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thoracic Flashcards

1
Q

What opacity can be seen in Raider Triangle?

A

aberrant right subclavian

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2
Q

A pacemaker wire going through a valve makes it what valve?

A

tricuspid

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3
Q

What is a pig bronchus? What is the trigger phrase on exams?

A

right upper lobe bronchus taking off of trachea

recurrent RUL infection

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4
Q

Where does a cardiac bronchus arise from?

A

bronchus intermedius

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5
Q

What is the most common pulmonary vein anatomy?

A

separate vein draining RML

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6
Q

Is the distal vasculature usually present in UAPA?

A

yes

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7
Q

What is a UAPA usually opposite of?

A

the aortic arch

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8
Q

Masses above the cervicothoracic junction are located in what part of the mediastinum?

A

posterior

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9
Q

What pneumonia causing bug is associated with recent dental procedures and/or jaw osteomyelitis?

A

actinomyces

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10
Q

Flame shaped perihilar opacity in AIDS pt should make you think what?

A

kaposi sarcoma

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11
Q

What are the four most common cystic causing lung diseases?

A

LIP

LAM

DIP

BHD

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12
Q

Lung cysts + GGOs + ptx = what disease?

A

PCP

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13
Q

Hypervascular lymph nodes in an AIDS pt should make you think what?

A

kaposi or castleman

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14
Q

What is a ghon focus?

A

TB granuloma

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15
Q

What is a ranke complex?

A

calcified ghon focus

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16
Q

What feature accompanies primary progression?

A

cavitation

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17
Q

What feature accompanies primary progression?

A

cavitation

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18
Q

What is the most common cause of primary progression of TB?

A

immunosuppression

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19
Q

What two surgeries can cause primary progression of TB?

A

jejuno-ileal bypass

subtotal gastrectomy

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20
Q

What environmental exposure can cause primary progression of TB?

A

silicosis

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21
Q

How is immune reconstitution reactivation syndrome treated?

A

steroids

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22
Q

How does one diagnose pleural involvement of TB?

A

pleural biopsy

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23
Q

An old man with upper lobe predominant cavitary lesions and adjacent nodules should raise the concern for what disease?

A

MAC

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24
Q

What are the two signs for angioinvasive aspergilloma?

A

halo sign

air crescent sign

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25
Q

What does the halo represent regarding the halo sign of angioinvasive aspergilloma?

A

halo = represents invasive component

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26
Q

What does the air crescent sign represent?

A

healing

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27
Q

ABPA can occur in what patient class in addition to chronic ashmatics?

A

CF

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28
Q

Lung Screen CT should have a CT dose less than what?

A

3 mGy

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29
Q

Growth is considered greater than what size in one year?

A

1.5 mm

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30
Q

What is the lung rads for an endobronchial lesion?

A

4a

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31
Q

What type of calcification of SPNs is the most suspicious?

A

eccentric

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32
Q

Central “popcorn” calcs can be suspicious in the setting of what type of cancer?

A

GI cancer

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33
Q

Where is a lung cancer most likely to arise in a patient with pulmonary fibrosis?

A

peripheral/basilar

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34
Q

What paraneoplastic syndrome can be associated with squamous cell lung cancer?

A

hyper-parathyroid-ism

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35
Q

Is large cell lung cancer more often found centrally or peripherally?

A

peripheral

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36
Q

What lung cancer is a known associate of pulmonary fibrosis?

A

adeno

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37
Q

Does adeno prefer a peripheral or central location?

A

peripheral

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38
Q

What imaging modality to stage a pancoast tumor? Why?

A

mri

brachial plexus

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39
Q

Can a pulmonary hamartoma be hot on PET?

A

yes

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40
Q

Is kaposi thallium hot or cold?

A

thallium hot

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41
Q

Is thallium gallium hot or cold?

A

cold

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42
Q

What is the triad of AIDS related pulmonary lymphoma?

A

nodules

pleural effusion

lymphadenopathy

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43
Q

How can poland syndrome look on a chest Xray?

A

hyper-lucent lung

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44
Q

Will a lung be hyperinflated or deflated distal to a bronchial atresia? Why?

A

hyperinflated

collateral flow through pores of Kohn

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45
Q

Will a lucent lobe cause by bronchial atresia be hyper-vascular or hypo-vascular?

A

decreased vascularity

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46
Q

Mucoid impaction is generally below what HU?

A

< 25 HU

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47
Q

Even though contested, treating an afferent vessel feeding a pulmonary AVM occurs at what size?

A

> 3mm

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48
Q

Where does a persistent left SVC drain into?

A

coronary sinus

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49
Q

What is the pathological term for Swyer James?

A

post infectious obliterative bronchiolitis

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50
Q

Is the lung effected by swyer james bigger or smaller than the unaffected lung?

A

smaller

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51
Q

What is horseshoe lung associated with?

A

scimitar syndrome

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52
Q

Pulmonary LCH exclusively effects which type of patient?

A

smokers

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53
Q

is Pulmonary LCH upper or lower lobe predominate?

A

upper

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54
Q

What two lung diseases spare the CP angles?

A

pulmonary LCH

hypersensitivity pneumonitis

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55
Q

What disease is LAM associated with?

A

tuberous sclerosis

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56
Q

What shape are BHD cysts?

A

oval

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57
Q

What two things happen in the kidney with BHD?

A

renal oncocytomas

chromophobe RCC

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58
Q

What disease is seen with LIP 25% of the time?

A

sjogrens

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59
Q

What drug can cause pan-lobular emphysema?

A

IV ritalin

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60
Q

What is the pathophysiology behind vanishing lung syndrome?

A

avascular necrosis

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61
Q

What % of patients with vanishing lung have A1AT?

A

20%

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62
Q

The interstitial pattern of asbestosis looks like what interstitial disease?

A

UIP

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63
Q

Is PMF T2 bright or T2 dark?

A

bright

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64
Q

Silo Fillers disease is caused by what compound?

A

nitrogen dioxide

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65
Q

What does Silo Fillers Disease look like on CT?

A

edema

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66
Q

What two structures run in the middle of the secondary pulmonary lobule?

A

artery and airway

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67
Q

What two structures run in the periphery of the secondary pulmonary lobule?

A

vein and lymphatics

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68
Q

What is the plain film equivalent of interlobular septal thickeing?

A

kerley B line

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69
Q

Is UIP homogenous or heterogenous inflammation?

A

heterogenous

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70
Q

Is NSIP homogenous or heterogenous inflammation?

A

homo

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71
Q

GGO alone in NSIP is what flavor of classification?

A

cellular

72
Q

What finding needs to be present to call it fibrotic type NSIP?

A

traction bronchiectasis

73
Q

How does DIP look like on CT?

A

lower lobe, peripheral GGO with small cystic spaces

74
Q

What is Stage 1 Sarcoidosis?

A

hilar and mediastinal nodes only

75
Q

What is Stage 2 sarcoidosis?

A

nodes and parechymal disease

76
Q

What is Stage 3 Sarcoidosis?

A

parenchyma only

77
Q

What is Stage 4 Sarcoidosis?

A

fibrosis

78
Q

Does sarcoid produce upper or lower lobe fibrosis?

A

upper

79
Q

Are the perilymphatic nodules in sarcoid upper or lower lobe predominant?

A

upper

80
Q

Swan Ganz catheters are an indirect measurement of what cardiac chamber?

A

left atria

81
Q

What is the most common opportunistic infection in a lung transplant PT?

A

CMV

82
Q

What disease most commonly recurs in transplanted lungs?

A

sarcoid

83
Q

What type of infection is associated with PAP?

A

nocardia

84
Q

What exposure is highly associated with PAP?

A

smoking

85
Q

What type of interstitial pneumonia looks like PAP?

A

Acute Interstitial Pneumonia

86
Q

What is the pathophysiology of endogenous lipoid pneumonia?

A

obstructive process causing build up of lipid laden macrophages

87
Q

What is the pathophysiology of organizing pneumonia?

A

build up of granulation tissue within alveolar spaces from fibroblasts

88
Q

What is the classic sign of COP?

A

reverse halo or atoll

89
Q

Does eosinophilic pneumonia favor the upper or lower lobes?

A

upper

90
Q

What interstitial lung disease does chronic hypersensitivity pneumonitis look like?

A

UIP + air trapping

91
Q

Where are the fibrotic changes of chronic HP?

A

mid to upper lobe predoominant

92
Q

What two diseases spare the posterior trachea?

A

relapsing polychondritis

TBO

93
Q

Which disease can produce calcifications, TBO or RP?

A

TBO

94
Q

How does RP present?

A

recurrent pna

95
Q

Which disease classically involves the posterior trachea?

A

amyloidosis

96
Q

Can amyloidosis form calcs?

A

yes

97
Q

Does pulmonary carcinoid tend to effect the left or right heart valves?

A

left

98
Q

What is more likely to be in the trachea, adenoid cystic or carcinoid?

A

adenoid cystic

99
Q

A single papilloma in the trachea should make you think what?

A

single = smoking

100
Q

Multiple papilloma in the trachea should make you think what?

A

HPV

101
Q

CF begins as what type of bronchiectasis? Progresses to what type?

A

cylindrical

progresses to varicoid

102
Q

What can happen reproductively to girls with CF?

A

ectopics

103
Q

Does CF or PCD have absent vas deferens?

A

CF

104
Q

How does Williams Campbell Syndrome present?

A

peripheral, cystic bronchiectasis presenting in 4-6th decade

105
Q

Bronchiolitis obliterans should make you think of what two diseases?

A

post-transplant rejection of lung

asthma/bronchiolitis

106
Q

Follicular bronchiolitis is seen with what two diseases?

A

sjogrens and RA

107
Q

How does ankylosing spondylitis look when it manifests in the lungs?

A

“upper lobe fibrobullous disease”

108
Q

How does Caplan syndrome look like in the lungs?

A

upper lobe nodules that can cavitate, with out without a pleural effusion

109
Q

Shrinking Lung should make you think of what disease?

A

lupus

110
Q

What does hepatopulmonary look like in the lung bases?

A

engorged vessels extending into periphery

111
Q

Solitary Fibrous Tumor of the Pleura can cause what 30% of the time?

A

hypertrophic osteoarthropathy

112
Q

What is the latin term for when an empyema eats through the chest wall?

A

empyema necessitans

113
Q

What will have fat in it, lymphoma or a large thymus?

A

large thymus

114
Q

Will calcs in a thymus make you think a benign or aggressive course?

A

aggressive

115
Q

Where do thymomas drop met?

A

retroperitoneum or pleura

116
Q

Are immature germ cell tumors of the mediastinum more common in men or women?

A

men

117
Q

What three conditions can a thymic cyst be seen with?

A

after thoracotomy

HIV

chemo

118
Q

Non-granulomatous mediastinal fibrosis can be associated with what medication?

A

methylsergide

119
Q

What are the three neurogenic tumors that can occur in the posterior mediastinum?

A

schwannoma

neurofibroma

malignant peripheral nerve sheath tumor

120
Q

What is the Fleischner sign?

A

enlarged PA

121
Q

What are the three most common causes of pulmonary artery pseudoaneurysm?

A

swan

bechet

chronic PE

122
Q

What causes the hot quadrate sign?

A

SVC obstruction

123
Q

What muscle separates the tricuspid valve from the pulmonic valve?

A

crista supraventricularis

124
Q

Do the papillary muscles of the mitral or tricuspid valve insert on the septum?

A

tricuspid

125
Q

What heart structure will lipomatous hypertrophy spare?

A

fossa ovalis

126
Q

What heart structure will a interatrial lipoma not spare?

A

fossa ovalis

127
Q

What coronary artery gives off the conus branch? What does the conus branch supply?

A

RCA

ventricular outflow tract

128
Q

What artery gives off the diagonals?

A

LAD

129
Q

What artery gives off the obtuse marginals?

A

circumflex

130
Q

What is the definition of a coronary fistula?

A

abnormal connection between coronary artery and ventricular chamber or great vessels

131
Q

How does a coronary fistula most often manifest?

A

coronary aneurysm

132
Q

HR under what for coronary CT?

A

60

133
Q

Is prospective coronary CT axial or helical?

A

axial

134
Q

Is retropective coronary CT axial or helical?

A

helical

135
Q

Bicuspid aortic valve is an independent risk factor for what abnormality? (something other than stenosis)

A

aortic aneurysm

136
Q

What is Ortners syndrome?

A

LA enlargement compressing recurrent laryngeal nerve

137
Q

MItral regurgitation can cause isolated pulmonary edema to what lobe?

A

right upper lobe

138
Q

Where does ToF cause pulmonic stenosis?

A

subvalvular

139
Q

Other than ToF, what two inherited diseases can cause pulmonic stenosis?

A

williams syndrome and noonan syndrome

140
Q

Where does Williams syndrome cause pulmonary stenosis?

A

valvular

141
Q

Where does Noonas syndrome cause pulmonary stenosis?

A

supra-valvular

142
Q

Multivalve pathology should make you think what disease?

A

post-rheumatic

143
Q

Does TR cause RV dilation or hypertrophy?

A

dilation

144
Q

What is the most common cause of TR in adults?

A

pulmonary arterial hypertension

145
Q

What ventricle is hypoplastic with tricuspid atresia?

A

RV hypoplastic

146
Q

What type of right arch anatomy has the highest likelihood of other congenital abnormalities? Which anamoly specifically?

A

mirror image

ToF

147
Q

What is the most common vascular ring?

A

double aortic arch

148
Q

What two congenital anamolies are most common with a right arch?

A
  1. ToF

2. Truncus

149
Q

What is the most common cause of CHF in a newborn?

A

TAPVR

150
Q

What is the most common congenital heart disease?

A

VSD

151
Q

When does a PDA close functionally? Anatomically?

A

functional = 24 hours

anatomic = 1 month

152
Q

What maternal infection can cause a PDA?

A

maternal rubella

153
Q

What is the most common type of ASD?

A

secundum

154
Q

What is the only type of ASD that may close w/o surgery?

A

secundum

155
Q

Can primum type be closed with a closure device?

A

no

156
Q

What are the two findings of holt oram?

A

ASD

hand/thumb defects

157
Q

What type of ASD do Downs patients most commonly have?

A

ostium primum

158
Q

What type of ASD do PAPVR patients most commonly have?

A

sinus venosus

159
Q

What are the two findings of Scimitar Syndrome?

A
  1. right sided PAPVR

2. lung hypoplasia

160
Q

How does type III TAPVR present?

A

full blown pulmonary edema

161
Q

What is the most common cyanotic HD?

A

ToF

162
Q

What is the most common complication follow ToF repair?

A

pulmonary regurgitation

163
Q

What cyanotic heart disease is associated with DiGeorge Syndrome?

A

truncus arteriousus

164
Q

Cor Triatriatum sinistrum can be the otherwise unexplained cause of what?

A

pediatric pulmonary hypertension

165
Q

What does perfusion look like regarding stunned myocardium? Contractility?

A

perfusion = normal

contractility = bad

166
Q

Will hibernating myocardium take up thalium and FDG?

A

yes

167
Q

Which would occur first, ventricular pseudoaneurysm or aneurysm? What is the typical time frame?

A

pseudo-aneurysm

3-7 days

168
Q

What cardiac process may need to use a long Time to Inversion? What buzz phrase?

A

amyloid

“difficult to suppress myocardium”

169
Q

Biventricular thrombus should make you think what disease process?

A

eosinophilic (loeffler) cardiomyopathy

170
Q

What size defines a thickened pericardium?

A

> 4mm

171
Q

Myocarditis will not effect which part of the myocardium?

A

subendocardial

172
Q

Will Takotsubo have delayed enhancement?

A

no

173
Q

What finding on cardiac MR is an independent risk factor for sudden death in HCM?

A

patchy midwall late Gd enhancement

174
Q

Will a left atrial myxoma enhance?

A

yes

175
Q

What is the most common fetal cardiac tumor? Where is it located? What disease is it associated with?

A

rhabdomyoma

LV

TS

176
Q

What is the most common cardiac neoplasm to involve the valves? What is a known complication?

A

fibroelastoma

systemic emboli

177
Q

Where is the most common location for congenital absence of the pericardium? What heart structure is most common to be herniated?

A

overlying left atrium

left atrial appendage

thoracic (1 decks)

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