Thoracic Flashcards

1
Q

What causes obliteration of the Raider Triangle?

A

aberrant right subclavian artery

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2
Q

What cardiac valve is most superior?

A

pulmonic

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3
Q

What cardiac valve is most anterior?

A

tricuspid

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4
Q

What are the segments of the right upper lobe?

A

apical, posterior, anterior

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5
Q

What are the segments of the right middle lobe?

A

lateral, medial

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6
Q

What are the segments of the right lower lobe?

A

superior, antero-basal, medial-basal, lateral, posterior

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7
Q

What are the segments of the left upper lobe?

A

apical-posterior, anterior

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8
Q

What are the segments of the lingula?

A

superior, inferior

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9
Q

What are the segments of the left lower lobe?

A

superior, antero-medial basal, posterior, lateral

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10
Q

What is the most common pulmonary vein anomaly?

A

Separate vein draining the right middle lobe

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11
Q

What is an interrupted left PA associated with? 2

A

TOF and truncus

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12
Q

What does strep pneumo look like?

A

lobar consolidation

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13
Q

bulging fissure=

A

klebsiella

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14
Q

What does legionella look like?

A

peripheral and sublobar opacity

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15
Q

What does actinomyces look like?

A

peripheral opacity in lower lobes

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16
Q

What does mycoplasma look like?

A

patchy opacity w/ tree in bud

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17
Q

What infections are seen with CD 4 > 200

A

bacterial infections and TB

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18
Q

What infections are seen with CD 4< 200

A

PCP, atypical mycobacterial

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19
Q

What infections are see with CD 4 <100

A

CMV, disseminated fungal, mycobacterial

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20
Q

GGO in AIDS?

A

PCP

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21
Q

AIDS +lung cysts=

A

LIP

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22
Q

hypervascular lymph nodes + AIDS= 2

A

castleman + kaposi

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23
Q

At what CD 4 count is reactive TB seen?

A

> 200

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24
Q

At what CD 4 count is primary progressive TB seen?

A

<200

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25
Q

What are the features of hypersensitivity pneumonitis?

A

GG centrilobular nodules

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26
Q

Two signs in invasive aspergillus?

A

air crescent, halo

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27
Q

Sign in hyper immune ABPA?

A

finger in glove

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28
Q

Influenza on CT

A

coalescent lower lobe opacity

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29
Q

SARS on CT

A

lower lobe GGO

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30
Q

Varicella on CT

A

peripheral nodular opacities, become calcified

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31
Q

What met type might popcorn and central calcifications been seen?

A

GI cancer

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32
Q

Solid calcs seen in what met?

A

osteosarcoma

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33
Q

Ectopic PTH seen in which cancer type

A

squamous

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34
Q

SIADCH and ACTH seen in which cancer type?

A

small cell

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35
Q

What qualifies as stage T3b small cell cancer? 3

A

same lung but different lobes; SC, scalene or contralateral mediastinal or hilar adenopathy; malignant pleural effusion

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36
Q

What NM test can be done to evaluate for bronchopleural fistula?

A

xenon

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37
Q

Cannonball mets from which two?

A

renal cell or choriocarcinoma

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38
Q

What is the most common bronchial gland tumor?

A

adenoid cystic (cylindroma)

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39
Q

Which type of lymphoma most commonly involves the lungs?

A

Hodgkins

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40
Q

What is PTLD?

A

B cell lymphoma- nodules/mass, halo sign, septal thickening

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41
Q

At what CD 4 is AIDS related lymphoma seen?

A

<100

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42
Q

What is gallium avid- kaposi or lymphoma?

A

lymphoma

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43
Q

What is thallium avid- kaposi or lymphoma?

A

kaposi and lymphoma

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44
Q

When is a pulmonary AVM treated?

A

when afferent vessel >3mm

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45
Q

What does a persistent left SVC drain into?

A

coronary sinus

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46
Q

What is the most common venous anomaly in the chest?

A

persistent left SVC

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47
Q

How does an intralobar sequestration present?

A

in adolescence with recurrent pneumonias

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48
Q

How does an extralobar sequestration present?

A

in infancy

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49
Q

Where does an intralobar sequestration most commonly occur?

A

posterior segment LLL with own pleural covering

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50
Q

Type 1 CCAM=

A

cystic

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51
Q

Type 3 CCAM=

A

solid

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52
Q

Type 2 CCAM=

A

solid/cystic

53
Q

What is a horseshoe lung?

A

posterior basilar segments fused behind heart

54
Q

What is a horseshoe lung associated with? 1

A

Scimitar syndrome

55
Q

What does pulmonary LCH look like?

A

bizarre cysts, centrilobular nodules with upper lobe predominance

56
Q

What two diseases spare the costophrenic angles?

A

LCH and hypersensitivity pneumonitis

57
Q

Birt Hogg Dube on CT

A

thin walled oval cysts

58
Q

What two renal abnormalities are associated with Birt Hogg Dube?

A

bilateral oncocytomas, chromophobe RCCs

59
Q

What disease is LAM seen in?

A

TS

60
Q

Thin walled oval cysts=

A

LAM

61
Q

What disease is LIP associated with?

A

Sjogrens

62
Q

PCP on CT

A

GGO in perihilar zone

63
Q

What NM scan will be hot for PCP

A

gallium

64
Q

central dot sign=

A

Centrilobular emphysema

65
Q

Pan lobular emphysema seen in what two diseases?

A

alpha 1 antitrypsin, ritalin

66
Q

Bullous disease occupying at least on third of hemithorax=

A

vanishing lung syndrome

67
Q

What distinguishes abestos expsosure from UIP?

A

parietal pleural thickening

68
Q

pleural rind=

A

mesothelioma

69
Q

Silicosis on CT

A

multiple nodular opacities of upper lobes

70
Q

Cancer vs PMF

A

PMF is T2 dark

71
Q

What is PMF?

A

progressive massive fibrosis- seen in bad silicosis or coal workers pneumoconioses

72
Q

Simple coal workers pneumoconioses on CT

A

nodular opacities with calcs- central nodular dot

73
Q

Berylliosis on CT

A

upper lobe reticular opacity with granulomas diffusely

74
Q

Silo Filler on CT

A

pulmonary edema

75
Q

Talcosis on CT

A

hyperdense micronodules with conglomerate masses (like silicosis)

76
Q

Perilymphatic nodule ddx 3

A

sarcoid, lymphangitic spread, silicosis

77
Q

random nodules ddx 3

A

miliary TB, mets, fungal

78
Q

centrilobule nodule ddx 3

A

infection, RB ILD, hypersensitivity pneumonitis

79
Q

What is the first finding of UIP on CXR?

A

reticular pattern in posterior costophrenic angle

80
Q

UIP on CT?

A

worst at lower lobes, traction bronchiectasis, honeycombing

81
Q

heterogeneous histology=

A

UIP

82
Q

NSIP appearance

A

lower lobe posterior peripheral predominance of GGO/reticulation with subpleural sparing

83
Q

apical centrilobular GG + smoking history=

A

respiratory bronchiolitis ILD

84
Q

RB ILD progresses to what?

A

DIP- desquamative interstitial pneumonitis

85
Q

Sarcoid on CT

A

perilymphatic nodules with upper lobe predominance

86
Q

Stage 1 sarcoid=

A

hilar/mediastinal nodes

87
Q

stage 2 sarcoid=

A

nodules + parenchymal disease

88
Q

stage 3 sarcoid=

A

parenchymal disease

89
Q

stage 4 sarcoid=

A

fibrosis/end stage

90
Q

stage 1 chf wedge pressure=

A

13-18

91
Q

stage 2 chf wedge pressure=

A

18-25

92
Q

stage 3 chf wedge pressure=

A

> 25

93
Q

air trapping on expiration after 6 months post transplant=

A

chronic rejection

94
Q

What primary disease is most commonly recurrent after lung transplant?

A

sarcoid

95
Q

What are the two secondary causes of PAP?

A

cancer or inhalation/silicoproteinosis

96
Q

What are PAP patients at increased risk of?

A

nocardia

97
Q

When PAP in chidren, associated with?

A

alymphoplasia

98
Q

What is treatment for PAP?

A

bronchoalveolar lavage

99
Q

COP on CT?

A

patchy consolidation in peripheral or peribronchial distribution

100
Q

reverse atoll=

A

COP

101
Q

COP ddx

A

chronic eosinophilc pneumonia

102
Q

hypersensitivity pneumonitis on CT=

A

GGO centrilobular

103
Q

What two diseases spare the posterior tracheal membrane?

A

relapsing polychondritis, TBO

104
Q

What three diseases do not spare the posterior tracheal membrane?

A

amyloid, post intubation stricture, wegeners

105
Q

Difference between relapsing polychondritis and TBO?

A

TBO has nodules

106
Q

How to tell the difference between Wegeners and amyloid?

A

amyloid has calcs

107
Q

lower tracheal tumor=

A

squamous cell

108
Q

upper tracheal tumor=

A

adenoic cystic

109
Q

What is Williams Campbell syndrome?

A

4-6th order bronchictasis

110
Q

massive dilation of trachea=

A

mounier kuhn

111
Q

What is the cause of swyer james?

A

constrictive bronchiolitis

112
Q

Follicular bronchiolitis seen in what 2 diseases?

A

sjogrens or RA

113
Q

bronchiolitis on CT

A

air trapping with tree in bud opacity

114
Q

What is Mendelson’s syndrome?

A

aspiration of gastric acid

115
Q

scleroderm pulm findings

A

NSIP lower lobes w/ dilated esophagus

116
Q

sjogrens pulm finding

A

LIP

117
Q

ank spon pulm finding

A

upper lobe fibrobullous disease

118
Q

What is Caplan syndrome?

A

RA + upper lobe nodules

119
Q

shortness of breath when sitting up=

A

hepatopulmonary syndrome tcMAA shows shunting with tracer in brain

120
Q

Wegener pulm findings

A

cavitary nodules

121
Q

Fibrous tumor of the pleura associated with 2

A

hypoglycemia, hypertrophic osteoarthropathy

122
Q

What is the most likely to met to the pleura?

A

adenocarcinoma

123
Q

How much fluid to be seen on frontal XR?

A

175cc

124
Q

How much fluid to be seen on lateral XR?

A

75cc

125
Q

Mediastinal teratoma associated with what disease?

A

Klinefelters

126
Q

What is fibrosing mediastinitis caused by?

A

histoplasmosis

127
Q

What is hughes stovin syndrome?

A

similar to Behcet’s recurrent thrombophelbitis, pulm artery aneurysm

128
Q

PAH + normal wedge pressure=

A

pulmonary veno occlusive disease