Old flash

Question 1

Chylothorax

Answer 1

Most commonly neoplastic

Associated with LAM

Question 2

Pleural mets

Answer 2

Lung, breast, ovary, gastric, thymoma, lymphoma

Question 3

Broncholithiasis

Answer 3

Most commonly erosion from calcified granulomatous node

Question 4

Airway tumors

Answer 4

Adult tend to be malignant, child benign
Malignant: SCC (smoker), adenoid cystic (infiltrative), carcinoid, mucoepidermoid, lymphoma (MALT), mets, direct invasion
Benign: papilloma, chondroma, schwannoma, adenoma, hamartoma, haemangioma, lipoma, leiomyoma

Question 5

Endobronchial mets

Answer 5

Breast, renal, thyroid, lung, melanoma, sarcoma

Question 6

Tracheobronchopathia osteochondroplastica

Answer 6

Posterior tracheal spared

Submucosal calcified osteocartilaginous nodules

Question 7

Relapsing polychondritis

Answer 7

Multisystem
Posterior trachea spared
Tracheal and bronchial thickening in middle aged women
Nose, ear, joints also involved
Unknown aetiology

Question 8

Fibrosing mediastinitis

Answer 8

A cause of pulmonary artery hypertension

Most commonly secondary to histo or TB

Question 9

Tracheal disease, non-neoplastic

Answer 9

Relapsing polychondritis (smooth), tracehobrochopathia osteochondroplastica (nodular) [both spare posterior wall], TB, amyloid, Wegeners, Sarcoid
Post-intubation
Behcets and Crohns (rare)

Question 10

Air crescent sign

Answer 10

Retraction of infarcted nodule in angioinvasive Aspergillosis, heralding recovery.

Question 11

Semi-invasive aspergillosis

Answer 11

Seen in debilitated, diabetics, alcoholics, COPD

Necrotising granulomatous inflammation in response to chronic infection

Question 12

Mycetoma

Answer 12

Intertwined hyphae in pre-existing cavity
Mycetoma is mobile within cavity, and will change position when patient imaged in different positions
TB, sarcoid, congenital, postinfections, post-traumatic cavity
Monod sign (gas surrounding the mycetoma)

Question 13

Aspergillus

Answer 13

ABPA - asthma, finger in glove
Mycetoma - pre-existing cavity
Semi-invasive- chornic consolidation and cavitation in alcoholic, diabetic, debilitiated
Airways invasive - bronchopneumonia, tree-in-bud, immunocompromised
Angioinvasive - halo sign, air crescent sign, immunocompromised

Question 14

Finger in glove

Answer 14

Mucoid impaction in bronchiectatic airway

ABPA, bronchial atresia, CF

Question 15

Cryptococcus

Answer 15

AIDS
Fungus
Pulmonary infection usually coexists with meningitis
Wide range of appearances including cavitation, miliary, ground glass, consolidation

Question 16

PCP

Answer 16

Bilateral perihilar ground glass or consolidation or crazy paving
Upper lobe pneumatoceles
Effusions 5%, adenopathy 10%
Adenopathy and effusions, and noules and consolidation more common in those receiving prophylaxis

Question 17

Hot tub lung

Answer 17

Hypersensitivity reaction to inhaled mycobacteria, often in women

Question 18

Reactivation TB

Answer 18

Lacks adenopathy in immuocompetent

Upper lobe predominant

Question 19

Ghon focus, Ranke complex

Answer 19

Initial TB in upper lower lobe or lower upper lobe

Ranke complex is +lymphadenopathy

Question 20

Primary TB

Answer 20

Adenopathy common - low attenuation with peripheral enhancement
Effusions
Ghon focus and Ranke complex

Question 21

Empyema necessitans

Answer 21

TB, nocardia, actinomyces

Question 22

Pulmonary abscess

Answer 22

Staph, pseudomonoa, anaerobes

Equal dimensions frontal and lateral views

Question 23

Interstitial pneumonia

Answer 23

Viral, mycoplasma, chlamydia, PCP

Question 24

Bronchopneumonia

Answer 24

Most commonly staph

Question 25

Strep organisms

Answer 25

``` Young - mycoplasma, viral, chlamydira Old, smokers - leigonella Alcoholics / aspirators - klebsiella Hosp acq - MRSA, pseudomonas Ventilator - pseudomonas, acinetobacter ```

Question 26

LAM

Answer 26

Lympangioleiomyomatosis Proliferation of smooth muscle in small vessels, lymphatic, bronchioles Bronchiolar obstruction and lung destruction TS association Child-bearing age women Pneumothorax, chylous effusion Round, regular cysts

Question 27

Alveolar proteinosis

Answer 27

``` Crazy paving Idiopathic Superimposed nocardia Treat with lavage Alveoli fill with proteinaceous lipid rich material ```

Question 28

Pulmonary LCH

Answer 28

``` Smokers Upper lobe predominant Nodules which turn into cysts, irregular Usually isolated lung, but may affect bone, pituitary, skin May have spontaneous pneumothorax ```

Question 29

Diseases of lung and bone

Answer 29

Cancer, TB, fungal disease, sarcoid, gaucher, LCH

Question 30

Radiation lung

Answer 30

Non-anatomic linear margins Pneumonitis at 1-3-4 months, ground glass Fibrosis at 6-12 months

Question 31

Calcified nodules in trachea

Answer 31

Tracheobronchopathia osteochondroplastica