Pneumonia

Question 1

Risk Factors for Aspiration

Answer 1

Question 2

Branching tubular opacities may be seen, usually predominantly or exclusively involving upper lobes.

Answer 2

Allergic bronchopulmonary Aspergillosis

Question 3

Nonspecific bilateral consolidations and reticular opacities.

Answer 3

Acute eosinophilic lung disease

Question 4

Diffuse micronodular interstitial infiltrates. May see ground-glass densities in the lower or mid-lung fields. Bases spared.

Answer 4

Hypersensitivity pneumonitis (extrinsic allergic alveolitis)

Question 5

Patchy multifocal alveolar infiltrates without effusion.

Answer 5

Organizing pneumonia (bronchiolitis obliterans organizing pneumonia [BOOP])

Question 6

Bilateral peripheral, patchy, alveolar infiltrates and nodules.

Answer 6

Antinuclear cytoplasmic antibody (ANCA)–associated vasculitides: granulomatosis with polyangiitis (Wegener’s granulomatosis), Churg- Strauss syndrome

Question 7

Normal for first 12–24 h. Bilateral
opacities with sparing of costophrenic angles. Minimal or no pleural effusion. “White lung” due to extensive consolidation.

Answer 7

Acute interstitial pneumonia

Question 8

4 stages: bilateral hilar adenopathy; bilateral hilar adenopathy with reticulo- nodular pulmonary opacities; pulmonary opacities only; pulmonary fibrosis.

Answer 8

Sarcoidosis

Question 9

Diffuse, bilateral, predominantly alveolar densities with sparing of the apices and costophrenic angles.

Answer 9

Anti–glomerular basement membrane antibody disease (Goodpasture’s syndrome)

Question 10

Typically, bilateral interstitial infiltrates.

Answer 10

Drug-induced pneumonitis

Question 11

Diffuse alveolar and interstitial infiltrates.

Answer 11

Chemical pneumonitis

Question 12

Subtle hazy ground-glass densities to marked patchy infiltrates or homogenous consolidation. Air bronchograms are commonly present.

Answer 12

Radiation pneumonitis

Question 13

Peripheral alveolar infiltrates. May see peripheral nodule or mass.

Answer 13

Alveolar cell carcinoma,
often called bronchiolar or bronchioloalveolar carcinoma

Question 14

Interstitial or alveolar infiltrates. Diffuse infiltrates associated with hypoxia and need for intubation; focal infiltrates associated with coexistent pneumonia.

Answer 14

Leukemic infiltrates

Question 15

Interstitial prominence, suggesting interstitial edema. Radiographic findings may be delayed by hours after trauma

Answer 15

Fat emboli

Question 16

Focal or diffuse alveolar infiltrates.

Answer 16

Alveolar hemorrhage

Question 17

Classically, patchy peripheral infiltrates that extend to the lateral lung margins suggest the diagnosis.

Answer 17

Acute respiratory distress syndrome

Question 18

Autoimmune disease affecting the lungs and kidney due to autoantibodies to type IV collagen. Causes hemorrhagic interstitial pneumonitis.

Answer 18

Anti–glomerular basement membrane antibody disease (Goodpasture’s syndrome)

Question 19

Systemic granulomatous disease of unknown etiology. Noncaseating pulmonary granulomas.

Answer 19

Sarcoidosis

Question 20

Idiopathic or secondary (chemical agents). Three stages: interstitial edema spreads to alveoli with hemorrhage and hyaline membrane formation (exudative), organization of fibrinous exudate (proliferative), scarring and cyst formation and honey comb fibrosis (fibrotic).

Answer 20

Acute interstitial pneumonia

Question 21

Both systemic vasculitides of small and medium-sized vessels of unknown origin. Wegener’s characterized by necrotizing granulomatous vasculitis with involvement of upper respiratory tract, lung parenchyma, and kidneys. Churg-Strauss disease is an allergic eosinophilic condition. Most are asthmatic.

Answer 21

Antinuclear cytoplasmic antibody (ANCA)–associated vasculitides: granulomatosis with polyangiitis (Wegener’s granulomatosis), Churg- Strauss syndrome

Question 22

Inflammation of the bronchioles and surrounding tissues, leading to loss of the integrity of the bronchioles and organizing pneumonia without infection. Cryptogenic organizing pneumonia if immunocompromised or con- nective tissue diseases (e.g., SLE, rheumatoid arthritis, dermatomyositis).

Answer 22

Organizing pneumonia (bron- chiolitis obliterans organizing pneumonia [BOOP])

Question 23

Cause unknown. Association with new or binge smoking. Eosinophils accumulate in distal airways and alveolar and interstitial spaces.

Answer 23

Acute eosinophilic lung disease

Question 24

Symptoms occur 1–6 months after treat- ment: low-grade fever, cough, fullness in the chest.

Answer 24

Radiation pneumonitis