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Chapman Aids to differentials flashcards > Respiratory tract > Flashcards

Respiratory tract Flashcards

1
Q

Unilateral hypertransradiant hemithorax.

A

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.

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2
Q

bilateral hypertranparent hemithoraces

increased lung volume

A

emphysema

asthma

acute bronchiolitis

tracheal / laryngeal stenoses

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3
Q

bilateral hypertranparent hemithoraces

normal lungs

A

Oligaemia, heart disease

Features of large hilar vessels with distal pruning

Pulmonary artery stenosis
Multiple pulmonary emboli
Idiopathic pulmonary hypertension
Schistosamiasis
metaratic trophoblastic tumour

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4
Q

tracheal narrowing

subglottic stneosis

A

post intubation
wegeners granulomatosis

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5
Q

tracheal narrowing

diffuse inflammatory

A

Sarcoid
Wegeners
Relapsing polychondritis

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6
Q

Causes of distal airway narrowing

in the lumen

A

FB
Mucus plug
Bronchiolithiasis

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7
Q

Causes of distal airway narrowing

in the wall

A

Tracheal cancer

other tumours

inflammation / fibrosis

bronchial atresia

tracheobronchomalacia

fractured bronchus

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8
Q

causes of airway narrowing

outside the wall

A

Lymph nodes
mediastinal tumour
left atria enalrgement
aorta aneurysm
Anom LPA from right pA (compress right main bronchus)

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8
Q

increased density of one hemithorax

normal mediasitnum

A

Consolidation

pleural effusion

malignant pleural mesothelioma

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9
Q

increased density of one hemithorax

mdiastinum pushed away

A

LARGE pleural effusion
diaphragmatic hernia

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10
Q

increased density of one hemithroax

mediasitnum pulled towards

A

lung collapse
post pneumonectomy
Lymphangitis carcinomatosa
puomonary agenesis and hypoplasia
malignant pleural mesothelioma

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11
Q

Puomonary air cysts

post infective, what types of bacteria cause cysts

A

staph A - kids!
Strep Pneumoniae
E Coli
Kleb
H Inf
PCP, upper parts multiple
Legionella
Hydatid

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12
Q

Puomonary cysts

congenital causes

A

Congenital puomonary adenomatoid malformation / sequestration

intrapuomonary bronchogenic cyst.

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13
Q

neoplastic casues of pulmonary cysts

A

treated mets (germ cell and bladder)
Hyalinizing granulomas
metastatic epithelioid sarcoma

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14
Q

diffuse lung disease

A

LCH

LAM

TS

Neurofibromatosis

Birt Hogg Dube

LIP

HS pneumonitis
End stage fibrotic ILD

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15
Q

non resolving or recurrent consolidaiton

A

bronchial obstruction

infection - TB, Kleb, fungal

Malignancy

Recurrent aspiration

Pre-existing lung pathology

Impaired immunity

OP

Sarcoidosis

Wegeners Grnaulomatosis

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16
Q

Consoldiation with an elarged hilum

A

primary TB
Viral penumonia
Mycoplasma pneumonia
Primary histoplasmosis
Coccidioidomycosis

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17
Q

lobar pnumonia

organism types

A

Strep Pneumonia

Kleb

Staph Pneumoniae

TB

Strep Pyogenes- lower lobes

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18
Q

consolidation with bulging fissures

A

Klebsiella, Strep pneumoniae, Myco TB, Yersinia.
- lots of exudates.

Abscess - staph A, Kleb,

Lung Cancer

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19
Q

causes of bronchiectasis

common causes

A

Immunodeficency
- hypoIgG
- chronic granulomatous disease
HIV
hediak- Higashi

Cystic Fibrosis

Idiopathic - one third

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20
Q

causes of air space opacifciation

A

oedema
infection
diffuse pulmonary haemorrhage
malignancy - adeno / lymphoma
sarcoid
EG
OP

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21
Q

less common causes ofbronchiectasis

A

post kid infection , measels / pertusissis
bronchial obstruction
chronic aspiraiton

kartageners / William Cambell / Mounier Kuhn / Alpha 1 antitrypsin / Swayer james

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22
Q

Cardiogenic Puomonary oedema

A

imparied left ventricular fuction

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23
Q

non cardiogenic pumoonary oedema

A

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

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24
unilateral puomonary oedema same side as abnormality
lat decubitus aspiraiton pulmonary contusion thoracocentesis bronchial obstruction systemic artery to pulmonary artery shunts
25
Pulmonary oedema on the opposite side to existing pathology
Congenital absence of pulmonary artery mcleod syndrome thromboembolism unilateral emphysema lobectomy pleural disease
26
septal lines causes of pulmonary venous engorment
Left ventricular failure mitral stenosis pulmonary veno-oclusive disease
27
septal lines lymphatic infiltration
cancer pneumoconioses sarcoid - uncommon Idiopathic bronchiectasis Erdeim Chester Diffuse pumonary haeorrhage lymphnagiomatosis Congenital lymphangiectasia alveolar proteinosis alveolar microlithiasis amyloidosis
28
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
29
nodules - measurement
<3mm - micronodules >3cm - mass
30
multiple micronodules high density
post lymphangiography silicosis stannosis barytosis limestone and marble workers alveolar microlithiasis - familial disorder
31
multiple micronodules soft tissue density
miliary TB fingal infection coal miners - mid zone sarcoid
32
multiple micronodules great than soft tissue density
haemosiderosis, if raised venous pressure. goodpastures. silicosis siderosis stannosis barytosis
33
multiple soft tissue density nodules 2-5mm
cancer - breast, thyroid, mel, prosdtate, pacnrea or lung Subacute hypersensitivity penumonitis resp bronchiolitis lymphoma sarcoid LCH
34
multiple nodules which can confluence
multifocal pneumonia pulmonary. oedmea diffus epulmonary haemorrhage
35
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
36
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
37
types of sequestation
venous drains to pulmonary veins intra. or extra into systemic. Both systemic arterial supply
38
apical mass
Pancoast tortuous subclavian artery scarring/fibrosis Mycetoma in cavity chet wall tumours plombage meningocele
39
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
40
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
41
Diffuse cystic lung diseases
LCH LAM TS LIP NF Birt HOgg Dube - renal tumours HP End ILD DIP
42
Calc in a solitary nodule
BENIGN though cancer around a granuloma mets - ostesarc papillary adeno or Squamous cell
43
Pulmonary calcifcaiont / ossificaiotn Localized area
TB - small nidus Histoplasmosis Coccidiodomycosis Blastomyocosis
44
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
45
Nonthrombotic pulmonary EMBOLI
Septic Iatrogenic Phlebolith Fat Amniotic Tumour Talc Hydatid
46
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
47
HRCT nodular patterns Periplymphatic
Sarcoid Lymphangitis carcinomatosis Solicosis Lymphoma Amyloidosis
48
HRCT nodular patterns Random
Miliary TB Miliary mets Silicosis and coals workers pneumoconiosis LCH LIP Fungal infection
49
Ground glass on HRCT acute presentation
Pulmonary oedema infection haemorrhage ARDS AHcute hypersensitivity pnuemonitis acute oesinophilic pneumonia
50
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
51
HRCT Mosaic attenuation what three categories are there
Small airways diseases Pulmonary vascular diseases Infiltrative lung diseases
52
mosaic atenuation small airways disease
Post infective - swayer jams post transplanation connective tissue drugs Toxic fumes bronchiectaisis sarcoid
53
mosaic attenuation pulmonary vascular diseases
chronic thromboembolic disease pulmonary arterial htn pulmonary artery tumours - sarcoma
54
mosaic attenuation infiltrative lung disease
not sure
55
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
56
bilateral hilar enlargement
Sarcoid lymphoma carincomatosis castleman infective silicosis (egg shelll)
57
Egg shell lymph nodes
Silicosis Coal workers pneumoconiosis Sarcoidosis Lymphoma post rdiotherapy
58
Transudate pleural effusion
Cardiac, renal or hepatic failure
59
Exudate pleural effusion
Infection , malignancy, collagen vascular disorder infarction
60
page 94. pleural effusion due to extrathoracic disease
Pancreatitis (left) Subphrenic abscess Post surgery Meigssyndrome - benign ovaria tumour Nephrotic fluid overload Cirrhosis
61
causes of pleural calc
asbesotos exposure prior infection talc pleurodesis - pet avid for years prior haemothroax
62
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
63
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
64
PNeumomediastinum
extension of Pulmonary interstitial emphysema - sudden increase presus.re Oesophagus perf abdominal perf in retroperitonum
65
Diaphragmatic hump causes for any location
Collapse / consolidaiton localised eventration Subpulmonary effusion Pulmonary infarct - hampton hump extend from liver: hepatic abscess, mets, hydatid cyt
66
Diaphragmatic hump medial causes
fat pad hiatus hernia A aneurysm pericaridal cyst pulmonary sequestration
67
diaphragmatic hump anterior
morgani hernia
68
diaphgramtic hump posterior
bochdalek hernia neurogenic tumour
69
Causes of an elevated hemidiaphragm Above diaphragm causes
Phrenic nerve palsy Lung collapse pleural disease pain - splinting hemiplegia SCOLIOSIS causes this
70
Elevated hemidiaphragm diaphragmatic causes
eventration herniation
71
elevated hemidiahpragm sub diaphragm causes
inflmaation below hepatomegaly or splenomegaly Gas distension of the stomach
72
causes of bilateral raised hemi diaphragms
low inspiration obesity myopathy lordotic projection baal lung collapse small lungs ascites pneumoperitoneum pregnancy hepatosplenomegaly tumour subphrenic abscess
73
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
74
describe some germ cell tumours
dermoid, teratoma seminomas choriocarcinomas embryonal carcinoma thymomas
75
Middle mediastinal mass in adults
Lymphadneopathy bronchogenic carcinoma totuous subclavian aortic aneurysm bronchogenic cyst fibrosing mediastinitis
76
posterior mediastinal masses in adults
lymphoma abscess extramedullary haematopoiesis neurogenic tumours meningocele neuroenteric cyst dilated oseophagus descending aorta oesophageal duplciation cyst
77

Chapman Aids to differentials flashcards (5 decks)

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