Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Thoracic and Respiratory > Interstitial and Occupational Lung Disease > Flashcards

Interstitial and Occupational Lung Disease Flashcards

0
Q

Features of pleural plaque on CT

A

Well defined borders
Associated with ribs
Lower zones mainly
Smooth pleural thickening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

Features of asbestosis lung

A 
Pleural plaques
Pleural effusion
Pleural thickening
Folded stele tasks
Interstitial lung fibrosis

Holly leaf appearance on cxr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Features of diffuse pleural thickening

A

Smooth uninterrupted layer of thickened pleura. Extends over one quarter of chest wall

> 3mm thick
8cm cranio caudial
5cm lateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the comet tail sign

A

Folded or round atelectasis seen in asbestosis. Sub pleural. Bronchi and vessels appear to be drawn into it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

HRCT features of asbestosis

A

Sub pleural branching opacities
Sub pleural curvilinear opacities
Parenchyma bands
Honeycomb change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Simple vs Complicated Pneumoconiosis

A

Simple: coal pigments 1-5mm no fibrosis

Complicated: coal pigment plus area > 1cm of fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

CXR findings of coal workers pneumoconiosis

A

Multiple small round opacities. Upper and mid zones

Hilar lymph node enlargement.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe caplans syndrome

A

CWP in rheumatoid patients. Multiple well defined nodules in apices.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Features of silicosis

A

Small. Sharply defined. Nodules. Perilymphatic. Upper and mid zones. Lymph node calcification. PMF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Features of silicoproteinosis

A

Centrilobular ground glass nodules. Crazy paving

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Features of siderosis

A

Reticule nodular opacities widespread though out the lung.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe the appearances of IPF

A

Increased risk bronchogenic carcinoma.

CXR: basal bilateral peripheral reticular and small rounded opacities. Lung volume loss.

HTCT: sub pleural cystic air spaces. Honeycombing. Traction Dilatation. Starts posterior lung bases. Mid zone lateral. Upper zone anterior.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Features of non specific interstitial pneumonitis

A

CXR: mid and lower zone infiltrates

HRCT: symmetrical bilateral ground glass opacity bases. Traction Dilatation. Consolidation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Features of respiratory Bronchiolitis associated interstitial lung disease.

A

CXR: patchy ground glass on lower zones.

HRCT: patchy ground glass. Low attenuation centrilobular nodules. Patches of low attenuation die to air trapping.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Features of desquamative interstitial pneumonitis

A

Patchy ground glass shadowing lower peripheral zones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Features of acute interstitial pneumonitis

A

CXR: Bilateral patchy air space opacificaton. Air bronchi grams. Sparing the costophrenic angles

HRCT: ground glass. Air space consolidation. Bronchial Dilatation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Features of cryptogenic organising pneumonia.

A

Occurs 3months after LRTI

CXR: patchy sub pleural area of consolidation bilaterally. Areas of cavitation

HRCT: consolidation around main bronchi. Ground glass. Multiple nodules. Band opacities. Ring opacities surrounding secondary lobules.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Features of hypersensitivity pneumonitis

A

Centrilobular nodules. Areas of GGO. Mosaic perfusion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

CXR features of sarcoidosis

A

Bilateral hilar lymphadenopathy

Differentials:
TB (unilateral)
Lymphoma (anterior mediastinum and paratracheal)

Nodules: upper mid zone
Reticulonodular: nodule plus inter lobar thickening
Airspace consolidation: upper zone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Features of sarcoidosis on HRCT

A

Bilateral hilar lymphadenopathy
Can compress bronchi causing lobar atelectasis.
Egg shell calcification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

HRCT features of sarcoidosis

A

Irregular small nodules. Around lymph vessels. Bronchi vascular margins. Inter lobule septae. Give a beading appearance to septae.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Feature of Hodgkin’s lymphoma on CXR

A

Anterior mediastinum lymphadenopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Five causes of air space shadowing

A 
Water
Pus
Blood
Cells
Protein
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Causes of airspace shadowing due to water

A

Hydrostatic: ccf. Overload. Renal failure

Capillary Leakage: ards

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Causes of air space shadowing due to blood

A

Trauma
Good pastures
Vasculitis
Idiopathic pulmonary haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Causes of air space shadowing due to cells

A

Alveolar cell carcinoma

Lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Causes of localised air space opacity

A

Lobar pneumonia

Round pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Causes of Central diffuse airspace shadowing

A

Pulmonary odema
Atypical infections
Lymphangitisncarcinonatosa
Alveolar proteinosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Causes of diffuse peripheral airspace shadowing

A

Eosinophilic lung disease

COP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Causes of multiple focal airspace shadowing

A 
Alveolar cell carcinoma
Lymphoma
Pulmonary haemorrhage 
Wegeners granulomatosis
Pulmonary infarcts
Alveolar sarcoidosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Describe the different appearances of kerley lines

A

Due to thickening of the inter lobular septum.

A lines: Central. few centimeters long
B lines: subpleural 1cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Causes of inter lobar septal thickening

A

Raised pulmonary venous pressure: left ventricular failure. Pull odema. Mitral stenosis. Left atrial myxoma. Pulmonary venoocclusive disease.

Tumour: lumphangitis. Sarcoidosis.
Depositis: pneumoconiosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Describe types of septal thickening and causes

A

Smooth: pulmonary odema. Lymphangitis

Nodular thickening: sarcoidosis. Lymphangitis

Septal thickening with lung distortion: fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How do you distinguish between fluid overload post renal transplant and cardiogenic odema.

A

Normal heart size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Features of Sarcoidosis on CXR and HRCT

A

Interstitial shadowing middle and upper zones

Nodular septal thickening
Subpleural nodules.
Peribronchovascular thickening
Beading of fissures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Features of Lymphangitis on CXR

A

Smooth or Nodular septal thickening

Evidence of malignancy:
Lung mass
Mets
Lymphadenopathy 
Effusions 
Bone lesions 
Mastectomy 
Previous lung surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Signs of pulmonary fibrosis on CXR and HRCT

A 
Irregular septal thickening. 
Honeycombing 
Volume loss
Peripheral and subpleural predominance
Asbestos related pleural disease

Emohsema
Irregular septal thickening
Traction bronchiectasis
Ground glass fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Signs of pneumoconiosis

A 
Septal thickening 
Lung nodules upper zones 
Fibrosis
Egg shell calcification
Progressive massive fibrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are reticular patterns on a CXR ?

A

Overlapping. Intersecting lines. Resembling a net. Or mesh.

Narrow the differential by noting the zonal distribution and associated signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Features of established fibrosis on HRCT

A

Traction bronchiectasis
Honeycombing
Inter lobular septal thickening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Differential for reticular pattern on CXR

A 
IPF
CVD fibrosis 
Asbestosis
Drug induced fibrosis
Lymphangitis 
EAA
TB fibrosis
Sarcoidosis
Pneumoconiosis 
Radiation induced fibrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Most common cause of reticular pattern on CXR

A

IPF

Peripheral and bases reticular pattern
Honeycombing signifies severe disease

42
Q

How do you distinguish between IPF and CVD fibrosis

A

Look for associated findings

RD: clavicle erosion. Shoulder disease. Rheumatoid nodules (caseating)

Effusion: RA and SLE. Not SS
Oesophageal Dilatation: SS and Crest

43
Q

Features of asbestosis on CXR

A

Lateral pleural plaques
Holly leafs
Calcified plaques

44
Q

Common drugs causing pulmonary fibrosis and specific feature of amiodarone

A

Methotrexate. Amiodarone. Bleomycin. Nitrofurantoin.

Amiodarone causes increase attenuation in the liver due to iodine metabolite. Hu 70-94 normal 50-65

45
Q

Feature of. Extrinsic allergic alveolitis

A

Chronic. Upper zone reticular

Acute and subacute. Bases

46
Q

Features of Sarcoidosis vs TB

A

Common: reticular upper zone pattern. Lymphadenopathy

Difference: sarcoidosis bilateral. Apical sparing.

47
Q

Features of pneumoconiosis

A

Upper zone predominance. Reticulonodular.

Silicosis: egg shell calcification
PMR: mass like opacities

48
Q

Features of radiation induced fibrosis

A

Lung damage only occurs in field of therapy. Sharp line of demarcation. Previous malignancy history.

49
Q

General rule for causes of upper and lower zone predominance

A

Upper: inhaled dust causes where ventilation is greatest; pneumoconiosis. Sarcoidosis. Tb. Ank spond. Chronic eaa. Radiation induced. Histoplasmosis.

Lower: immunological causes where perfusion is better.; IPF. CVD. Asbestosis. Drug induced fibrosis. Chronic aspiration.

50
Q

CXR differentials for septal lines.

A

Lymphangitis carinomatosa

Pulmonary odema

51
Q

CXR differentials for honeycombing

A

End stage pulmonary fibrosis
Langerhans cell histocytosis
Lymphangioleiomyomatosis

52
Q

CXR differentials for lymadenopathy

A 
Sarcoidosis
Tb
Lymphoma
Lymphangitis 
Silicosis
53
Q

Two causes of mosaicism

A

Increase filling GGO

Deceased perfusion

54
Q

How can mosaicism help identify pulmonary embolism

A

Areas not perfused will be hypo attenuated. Less vascular markings. Compensatory increase in perfused areas. May extend to pulmonary arterial hypertension. Increase in size of pulmonary outflow tract greater than the aorta

55
Q

Causes of crazy paving?

A

Alveolar proteinosis

Heart failure
Lymphangitis carcinomatosa
Non specific interstitial pneumonitis

56
Q

Carcinoma associated with Lymphangitis carcinomatosa

A

Adenocarcinoma of breast, bronchus, stomach, pancreas, cervix and thyroid

57
Q

Causes of tree in bud

A

Mucus plugging

Asthma
Aspiration
ABPA
Bronchiectasis
Infectious Bronchiolitis 
Panbronchiolitis
Endobroncial TB
58
Q

Causes of predominately central consolidation

A

Cardiac failure
Cancer
PCP
Alveolar proteinosis

59
Q

Causes of peripheral consolidation

A

Pneumonias

Poly myosotis

60
Q

Characteristics of sarcoidosis on HRCT

A

Subpleural nodules. Peribronchovascular nodules. May coalesce to form consolidation. Beading of fissures. Lymphadenopathy

61
Q

Difference between UIP and COP

A

Both have consolidation. GGO. Small nodules.

UIP has added fibrosis

62
Q

Appearances of EAA

A

Acute: centrilobular nodules. GGO. Can cause consolidation

Subacute: more upper lobe.

Chronic. Plus fibrosis

63
Q

Presentations of Bronchioloalveolar cell carcinoma

A
  1. Solitary peripheral nodules
  2. Pneumonic consolidation. 20%. Nodules same lobe
  3. Multiple 5-6 mm nodules
64
Q

Features of Chronic eosinophilic pneumonia

A

Middle aged women
Peripheral consolidation
Resolved with steroids

Area of consolidation moves around lung.

65
Q

Presentations of Bronchioloalveolar cell carcinoma

A
  1. Solitary peripheral nodules
  2. Pneumonic consolidation. 20%. Nodules same lobe
  3. Multiple 5-6 mm nodules
66
Q

Features of acute interstitial pneumonia

A

Rapidly increasing dyspnoea following ? Viral URTI.

Bilateral GGO
Apical consolidation

Phases:
Exudative-GGO consolidation
Proliferative-traction bronchiectasis
Fibrotic-honeycombing

Half die in 2months

67
Q

Features of acute interstitial pneumonia

A

Rapidly increasing dyspnoea following ? Viral URTI.

Bilateral GGO
Apical consolidation

Phases:
Exudative-GGO consolidation
Proliferative-traction bronchiectasis
Fibrotic-honeycombing

Half die in 2months

68
Q

Three diseases which are primarily cystic in nature

A

Langerhans cell histopcytosis
Lymphangioleiomyomatoisis
Tuberous sclerosis

69
Q

Radiological features of Langerhans cell histiocytosis.

A

Initially Nodular appearance due to granuloma at terminal bronchioles. Progress to cyst. Cyst due to bronchi Dilatation. Varicose bronchi. Extensive lung destruction and bulbous emphysema.

Upper zone predominance. Costophrenic angles are spared.

70
Q

Clinical features of LAM

A

Lymphangioleiomyomatosis
Smooth muscle cell proliferation in bronchi and mediastinum.
Women
Childbearing age.

Numerous thin walled cysts uniform distribution surrounded by normal lung no basal sparing. Later stages chylous effusion due to blockage of lymph drainage.

71
Q

Three mimics of cystic lung disease

A

Centrilobular emphysema
Para septal emphysema
Cystic bronchiectasis

72
Q

Pathology of two types of centrilobular emphysema

A
  1. Entire parenchyma of secondary lobule destroyed. Septa are intact. Upper zone. Subtle areas of low attenuation. Without any walls
  2. Destruction spreads over septa. However bronchi vascular bundle traverses the cystic space
73
Q

How do you distinguish para septal emphysema from cysts

A

Para septal emphysema produced single later of subpleural and mediastinal cysts. Upper lobe.

Honeycombing. Several layers. Lower zones

74
Q

How to distinguish cystic bronchiectasis from cysts

A

Signet ring sign due to dilated bronchiole and adjacent arterioles

75
Q

Four mechanisms of atelectasis

A

Relaxation
Cicatrisation
Adhesive
Resorptive

76
Q

Features of relaxation atelectasis

A

Due to space occupying process. Adjacent to the lung. Ie pressure increase

Causes: pleural effusion. Pneumothorax. Mass. Gravity

77
Q

Features of cicatrisation atelectasis

A

Due to lung fibrosis

78
Q

Features of adhesive atelectasis

A

Lack of surfactant. Alveolar collapse.

Ards
Pneumonia
Pe
Smoke inhalation
Radiation pneumonitis

GGO
Consolidation. Volume loss

79
Q

What is the significance of consolidation without air bronchi grams

A

Suggests bronchial obstruction. Rather than infective consolidation. ? Mass. Golden S sign

80
Q

Features of Resorptive atelectasis

A

Bronchus blocked. Air reabsorbed into capillaries.

81
Q

Two direct signs of atelectasis

A

Displacement of inter lobar fissures

Crowding of vessels

82
Q

Indirect signs of atelectasis

A 
Local increase in opacity 
Elevation of hemidiaphragm 
Mediastinal displacement 
Compensatory hyperinflation
Displacement of the hilim
Crowding of the ribs 
Absence of an air bronchi gram
Absence of the inter lobar artery
83
Q

Features of right upper line atelectasis on CXR

A

Elevation of concave minor fissure

84
Q

Features of left upper lobe atelectasis
On CXR

What is luftsichel sign ?

A

Veil like opacity over the left lung. Obscured left heart border if linguist region involved.

Air crescent in left upper lobe as upper lobe is pulled down and aerated lower lobe fills space

85
Q

What’s is the juxtaphrenic peak

A

Seen in both left and right upper lobe atelectasis

Small triangular opacity medial half of diaphragm. Site of inferior accessory ligament.

86
Q

Feature of right middle lobe atelectasis

A

Obscured right heart border

87
Q

Features of lower lobe atelectasis.

A

Triangular opacity lower lobe. Blurred diaphragm. Hilum pulled down

88
Q

Feature of right middle and lower lobe collapse

A

Obstruction of bronchus intermedia.

combination of middle and lower lobe collapse. Extends to costophrenic angle

89
Q

Features of segmental atelectasis

A

No air bronchogram
Linear opacity.
Volume loss.

Need to rule out bronchogenic carcinoma

90
Q

Features of liner atelectasis

A

Linear opacity extending to pleural.

Seen in patients with reduced diaphragm movement. Surgery. Acute abdomen.

91
Q

Feature of rounded atelectasis

A

Area of folded lung. Occurs adjacent to thickened pleural of any cause. Lung adjacent to thickened pleural becomes atelectic. Produced round oval density.

CXR : bronchi vascular bundle radiates toward in a. Curvilinear fashion

CT: comet tails

92
Q

On CXR in connective tissue disorders which additional areas should you pay attention to

A

Joint abnormalities - rheumatoid
Oesophageal Dilatation - scleroderma
Enlarged pulmonary artery - PAH
Soft tissue calcification - dermatomyositis

93
Q

Difference between UIP and NSIP

A

UIP - rheumatoid. With honeycombing

NSIP - systemic sclerosis and crest. No honeycombing

94
Q

Lymphocytic interstitial pneumonitis is associated with which disorders

A

Sjogrens
AIDs
Primary Biliary Cirrhosis

95
Q

In SLE patients what are they more at risk of

A

VTE

96
Q

Features of systemic sclerosis on CT

A

Oesophageal Dilatation
Subpleural GGO
Fibrosis
No honeycombing

97
Q

How do you classify causes of pulmonary haemorrhage

A 
Diffuse
    Immunologically mediated
    Non immunologically mediated
         Immunocompromised 
         Immune competent

Focal

98
Q

Causes of focal pulmonary haemorrhage

A 
Chronic bronchitis
Tumours
Infection
Bronchiectasis 
Local trauma
PE 
Vascular erosis
99
Q

Cause of immunologically mediated diffuse pulmonary haemorrhage

A 
Good pastures
CVD
    SLE
     Wegeners 
      Polyarteritis nodosa
      Microscopic polyarteritis
100
Q

Causes of pulmonary haemorrhage in non immunologically mediated immunocompetent

A

Idiopathic pulmonary haemosiderosis
Drugs
Tumors - angiosarcoma
Haemorrhagic diathesis - antiphospholipid/DIc/TTp

101
Q

Causes of diffuse pulmonary haemorrhage in immunocompromised patient

A

Coagulopathy
Infection in the setting of thrombocytopenia
Chemo
Hiv kaposis

102
Q

Feature of PAH on CXR

A

Bilateral hilar opacificaton.

Sparing costophrenic angles and apices

103
Q

Differential for crazy paving

A 
Bronchioalveolar carcinoma 
Alveolar proteinosis
Lipoid pneumonia
Ards
PCP
Pulmonary haemorrhage 
Sarcoidosis
NSIP
Organising pneumonia

Thoracic and Respiratory (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions