Respiratory tract Flashcards
Unilateral hypertransradiant hemithorax.
look at number of blood vessels to confirm abnormal side.
Rotation / scoliosis.
chest wall
- mastectomy
poliomyelitis
Polands syndrome
pneumothorax
Lung - post surgical expansion.
- airway obstruction
- unilateral bullae
- swayer james - expiratory air trapped
- congenital lobar emphysema
PE.
bilateral hypertranparent hemithoraces
increased lung volume
emphysema
asthma
acute bronchiolitis
tracheal / laryngeal stenoses
bilateral hypertranparent hemithoraces
normal lungs
Oligaemia, heart disease
Features of large hilar vessels with distal pruning
Pulmonary artery stenosis
Multiple pulmonary emboli
Idiopathic pulmonary hypertension
Schistosamiasis
metaratic trophoblastic tumour
tracheal narrowing
subglottic stneosis
post intubation
wegeners granulomatosis
tracheal narrowing
diffuse inflammatory
Sarcoid
Wegeners
Relapsing polychondritis
Causes of distal airway narrowing
in the lumen
FB
Mucus plug
Bronchiolithiasis
Causes of distal airway narrowing
in the wall
Tracheal cancer
other tumours
inflammation / fibrosis
bronchial atresia
tracheobronchomalacia
fractured bronchus
causes of airway narrowing
outside the wall
Lymph nodes
mediastinal tumour
left atria enalrgement
aorta aneurysm
Anom LPA from right pA (compress right main bronchus)
increased density of one hemithorax
normal mediasitnum
Consolidation
pleural effusion
malignant pleural mesothelioma
increased density of one hemithorax
mdiastinum pushed away
LARGE pleural effusion
diaphragmatic hernia
increased density of one hemithroax
mediasitnum pulled towards
lung collapse
post pneumonectomy
Lymphangitis carcinomatosa
puomonary agenesis and hypoplasia
malignant pleural mesothelioma
Puomonary air cysts
post infective, what types of bacteria cause cysts
staph A - kids!
Strep Pneumoniae
E Coli
Kleb
H Inf
PCP, upper parts multiple
Legionella
Hydatid
Puomonary cysts
congenital causes
Congenital puomonary adenomatoid malformation / sequestration
intrapuomonary bronchogenic cyst.
neoplastic casues of pulmonary cysts
treated mets (germ cell and bladder)
Hyalinizing granulomas
metastatic epithelioid sarcoma
diffuse lung disease
LCH
LAM
TS
Neurofibromatosis
Birt Hogg Dube
LIP
HS pneumonitis
End stage fibrotic ILD
non resolving or recurrent consolidaiton
bronchial obstruction
infection - TB, Kleb, fungal
Malignancy
Recurrent aspiration
Pre-existing lung pathology
Impaired immunity
OP
Sarcoidosis
Wegeners Grnaulomatosis
Consoldiation with an elarged hilum
primary TB
Viral penumonia
Mycoplasma pneumonia
Primary histoplasmosis
Coccidioidomycosis
lobar pnumonia
organism types
Strep Pneumonia
Kleb
Staph Pneumoniae
TB
Strep Pyogenes- lower lobes
consolidation with bulging fissures
Klebsiella, Strep pneumoniae, Myco TB, Yersinia.
- lots of exudates.
Abscess - staph A, Kleb,
Lung Cancer
causes of bronchiectasis
common causes
Immunodeficency
- hypoIgG
- chronic granulomatous disease
HIV
hediak- Higashi
Cystic Fibrosis
Idiopathic - one third
causes of air space opacifciation
oedema
infection
diffuse pulmonary haemorrhage
malignancy - adeno / lymphoma
sarcoid
EG
OP
less common causes ofbronchiectasis
post kid infection , measels / pertusissis
bronchial obstruction
chronic aspiraiton
kartageners / William Cambell / Mounier Kuhn / Alpha 1 antitrypsin / Swayer james
Cardiogenic Puomonary oedema
imparied left ventricular fuction
non cardiogenic pumoonary oedema
FLuid overload
Cerebrald disease
Near drowning
aspiraiton - mendelsons syndrome
radiotherapy
rexpanded lung from thoracentesis
liver disease
TRALI
Drugs
Poisons - smoke
mediastinal tumours
acute resp distress syndrome
high altitude
unilateral puomonary oedema
same side as abnormality
lat decubitus
aspiraiton
pulmonary contusion
thoracocentesis
bronchial obstruction
systemic artery to pulmonary artery shunts
Pulmonary oedema on the opposite side to existing pathology
Congenital absence of pulmonary artery
mcleod syndrome
thromboembolism
unilateral emphysema
lobectomy
pleural disease
septal lines
causes of pulmonary venous engorment
Left ventricular failure
mitral stenosis
pulmonary veno-oclusive disease
septal lines
lymphatic infiltration
cancer
pneumoconioses
sarcoid - uncommon
Idiopathic bronchiectasis
Erdeim Chester
Diffuse pumonary haeorrhage
lymphnagiomatosis
Congenital lymphangiectasia
alveolar proteinosis
alveolar microlithiasis
amyloidosis
reticular pattern
IPF
Connective tissue diseases
Occupation lung disease - asbestosis. pneumoconiosis, paraquat poisoning
sarcoid - upper zone
Chronic hypersentivity.
cystic lung diease - if CXR as projecitonal pattern
Drug induced - Nitro, bleomycin, cyclo
Bone marrow tx - constrictive obliterative bronchiolitis.
misc causes of diffuse lung disease
- alveolar proteinosis
- idopathic pulmonary haenosiderosis
amylodiosis
nodules - measurement
<3mm - micronodules
> 3cm - mass
multiple micronodules
high density
post lymphangiography
silicosis
stannosis
barytosis
limestone and marble workers
alveolar microlithiasis - familial disorder
multiple micronodules
soft tissue density
miliary TB
fingal infection
coal miners - mid zone
sarcoid
multiple micronodules
great than soft tissue density
haemosiderosis, if raised venous pressure. goodpastures.
silicosis
siderosis
stannosis
barytosis
multiple soft tissue density nodules
2-5mm
cancer - breast, thyroid, mel, prosdtate, pacnrea or lung
Subacute hypersensitivity penumonitis
resp bronchiolitis
lymphoma
sarcoid
LCH
multiple nodules which can confluence
multifocal pneumonia
pulmonary. oedmea
diffus epulmonary haemorrhage
multiple nodules
larger than 5mm
Neoplastic
- mets
- lung cancer
- Kaposi sarcoma
- beningn mets.
Infection
- abcess
- coccidiomycosis
-histoplasmosis
-hydatid
Immunological
- Wegeners
-Rheumatoid nodules
- PMF
- OP
-Amyloidosis
- Hyalizing granulomas
Vascular
- AMV
Solitary nodule/mass like lesion
Granulomatous
- Tuberculoma
- Histoplasmoma
Malignant
- Lung Ca
- Solitary mets
Benign tumours
- Carcinoid
- Hamartoma
INfectious
- pneumonia
-ruonded atelectasisi
- yatid
- wegerns
- sarcoid
- OP
Congenital
- lymhp node.
- sequestratrion,
Vasc
- haematoma
- AVM
types of sequestation
venous drains to pulmonary veins intra. or extra into systemic. Both systemic arterial supply
apical mass
Pancoast
tortuous subclavian artery
scarring/fibrosis
Mycetoma in cavity
chet wall tumours
plombage
meningocele
Pulmonary cavities
Infective
- Staph A, Kleb, TB, Emboli, Aspiration. hydatid, aspergiluus,. lots
Neoplastic
- SCC commonly.
- Mets (SCC, colon and sarcoma)
- Tracheobronchial papillomatosis, caviate nodules
- lymphoma (uncommon)
Vascular
- infarction
Inflammatory
- Wegeners
- RHeumatoid nodules
- PMF
- sarcoid
Trauma
- Haematoma
- pneumatoclele
Cystic lung disease
Post infective
-Staph A ect
- PCP (upper)
- hydatid
Trauma
- laceration. resolves
COngenital
- CPAM
- bronchogenic cyst
Neoplastic
- post treatment
- colonic mets, sarcoma, endometrial stromal sarcoma
Diffuse cystic lung diseases
LCH
LAM
TS
LIP
NF
Birt HOgg Dube - renal tumours
HP
End ILD
DIP
Calc in a solitary nodule
BENIGN
though
cancer around a granuloma
mets - ostesarc
papillary adeno or Squamous cell
Pulmonary calcifcaiont / ossificaiotn
Localized area
TB - small nidus
Histoplasmosis
Coccidiodomycosis
Blastomyocosis
Diffuse calc in the lung
Infection - mil Tb, varicella,
chronic venous HTN
silicosis
mets
alveolar microlithiasis - familial
metastatic due to high Calc - upper zone
Talcosis
Post lymphoma radiotherapy
Nonthrombotic pulmonary EMBOLI
Septic
Iatrogenic
Phlebolith
Fat
Amniotic Tumour
Talc
Hydatid
HRCT nodular patterns
Centrilobular
Infective bronchiolitis
- TB
- Aspiration
- mycoplasma, viral, fungal
HP
- allergens
Respiratory bronchiolitis
follicular bronchiolitis
diffuse panbronchiolitis
Bronchiectasis diseases. CF, PCD
Endobronchial tumour
HRCT nodular patterns
Periplymphatic
Sarcoid
Lymphangitis carcinomatosis
Solicosis
Lymphoma
Amyloidosis
HRCT nodular patterns
Random
Miliary TB
Miliary mets
Silicosis and coals workers pneumoconiosis
LCH
LIP
Fungal infection
Ground glass on HRCT
acute presentation
Pulmonary oedema
infection
haemorrhage
ARDS
AHcute hypersensitivity pnuemonitis
acute oesinophilic pneumonia
Ground glass on HRCT
chronic illness
Diffuse
- interstitial pnuemoina
- organising pneumonia
- RB ILD
- DIP
- LIP
Chronci HP
Chronic Esoinophilic pnuemonia
Drug induced
Alveolar sarcoidosis
Alveolar proteinosis
adenocarcinoma
HRCT Mosaic attenuation
what three categories are there
Small airways diseases
Pulmonary vascular diseases
Infiltrative lung diseases
mosaic atenuation
small airways disease
Post infective - swayer jams
post transplanation
connective tissue
drugs
Toxic fumes
bronchiectaisis
sarcoid
mosaic attenuation
pulmonary vascular diseases
chronic thromboembolic disease
pulmonary arterial htn
pulmonary artery tumours - sarcoma
mosaic attenuation
infiltrative lung disease
not sure
unilateral hilar enlargement
Lymph
- lung cancer
- inection
- unicentric castleman disease
– lymphoma
-sarcoid
artery
- poststenotic dilattion
aneurysm - eg bechets
- PE
Crcinoid tumour
mediastinal mass
perihilar pneumonia
bilateral hilar enlargement
Sarcoid
lymphoma
carincomatosis
castleman
infective
silicosis (egg shelll)
Egg shell lymph nodes
Silicosis
Coal workers pneumoconiosis
Sarcoidosis
Lymphoma post rdiotherapy
Transudate pleural effusion
Cardiac, renal or hepatic failure
Exudate pleural effusion
Infection , malignancy, collagen vascular disorder
infarction
page 94.
pleural effusion due to extrathoracic disease
Pancreatitis (left)
Subphrenic abscess
Post surgery
Meigssyndrome - benign ovaria tumour
Nephrotic
fluid overload
Cirrhosis
causes of pleural calc
asbesotos exposure
prior infection
talc pleurodesis - pet avid for years
prior haemothroax
diffuse pleural thickening
Exudative pleural effusion (empyema). asbestos exposure (smooth, pleural plaques)
malignant mesothelioma
estrapleural fat ploriferation
Pleural mets
post haemothorax / surgery
fibrosis related pleuroparenchymal bands
focal pleural mass
causes
empyema
mets (multiple and effusion)
mal mesothelioma
Solitary fibrous tumour of the pleura (can change position if peducnulated). Asymptomatic.
Extrapleural haematoma
chest wall masses
PNeumomediastinum
extension of Pulmonary interstitial emphysema - sudden increase presus.re
Oesophagus perf
abdominal perf in retroperitonum
Diaphragmatic hump
causes for any location
Collapse / consolidaiton
localised eventration
Subpulmonary effusion
Pulmonary infarct - hampton hump
extend from liver:
hepatic abscess, mets, hydatid cyt
Diaphragmatic hump
medial causes
fat pad
hiatus hernia
A aneurysm
pericaridal cyst
pulmonary sequestration
diaphragmatic hump
anterior
morgani hernia
diaphgramtic hump
posterior
bochdalek hernia
neurogenic tumour
Causes of an elevated hemidiaphragm
Above diaphragm causes
Phrenic nerve palsy
Lung collapse
pleural disease
pain - splinting
hemiplegia
SCOLIOSIS causes this
Elevated hemidiaphragm
diaphragmatic causes
eventration
herniation
elevated hemidiahpragm
sub diaphragm causes
inflmaation below
hepatomegaly or splenomegaly
Gas distension of the stomach
causes of bilateral raised hemi diaphragms
low inspiration
obesity
myopathy
lordotic projection
baal lung collapse
small lungs
ascites
pneumoperitoneum
pregnancy
hepatosplenomegaly
tumour
subphrenic abscess
anterior mediastinal masses by region
Superior
goitre
lymphadenopathy
thymic tumours
Middle anterior
Germ cell neoplasm -
thymic tumours
sternal tumours
inferior - anterior cardiophrenic angle
fat pad
diaphragmatic eventration
morgagni hernia
pericardial cyysts
describe some germ cell tumours
dermoid, teratoma
seminomas
choriocarcinomas
embryonal carcinoma
thymomas
Middle mediastinal mass in adults
Lymphadneopathy
bronchogenic carcinoma
totuous subclavian
aortic aneurysm
bronchogenic cyst
fibrosing mediastinitis
posterior mediastinal masses in adults
lymphoma
abscess
extramedullary haematopoiesis
neurogenic tumours
meningocele
neuroenteric cyst
dilated oseophagus
descending aorta
oesophageal duplciation cyst
