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Chest > Pleural Diseases > Flashcards

Pleural Diseases Flashcards

1
Q

What is the difference between transudates and exudates?

A

Transudates = low protein content

Exudates = high protein content

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2
Q

What are the causes for pleural exudates?

A
  • infections
  • neoplastic
  • hepatic
  • renal
  • inflammatory (RA, SLE, scleroderma)
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3
Q

What are some causes for pleural transudate?

A
  • raised microvascular pressure
  • reduced pleural surface pressure
  • major atelectasis
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4
Q

What are 3 common causes for large pleural effusions?

A

(3 T’s)
Tumor
TB
Trauma

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5
Q

What is the M/C/C of transudative pleural effusion?

A 
Heart failure (usually left & right)
Effusion is usually bilateral.
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6
Q

What is Meigs-Salmon syndrome?

A

a) benign ovarian tumor
b) pleural effusion
c) ascites

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7
Q

Which anatomical structure is usually response for the chylothorax?

A

Thoracic duct (close to aortic arch and mid-esophagus and surgery to these two areas can cause chylothorax).

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8
Q

What are the radiographic differences between pleural effusion and empyema?

A

Empyema

  • lenticular shape
  • unilateral or asymmetric
  • forms obtuse angle with chest wall
  • thickened pleura (split pleural sign)
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9
Q

What are the 3 types of pneumothorax? And which one is the M/C?

A

1) Spontaneous M/C
2) Tension
3) Traumatic (iatrogenic)

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10
Q

How many and what types of spontaneous pneumothorax are there?
Which is the M/C?

A

1) Primary (M/C) – rupture of bleb

2) Secondary (eg. airflow obstruction, interstitial lung disease)

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11
Q

Which side is more common to develop primary spontaneous pneumothorax?

A

Right side

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12
Q

What is tension pneumothorax and which pop’n are most prone to develop it?

A

Intrapleural pressure becomes positive, compressing normal lung.

Usually seen in mechanically ventilated and chest trauma patients.

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13
Q

What are 2 radiographic findings seen with tension pneumothorax?

A
  • diaphragmatic depression

- medastinal shift

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14
Q

Which pop’n is most likely to get traumatic pneumothorax?

A

Newborns

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15
Q

What is the normal allowed amount for apical capping?

A

<5mm

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16
Q

Apical capping exceeding 5mm is associated with which disease process?

A

Inflammatory disease (eg. TB)

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17
Q

What are the most likely benign differentials for a localized pleural tumor and which is M/C?

A
  • Lipoma (M/C)
  • Fibroma
  • Hemangioma
  • Neurofibroma
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18
Q

Fibrous localized tumors of the pleural M/C arise from which pleura?

A

Visceral pleura (87%)

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19
Q

True or false: smoking increases the risk for malignant mesothelioma.

A

False. It does not.

20
Q

What are the 3 types of malignant mesothelioma and which one is M/C?

A

a. Epithelial (M/C)
b. Sarcomatous
c. Mixed

21
Q

What are the M/C causes for pleural calcification?

A

HEATR

  • Hemothorax
  • Empyema
  • Asbestosis
  • Talcosis/TB
  • Radiation
22
Q

What is the M/C of acute mediastinitis?

A

Spontaneous or iatrogenic esophageal rupture (90%).

eg. Boerhaave syndrome

23
Q

What is a key radiographic feature indicating perforation of the esophagus?

A

Pneumomediastinum

24
Q

What is the M/C/C for chronic mediastinitis in the US?

A

Histoplasma capsulatum

25
Q

Chronic mediastinitis is characterized by what feature?

A

Progressive proliferation of fibrous tissue within mediastinum that encases and obstructs vital structures.

26
Q

A continuous diaphragm sign is suggestive of which condition?

A

pnumomediastinum

27
Q

What is the M/C primary tumor of the anterior mediastinum in adults?

A

Thymoma (20%)

28
Q

Thymomas M/C present unilateral or bilateral?

A

Unilateral

29
Q

What is the M/C thymic carcinoma?

A

squamous cell carcinoma

30
Q

Neuroendocrine tumors of the thymus originate in which cells?

A

Kulchitsky cells

31
Q

What is the M/C extragonadal location for germ cell tumors (eg. teratoma)?

A

Mediastinum

32
Q

Dermoid cysts contain mostly which embryological componenets?

A

Ectodermal (eg. skin, hair, cartilage)

33
Q

What endocrine condition is often associated with the thymus?

A

Myasthenia gravis

34
Q

Which malignant germ cell tumor is likely to be found in the anterior mediastinum?

A

Seminoma (seen in young men)

35
Q

What is a very sensitive and specific method for determining an intrathoracic mass to be thyroid in nature?

A

Radionuclide w/ iodine

36
Q

What is the M/C mediastinal mass of thyroid origin?

A

Benign multinodular goiter

37
Q

What are the two variants of Castleman Disease and which one is M/C?

A

a) Hyaline vascular (M/C 90%)
- seen in children & young adults
b) Plasma cell (10%)

38
Q

Castleman disease is known to overlap with which multicentric syndrome?

A

POEMS

39
Q

What are the differentials for egg-shell calcifications?

A
  1. Silicosis
  2. Coal miners pneumoconiosis
  3. Sarcoidosis
  4. Lymphoma following radiation
  5. Idiopathic
  6. TB/Fungal infections
40
Q

What is the M/C abnormality of the middle mediastinum?

A

Lymph node enlargement

41
Q

What are the 2 classifications used for aortic aneurysms?

A

1) DeBakey

2) Stanford

42
Q

What is the Standford classification for aortic aneurysms?

A

Type A = Affects Ascending Aorta and Arch
- requires surgical management

Type B = Begins Beyond Brachiocephalic vessels
- requires medical management

43
Q

What is the DeBakey classification for aortic aneurysms?

A

Type 1: ascending & descending aorta
Type 2: ascending aorta
Type 3: descending aorta

44
Q

What are some differentials for middle mediastinal masses?

A
  1. Lymph nodes
  2. Bronchogenic cyst
  3. Aortic aneurysm
  4. Carcinoma of bronchus
45
Q

What are some differentials for posterior mediastinal masses?

A
  1. Aorta (aneurysm/tortous)
  2. Extramedullary haemopoiesis
  3. Neural tumor
  4. Hiatal hernia
  5. Bone tumor (metastases, myeloma etc.)
  6. Dilated esophagus

Chest (12 decks)

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