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Chest Imaging > J. Mandell & D. Marchiori > Flashcards

J. Mandell & D. Marchiori Flashcards

1
Q

Direct signs of atelectasis includes displacement of fissures as well as what else?

A

Vascular crowding

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2
Q

Adhesive atelectasis is most commonly seen in which neonatal syndrome?

A

Neonatal respiratory distress syndrome, but can also be seen in acute respiratory distress syndrome (ARDS)

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3
Q

What is the most common location for round atelectasis?

A

Posterior lower lobes

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4
Q

What is an air bronchogram and what does it indicate?

A

Air bronchogram represents lucent air-filled bronchus seen within consolidation. It represents air-space consolidation

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5
Q

Acute consolidation is most common due to pneumonia but can be caused by what other conditions?

A

Pulmonary hemorrhage
Acute respiratory distress syndrome (ARDS)
Pulmonary edema (uncommon manifestation)

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6
Q

What are differential diagnosis that should be considered for chronic consolidation?

A

Bronchioalveolar carcinoma
Organizing pneumonia
Chronic eosinophilic pneumonia

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7
Q

What is the first suspicion when there is acute ground glass opacification?

A

Pulmonary edema

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8
Q

What is the most common cause of smooth inter-lobar septal thickening?

A

Pulmonary edema

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9
Q

Name 3 differential diagnosis for “crazy paving” pattern in the lungs

A

Alveolar proteinosis
Pneumocystis jiroveci pneumonia
Organizing pneumonia

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10
Q

What is the most common cause of perilymphatic nodules, typically with upper-lobe distribution?

A

Sarcoidosis

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11
Q

What are 3 differential diagnosis for a miliary pattern seen within the chest?

A

Tuberculosis
Fungal infection
Hematogenous metastasis

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12
Q

“Tree-in-bud” nodules are almost always associated with small airway infections, causes include

A

Mycobacteria tuberculosis
Atypical mycobacteria
Bacterial pneumonia
Aspiration pneumonia

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13
Q

A solitary cavitating lesion is typically caused by which 2 possibilities?

A

Primary bronchogenic carcinoma or infection

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14
Q

Which 2 primary lung malignancies are known to cause cavitations?

A

Squamous cell carcinoma and adenocarcinoma (squamous cell carcinoma cavitates more often).
Small cell carcinoma is never known to cavitate

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15
Q

3 differential diagnosis for basal-predominant fibrotic changes include what?

A

End-stage asbestosis
Idiopathic pulmonary fibrosis (IPF)
Nonspecific interstitial pneumonia (NSIP), fibrotic form

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16
Q

3 differential diagnosis for upper lobe dominant fibrotic changes include what?

A

End-stage sarcoidosis
End-stage silicosis
Chronic hypersensitivity pneumonitis

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17
Q

Round pneumonia is typically only seen in which population?

A

Children (most commonly caused by Strep. pneumoniae)

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18
Q

A pulmonary abscess is typically caused by which organisms?

A

Staph. aureus (most common)
Pseudomonas
Anaerobic bacteria

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19
Q

What is a pneumatocele?

A

A thin-walled, gas-filled cyst that may be post-traumatic or develop as sequela of pneumonia.
Typically from Staph. aureus or pneumocystis

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20
Q

What percentage of people infected with tuberculosis have no radiographic changes?

A

15%

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21
Q

What is the most common sequelae of histoplasmosis infection?

A

Calcified granuloma

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22
Q

How is histoplasmosis spread?

A

Through contaminated soil with bat/bird feces

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23
Q

What is the most common fungal infection in AIDS patients?

A

Cryptococcus neoformans

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24
Q

Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to aspergillum most commonly seen in what type of patients?

A

Those with long-standing asthma

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25
What type of fungus is aspergillus?
A soil fungus
26
Aspergillus only affects individuals in which 2 populations?
Abnormal immunity | Pre-existing pulmonary disease
27
If an aspergilloma (mass-like fungus ball) is symptomatic, what is the most common symptom?
Hemoptysis
28
What is the most common type of lung cancer?
Adenocarcinoma
29
Where in the lung does adenocarcinoma tend to occur?
Peripheral lung
30
What is the second most common type of lung cancer?
Squamous cell carcinoma (non-small cell)
31
What is the third most common type of lung cancer?
Small cell carcinoma
32
What is Churg-Strauss disease?
A systemic small-vessel vasculitis associated with asthma and peripheral eosinophilia
33
What is another name for Churg-Strauss?
Allergic angiitis and granulomatosis
34
Describe lymphangioleiomyomatosis (LAM)
A diffuse cystic lung disease caused by bronchiolar obstruction and lung destruction due to proliferation of immature smooth muscle cells
35
What is the most common primary tumor of the anterior mediastinum?
Thymoma
36
What is the most common anterior mediastinum germ cell tumor?
Teratoma
37
What is the most common malignant anterior mediastinum germ cell tumor?
Seminoma (occurs almost exclusively in men)
38
What is the most concerning cause of a middle mediastinum mass on radiographs?
Lymphadenopathy
39
What are the 3 most common neurogenic tumors of the posterior mediastinum in adults?
Schwannoma (most common) Neurofibroma Malignant peripheral nerve sheath tumor
40
What are the 3 most common neurogenic tumors of the posterior mediastinum in children/young adults?
Ganglioneuroma (most common and benign) Neuroblastoma (malignant) Ganglioneuroblastoma
41
What is the most common cause of broncholithiasis (calcified/ossified material within the bronchial lumen)
Erosion of an adjacent calcified granulomatous lymph node
42
What are 3 common causes of transudative pleural effusion?
Systemic low-protein states Heart failure Nephrotic syndrome
43
What does the "air-crescent" sign represent?
Seen at the periphery of a lung mass/spherical region of lung consolidation Represents a region of necrotizing cavitations/fungal infection
44
What is the "fallen lung" sign?
Inferior displacement of the lung, suggesting a fractured bronchus
45
What is the "figure 3" sign?
A "3" configuration develops along the outer contour of proximal descending aorta with coarctation of the aorta
46
"Gloved finger" sign is associated with allergic bronchopulmonary aspergillosis (ABPA) and what other condition?
Asthma
47
What is the most common type of atelectasis?
Obstructive atelectasis (aka resorptive atelectasis)
48
What is the definition of bronchial asthma?
Widespread, episodic, reversible narrowing of the airways resulting from smooth muscle spasms
49
What is the definition of bronchiectasis?
Chronic, irreversible dilatation of bronchi or bronchioles occurring as a sequelae of inflammatory disease
50
Describe bronchopulmonary sequestration
Congenital malformation of the foregut, resulting in a portion of lung that is unconnected to the tracheobronchial tree
51
What is the resulting consequence of bronchopulmonary sequestration?
A non-functioning segment of lung unconnected to the bronchopulmonary tree
52
What is the most common type of emphysema?
Centrilobar
53
Aside from centrilobar, what other types of emphysema are recognized?
Panacinar Distal acinar (paraseptal) Irregular (paracicatricial)
54
The following radiographic findings of the chest are found with congestive heart failure
Enlarged heart shadow Left ventricular enlargement Left atrial enlargement Cephalization of blood flow (increased vascular marking within superior lung zones) Enlarged superior vena cava (right mediastinal border) Thickening of interlobar fissures Pleural effusion (transudate accumulation in pleural space)` Pleural edema ("batwing"/"butterfly"/"perihilar haze" signs)
55
Describe the "pseudotumor" sign that is associated with pleural effusion
Located fluid within the interlobar fissure that may appear as a mass Characteristically shrinks and disappears, known as the "vanishing"/"phantom" tumor
56
Pulmonary edema due to cardiac failure often presents as follows
Cephalic redistribution of pulmonary blood flow Creates prominent vascular marking in upper lung zone Enlarged cardiac shadow Pleural effusion (often more prominent on the right side)
57
Pulmonary edema due to renal failure often presents as follows
Enlarged cardiac shadow Normal pulmonary vasculature distribution Symmetric, bilateral perihilar opacities
58
Pulmonary edema due to increased vascular permeability often presents as follows
Widespread pattern of alveolar filling Normal sized cardiac shadow Normal vascular distribution
59
Where do pulmonary emboli arise from?
``` Thrombi in the venous circulation Tumors in the venous system Non-venous sources such as: Amniotic fluid Bone marrow Air ```
60
Where do most pulmonary emboli originate from?
Clots in the deep veins of the lower extremities
61
Which portions of the lung are more predisposed to pulmonary emboli?
Lower lung zones
62
Of the patients who develop a pulmonary embolism, what percentage also develops a pulmonary infarct?
15%
63
What do pulmonary infarctions often look like on chest radiographs?
Triangular, pleural-based, radiodense region
64
What are the 2 most common infectious agents causing empyema?
Tuberculosis | Staph. aureus
65
What are the 2 most common infectious agents causing lung abscesses?
Staph. aureus | Klebsiella pneumoniae
66
People at risk for tuberculosis include the following
``` Homeless individuals Prisoners Elderly people in nursing homes IV drug users AIDS patients ```
67
What is the most important risk factor for developing lung cancer?
Cigarette smoking
68
Benign patterns of nodule calcifications seen in the chest includes the following
``` Central Homogenous (total) Laminated Amorphous Speckled ```
69
The majority of lung cancers appear as one of the two following patterns
Solitary parenchymal nodule/mass | Hilar mass demonstrating progressive growth over time
70
Lymphoma of the thorax typically involves these 3 following locations
Mediastinum Hilum Lung parenchyma
71
Thymomas account for what percentage of anterior mediastinal masses?
10% (following lymphoma as the second most common)
72
What are the 3 most common sites for teratomas?
Gonadal Sacrococcygeal locations Anterior mediastinum
73
What percentage of mediastinal tumors are teratomas?
10%
74
Nearly all intrathoracic teratomas are located where?
Mediastinum
75
What is extrinsic allergic alveolitis (EAA), aka hypersensitivity pneumonitis?
Nonatopic, non asthmatic allergic lung disease
76
hypersensitivity pneumonitis manifests as an occupational lung disease caused by _____
Inhalation of organic dusts | This produces granulomatous and interstitial lung changes
77
The following provocative agents are known causes of extrinsic allergic alveolitis
Bagassosis: moldy sugar cane Bird fanciers lung: avian excrete Farmer's lung: moldy hay Humidifier lung: contaminants from humidifying, heating, air conditioning systems Malt worker's lung: moldy malt Maple bark stripper's lung: moldy maple bark Mushroom worker's lungs: mushroom sporres Sequoiosis: redwood dust Suberosis: moldy cork dust
78
What are some common differential diagnosis to consider for chest wall/pleural based lesions?
``` Abscess Hematoma Pleural fluid Rib fracture Rib tumors Skin lesions Soft tissue tumors (malignant/benign) ```
79
What are some causes of hemidiaphragm elevation?
``` Congenital eventration Diaphragm splinting Diaphragmatic hernia Intra-abdominal mass Phrenic nerve paralysis Poor-inspiratory effort ```
80
What are some causes of diffuse alveolar (air-space) disease?
``` Acute respiratory distress syndrome (ARDS) Near-drowning Pneumonia Pulmonary edema Pulmonary hemorrhage ```
81
What are some causes of localized alveolar (air-space) disease?
``` Bronchioalveolar carcinoma Obstructive pneumonitis Pneumonia Lymphoma Pulmonary infarct ```
82
What are some causes of diffuse interstitial disease?
``` Infection Pulmonary edema Connective tissue disorders Langerhans cell histiocytosis Idiopathic interstitial fibrosis Pneumoconiosis ```
83
What are some causes of enlarged hilum?
``` Bronchogenic carcinoma Infectious adenopathy Leukemia Lymphoma Metastatic adenopathy Sarcoidosis ```
84
What are the 4 most common causes of cavitations within the thorax?
Infection Neoplasms Septic embolism Wegener granulomatosis
85
What are some causes of cysts within the thorax?
``` Bronchogenic cyst Bulla/bleb Cystic fibrosis Hydatid cyst Pneumatocele ```
86
What are some causes of hilar/mediastinal calcifications?
``` Granuloma Calcification secondary to radiation therapy Silicosis Teratoma Thyroid calcification Tracheobronchial cartilage calcification ```
87
What are some causes of lung parenchymal calcifications?
``` Fungal ball Granuloma Hamartoma Metastasis Pneumoconiosis Varicella (chickenpox) ```
88
What are the 3 main causes of pleural calcifications?
Empyema Hemothorax Pneumoconiosis (asbestos-related pleural disease)
89
What are some causes of anterior mediastinal lesions?
``` Ascending aortic aneurysm Lipoma Lymphoma Morgagni hernia Pericardial cyst Teratoma Thymic mass ```
90
What are some causes of middle mediastinal lesions?
``` Aortic aneurysm Bronchogenic cyst Esophageal neoplasm Hiatal hernia Lymph node enlargement Mediastinal lipomatosis Pneumomediastinum ```
91
What are some causes of posterior mediastinal lesions?
``` Aneurysm of descending aorta Bochdalek hernia Extramedullar hematopoiesis Neurogenic neoplasm Spinal neoplasm ```
92
What are some causes of pulmonary edema?
``` Acute respiratory distress syndrome (ARDS) Aspiration pneumonia Cardiogenic causes Extrinsic allergic alveolitis Fat embolism Near-drowning Nephrogenic Neurogenic ```
93
What are some causes of a solitary pulmonary nodule/mass?
``` Abscess Arteriovenous malformation Bronchogenic carcinoma Bronchogenic cyst Chest wall lesion Granuloma Hamartoma Metastasis Progressive massive fibrosis ```
94
What are some causes of multiple pulmonary nodules/masses?
``` Alveolar cell carcinoma Granuloma Lymphoma Metastasis Rheumatoid arthritis Sarcoidosis Wegener granulomatosis ```

Chest Imaging (3 decks)

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