MID 4 Flashcards

1
Q

Which two of the following are in the DD for upper lobe fibrosis and cicatrix atelectasis? (pick2)

a. Coccidioidomycosis
b. Tuberculosis
c. Klebsiella pneumonia
d. Histoplasmosis

A

b. Tuberculosis

c. Klebsiella pneumonia

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2
Q

Central versus peripheral lung tumors present with different symptomatology. Which one of the following would be more likely expected with left hills tumor

a. Hemoptysis
b. Wheezing
c. Cough
d. Hoarseness

A

D. Hoarseness

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3
Q

Which T # would be likely with a lung tumor patient complaining of dysphagia?

a. T0
b. T1
c. T2
d. T4

A

D. t4

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4
Q

The most common location for a peripheral lung tumor:

a. RUL
b. RML
c. LLL
d. Lingula

A

A. RUL

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5
Q

End stage tuberculosis and sarcoidosis have ___ in common which may lead to ___ (one answer)

a. air space consolidation, cavitation
b. Fibrotic nodules, conglomerate masses
c. nodular densities, multiple calcific nodules
d. Cicatrization, pulmonary arterial hypertension

A

b. Fibrotic nodules, conglomerate masses

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6
Q

Henry Pancoast describes a peripheral tumor location from which group?

a. Bronchogenic cancer
b. bronchial adenoma
c. alveolar cell carcinoma
d. sarcoma

A

a. Bronchogenic cancer

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7
Q

A characteristic of hematogenous pulmonary metastasis

a. Indicates low primary growth
b. may have no known primary tumor at diagnosis
c. The primary lesions is a sarcoma
d. The primary lesion is an adenoma

A

c. The primary lesions is a sarcoma

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8
Q

A fungal mycetoma could be found in (pick 2)

a. Paranasal sinuses
b. Gastric fundus
c. Large bowel
d. Bronchiectasis

A

A. Paranasal sinuses

D. Bronchiectasis

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9
Q

Which of the following would not be part of the TNM system of tumor staging

a. T4
b. M1
c. N4
d. M0

A

C. N4

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10
Q

Indirect radiographic signs of lung collapse include all of the following except:

a. Increased density
b. Herniation of lung tissue
c. Tracheal deviation
d. Narrowed rib cage on collapsed side

A

A. Increased density

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11
Q

Sings of consolidation seen on plain film:

a. late appearance after symptoms, wide spread 3-5 mm densities
b. Sub-Segmental densities, will defined boarder, lower lung commonly
c. Lobar densities, acinar shadows, silhouette sign possible
d. Kerley’s lines, early coalescence, butterfly pattern

A

c. Lobar densities, acinar shadows, silhouette sign possible

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12
Q

Five year survival rates with lung cancers are generally considered to be less then____

a. 25-30%
b. 30-35%
c. 45-55%
d. 10-13%

A

d. 10-13%

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13
Q

Hilar mediastinal lymphadenopathy most often due to ____ in young patient and ____ in older patients

a. Sarcoidosis, Lung cancer
b. TB Lymphoma
c. Coccidioidomycosis, TB
d. Histoplasmosis, Adenocarcinoma

A

a. Sarcoidosis, Lung cancer

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14
Q

neumothorax would produce

a. Passive atelectasis
b. Bilateral localized hyperluccency
c. Bilateral, widespread Hyperluccency
d. No hyperluccency but may produce tracheal deviation

A

A. Passive atelectasis

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15
Q

Pleural effusion can cause unilateral localized water density, which will move with changing patient position. Best imagining for demonstrating this (pick 2)

a. Lateral decubitus view
b. CT
c. Recumbent AP
d. A cross-table lateral projection

A

a. Lateral decubitus view

b. CT

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16
Q

__ is the #1 cancer killer in men and women

a. Lung
b. Breast
c. Colon
d. Kidney

A

A. Lung

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17
Q

The most common of the major subtypes of primary epithelial related malignancy of the lung is:

a. Alveolar cell carcinoma
b. Bronchial adenoma
c. Carcinoid tumor
d. bronchogenic carcinoma

A

d. bronchogenic carcinoma

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18
Q

“Water-Lilly sign” is related to:

a. Asperoliosis
b. Nacardiosis
c. Blastomycosis
d. Echincoccosis

A

d. Echincoccosis

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19
Q

Which of the following are considered to be associated causes (risk factors) for bronchogenic cancer: (pick all correct)

a. Cigarette smoking
b. Asbestosis
c. Pulmonary fibrosis
d. Radon gas exposure

A

a. Cigarette smoking
b. Asbestosis
c. Pulmonary fibrosis
d. Radon gas exposure

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20
Q

Scleroderma lung would be a risk factor for ____

a. Squamous cell carcinoma
b. Adenocarcinoma
c. Bronchiolar carcinoma
d. Small cell carcinoma

A

B. Adenocarcinoma

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21
Q

A patient suspected of having Kartagner’s syndrome could be confirmed by which imagining procedures

a. Plan film chest series
b. Bronchography
c. Pulmonary MRI
d. Pulmonary CT

A

D. Pulmonary CT

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22
Q

A common cause of a chronic wide spread reticular …. honeycomb interstitial pulmonary pattern is

a. Pulmonary fibrosis
b. Tuberculosis
c. Staphylococcus aureus
d. Silicosis

A

D. Silicosis

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23
Q

Negative chest x-ray would be expected with (pick 2)

a. Acute Congenital
b. Congenital lung cyst
c. Emphysema
d. T0 Bronchogenic cancer

A

a. Acute Congenital

d. T0 Bronchogenic cancer

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24
Q

All of the following re considered to be an acute infectious pneumonia with the exception of:

a. Pneumococcal pneumonia
b. Staph aureus pneumonia
c. Klibesiella pneumonia
d. Viral pneumonia
e. Nacardiosis pneumonia

A

e. Nacardiosis pneumonia

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25
Q

Resorption/obstructive atelectasis or local air trapping (the opposite of atelectasis) could be seen with:

a. Endobronchial tumor
b. Emphysema
c. Bronchiectasis
d. Chronic bronchitis
e. Bronchiolitis

A

a. Endobronchial tumor

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26
Q

Acute interstitial lung disease usually due to pulmonary edema or ___ pneumonia

a. Viral/Mycoplasma
b. Staph aureus
c. Streptococcus
d. Aspiration

A

a. Viral/Mycoplasma

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27
Q

Occupational disease related to mineral dust inhalation proceeds which form of pulmonary disease

a. Sub-segmental air apace only
b. Interstitial
c. Lobar consolidation
d. Widespread consolidation consolidation e. Lobar atelectasis

A

B. Interstitial

28
Q

Which of the following are considered to be fibrogenic pneumoconiosis

  1. Silicosis
  2. Asbestosis
  3. CWP
  4. Bagassosis
  5. Farmer’s lung

a. 1,2,3
b. 2,4
c. 1,2,3,5 d. 3,4
e. 2,3,4,5

A

A. 1,2,3

BAGASSOSIS IS HYPERSENSITIVITY

29
Q

Early stage silicosis is characterized by which radiographic finding?

a. Basilar fibrosis
b. Fibrotic masses adjacent to upper mediastinum
c. Patchy air space consolidation
d. Miliary nodules
e. Widespread honeycomb lung

A

D. Miliary nodules

30
Q

Of the causes of infective/abscess cavitation, which one might be considered by location:

a. Fungal pneumonia
b. Staph aureus pneumonia
c. Streptococcus pneumonia
d. Aspiration pneumonia

A

d. Aspiration pneumonia

31
Q

Of the acute infectious, cavitation is most likely to be associated with:

a. Streptococcus pneumonia
b. Staph aureus pneumonia
c. Viral pneumonia
d. Mycoplasma pneumonia e. Tuberculosis pneumonia

A

b. Staph aureus pneumonia

32
Q

Which radiographic cause of a cystic cavitation space is not directly related to tissue necrosis?

a. Squamous cell carcinoma
b. Pulmonary metastasis
c. Traumatic cyst
d. Wegner’s Granulomatosis

A

C. traumatic cyst

33
Q

Pneumoconiosis could be associated with two of the following work groups or jobs

  1. Sandblasting
  2. Sugar cane processing
  3. Oil refining
  4. Air condition repair
  5. Construction and demolition

a. 1,3
b. 1,5
c. 1,2
d. 2,4
e. 3,5

A

B. 1,5

Sandblasting
Construction and demolition

34
Q

Which of the following would be associated with granulomatous lymph node calcification?

  1. Silicosis
  2. Klebsiella
  3. TB
  4. sarcoidosis
  5. Histoplasmosis

a. 1,3,4
b. 1,3,,4,5
c. 1,2,3,4
d. 3,4
e. 4,5

A

b. 1,3,,4,5
1. Silicosis

  1. TB
  2. sarcoidosis
  3. Histoplasmosis
35
Q

What is the principal mechanism for atelectasis with large hilar related neoplasms?

a. Passive
b. Cicatricial
c. Adhesive
d. Resorptive

A

D. Resorptive

36
Q

hich of the following would be asbestosis related (pick all that apply)

a. Basilar fibrosis
b. Upper lung fibrosis
c. Mesothelioma
d. Linear diaphragmatic pleural calcifications e. Lymph node calcification (eggshell)

A

a. Basilar fibrosis
c. Mesothelioma
d. Linear diaphragmatic pleural calcifications

37
Q

Caplan’s and Sjrogen’s syndromes have ___ in common in most patients

a. Psoriatic arthritis
b. RA
c. RAS
d. AS

A

B. RA

38
Q

The least likely location for a peripheral lung tumor

a. RUL
b. RML
c. LLL
d. Lingula

A

D. Lingula

39
Q

Gran….. disease associated with tissue cavitation (hint 6 categories)

a. Rheumatoid
b. Hodgkin’s disease c. pneumonia
d. Bronchiectasis
e. Infarction

A

A. Rheumatoid

40
Q

Which pulmonary cavitation cause typically has a smooth inner boarder and may not have an air-fluid level?

a. TB
b. Infectious abscess
c. Rheumatic nodule
d. Squamous cell

A

A. TB

41
Q

Metastasis to the lung from renal cell carcinoma may initially present as:

a. A solitary cavitation lesion
b. Multiple pulmonary nodules > 8mm
c. Multiple cavitation nodules > 2cm
d. Multiple Evenly distributed nodules 3-5 mm in size

A

d. Multiple Evenly distributed nodules 3-5 mm in size

42
Q

On an AP thoracic spine radiograph you notice the heart projects to the right and the aortic knob is on the right side, which one of the following would not be part of your clinical through process:

a. Does the patient have brocheietasis
b. Does this patient have pectus patient
c. Does this patient have chronic sinusitis
d. Does the patient have dys-motile cilia syndrome

A

b. Does this patient have pectus patient

43
Q

Aspiration pneumonitis

a. Affinity for lingula
b. Atelectasis
c. RUL cicatrix fibrosis
d. Lobar pattern of consolidation
e. Central to peripheral spread of consolidation f. Boeck’s disease
g. Right lung segments #5,7
h. Opportunistic, commonly fatal pneumonia

A

g. Right lung segments #5,7

44
Q

Garland’s triad

a. Affinity for lingula
b. Atelectasis
c. RUL cicatrix fibrosis
d. Lobar pattern of consolidation
e. Central to peripheral spread of consolidation f. Boeck’s disease
g. Right lung segments #5,7
h. Opportunistic, commonly fatal pneumonia

A

f. Boeck’s disease

45
Q

Tuberculosis

a. Affinity for lingula
b. Atelectasis
c. RUL cicatrix fibrosis
d. Lobar pattern of consolidation
e. Central to peripheral spread of consolidation f. Boeck’s disease
g. Right lung segments #5,7
h. Opportunistic, commonly fatal pneumonia

A

h. Opportunistic, commonly fatal pneumonia

46
Q

Bronchopneumonia

a. Affinity for lingula
b. Atelectasis
c. RUL cicatrix fibrosis
d. Lobar pattern of consolidation
e. Central to peripheral spread of consolidation f. Boeck’s disease
g. Right lung segments #5,7
h. Opportunistic, commonly fatal pneumonia

A

e. Central to peripheral spread of consolidation

47
Q

Pneumococcal p.n..

a. Affinity for lingula
b. Atelectasis
c. RUL cicatrix fibrosis
d. Lobar pattern of consolidation
e. Central to peripheral spread of consolidation f. Boeck’s disease
g. Right lung segments #5,7
h. Opportunistic, commonly fatal pneumonia

A

d. Lobar pattern of consolidation

48
Q

18% of peripheral bronchogenic carcinoma happen at the :

a. RML
b. RLL
c. LLL
d. Lingula

A

B. RLL

49
Q

Irritant gases and chemicals case

a. Basilar consolidation
b. Non cardiac edema
c. upper lung fibrosis
d. Widespread miliary 1-2mm nodules
e. Honeycomb interstitial

A

b. Non cardiac edema

50
Q

Sequela of previous grenulmatosus infection include

  1. Calcified granuloma
  2. Splenic calcification
  3. Upper lung fibrosis
  4. Calcified lymph nodes
  5. Pleural effusion

a. 1,2,3,4,5
b. 2,4
c. 1,2,3
d. 1,4,
e. 1,2,3,4

A

e. 1,2,3,4

  1. Calcified granuloma
  2. Splenic calcification
  3. Upper lung fibrosis
  4. Calcified lymph nodes
51
Q

Calcification within lung tumors is rarely seen on plain films, however, CT of of tumors will show calcification in ___% of lesions not sen on plain film

a. 6-7
b. 10-20
c. 50
d. 1

A

A. 6-7

52
Q

A patient presenting with a bronchogenic cancer history, how is familiar with their staging numbers tells you that they have a “T3N3 neoplasm and a possible nodular mets in their liver on CT. What is their 5 year survival potential

a. 80-90%
b. ~50%
c. ~35%
d.

A

c. ~35%

53
Q

A patient presenting with bronchogenic cancer history, how is familiar with their staging numbers tells you that they have a “stage IIIB non-small cell” neoplasm What is their 5 year survival potential

a. 80-90%
b. ~65% or >
c. Maybe 1/3 at best
d.

A

c. Maybe 1/3 at best

54
Q

A patient presenting with bronchogenic cancer history, familiar with their cell type tells you they have a small 2cm peripheral lung squamous cell neoplasm with all other assessments negative. What is their 5 year survival rate potential and staging?

a. 80-90%, T1N0M0
b.

A

a. 80-90%, T1N0M0

55
Q

Peripheral pulmonary nodules are malignant ___ of the time when >3cm

a. 25%
b. 85%
c. 50%
d. 45%

A

B. 85%

56
Q

Cystic bronchiectasis

a. 95% five year survival rate
b. Never surgically resectable
c. Clinical diagnosis chest x-ray normal typical
d. Cigarettes/day x month consumed
e. Rarely infectious spondylodiscitis
f. Best visualized with CT or Honeycomb mimc g. Fibrosing Mediastinitis
h. Rapidly fatal
i. Reticular interstitial patterns
j. 2/3 central, 1/3 peripheral
k. Related to cancer incidence
l. #3or7C
m. Mycetoma

A

f. Best visualized with CT or Honeycomb mimc

57
Q

Chronic bronchitis

a. 95% five year survival rate
b. Never surgically resectable
c. Clinical diagnosis chest x-ray normal typical d. Cigarettes/day x month consumed
e. Rarely infectious spondylodiscitis
f. Best visualized with CT or Honeycomb mimc
g. Fibrosing Mediastinitis
h. Rapidly fatal
i. Reticular interstitial patterns
j. 2/3 central, 1/3 peripheral
k. Related to cancer incidence
l. #3or7C
m. Mycetoma

A

c. Clinical diagnosis chest x-ray normal typical

58
Q

Coccidoidmycosis

a. 95% five year survival rate
b. Never surgically resectable
c. Clinical diagnosis chest x-ray normal typical d. Cigarettes/day x month consumed
e. Rarely infectious spondylodiscitis
f. Best visualized with CT or Honeycomb mimc g. Fibrosing Mediastinitis
h. Rapidly fatal
i. Reticular interstitial patterns
j. 2/3 central, 1/3 peripheral
k. Related to cancer incidence
l. #3or7C
m. Mycetoma

A

e. Rarely infectious spondylodiscitis

59
Q

Histoplasmosis

a. 95% five year survival rate
b. Never surgically resectable
c. Clinical diagnosis chest x-ray normal typical d. Cigarettes/day x month consumed
e. Rarely infectious spondylodiscitis
f. Best visualized with CT or Honeycomb mimc g. Fibrosing Mediastinitis
h. Rapidly fatal
i. Reticular interstitial patterns
j. 2/3 central, 1/3 peripheral
k. Related to cancer incidence
l. #3or7C
m. Mycetoma

A

g. Fibrosing Mediastinitis

60
Q

Ammonia gas

a. 95% five year survival rate
b. Never surgically resectable
c. Clinical diagnosis chest x-ray normal typical d. Cigarettes/day x month consumed
e. Rarely infectious spondylodiscitis
f. Best visualized with CT or Honeycomb mimc g. Fibrosing Mediastinitis
h. Rapidly fatal
i. Reticular interstitial patterns
j. 2/3 central, 1/3 peripheral
k. Related to cancer incidence
l. #3or7C
m. Mycetoma

A

h. Rapidly fatal

61
Q

Bronchial adenoma

a. 95% five year survival rate
b. Never surgically resectable
c. Clinical diagnosis chest x-ray normal typical d. Cigarettes/day x month consumed
e. Rarely infectious spondylodiscitis
f. Best visualized with CT or Honeycomb mimc g. Fibrosing Mediastinitis
h. Rapidly fatal
i. Reticular interstitial patterns
j. 2/3 central, 1/3 peripheral
k. Related to cancer incidence
l. #3or7C
m. Mycetoma

A

A. 95% five year survival rate

62
Q

“pack year” history

a. 95% five year survival rate
b. Never surgically resectable
c. Clinical diagnosis chest x-ray normal typical d. Cigarettes/day x month consumed
e. Rarely infectious spondylodiscitis
f. Best visualized with CT or Honeycomb mimc g. Fibrosing Mediastinitis
h. Rapidly fatal
i. Reticular interstitial patterns
j. 2/3 central, 1/3 peripheral
k. Related to cancer incidence
l. #3or7C
m. Mycetoma

A

k. Related to cancer incidence

63
Q

Squamous cell carcinoma

a. 95% five year survival rate
b. Never surgically resectable
c. Clinical diagnosis chest x-ray normal typical d. Cigarettes/day x month consumed
e. Rarely infectious spondylodiscitis
f. Best visualized with CT or Honeycomb mimc g. Fibrosing Mediastinitis
h. Rapidly fatal
i. Reticular interstitial patterns
j. 2/3 central, 1/3 peripheral
k. Related to cancer incidence
l. #3or7C
m. Mycetoma

A

j. 2/3 central, 1/3 peripheral

64
Q

Tuberculosis

a. 95% five year survival rate
b. Never surgically resectable
c. Clinical diagnosis chest x-ray normal typical d. Cigarettes/day x month consumed
e. Rarely infectious spondylodiscitis
f. Best visualized with CT or Honeycomb mimc g. Fibrosing Mediastinitis
h. Rapidly fatal
i. Reticular interstitial patterns
j. 2/3 central, 1/3 peripheral
k. Related to cancer incidence
l. #3 or 7C
m. Mycetoma

A

l. #3 or 7C

65
Q

Small Cell carcinoma

a. 95% five year survival rate
b. Never surgically resectable
c. Clinical diagnosis chest x-ray normal typical d. Cigarettes/day x month consumed
e. Rarely infectious spondylodiscitis
f. Best visualized with CT or Honeycomb mimc g. Fibrosing Mediastinitis
h. Rapidly fatal
i. Reticular interstitial patterns
j. 2/3 central, 1/3 peripheral
k. Related to cancer incidence
l. #3 or 7C
m. Mycetoma

A

B. Never surgically resectable