Image interpritation book - chest

Question 1

What are typical strains of pneumonia?

Answer 1

Streptococcus pneumoniae
haemophilius influenzae

Question 2

What are atypical strains of pneumonia?

Answer 2

Mycoplasma
legionella
Pneumocystis
viral or fungal

Question 3

How long after pneumonia treatment do we CXR?

Answer 3

6 weeks - to ensure resolution and exclude lung mass

Question 4

How does pneumonia appear?

Answer 4

Typical - airspace opacity with air bronchograms (usually 1 lobe)

Atypical - Variable : ground glass opacity, nodules with ground glass halo

Question 5

What are the 2 types of Pleural effusions?

Answer 5

Transudate : imbalance of hydrostatic and oncotic forces. Low protein.
commonly caused by organ failure.

Exudate: local pathology (infective, inflammatory, malignant). High protein

Question 6

What are the appearances of Pleural effusion on CXR and CT?

Answer 6

Erect CXR - fluid density within the bases
Supine CT - fluid posteriorly

Question 7

what are common routes of spread of primary lung cancer?

Answer 7

Direct - bronchus, chest wall, aorta, esophagus
Lymphatic - Hilar, mediastinal lymph nodes
Haematogenous - bone, brain, liver adrenal
Transcoelomic - malignant pleural effusion

Question 8

What are the appearances of primary lung cancer?

Answer 8

Discrete mass of soft tissue density.
can be associated with lung nodules, mediastinal and hilar lymphadenopathy or Pleural effusion.

Question 9

What is lymphadenopathy?

Answer 9

Enlargement of lymph nodes due to pathology.
Enlargement = > 1 cm in the short axis (width)

Question 10

what is lymphoma?

Answer 10

malignancy of B or T lymphocytes. comes with solid tumors.

It can involve nodal and extra nodal sites.

Question 11

What are common subtypes of Lymphoma?

Answer 11

Hodgkin and non-Hodgkin

Question 12

What classification system is used for lymphoma?

Answer 12

Ann-Arbor

I - single node group
II - > 1 node groups, same side of the diaphragm
III: > 1 node group both sides of diaphragm
IV : extra nodal disease (liver , marrow)

The letter B is added if there are ‘B symptoms’ - fever, weight loss, night sweats) . If no B symptoms then A is added.

Question 13

What are causes of lymphadenopathy seen on CXR?

Answer 13

Lymphoma, Sarcoidosis or TB

Question 14

What is the appearance of lymphoma?

Answer 14

Widespread lymphadenopathy (soft tissue density) involving one or more groups of lymph nodes

Question 15

What is Sarcoidosis?

Answer 15

Sarcoidosis is a condition where lumps called granulomas develop at different sites within the body. Granulomas are made up of clusters of cells involved in inflammation.

It often affects the lungs but can also affect the skin, eyes, joints, nervous system, heart and other parts of the body.

Question 16

What is bronchiectasis?

Answer 16

Its a fixed dilatation of part of the bronchial tree.

Question 17

What are causes of bronchiectasis?

Answer 17

Congenital: CF, Primary ciliary dyskinesia

Acquired: pneumonia, allergic bronchopulmonary aspergillosis

Question 18

How does bronchiectasis appear?

Answer 18

Dilatation of the bronchi with or without bronchus wall thickening or mucus plugging.

Tram-track sign can be seen on CXR and CT
Tree-bud sign and signet ring sign can be seen on CT.