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Medical Studies 1 > Medical Imaging: Lung Pathology > Flashcards

Medical Imaging: Lung Pathology Flashcards

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USMLE® Step 1 flashcards
1
Q

How many acini per 2° pulmonary lobule?

A

3-5

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2
Q

Secondary pulmonary lobule diameter

A

1.5-2cm

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3
Q

What is the basic lung unit visible on HRCT?

A

Secondary pulmonary lobule

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4
Q

Which vessels are located centrally vs peripherally in secondary pulmonary lobules?

A

Central: Artery and bronchiole
Peripheral: Lymphatic and vein

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5
Q

What can cause interstitial opacity on CXR?

A
  • Interstitial thickening
  • Filling of intersitium with fluid or cells
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6
Q

What can cause alveolar opacity on CXR?

A
  • Alveoli fill with fluid or cells or extra air
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7
Q

Does lung consolidation refer to alveolar or interstitial opacity? What substances can accumulate in the alveoli/interstitium to cause this?

A
  • Alveolar opactiy
  • Can be blood, pus, fluid, tumour cells
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8
Q

What can happen to lung volume during consolidation?

A
  • Increase
  • Stays the same
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9
Q

Describe five possible distributions of lung consolidation, and provide one instance in which each of these can occur

A
  • Focal (tumour)
  • Multifocal (granulomatous disease)
  • Diffuse (bronchopneumonia)
  • Lobar (lobar pneumonia)
  • Segmental (infarct)
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10
Q

Why are the central airways usually not seen on CXR and CT-chest?

A

Because they are air-filled, and the lung parenchyma is also air filled; equal density, no visibility

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11
Q

What is the air bronchogram sign? What is its significance?

A
  • When alveoli become consolidated, central airways become visible, which they usually are not
  • If we see this sign, we know the issue must come from the lung parenchyma, and not the pleura or the mediastinum
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12
Q

What is it called when a pathological process causes two adjacent structures to become indistinguishable on radiological imaging?

A

Silhouette sign

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13
Q

What signs indicate LLL consolidation on XCR?

A
  • Effacement of left hemidiaphragm
  • Opacity behind heart
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14
Q

What signs indicate RLL consolidation on XCR?

A
  • Effacement of right hemidiaphragm
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15
Q

What signs indicate RML consolidation on XCR?

A
  • Right hemidiaphragm visible
  • Consolidation over right heart border seen in lateral CXR
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16
Q

Lingula consolidation CXR signs?

A
  • Effacement of left heart border
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17
Q

Which lung lobe is the lingula in?

A

Left upper lobe

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18
Q

Left upper lobe consolidation CXR signs

A
  • Effacement of left mediastinum (PA film)
  • Superior lung consolidation (lateral film)
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19
Q

Describe the CXR findings of bronchopneumonia. Is it as dense as lobar consolidation?

A
  • Diffuse lung consolidation, bilateral
  • No, it is not as dense as lobar consolidation
20
Q

Other than bronchopneumonia, list two other conditions/events that can cause diffuse lung consolidation

A
  • Pulmonary alveolar oedema
  • Pulmonary haemorrhage
21
Q

List two conditions that can cause focal lung consolidation

A
  • Lymphoma
  • Pulmonary infarct
22
Q

Acute CT findings of covid pneumonia

A

Diffuse patchy areas of ground glass opacity

23
Q

Miliary nodule size

A

<2mm

24
Q

Lung nodule size

A

<3cm

25
Q

Lung mass size

A

> 3cm

26
Q

List three possible distributions of lung nodules

A
  • Random
  • Centrilobular
  • Perilymphatic
27
Q

What is the most common cause of randomly distributed lung nodules?

A

Haematogenous spread

28
Q

What is the most common cause of centrilobular nodule distribution within the lungs?

A

Airway infection

29
Q

What kinds of infections/conditions cause perilymphatic lung nodules

A

Infections/conditions that are spread through the lymphatic system

30
Q

List four kinds of lung collapse (i.e. atalectesis)

A
  • Resorption atalectasis
  • Relaxation/passive atalectasis
  • Scarring atalectasis
  • Adhesive atalectasis
31
Q

Describe resorption atalectasis

A
  • Blockage of airways
  • Air distal to blockage is absorbed, and the distal portion of the lung collapses
32
Q

What type of substances can cause resorption atalectasis

A
  • Mucous plug
  • Tumour (external, pressing on airway)
  • Foreign body
  • Blood
33
Q

Describe relaxation pneumothorax

A
  • Gas (pneumothorax) or fluid (pleural effusion) creates extrinsic pressure on the lung
  • This separates the lung from the negative pressure of the parietal pleura, and so it follows its natural inclination to collapse
34
Q

Describe scarring atalectasis. What can cause it?

A
  • Fibrosis/scarring of lungs means that lung parenchyma loses compliance, cannot expand as much as it should, and hence collapses
  • Can be caused by factors such as inflammation or infection
35
Q

Describe adhesive atalectasis. In which demographic does it most commonly occur, and when?

A
  • Less surfactant production in the lungs promotes volume loss
  • Commonly occurs in newborn babies during lung infection/disease
36
Q

Describe some universal signs of atalectasis

A
  • Increased density of lung tissue
  • Displacement of other lung towards collaped lung
  • Displacement of trachea towards collapsed lung
  • Displacement of hilum and trachea upward or downward
  • Adjacent lobes may hyperinflate
37
Q

Describe radiographic findings of lower lung lobe collapse; PA and lateral

A

PA: elevated diaphragm, inferior displacement of the hilum
Lateral: Oblique fissure is displaced inferiorly

38
Q

What is sabre-sheathed trachea? What causes it?

A
  • Trachea enlarges in saggital plane and shrinks in coronal plane
  • Can be caused by emphysema -> lung hyperinflation
39
Q

Emphysema vs cysts on lung CT

A
  • Cysts have walls
  • Emphysema doesn’t
40
Q

True or false: all lung interstitium lies between secondary lobules?

A
  • False
  • There is also some within the interstitium (since each 2° lobule contains mutiple acini)
  • This is called intralobular interstitium
41
Q

Describe two different patterns of interstitial thickening seen on lung radiology

A
  • Reticular/linear
  • Formation of tiny nodules
42
Q

How to differentiate between acute and chronic interstitial thickening when looking at lung radiology

A

Acute: Hazy, not distorted
Chronic: Sharp, distorted

43
Q

What causes kerley B lines during pulmonary oedema?

A

Distension of lymphatic vessels

44
Q

Signs of pulmonary oedema

A
  • Engorged veins in upper lung
  • Interstitium becomes thickened
  • Alveoli fill with fluid (consolidation etc.)
45
Q

What is the ‘batwing’ appearance on CXR?

A
  • Alveolar congestion bilateral perihilar region
46
Q
A

Medical Studies 1 (90 decks)

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