OST Module 1 Flashcards
ARDS CXR appearances
similar to pulmonary oedema WITHOUT pleural effusion
Perfusion defect with surrounding rim of normal perfusion (VQ)
Low probability for PE
Chronic hypersensitivity pneumonitis
Fibrosis affects subpleural and peribronchovascular lung, sparing posterior costophrenic angles
Melanoma mets - imaging
Multiple cavitating nodules with surrounding GGO (Haemorrhage)
BAC - CT and PET
Peripheral lesion causing extrinsic compression on airways.
often COLD on PET
Pulmonary artery sarcoma
Low attenuation filling defect occupying entire lumen of proximal pulmonary artery with expansion of involved arteries and extraluminal invasion
Unresectable features of mesothelioma
Nodal involvement in:
- Contralateral mediastinum
- Contralateral internal mammary
- Supraclavicular nodes
Distant mets including disease below the diaphragm
NM imaging to demonstrate right to left shunt
99mTC MAA (Micro-Aggregated Albumin)
Will show activity outside the lungs only if there’s a shunt
Replaced/accessory hepatic artery origins
Replaced left from left gastric
Replaced right from SMA
Exception for TNM staging of lung cancer
Not uesed for small cell
Treatment of choice for femoral pseudoaneurysm
US guided thrombin injection
T staging for lung Ca
T1a <2cm, T1b 2-3cm, T2a 3-5cm, T2b 5-7cm, T3 >7cm
Multiple lesions in primary lobe also T3
Stage 2a: T2aN1 or T2b N0
Stage 2b: T3 N0
Stage 3a: T3N1 or T1/T2 N2
Siderosis
Inhaled FeO during welding.
Small centrilobular lobules, usually no fibrosis or symptoms
Adenocarcinoma (lung)
30% of all lung cancers.
Usually peripheral, can be central.
Rarely cavitates.
Mycoplasma pneumonia
Serum cold agglutinin positive (70%).
GGO surrounding areas of consolidation.
Centrilobular nodules and peribronchovascular thickening
Invasive aspergillosis - imaging and Rx
Consolidation leading to cavitation, with surroundign GGO.
Urgent systemic amphotericin
Poor prognostic features of influenza on CXR
Multiple bilateral, peripheral opacities
Mosaic attenuation: Dense or Lucent areas abnormal
Reduced vessel caliber in lucent areas suggests they are abnormal
Thymoma vs Carcinoma
Carcinoma will invade great vessels, have distal mets or nodal involvement.
Thymoma will cause myasthenia gravis
Batwing oedema on CXR
Acute mitral valve insufficiency
Threshold for PCI in coronary artery stenosis
suitable if >75% stenosed.
May be suitable if 50-75%
Rx of Angina guidelines
Typical symptoms with normal ECG and lack of risk factors - 10-29% probability - CT Calcium score. <400 - CT angio, >400 - Cath angio
30-59% probability (incl uncertain results from CT angio or cath angio) - MRI or stress imaging
> 60% probability - cath angio
Pulmonary eosinophilia
Raised serum eosinophils.
B/L consolidation and GGO without fibrosis
Caused by many drugs including nitrofurantoin, penicillamine, sulphasalazine, NSAIDS, para-aminosalicylic acid
Semi-invasive aspergillosis
More indolent, slower course in mild impaired immunity (e.g. alcoholics).
Upper lobe consolidation, multiple nodules and cavitations.
