Images Flashcards
Aphthous Stomatitis
(Canker sore)
- Tx: Good oral hygiene, symptom relief (topical lidocaine), and/or avoidance of exacerbating factors (e.g. braces or habitual cheek biting)
Allergic Rhinitis
(Transverse Nasal Crease)
- 2/2 “allergic salute”
HSV-1 Gingivostomatitis
- Orolabial herpes
- Often the first presentation of primary HSV-1 infection
- Inflammation of the oral muscoa & gingiva
Leukoplakia
(precancerous SCC)
- Smoking, drinking, +/- other SCC risk factors
- Does not scrape off like candida
Lymphedema
(Disruption of lymphatics)
- Tx: Weight loss, elevation & compression, & physiotherapy (e.g. lymphatic drainage by massage)
Oral Candidiasis
(oral thrush)
- DM
- HIV/imcx
- Glucocorticoids (e.g. long term asthma tx)
- Abx
PJP
- Patches of ground-glass opacity
- Cystic lesions
- Reticulation
- Septal thickening
PJP
- Patches of ground-glass opacity
- Cystic lesions
- Reticulation
- Septal thickening
Pancoast tumor
(SST–Superior Sulcus Tumor)
- P/w Horner syndrome (ptosis, miosis, anhydrosis; sympathetic nerve fiber injury)
ARDS
Asbestos
(Pleural plaques on CXR)
Aspergilloma
- Chronic pulmonary aspergillosis - usually superimposed onto apical cavitary TB
- Halo sign (surrounding ground-glass opacities) on CXR
- Invasive aspergillosis - occurs in imcx setting (e.g. neutropenia, glucocorticoids, HIV)
- +galactomannan, +ß-D-glucan
- Tx: Voriconazole ± casopofungin (an echinocandin)
Lung cancer
(Left)
- Central: SCC or SCLC
- Peripheral: Adenocarcinoma or LCC
PJP
- Small pneumatocoeles and/or subpleural blebs (random scattered black pockets overlaying diffuse reticular pattern on CXR)
- Fine, reticular interstitial pattern
- Often perihilar distribution
- Ground-glass on HRCT
Pleural Effusion
(2/2 Empyema in HIV pt)
- Exudative = high protein, high LDH
- Complicated = low glucose, low pH
- Empyema = Exudative & Complicated parapneumonic effusion
- Causes of exudative: IMP: Infection, Malignancy, PE
Aspergilloma
- Chronic pulmonary aspergillosis - usually superimposed onto apical cavitary TB
- Halo sign (surrounding ground-glass opacities) on CXR
- Invasive aspergillosis - occurs in imcx setting (e.g. neutropenia, glucocorticoids, HIV)
- +galactomannan, +ß-D-glucan
- Tx: Voriconazole ± casopofungin (an echinocandin)
Bacterial PNA
Aspergilloma
- Chronic pulmonary aspergillosis - usually superimposed onto apical cavitary TB
- Halo sign (surrounding ground-glass opacities) on CXR
- Invasive aspergillosis - occurs in imcx setting (e.g. neutropenia, glucocorticoids, HIV)
- +galactomannan, +ß-D-glucan
- Tx: Voriconazole ± casopofungin (an echinocandin)
Pancoast tumor
(SST–Superior Sulcus Tumor)
- P/w Horner syndrome (ptosis, miosis, anhydrosis; sympathetic nerve fiber injury)
Lung Abscess
(Cavity w/ Air-Fluid Level; Thick-walled)
PE
(CT w/ contrast)
- Shows pulmonary artery filling defect, which indicates acute PE
TB
(Reactivation TB)
PE
COPD
Mesothelioma
(Pleural thickening w/ effusion)
- Adeno- still more common w/ asbestos exposure
Alveolar bleb rupture from COPD
(SSP: Secondary Spontaneous PTX)
- UL decreased breath sounds in pts with known COPD or CF
- Hyper-resonance on percussion
- Smoking
- Destruction of alveolar sacs > formation of large alveolar blebs > rupture, leaking air into pleural space
Cryptogenic Organizing PNA
(BL ground glass infiltrates)
Lung Cancer
(Malignancy)
PE
(Wedge-shaped, pleural-based opacification)
Pulmonary Fibrosis
(ILD)
- Honeycombing
- If 2/2 Rx: ABBMNR
- Amiodarone
- Busulfan
- Bleomycin
- MTX
- Nitrofurantoin
- Radiation
Lobar PNA
Asbestosis
(Pleural Plaques)
PTX
PTX
Superior Sulcus Tumor
(Pancoast Tumor)
- P/w Horner syndrome (ptosis, miosis, anhidrosis)
50M presents to ED w/ fevers, cough, hypoxia
Severe CAP
(Left hemithorax white-out)
- Tx: CAP CAM = CTX + Azithromycin
- or: Moxifloxacin
55F
Lobar PNA (RLL)
48F
Lobar PNA (RLL)
Lobar PNA (RUL)
Lobar PNA (RML)
Lobar PNA (RML)
1
SVC
2
Ascending Aorta
3
Main Pulmonary Artery
4
L Pulmonary Artery
5
Descending Aorta
6
Thoracic Duct
7
Azygos Vein
- Runs up thoracic vertebral column from lumbar region and drains into SVC just above RA
8
Esophagus
9
R Pulmonary Artery
A
Stomach
C
Gallbladder
E
Duodenum
F
Portal Vein
- Always next to IVC
- Drains INTO liver from small intestine (SMV), large intestine (IMV), and spleen (splenic vein)
- Formed by the superior mesenteric vein, inferior mesenteric vein, and splenic vein
H
Descending Colon
GBM
(Grade IV Astrocytoma)
- Classic appearance on MRI imaging
- Risk factors: Neurofibromatosis, Li Fraumeni syndrome, previous radiation therapy
- Tx: Surgery, HD Steroids, Temozolomide (CTX)
- High recurrence rate, low survival
- Differs from Grade III in that it has:
- necrotizing tissue
- anaplastic cells (no differentiation)
- hyperplastic blood vessels (proliferative)
GBM
(Grade IV Astrocytoma)
- Classic appearance on MRI imaging
- Risk factors: Neurofibromatosis, Li Fraumeni syndrome, previous radiation therapy
- Tx: Surgery, HD Steroids, Temozolomide (CTX)
- High recurrence rate, low survival
- Differs from Grade III in that it has:
- necrotizing tissue
- anaplastic cells (no differentiation)
- hyperplastic blood vessels (proliferative)
Epidural Hematoma
(Biconvex)
- Middle Meningeal Artery rupture
- Often w/ skull fracture
Subdural Hematoma
(Bridging Vein Rupture)
- Elderly, hx of fall, delayed sx
Subarachnoid Hemorrhage (SAH)
(Aneurysm rupture 2/2 HTN or vascular disease)
- Suspect SAH if HA reaches peak, severe intensity within seconds of onset or causes LOC
- If CT negative but still suspect, and low suspicion for IIP, do LP
- CSF:
- Xanthochromia
- Numerous RBCs
- Elevated Pressure
