Thoracic Flashcards
1
Q
What causes obliteration of the Raider Triangle?
A
aberrant right subclavian artery
2
Q
What cardiac valve is most superior?
A
pulmonic
3
Q
What cardiac valve is most anterior?
A
tricuspid
4
Q
What are the segments of the right upper lobe?
A
apical, posterior, anterior
5
Q
What are the segments of the right middle lobe?
A
lateral, medial
6
Q
What are the segments of the right lower lobe?
A
superior, antero-basal, medial-basal, lateral, posterior
7
Q
What are the segments of the left upper lobe?
A
apical-posterior, anterior
8
Q
What are the segments of the lingula?
A
superior, inferior
9
Q
What are the segments of the left lower lobe?
A
superior, antero-medial basal, posterior, lateral
10
Q
What is the most common pulmonary vein anomaly?
A
Separate vein draining the right middle lobe
11
Q
What is an interrupted left PA associated with? 2
A
TOF and truncus
12
Q
What does strep pneumo look like?
A
lobar consolidation
13
Q
bulging fissure=
A
klebsiella
14
Q
What does legionella look like?
A
peripheral and sublobar opacity
15
Q
What does actinomyces look like?
A
peripheral opacity in lower lobes
16
Q
What does mycoplasma look like?
A
patchy opacity w/ tree in bud
17
Q
What infections are seen with CD 4 > 200
A
bacterial infections and TB
18
Q
What infections are seen with CD 4< 200
A
PCP, atypical mycobacterial
19
Q
What infections are see with CD 4 <100
A
CMV, disseminated fungal, mycobacterial
20
Q
GGO in AIDS?
A
PCP
21
Q
AIDS +lung cysts=
A
LIP
22
Q
hypervascular lymph nodes + AIDS= 2
A
castleman + kaposi
23
Q
At what CD 4 count is reactive TB seen?
A
> 200
24
Q
At what CD 4 count is primary progressive TB seen?
A
<200
25
What are the features of hypersensitivity pneumonitis?
GG centrilobular nodules
26
Two signs in invasive aspergillus?
air crescent, halo
27
Sign in hyper immune ABPA?
finger in glove
28
Influenza on CT
coalescent lower lobe opacity
29
SARS on CT
lower lobe GGO
30
Varicella on CT
peripheral nodular opacities, become calcified
31
What met type might popcorn and central calcifications been seen?
GI cancer
32
Solid calcs seen in what met?
osteosarcoma
33
Ectopic PTH seen in which cancer type
squamous
34
SIADCH and ACTH seen in which cancer type?
small cell
35
What qualifies as stage T3b small cell cancer? 3
same lung but different lobes; SC, scalene or contralateral mediastinal or hilar adenopathy; malignant pleural effusion
36
What NM test can be done to evaluate for bronchopleural fistula?
xenon
37
Cannonball mets from which two?
renal cell or choriocarcinoma
38
What is the most common bronchial gland tumor?
adenoid cystic (cylindroma)
39
Which type of lymphoma most commonly involves the lungs?
Hodgkins
40
What is PTLD?
B cell lymphoma- nodules/mass, halo sign, septal thickening
41
At what CD 4 is AIDS related lymphoma seen?
<100
42
What is gallium avid- kaposi or lymphoma?
lymphoma
43
What is thallium avid- kaposi or lymphoma?
kaposi and lymphoma
44
When is a pulmonary AVM treated?
when afferent vessel >3mm
45
What does a persistent left SVC drain into?
coronary sinus
46
What is the most common venous anomaly in the chest?
persistent left SVC
47
How does an intralobar sequestration present?
in adolescence with recurrent pneumonias
48
How does an extralobar sequestration present?
in infancy
49
Where does an intralobar sequestration most commonly occur?
posterior segment LLL with own pleural covering
50
Type 1 CCAM=
cystic
51
Type 3 CCAM=
solid
52
Type 2 CCAM=
solid/cystic
53
What is a horseshoe lung?
posterior basilar segments fused behind heart
54
What is a horseshoe lung associated with? 1
Scimitar syndrome
55
What does pulmonary LCH look like?
bizarre cysts, centrilobular nodules with upper lobe predominance
56
What two diseases spare the costophrenic angles?
LCH and hypersensitivity pneumonitis
57
Birt Hogg Dube on CT
thin walled oval cysts
58
What two renal abnormalities are associated with Birt Hogg Dube?
bilateral oncocytomas, chromophobe RCCs
59
What disease is LAM seen in?
TS
60
Thin walled oval cysts=
LAM
61
What disease is LIP associated with?
Sjogrens
62
PCP on CT
GGO in perihilar zone
63
What NM scan will be hot for PCP
gallium
64
central dot sign=
Centrilobular emphysema
65
Pan lobular emphysema seen in what two diseases?
alpha 1 antitrypsin, ritalin
66
Bullous disease occupying at least on third of hemithorax=
vanishing lung syndrome
67
What distinguishes abestos expsosure from UIP?
parietal pleural thickening
68
pleural rind=
mesothelioma
69
Silicosis on CT
multiple nodular opacities of upper lobes
70
Cancer vs PMF
PMF is T2 dark
71
What is PMF?
progressive massive fibrosis- seen in bad silicosis or coal workers pneumoconioses
72
Simple coal workers pneumoconioses on CT
nodular opacities with calcs- central nodular dot
73
Berylliosis on CT
upper lobe reticular opacity with granulomas diffusely
74
Silo Filler on CT
pulmonary edema
75
Talcosis on CT
hyperdense micronodules with conglomerate masses (like silicosis)
76
Perilymphatic nodule ddx 3
sarcoid, lymphangitic spread, silicosis
77
random nodules ddx 3
miliary TB, mets, fungal
78
centrilobule nodule ddx 3
infection, RB ILD, hypersensitivity pneumonitis
79
What is the first finding of UIP on CXR?
reticular pattern in posterior costophrenic angle
80
UIP on CT?
worst at lower lobes, traction bronchiectasis, honeycombing
81
heterogeneous histology=
UIP
82
NSIP appearance
lower lobe posterior peripheral predominance of GGO/reticulation with subpleural sparing
83
apical centrilobular GG + smoking history=
respiratory bronchiolitis ILD
84
RB ILD progresses to what?
DIP- desquamative interstitial pneumonitis
85
Sarcoid on CT
perilymphatic nodules with upper lobe predominance
86
Stage 1 sarcoid=
hilar/mediastinal nodes
87
stage 2 sarcoid=
nodules + parenchymal disease
88
stage 3 sarcoid=
parenchymal disease
89
stage 4 sarcoid=
fibrosis/end stage
90
stage 1 chf wedge pressure=
13-18
91
stage 2 chf wedge pressure=
18-25
92
stage 3 chf wedge pressure=
>25
93
air trapping on expiration after 6 months post transplant=
chronic rejection
94
What primary disease is most commonly recurrent after lung transplant?
sarcoid
95
What are the two secondary causes of PAP?
cancer or inhalation/silicoproteinosis
96
What are PAP patients at increased risk of?
nocardia
97
When PAP in chidren, associated with?
alymphoplasia
98
What is treatment for PAP?
bronchoalveolar lavage
99
COP on CT?
patchy consolidation in peripheral or peribronchial distribution
100
reverse atoll=
COP
101
COP ddx
chronic eosinophilc pneumonia
102
hypersensitivity pneumonitis on CT=
GGO centrilobular
103
What two diseases spare the posterior tracheal membrane?
relapsing polychondritis, TBO
104
What three diseases do not spare the posterior tracheal membrane?
amyloid, post intubation stricture, wegeners
105
Difference between relapsing polychondritis and TBO?
TBO has nodules
106
How to tell the difference between Wegeners and amyloid?
amyloid has calcs
107
lower tracheal tumor=
squamous cell
108
upper tracheal tumor=
adenoic cystic
109
What is Williams Campbell syndrome?
4-6th order bronchictasis
110
massive dilation of trachea=
mounier kuhn
111
What is the cause of swyer james?
constrictive bronchiolitis
112
Follicular bronchiolitis seen in what 2 diseases?
sjogrens or RA
113
bronchiolitis on CT
air trapping with tree in bud opacity
114
What is Mendelson's syndrome?
aspiration of gastric acid
115
scleroderm pulm findings
NSIP lower lobes w/ dilated esophagus
116
sjogrens pulm finding
LIP
117
ank spon pulm finding
upper lobe fibrobullous disease
118
What is Caplan syndrome?
RA + upper lobe nodules
119
shortness of breath when sitting up=
hepatopulmonary syndrome tcMAA shows shunting with tracer in brain
120
Wegener pulm findings
cavitary nodules
121
Fibrous tumor of the pleura associated with 2
hypoglycemia, hypertrophic osteoarthropathy
122
What is the most likely to met to the pleura?
adenocarcinoma
123
How much fluid to be seen on frontal XR?
175cc
124
How much fluid to be seen on lateral XR?
75cc
125
Mediastinal teratoma associated with what disease?
Klinefelters
126
What is fibrosing mediastinitis caused by?
histoplasmosis
127
What is hughes stovin syndrome?
similar to Behcet's recurrent thrombophelbitis, pulm artery aneurysm
128
PAH + normal wedge pressure=
pulmonary veno occlusive disease
