Brainscape's Knowledge GenomeTM

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


See full index

Thoracic > Lungs > Flashcards

Lungs Flashcards

1
Q

Causes of pulmonary granulomas?

A

Post-infection/inflammatory(eg TB, vasculitides, fungal disease)

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

Benign vs Malignant calcifications?

A

-benign(central, diffuse, popcorn, laminates) -malignant(eccentric, speckled, amorphous)

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

Typical age of round pneumonia?

A

Paediatric < 8 yrs

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

Association of multiple pulmonary AVMs?

A

Osler-Weber-Rendu syndrome(90%) = Hereditary hemorrhagic telangiectasia -epistaxis -telangiectasia of skin/mucous membrane -GI bleed

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

Communications of pulmonary AVMs?

A

Between pulmonary/system artery with a pulmonary vein

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

Acquired causes of pulmonary AVMs?

A

Cirrhosis, trauma, infections

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

Is it reliable to evaluate pulmonary harmatomas by HU?

A

No, as may be falsely low by averaging with air, it should instead rely on visible fat

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

Ddx of feeding vessel sign(a distinct vessel leading directly to a nodule or mass)?

A

Infarction

Embolism

Angioinvasive

pulmonary aspergillosis

Vasculitis

AVMs

Metastases

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

Ddx of multiple lung nodules?

A

metastases, lymphoma, Ca lung with synchronous primary tutors, infections, granulomatous diseases, sarcoidosis, GPA, rheumatoid lung disease, amyloidosis, septic embolism

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

Predilection of pulmonary metastases?

A

peripheral and subpleural

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

Associated findings of pulmonary metastases?

A

-surrounding haemorrhage(ill defined or halo sign) -cavitation -calcification -feeding vessel sign(reflect their embolic nature)

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

Prognosis of invasive mucinous adenocarcinoma(IMA)?

A

poor

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

CT features of invasive mucinous adenocarcinoma(IMA)?

A

-diffuse/patchy lung consolidation -GGO -multiple lung nodules in centrilobular location -CT angiogram sign(visible opacified arteries within consolidative areas on contrast-chanced CT)

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

Tumour behaviour of invasive mucinous adenocarcinoma(IMA)?

A

-lepidic growth(tumor cells proliferating along the surface of intact alveolar walls without stromal or vascular invasion pathologically) -they secrete mucin to fill the alveoli so consolidation can be seen as well

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

Old terms for invasive mucinous adenoCA?

A

diffuse or multifocal broncioloalveolar carcinoma

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

Features?

A
  • Large arrows: focal areas of consolidation
  • Small arrows: multiple nodules in centri-lobular location reflecting endobronchial spread of tumour
  • Dx: invasive IMA with consolidaiotn and multiple nodules
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Common fungal organism giving lung infection in immunocompromised patients?

A

Aspergillus

18
Q

Differences in CT features of pulmonary infections in immunocompetent vs immunocompromised patients?

A
  • Immunocompetent: focal consolidation/solitary nodule/solitary mass more common except massive inoculation of organism(e.g. histoplasmosis in a cave explorer)
  • Immunocompromised: multiple nodules +/- halo sign +/- cavitation
19
Q

What is granulomatosis with polyangiitis?

A
  • multisystem disease of unknown cause

associated with upper, lower resp tract and kidney

  • 90% ANCA +ve
20
Q

Typical locations of lung nodules in amyloidosis?

A

peripheral or subpleural

21
Q

CT features of granulomatosis with polyangiitis?

A
  • typical multiple lung masses/cavities 2-4cm
  • less commonly solitary nodule/mass
  • +/- pulmonary hemorrhage
  • with treatment, cavitatory nodules and masses become thin walled and decrease in size/complete resolution
22
Q

Massive PE vs Submassive PE?

A

(1) Massive PE
- systemic hypotension
- drop in systolic arterial pressure >= 40mmHg for at leasts 15 minutes not caused by new-onset arrhythmias
- shock
(2) Submassive PE
- haemodymically stable but with RV dysfunction or hypokinesis confirmed by echocardiography

23
Q

What is saddle embolus?

A
  • large pulmonary embolism that straddles the birfurcation of the pulmonary trunk extending into left and right pulmonary arteries
  • right heart strain signs usually present
    (1) RV width > LV width
    (2) straightening/leftward bulging of IV septum
    (3) enlarged pulmonary trunk
  • contrast reflux into azygos vein(via SVC)/hepatic veins(via IVC) is controversial as it often occurs in the absence of raised RV pressure
24
Q

Contrast density < ___ HU implied non-diagnostic study in CTPA?

A

300-350 HU

25
Q

CTPA reliably detect emboli in up to _ mm in diameter(_ order vessels)?

A

7mm

(4th order vessels)

26
Q

CXR signs of PE?

A

*low sensitivity and specificity

(1) Most common signs
- Watermark’s sign(localized peripheral ligaemia secondary to embolus lodging in peripheral artery) +/- proximal arterial dilatation
- peripheral airspace opacification(pulmonary haemorrhage)
- linar atelectasis(ischemic injury leading to surfactant deficiency)
- pleural effusions
- central pulmonary arterial enlargement
(2) signs associated with infarction
- Hampton’s hump(rare, non-specific)
- consolidation may be multifocal
- cavittion follows secondary infection
- haemorrhagic pleural effusions in 50% of patients

27
Q

Features of chronic PE?

A
  • crescentic thrombus adherent to arterial wall(+/-calcified/recanalization)
  • enlarged bronchial vessels(collateral supply)
  • mosaic attenuation pattern
  • right heart strain
28
Q

Two vs Three Tier model in Well’s criteria for PE?

A

(1)Two tier

<= 4 unlikely -> D-dimer

>= 4.5 likely -> CTPA

(2)Three tier

0-1 low risk -> PERC and D-dimer

2-6 moderate risk -> D-dimer/CTPA

>6 high risk -> D-dimer not recommended

29
Q

What is pulmonary embolism rule-out criteria(PERC)?

A

***+ve if for any of the followings, D-dimer sould be considered

  • age <50
  • pulse <100 bpm
  • oxygen saturation >95% on room air
  • absence of unilateral leg swelling
  • absence of haemoptysis
  • no recent trauma or surgery
  • no prior history of venous thromboembolism
  • no exogenous oestrogen use
30
Q

Definition of pulmonary arterial hypertension?

A
  • systolic pulmonary artery pressure > 35mmHg or
  • mean pulmonary artery pressure > 25mmHg at rest or
  • mean pulmonary artery pressure > 30mmHg at exercise
31
Q

CT features of pulmonary infarction?

A
  • Hampton hump(juxtapleural wedge shaped opacification without air bronchogram)
  • consolidation with internal air lucencies, “bubbly consolidation”
  • convex borders with halo sign secondary to adjacent haemorrhage
  • decreased in normal lung enhancement
  • cavitation in septic embolism and infection
32
Q

In PE, what is it?

A

bubbly consolidation suggests pulmonary infarction

33
Q

In PE, what is it? DDx?

A
  • juxtapleural wedge shape opacification without air bronchogram(Hampton hump) suggests pulmonary infarction
  • DDx of peripheral wedge-shaped lesion: pulmonary haemorrhage(ischemic chnge without infarction), septic pulmonary emboli
34
Q

Oxygen supply of lungs?

A
  • pulmonary vascular system
  • bronchial vascular system
  • directly from inspired air

**following occlusive pulmonary embolus, bronchial arteries are recruited as primary source of perfusion, leading to higher pressure of bronchial arteries(prone to haemorrhage)

35
Q

causes of UIP?

A
  • idiopathic pulmonary fibrosis
  • secondary to CTD, asbestosis, chronic hypersensitivity pneumonitis, radiation, amiodarone, Hermansky-Pudlak syndrome
36
Q

typical CT features of UIP?

A
  • honeycombing (if >8% of lung vol then highly specific)
  • reticular opacities in the immediate subpleural lung often associated with honeycombing and traction bronchiectasis with peripheral, posterior and lower lobe predominance (apicobasal gradient), posterior costophrenic angles are almost always involved
  • reticular opacity-to-GGO ratio: >= 1; GGO less extensive and almost never seen in isolation
  • lung architectural distortion reflecting lung fibrosis
  • lobar volume loss predominantly lower lobes in advanced fibrosis
  • absence of upper or mid-lung or peribronchovascular predominance
  • absence of extensive GGO
  • absence of discrete bilateral cysts
  • absence of significant mosaic perfusion or air trapping
  • absence of profuse micronodules
37
Q

HRCT features of honeycombing?

A
  • subpleural in location
  • 3 to 10mm
  • thick easily seen walls
  • cysts in cluster or layer and share walls
  • air attenuation
  • empty without “anatomy” within; complete black hole
  • do not branch
  • associated with other signs of fibrosis(traction bronchiectasis and irregular reticulation)
38
Q

pathologically what is honeycombing?

A
  • interstitial fibrosis with lung destruction and dilatation of peripheral airspaces
  • most specific HRCT sign of fibrosis
39
Q

DDx of interlobular septal thickening?

A

1) smooth: pulmonary edema, lymphangitis carcinomatosis, lymphproliferative disease, amyloidosis(rare), pulmonary veno-occlusive disease(rare), Erdheim-Chester diseaes(rare)
2) nodular: sarcoidosis, lymphangitic carcinomatosis, lymphoproliferative disease, amyloidosis (rare)
3) irregular: fibrotic lung disease

40
Q

paraseptal emphysema vs honeycombing

A

1) paraseptal emphysema: always one layer; very thin wall; upper lobes predominance; large size; increased overall lung vol; absent associated reticulation or traction bronchiectasis; +/- associated with centrilobular emphysema
2) honeycombing: one/more layers; thick walled; traction bronchiectasis; irregular reticulation; lower lobes predominance; small size; decreased overall lung volume

41
Q
A

Thoracic (2 decks)

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