

A

Females

Age 20-40

With atopic history

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17
Q

Chronic eosinophilic pneumonia will show up like this on chest x-ray

A

“Reverse pulmonary edema” - more white on outside, clear in the center

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18
Q

Treatments for simple, chronic, and acute eosinophilic pneumonias

A

Simple = d/c drug cause or treat parasite

Chronic = prednisone

Acute = methylprednisolone

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19
Q

This type of eosinophilic pneumonia will present with rales

A

Acute eosinophilic pneumonia

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20
Q

Which eosinophilic pneumonia will present without peripheral eosinophilia?

A

Acute eosinophilic pneumonia (too fast to spread)

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21
Q

Three causes of BOOP

A

Rheumatoid arthritis

Graft vs heart disease

Bleomycin

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22
Q

Treatment for BOOP

A

Chronic prednisone

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23
Q

Telltale symptom for patients with eosinophilic granulomatosis with polyangiitis (Churg-Strauss)

A

Footdrop

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24
Q

Patients with this condition have atopy/asthma, neuropathic and skin lesions, high absolute eosinophils, and infiltrates and nodules without cavitations

A

Granulomatous with polyangiitis (Wegener’s)

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25
Q

Silicosis in patients with rheumatoid arthritis is called this …

A

Caplan syndrome

26
Q

Describe how multifocal pulmonary infiltrates as a result of ankylosing spondylitis would present

A

Upper lung fibrous infiltrates

Looks like TB (cavitations)

Aspergillus colonization in cavities

27
Q

True or false. Bacterial pneumonia commonly presents as segmental/lobar infiltrates

A

False. More commonly focal/multifocal

28
Q

Mycoplasma pneumonia primarily shows up in these areas of the lungs

A

Lung bases or right middle lobe

29
Q

Describe the spread pattern of invasive aspergillosis and mucor

A

Angioinvasive, follows blood vessels

30
Q

Describe the cough in segmental/lobar tuberculosis

A

Non-productive

May have hemoptysis

31
Q

In which airways are carcinoid tumors typically found?

A

Central airways

32
Q

Are foreign bodies causing segmental/lobar pulmonary blockage more often radiolucent or radiopaque?

A

90% are radiolucent (don’t show up)

33
Q

Aspiration of medications with this ingredient in particular is a medical emergency

A

Medications containing iron

34
Q

This segmental/lobar pulmonary infiltrate shows with a classic fingerlike plugging of airways pattern

A

ABPA

Allergic Bronchopulmonary Aspergillus

35
Q

Asthma with hypersensitivity to aspergillus causes atelectasis in these areas of the lungs and this type of sputum

A

Atelectasis in upper lobes

Brown sputum

36
Q

Treatment for ABPA (allergic bronchopulmonary aspergillus)

A

Prednisone (treat the asthma)

37
Q

Wedge shaped infiltrates on chest x-ray (Hampton Hump) suggest this condition

A

Pulmonary infarction

38
Q

Symptom for patients with pulmonary infarction

A

Hemoptysis (but continue anticoagulation)

39
Q

Which cavitary pulmonary infiltrate shows with effusions and air-fluid levels in the cavities?

A

Pyogenic bacterial pneumonia

40
Q

Which pneumonia shows with thick walled upper lobe cavitations without fluid levels?

A

Suppurative pneumonias

41
Q

Most common cause of rapidly growing lung cancers which present with cavitations

A

Squamous cell carcinoma

(cancer outgrows its blood supply)

42
Q

Typical symptoms (4) for cavitary GPA (Wegener’s granulomatosis)

A

Lower respiratory tract webbing

Glomerulonephritis

Vasculitis - ulcers/rashes on body

Generally very sick (fever, weight loss, sinus issues)

43
Q

Tests for cavitary GPA (Wegener granulomatosis)

A

cANCA/PR3 or pANCA/MPO

Will also have elevated ESR

Biopsy preferred (renal better than lung)

44
Q

Treatment for cavitary GPA (Wegener’s granulomatosis)

A

Cyclophosphamide, steroids, rituximab

45
Q

Size of pulmonary nodules

A

<3mm (larger is a mass)

46
Q

A granulomas solitary pulmonary nodule would look like this on a PET scan

A

“Flip-flop fungus”

Lymph nodes brighter than nodule

47
Q

True or false. A single nodule in the lung is rarely a metastatic malignancy

A

True

48
Q

A ball seen on the peripheral edge of the lung with a comet tail would be seen in this condition

A

Rounded atelectasis

49
Q

Describe the Fleischner criteria

A

Guidelines for follow-up/management of pulmonary nodules in patients aged 35+

50
Q

This fungus can cause lung masses up to 10cm in size

A

Cryptococcus

51
Q

Pulmonary masses in the hilar portion of the lower lung lobes are caused by this

A

Blastomycosis

52
Q

Patients with bone marrow transplants (neutropenic) are more likely to have this type of pulmonary mass

A

Invasive pulmonary aspergillosis + mucormycosis

53
Q

Describe bronchopulmonary sequestration and how it would look on imaging

A

Lung area that never developed properly

Well-defined on imaging with no change over time

54
Q

If multiple pulmonary nodules are seen on imaging, the etiology is suspected to be this type of cancer

A

Hematogenous spread from elsewhere in the body (metastasis)

55
Q

IV drug users are most at risk of these types of pulmonary nodules

A

Bacterial endocarditis spread from right sided heart valve

56
Q

Small satellite nodules seen in the lungs surrounding a larger nodule suggest this type of infection

A

Fungal infection

57
Q

Echinococcal lesions in the lungs and other organs are typically caused by this type of infection

A

Parasitic infection

58
Q

Metastatic carcinomas in the lungs have this classic appearance on imaging

A

Cannon-ball metastases in lower lobes

59
Q

Three most common cancers that cause pulmonary metastatic carcinomas

A

Renal

Prostate

Breast

60
Q

Well circumscribed nodules without adenopathy are seen in this condition

A

Post-transplant lymphoproliferative disorders

61
Q

Which type of pulmonary nodule mimics GPA?

A

Lymphomatoid granulomatosis

Clin Med 1 - Exam 3 (4 decks)

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