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Chest and vascular > MCQ > Flashcards

MCQ Flashcards

1
Q

Spontaneous coronary dissection

A

Rare
80% women
Late preganancy, post-partum, perimenopausal often (1/3)
Healthy individuals

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2
Q

Cardiac sarcoidosis

A

May manifest as bradycardia secondary to AV block
Arrythmias may cause sudden death
5-10% symptomatic, with findings in 25%
May cause ventrircular aneurysms

Restrictive cardiomyopathy

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3
Q

Caval filter

A

3rd lumbar vertebra level, infrarenal

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4
Q

Intra-aortic balloon pump

A

Should be located at proximal descending aorta, just beyond origin of left subclavian.

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5
Q

Most common cause of bronchial artery hypertrophy leading to massive haemoptysis

A

Bronchiectasis

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6
Q

Wells score

A 
Clinical signs and symptoms
Alternative diagnosis
Tachycardia
Immobilisation or surgery
Previous DVT or PE
Haemoptysis
Malignancy
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7
Q

HOCM

A

The majority of patient show asymmetric septal hypertrophy
Associated with systolic anterior motion of mitral valve, which can cause LVOT obstruction
Tends to cause MR as above, with left atrial enlargementff

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8
Q

Pancoast tumour

A

Syndrome - mass, Horners, shoulder pain, radicular arm pain.

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9
Q

Left atrial enlargement associations

A

Can cause left lower lobe collapse

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10
Q

Takayasu arteritis

A

Most common aortic segment involved is abdominal aorta

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11
Q

Cardiac myxoma

A

Most common benign cardiac mass in adults
Infrequent in children - rhabdomyomas instead
Low T1, variable T2 (some high - myxo)
Heterogeneous enhancement
Arrythmias, dyspnoea, murmur
Solitary in left atrium most common, attached to septum at fossa ovale
Associated with Carneys complex MEN

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12
Q

Bronchiolitis obliterans

A

Bilateral peripheral patchy opacities without zonal distribution
Mosaic perfusion
May have decreased vascular marking and hyperinflation
May be seen in chronic rejection, and graft-v-host disease
Also post infectious. E.g. in CF, or in Swyer-James

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13
Q

Air trapping

A

Most commonly superior segments of lower lobes, or anterior middle lobe or lingula, on expiratory CT

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14
Q

AIP

A

AKA Hamman-Rich
Previously healthy subjects
Diffuse alveolar damage

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15
Q

Infection v lymphoma v kaposi

A

Thalium and gallium scanning
Infection (e.g. PCP) and lymphoma are gallium positive (kaposi not)
Lymphoma and kaposi sarcoma thalium positive
Thalium scanning performed prior to gallium

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16
Q

IPF

A

Can be diagnosed with ATS major and minor criteria in absence of surgical biopsy
Minor: Age > 50 plus symptoms and signs - crackling
Major: absence of alternative on lavage or transbronchial biopsy, exclusion of other causes, UIP on CT

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17
Q

Hodgkin lymphoma, lung

A

10%

Nodules or masses, single or multiple, may cavitate, discrete or indistinct

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18
Q

Best place for PICC

A

Basilic vein

Basilic vein drains ulnar hand. Joins with brachial veins to form axillary vein. Cephalic then joints the axillary vein.

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19
Q

Rebound thymic hyperplasia

A

May occur post chemo

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20
Q

Organising pneumonia

A

Peripheral, lower zone predominant chronic consolidation
Adenopathy in 27%
Effusion in 30%
Atol sign
Non or ex-smokers
Idiopathic, collagen vascular disease, drugs

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21
Q

CPAM

A

25% of congenital lung disease
95% of cystic
1 - 50%
2 - 40%
3 - 10%
Type 2 associated with renal agenesis / dysgenesis, pulmonary sequestration, congenital cardiac disease
No lobar prediliction of sex predominance

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22
Q

Bronchopleural fistula risk factors post pneumonectomy

A 
Pre-op radiation
Pre-op uncontrolled infection
Post-op PPV
Faulty closure of stump
Right pneumonectomy - shorter bronchus
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23
Q

Pulmonary infarct stats

A

Only in 10-15% of emboli
Lower lobe 75%
Haemorrhage can occur without infarction

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24
Q

Extralobar sequestration M:F

A

4:1

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25
Q

TB resolution

A

2/3 no sequelae
Ghon focus is calcified granuloma in lungs
Ghon complex is above plus lymph node
Ranke complex is above but calcified lymph node

Calcified lung disease is inactive
Or no change for 6 months

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26
Q

ARDS

A

10% have chronic changes in non-dependent lung

Mild chronic fibrosis

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27
Q

PIOPED

A

High probability scan plus high probability clinically is PE confirmed
Low probability or normal scan + low clinical probability, PE excluded
Otherwise uncertain, and lower limb US or angiography of pulmonary arteries recommended
High probability - 2 or more large mismatched defects
Intermediate - rest
Low - non segmental or subsegmental defects, or matched defects with normal radiograph, or substantially larger radiograph abnormality than perfusion decect
Normal - no defect

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28
Q

Rasmussen aneurysm

A

Complication of TB

Pulmonary artery aneurysm adjacent to a tuberulous cavit

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29
Q

Lateral CXR

A

Posterior wall bronchus intermedius / posterior stem line <3mm
RUL bronchus above LUL bronchus
Left artery superoanterior to bronchus
Right artery anterior to bronchus
The left pulmonary artery marks superior and posterior contour of hilar complex

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30
Q

Earliest asbestos related disease

A

Pleural effusions, 8-10years post exposure

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31
Q

Aortic dissection

A

Anterior and right lateral wall, just distal to valve, in 65%
Transverse or oblique tears, 1-5cm in length with jagged edges
Intimal flap detectable in 85-90%
Occlusion of coronary arteries in 8%

De Bakey - 1 and 2 A, 3 B
1 ascending and descending, 2 ascending only

HTN almost invariably
Structural abnormalities - bicuspid valve, coarctation, connective tissue e.g. Marfans
Turners
Pregnancy
Balloon pumps
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32
Q

Libman-Sachs endocarditis

A

Non-infective, SLE endocarditis
Mitral valve (or tricuspid)
Intense valvulitis and fibrinoid necrosis
Sterile, granular pink vegetations
SLE vasculitis can cause pancreatitis, peritonitis, colitis

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33
Q

Antiphospholipid syndrome

A

34% have SLE

Thrombotyic disease, thrombocytopenia, miscarriages

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34
Q

RI

A

PSV - EDV / PSV

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35
Q

PI

A

PSV - EDV / mean V

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36
Q

Kasabach-Merritt

A

Haemangioma causing thrombocytopaenia

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37
Q

Endoleak treatment

A

1 - ASAP repair
2 - If have not stopped spontaneously in 1 month, thrombose
3 - repair with an additional graft

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38
Q

Renal artery stenosis

A

Acceleration time > 0.07 in intrarenal arteries (tardus)
Renal aortic ratio >3.5 –> 60% stenosis
RI > 0.7
PSV > 180

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39
Q

Carotid stenosis

A

> 115 <230 50-69 (ratio 2-4)

>240 >69 (Ratio >4)

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40
Q

Renal artery aneurysm

A

Saccular, non-calcified, occur at bifurcation
FMD common cause
Female prediliction
PAN, IVDU, SLE, RCC, AML, metastatic arterial myxoma, transplant rejection
2/3 extrarenal, 1/3intra

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41
Q

FMD

A

Bilateral renal arteries in 50%
Responds well to angioplasty
Restenosis 12-25% over 2 years, but HTN doesn’t necessarily recur

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42
Q

Cardiac MR

A

Spin echo - black blood
Gradient echo - bright blood
Gradient echo are flow sensitive
Retrospective gating better for diastole

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43
Q

Femoral venous catheter

A

Higher incidence of infection, limit mobility, risk iliac vein stenosis
Intended use <30 days

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44
Q

Fibrin sheath, tunneled line

A

Treat with thrombolysis

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45
Q

Dural venous sinus thrombosis

A

Higher risk in puerperium than pregnancy

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46
Q

AV fistula stenosis treatment

A

Angioplasty

Surgery if recurrent or in lower forearm

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47
Q

Idiopathic inflammatory AAA

A

5-25%
Fusiform often
Delayed enhancement of soft tissue component
Dense perianeursymal fibrosis

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48
Q

Mycotic aneurysm

A

2.5% AAA
Saccular
Perianeurysmal gas, stranding, psoas involvement
Staph, salmonella most common

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49
Q

Azygous IVC

A

Associated with polysplenia, dextrocardia

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50
Q

Polyarteritis nodosa

A

Kidneys 70-80%
Multiple small aneurysms
CNS 10%
Most common systemic vasculitis to involve CNS
Transmural necrotising vasulitis, fibrinoid necrosis
pANCA positive (correlates with disease activity)
Good response to treatment
Associated with HBV and HIV antigenaemia
Males, 5th-7th decade

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51
Q

Churg-Strauss

A

Asthma, hypereosinophilia, systemic small vessel granulomatous necrotising vasculitis
May be histo identical to PAN
pANCA in 20-70% (Wegeners is cANCA)
Renal disease infrequent - heart lungs skin spleen
Coronary arteritis and myocarditis

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52
Q

Endocardial fibroelastosis

A

Enlarged left heart and pulmonary venous congestion
Restrictive cardiomyopathy
Fatal by 2
Endocardial deposition of colagen and elastic tissue

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53
Q

Calf vein thrombosis

A

<5% PE incidence

Propogate in 20%

54
Q

Marantic endocarditis

A

Non-infective endocarditis
Libman Sachs (SLE) or cancer - mucinous adeno of pancreas most common, trauma - catheters
Thrombi causing strokes
Previous rheumatic fever predisoses

55
Q

Wegeners

A

Focal necrotising or granulomatous vasculitis
cANCA highly specific, correlates with disease activity
Cresentic glomerulonephritis
Upper and lower respiratory tract

56
Q

Goodpastures

A

Autoimmune type 2 hypersensitivity to glomerular and alveolar basement membrane

57
Q

Mitral annular calc

A

Age related - women 60s
More common if LV pressure up - HTN, aortic stenosis, HOCM
May be a nidus for infective endocarditis,
or a focus for thrombus - increased stroke risk
Generally does not affect valvular function - rarely does,
Associated with mitral regurgitation and conduction defect

58
Q

Lung abscess

A

Staph, kleb, pseudomonas, proteus

Immunocompromised: candida, leigonella, PCP

59
Q

Plaque on carotid USS

A

Heterogeneous tends to be unstable

USS bad at detecting intimal flap in dissection - and may be too high to assess

60
Q

Cystic fibrosis

A

Fibrosing colonopathy usually of ascending colon, complication from excessive doses of pancreatic enzymes
Pseudomonas most common respiratory pathogen isolated
Survive 40 years
Males often infertile
Pansinusitis

61
Q 
Staging cancer, Diaphragm, Parietal pericardial invasion,  chest wall, visceral pleural invasion 
N
Satellite nodules
Collapse
Size
A 
Diaphragm T4, 
Parietal pericardium and chest wall (or phrenic nerve) T3
Visceral pleura T2 
Same lobe nodule T3
Same lung nodule T4

Ipsilateral hilar N1
Ipsilateral mediastinal and subcarinal N2
Contralateral or supraclav N3

Main bronchus but not carina now T2, carina T4

Atelectasis or obstructive pneumonitis, extending to hilar region T2

<3 1, 3-5 2, 5-7 3, >7 4

62
Q

Klebsiella pneumonia

A

Prediliction for posterior upper lobe
Can cause purulent pericarditis, but staph more common
One of the more common causes of empyema (along with strep and staph)
Bulging fissures characteristic, but unusual
Gram negative

63
Q

Pulmonary amyloid

A

May cause calcified nodules

Diffuse (alveolar septal), localised nodular, localised tracheobronchial

64
Q

ARDS

A

Absene of cardiomegaly, pulmonary venous congestion, pleural effusions favour ARDS
As does 24 latency of CXR changes
May be more peripheral than in hydrostatic oedema
Thrombosis may complicate

65
Q

HPOA

A

Causes identical to clubbing
Usually painful
Periosteal reaction of diaphysis and metaphysis of distal extremities without underlying bone reaction
Tram-track / symmetric linear uptake on bone scan

Differential - pachydermoperiostosis - primary POA, with skin thickening also, thyroid acropachy (presentation of autoimmune thyroid disease, almost always with thyroid eye disease),
Hypervitaminosis A
Chronic venous insufficiency

66
Q

Thymic PET activity

A

In young female with lymphoma, may be a normal finding before and after treatment

67
Q

Septic emboli

A

Most commonly IVDU tricuspid endocarditis

68
Q

SLE lung

A

Pulmonary involvement more common than any other connective tissue disease
Pleurisy, pleural disease most common (effusion, thickening)
Fibrosis is less common compared with other collagen vascular disease
Pulmonary HTN is rare. Can be due to lung disease, or thromboembolism, or may occur similar to primary

69
Q

Myasthenia gravis, thymus

A

Follicular thymic hyperplasia most common abnormality
But also associated with thymoma
10-25% of MG have a thymoma
30-50% of thymomas get MG

70
Q

Benign v malignant thymoma

A

T1 high in carcinoma, low in benign
Can see calcification in both (amorphous, flocculent)
Pleural seeding in invasive or malignant
SUV cutoff of 5 can give reasonable differentiation on PET for carcinoma v thymoma
Thymomas are 50-60 - rare in <20

71
Q

Thymolipoma

A

Large, fatty, pliable
Drapes over heart and vessels
Doesn’t compress
Doesn’t invade

72
Q

Mediastinal mass

A

Most commonly thymic in adults, lymphoma or rebound thymic hyperplasia in kids

73
Q

NF1 lung

A

Lung disease in 10-20% of adults
Upper lobe bullae, basal fibrosis

Thoracic meningoceles are on the convex side of the scoliosis

74
Q

Unilateral complete perfusion defect

A

More common in extrinsic compression than in acute PE

75
Q

Primary, secondary TB

A

Primary
Patchy or lobar consolidation, any lobe, preference for middle and lower lobes
Lymphadenopathy (especially in children - 90%, only 10-30% adults. Low density with rim enhancement, usually unilateral)
May be miliary (immunocompromised more)
Pleural effusions (30-40% adults, 10% children)
(so nodes more common in children but effusion more in adults. Adults can present just with lymph nodes [acc to old answers. probably kids can too])
May resolve without any radiological abnormality, or Ghon focus scar may remain (calcified granuloma)
Symptoms only in 5%
Cavitation uncommon
May have massive haemoptysis from erosion into a bronchial artery
May have atelectasis in children from compression of airways from lymph nodes.

Ghon focus is calcified caseous granuloma in lung
Ranke complex is this plus a calcifed node

Secondary
Apical, cavitates
Assman focus

76
Q

Pulmonary hamartoma

A

Popcorn calc
Fat diagnostic
6% of solitary nodules

77
Q

Kaposi sarcoma

A

Doesn’t take up gallium, but does thalium
Mid to lower zone, peribronchovascular (and perihilar i.e. cetnral)
Strongly enhancing nodes
Pleural effusion in 1-2/3. Worse prognosis

78
Q

Pulmonary sling

A

Aberrant left PA
Goes behind trachea, in front of oesophagus
Only vascular ring to pass between

79
Q

Atrial septal defect

A

Less common than VSD

Secundum 60-90%, then Primum, 5-20%, then sinus venosus 5%, with unroofed coronary sinus <1%
Secundum usually isolated (secundum at fossa ovalis)
Primum associated with mitral valve cleft (becomes AVSD)
Sinus venosus associated with PAPVR
Holt Oram may give secundum ASD, as well as radial ray anomalies (and clavicle hypoplasia)
Unroofed coronary sinus associated with left SVC and heterotaxy

80
Q

Pericardial effusion

A 
Idiopathic
Inflammatory (e.g. Dresslers, collagen vascular disease)
Infectious (inc TB)
PAH
Malignancy
Radiotherapy
Hypothyroidism
81
Q

VSD

A

Membranous most common (80-90%)

Other types: muscular, inflow, outflor

82
Q

Marfans

A

AD
Ascending aorta aneurysm
Aortic incompetence, mitral valve prolapse
(myxomatous degeneration of mitral valve)
Aortic dissection - cystic medial necrosis
Pulmonary artery aneurysms

83
Q

Vascular compression disorders

A

Eagle syndrome - stylohyoid compresses ICA (CN5,7,9,10 may be involved)
Thoracic outlet
Nutcracker - L renal vein by SMA
Posterior nutcracker - retroaortic L renal vein
Median arcuate - Coeliac
Popliteal artery entrapment - medial head of gastroc, or popliteus
Quadrilateral space syndrome - posterior humeral circumflex, and or axillary nerve. Shoulder pain and paraesthesia
Paget-Shroetter (subclavian vein)
May-Thurner (Left iliac vein by right iliac artery)
Malignant coronary artery
Hypothenar hammer

Also SMA syndrome (D3), and vascular rings and slings

84
Q

Pulmonary artery aneurysm

A 
Trauma
Infection e.g. syphilis, TB (Rasmussen)
Idiopathic
Post valvular dilatation
PAH
Marfans
Vasculitis e.g. Behcets, Takayasu

Swan-Ganz catheter placement

85
Q

Lung nodule, risk of malignancy

A

<7mm, 1%
8-20, 15%
>20, 75%

86
Q

Transudate v Exudate

A 
Exudate:
Protein >30g/L
Protein, fluid:serum ratio >0.5
LDH > 20 IU/L
LDH, fluid:serum ratio >0.6

Also pH

87
Q

Fleishner guidelines

A

HR is smoking or other RF (1st degree relative, other exposure)
<6mm: LR no FU, HR optional 12m CT
6-8mm: LR 6-12 month, possible 24. HR 6-12 and 18-24 if no change
>8mm: 3month CT, PET, or biopsy
Multiple 6-8: LR FU 3 month, possibly 24. HR 3 and 24
Multiple >8: LR 3-6 and maybe 24, HR 3-6 and 18-24
Ground glass: no FU if <6, if >6 do 6-12 month and every 2 years
Multiple subsolid, 3-6 month and possibly more

88
Q

Bronchial artery embolisation

A

Particles

Gelatin or PValcohol

89
Q

DVT

A

Acute thrombus anechoic
Chronic echogenic

Inspiration increased abdominal pressure and reduces flow, increases diameter (like a valsalva)

PEs in 50%

90
Q

PCP

A

Pleural effusions and lymphadenopathy uncommon
May have crazy paving
Gallium positive (before xray findings visible)
Reticular pattern, perhiliar distribution
Subpleural blebs
Atypical findings are more common in those on inhaled prophylaxis

91
Q

Fat emboli

A

Symptoms often transient
CT abnormalities last 2 weeks
Extent of lung opacification usually reflects severity of disease
Can have non-traumatic aetiology e.g. bone infarct, osteomyelitis, acute fatty liver, pancreatitis

92
Q

Amiodarone lung

A

Pulmonary toxicity in 10%
Chronic interstitial pneumonia (includes UIP, NSIP - this most common)
Organising pneumonia
Diffuse alveolar damage
Foamy histiocytes with intracytoplasmic osmiophilic lamellar bodies
Peripheral air space opacity, upper lobe predominant, and interstitial fibrosis

93
Q

Methotrexate lung

A 
5%
Organising pneumonia
Acute interstitial pneumonia
Fibrosis
Effusions

(answers said hypersensitivity pneumonitis, and can have adenopathy)

94
Q

Eosinophilic pneumonia

A 
Many drugs:
Penicillamine
Sulfasalazine
Nitrofurantoin
NSAIDs
Ampicillin
Anticonvulsants
ACE inhibitors
Beta blockers
Methotrexate
Amiodarone
95
Q

Cyclosporine lung

A

Can cause a solitary pulmonary mass (previous question)

96
Q

Thymic cysts

A 
Congenital or acquired
Acquired from: 
Thoracotomy
Radiotherapy or chemotherapy for mediastinal tumour
Thymic tumours
Inflammation
May be unilocular or multilocular
97
Q

Mesothelioma

A

May seed along biopsy tract
Calc seen in 20%, probably engulfed pleural plaques
Predominantly parietal, and to a lesser extent visceral pleura

Peritoneal 12-33%, strongly assocaited with asbestos, but 50% have no known exposure. Calc rare.

98
Q

Gallium scan

A

Positive in infection and lymphoma, not in Kaposi
Also in:
Sarcoid - pulmonary uptake correlates with disease activity and response to treatment (lambda sign)
Amyloid (intense cardiac)
Persitant uptake following therapy in Hodgkin lymhoma is a poor prognostic indicator, high risk of recurrence

Scan performed 48-72 hours post injection
Normal uptake in liver, bone marrow, spleen, salivary glands

99
Q

Hilar adenopathy, drugs

A 
Bleomycin
Phenytoin (/dilantin)
Methotrexate
Cyclosporine
Carbamazepine
Cotrimoxazole
Indomethacin
Penicillins

(not amiodarone or cyclophosphamide)

100
Q

Phenytoin

A

Can cause eosinophilic lung disease

And hilar adenopathy

101
Q

Bleomycin

A

A chemotherapy drug
SCC of head and neck, cervix, vagina, testicular cancer, Hodgkin lymphoma
Organising pneumonia, NSIP, other fibrosis

102
Q

Legionella

A

SIADH in 15%

Gram negative

103
Q

Pulmonary abscess

A 
Staph
Klebs
Pseudomonas
Proteus
Immunocompromised: candida, leigonella, PCP
104
Q

Pulmonary cavity

A 
Strep
Staph
Haemophilus
Other gram negatives (Klebsiella)
Anaerobes
Aspergillis
Legionella (also gram negative)
105
Q

Empyema

A

Chidren - pneumococcus
Adults - stap, gram negatives (klebsiella, pseudomonas, haemophilus), anaerobes (usually polymicrobial e.g. bacteroides, actinomyces, clostridium)

106
Q

Empyema necessitans

A

TB
Actinomyces
Nocardia

107
Q

Klebsiella

A

Gram negative
Higher incidence in alcoholics and debilitated
One of the most common causes of empyema
Abscess, effusions
Uni/multilocular cavities in 50%, appearing within 4 days
Propensity for posterior upper lobe and superior lower lobe
Dense lobar consolidation - associated with fissure displacement

108
Q

ABPA

A 
Asthmatics
Central and upper lobe bronchiectasis
Finger in glove
Transient consolidation - eosinophilic pneumonia
Cavitation in 10%
Effusions and adenopathy not a feature
109
Q

Hypersensitivity pneumonitis

A

Can rarely have nodes and effusions
Upper zone predominant fibrosis
Can have consolidation, ground glass depending on stage of disease

110
Q

Sarcoid

A 
ACE has 40% false negative and 10% false positive. 
May have hypercalcaemia and hypercalcuria
Schaumann bodies (laminated calcium containing concretions) (may also be seen in other granulomatous diseases - HSP, beryllosis, uncommonly Crohns and TB)
Asteroid bodies (seen in giant cells of granulomas)
111
Q

Fibrosing mediastinitis

A

Encasement and compression of mediastinal structures by fibrosis
Histoplasmosis and TB most common cause
Can cause pulmonary artery hypertension

112
Q

Histoplasmosis

A 
Endemic fungi
Can cause calcified granuloma
Can cause nodule
Can mimic TB
Can cause fibrosing mediastinitis
113
Q

Thymoma assoications

A 
MG
Red cell aplasia
Hypogammaglobulinaemia
SLE
RA
Non-thymic cancers
114
Q

Nodes - hyper, hypodense, and calcified

A

Hypo: Mets (lung, testis, ovary), lymphoma, infections (inc mycobacterial, fungal), Whipples
Hyper: vascular mets (RCC, melanoma, carcinoid, papillary thyroid, Kaposis), castlemans, mild enhancement may be seen in TB, fungal, lymhoma, metastatic lung, sarcoid
Calc: treated lymphoma, old granulomas, sarcoid, silicosis, PCP, calcifying mets (BOTOM)

115
Q

Pulmonary hydatid

A

Second most common organ after liver, most common in children
Only coexists with liver disease in 6%
Multiple or solitary cystic lesions, uni or bilateral, favous lower lobes.

116
Q

Pulmonary artery hypoplasia

A

Right > L 3:1, RML then RUL

Associated with bronchiectasis

117
Q

Lung cancer MR

A

Low to intermediate T1

High T2

118
Q

Behcets

A 
Vasculitis
M 2-5x F
Mediterranean, middle east, east asia
Oral ulceration, genital ulceration, ocular manifestations
Aorta and SVC
Pulmonary artery aneurysms
CNS
119
Q

Lung and bone

A 
LCH
Malignancy
TB
Fungal disease
Other infection
Sarcoid
Gauchers (rarely involves lungs, resembles DIP)
Phakomatoses - TS, NF1 (lower zone fibrosis, upper zone bullae, cor pulmonale)
120
Q

Ritalin lung

A

IV ritalin
Causes panlobular emphysema
May look like alpha-1-antitrypsin

121
Q

Heroin and Cocaine lung effects

A

IV heroin can cause pulmonary oedea, haemorrhage, eosinophilic pneumonia
IV cocaine can cause pulmonary oedema

Crack lung is from smoking crack cocaine
Diffuse alveolar damage / alveolar haemorrhage

122
Q

Talc lung

A

Talcosis - inhalation of talc
Pulmonary talc granulomatosis - from injection of tablets intended for oral consumption. Widespread small nodules, may have mid zone prediliction. Coalesce and cause PMF.
Talc embolus is often the start of the granulomatosis pathology

123
Q

Alpha-1-antitrypsin

A

Basal predominant pan-lobular emphysema

124
Q

Metastatic pulmonary calcification

A

Generally upper lobes. Ground glass nodules
Uptake on bone scan is confirmatory
Renal failure, HPT, sarcoid, vit D or Ca intoxication, multiple myeloma, massive osteolysis

125
Q

Solo met, septic emboli, met calc zones

A

Apparently are mostly upper zone (according to a 1987 paper)
Apparently septic emboli are predominantly lower lobe.
Metastatic calc is predominantly upper.

126
Q

Pulmonary alveolar microlithiasis

A

Mid to lower zone predominant.
Sand like calc in the lungs
Calcium phosphate microliths
Young adults

127
Q

Endobronchial metastases

A

RCC, thyroid, melanoma
Breast
Colorectal
Cervical

128
Q

Cannonball mets

A

Kidney, choriocarcinoma

Less commonly, prostate, endometrial, synovial sarc

129
Q

Lymphangitic carcinomatosis

A 
Breast
Lung
Colon
Stomach
Prostate
Cervical 
Thyroid
130
Q

Pleural mets

A 
Lung
Breast
Ovarian
Lymphoma
Gastric
Invasive thymoma

Chest and vascular (9 decks)

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