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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
Q

What type of fungus is aspergillus?

A

A soil fungus

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26
Q

Aspergillus only affects individuals in which 2 populations?

A

Abnormal immunity

Pre-existing pulmonary disease

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27
Q

If an aspergilloma (mass-like fungus ball) is symptomatic, what is the most common symptom?

A

Hemoptysis

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28
Q

What is the most common type of lung cancer?

A

Adenocarcinoma

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29
Q

Where in the lung does adenocarcinoma tend to occur?

A

Peripheral lung

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30
Q

What is the second most common type of lung cancer?

A

Squamous cell carcinoma (non-small cell)

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31
Q

What is the third most common type of lung cancer?

A

Small cell carcinoma

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32
Q

What is Churg-Strauss disease?

A

A systemic small-vessel vasculitis associated with asthma and peripheral eosinophilia

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33
Q

What is another name for Churg-Strauss?

A

Allergic angiitis and granulomatosis

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34
Q

Describe lymphangioleiomyomatosis (LAM)

A

A diffuse cystic lung disease caused by bronchiolar obstruction and lung destruction due to proliferation of immature smooth muscle cells

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35
Q

What is the most common primary tumor of the anterior mediastinum?

A

Thymoma

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36
Q

What is the most common anterior mediastinum germ cell tumor?

A

Teratoma

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37
Q

What is the most common malignant anterior mediastinum germ cell tumor?

A

Seminoma (occurs almost exclusively in men)

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38
Q

What is the most concerning cause of a middle mediastinum mass on radiographs?

A

Lymphadenopathy

39
Q

What are the 3 most common neurogenic tumors of the posterior mediastinum in adults?

A

Schwannoma (most common)
Neurofibroma
Malignant peripheral nerve sheath tumor

40
Q

What are the 3 most common neurogenic tumors of the posterior mediastinum in children/young adults?

A

Ganglioneuroma (most common and benign)
Neuroblastoma (malignant)
Ganglioneuroblastoma

41
Q

What is the most common cause of broncholithiasis (calcified/ossified material within the bronchial lumen)

A

Erosion of an adjacent calcified granulomatous lymph node

42
Q

What are 3 common causes of transudative pleural effusion?

A

Systemic low-protein states
Heart failure
Nephrotic syndrome

43
Q

What does the “air-crescent” sign represent?

A

Seen at the periphery of a lung mass/spherical region of lung consolidation
Represents a region of necrotizing cavitations/fungal infection

44
Q

What is the “fallen lung” sign?

A

Inferior displacement of the lung, suggesting a fractured bronchus

45
Q

What is the “figure 3” sign?

A

A “3” configuration develops along the outer contour of proximal descending aorta with coarctation of the aorta

46
Q

“Gloved finger” sign is associated with allergic bronchopulmonary aspergillosis (ABPA) and what other condition?

A

Asthma

47
Q

What is the most common type of atelectasis?

A

Obstructive atelectasis (aka resorptive atelectasis)

48
Q

What is the definition of bronchial asthma?

A

Widespread, episodic, reversible narrowing of the airways resulting from smooth muscle spasms

49
Q

What is the definition of bronchiectasis?

A

Chronic, irreversible dilatation of bronchi or bronchioles occurring as a sequelae of inflammatory disease

50
Q

Describe bronchopulmonary sequestration

A

Congenital malformation of the foregut, resulting in a portion of lung that is unconnected to the tracheobronchial tree

51
Q

What is the resulting consequence of bronchopulmonary sequestration?

A

A non-functioning segment of lung unconnected to the bronchopulmonary tree

52
Q

What is the most common type of emphysema?

A

Centrilobar

53
Q

Aside from centrilobar, what other types of emphysema are recognized?

A

Panacinar
Distal acinar (paraseptal)
Irregular (paracicatricial)

54
Q

The following radiographic findings of the chest are found with congestive heart failure

A

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
Q

Describe the “pseudotumor” sign that is associated with pleural effusion

A

Located fluid within the interlobar fissure that may appear as a mass
Characteristically shrinks and disappears, known as the “vanishing”/”phantom” tumor

56
Q

Pulmonary edema due to cardiac failure often presents as follows

A

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
Q

Pulmonary edema due to renal failure often presents as follows

A

Enlarged cardiac shadow
Normal pulmonary vasculature distribution
Symmetric, bilateral perihilar opacities

58
Q

Pulmonary edema due to increased vascular permeability often presents as follows

A

Widespread pattern of alveolar filling
Normal sized cardiac shadow
Normal vascular distribution

59
Q

Where do pulmonary emboli arise from?

A 
Thrombi in the venous circulation
Tumors in the venous system
Non-venous sources such as:
Amniotic fluid
Bone marrow
Air
60
Q

Where do most pulmonary emboli originate from?

A

Clots in the deep veins of the lower extremities

61
Q

Which portions of the lung are more predisposed to pulmonary emboli?

A

Lower lung zones

62
Q

Of the patients who develop a pulmonary embolism, what percentage also develops a pulmonary infarct?

A

15%

63
Q

What do pulmonary infarctions often look like on chest radiographs?

A

Triangular, pleural-based, radiodense region

64
Q

What are the 2 most common infectious agents causing empyema?

A

Tuberculosis

Staph. aureus

65
Q

What are the 2 most common infectious agents causing lung abscesses?

A

Staph. aureus

Klebsiella pneumoniae

66
Q

People at risk for tuberculosis include the following

A 
Homeless individuals
Prisoners
Elderly people in nursing homes
IV drug users
AIDS patients
67
Q

What is the most important risk factor for developing lung cancer?

A

Cigarette smoking

68
Q

Benign patterns of nodule calcifications seen in the chest includes the following

A 
Central
Homogenous (total)
Laminated
Amorphous
Speckled
69
Q

The majority of lung cancers appear as one of the two following patterns

A

Solitary parenchymal nodule/mass

Hilar mass demonstrating progressive growth over time

70
Q

Lymphoma of the thorax typically involves these 3 following locations

A

Mediastinum
Hilum
Lung parenchyma

71
Q

Thymomas account for what percentage of anterior mediastinal masses?

A

10% (following lymphoma as the second most common)

72
Q

What are the 3 most common sites for teratomas?

A

Gonadal
Sacrococcygeal locations
Anterior mediastinum

73
Q

What percentage of mediastinal tumors are teratomas?

A

10%

74
Q

Nearly all intrathoracic teratomas are located where?

A

Mediastinum

75
Q

What is extrinsic allergic alveolitis (EAA), aka hypersensitivity pneumonitis?

A

Nonatopic, non asthmatic allergic lung disease

76
Q

hypersensitivity pneumonitis manifests as an occupational lung disease caused by _____

A

Inhalation of organic dusts

This produces granulomatous and interstitial lung changes

77
Q

The following provocative agents are known causes of extrinsic allergic alveolitis

A

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
Q

What are some common differential diagnosis to consider for chest wall/pleural based lesions?

A 
Abscess
Hematoma
Pleural fluid
Rib fracture
Rib tumors
Skin lesions
Soft tissue tumors (malignant/benign)
79
Q

What are some causes of hemidiaphragm elevation?

A 
Congenital eventration
Diaphragm splinting
Diaphragmatic hernia
Intra-abdominal mass
Phrenic nerve paralysis
Poor-inspiratory effort
80
Q

What are some causes of diffuse alveolar (air-space) disease?

A 
Acute respiratory distress syndrome (ARDS)
Near-drowning
Pneumonia 
Pulmonary edema
Pulmonary hemorrhage
81
Q

What are some causes of localized alveolar (air-space) disease?

A 
Bronchioalveolar carcinoma
Obstructive pneumonitis
Pneumonia
Lymphoma
Pulmonary infarct
82
Q

What are some causes of diffuse interstitial disease?

A 
Infection
Pulmonary edema
Connective tissue disorders
Langerhans cell histiocytosis
Idiopathic interstitial fibrosis 
Pneumoconiosis
83
Q

What are some causes of enlarged hilum?

A 
Bronchogenic carcinoma
Infectious adenopathy
Leukemia 
Lymphoma 
Metastatic adenopathy
Sarcoidosis
84
Q

What are the 4 most common causes of cavitations within the thorax?

A

Infection
Neoplasms
Septic embolism
Wegener granulomatosis

85
Q

What are some causes of cysts within the thorax?

A 
Bronchogenic cyst
Bulla/bleb
Cystic fibrosis 
Hydatid cyst
Pneumatocele
86
Q

What are some causes of hilar/mediastinal calcifications?

A 
Granuloma
Calcification secondary to radiation therapy
Silicosis
Teratoma 
Thyroid calcification 
Tracheobronchial cartilage calcification
87
Q

What are some causes of lung parenchymal calcifications?

A 
Fungal ball
Granuloma
Hamartoma
Metastasis
Pneumoconiosis
Varicella (chickenpox)
88
Q

What are the 3 main causes of pleural calcifications?

A

Empyema
Hemothorax
Pneumoconiosis (asbestos-related pleural disease)

89
Q

What are some causes of anterior mediastinal lesions?

A 
Ascending aortic aneurysm
Lipoma
Lymphoma
Morgagni hernia
Pericardial cyst 
Teratoma
Thymic mass
90
Q

What are some causes of middle mediastinal lesions?

A 
Aortic aneurysm
Bronchogenic cyst
Esophageal neoplasm
Hiatal hernia
Lymph node enlargement
Mediastinal lipomatosis
Pneumomediastinum
91
Q

What are some causes of posterior mediastinal lesions?

A 
Aneurysm of descending aorta
Bochdalek hernia
Extramedullar hematopoiesis
Neurogenic neoplasm
Spinal neoplasm
92
Q

What are some causes of pulmonary edema?

A 
Acute respiratory distress syndrome (ARDS)
Aspiration pneumonia
Cardiogenic causes 
Extrinsic allergic alveolitis 
Fat embolism
Near-drowning
Nephrogenic
Neurogenic
93
Q

What are some causes of a solitary pulmonary nodule/mass?

A 
Abscess
Arteriovenous malformation 
Bronchogenic carcinoma
Bronchogenic cyst
Chest wall lesion
Granuloma
Hamartoma
Metastasis
Progressive massive fibrosis
94
Q

What are some causes of multiple pulmonary nodules/masses?

A 
Alveolar cell carcinoma
Granuloma
Lymphoma
Metastasis 
Rheumatoid arthritis
Sarcoidosis
Wegener granulomatosis

Chest Imaging (3 decks)

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