Radiology of the Thorax

Question 1

Spreading to both hemastorases

Answer 1

Mediastinum, from lymphadenopathy

Question 2

Degenerating ribs

Answer 2

Cancer of the nerves under the ribs

Question 3

Lung Diseases may affect…

Answer 3

Pulmonary Arteries: vasculitis, pulmonary emboli

Bronchi: Asthma, bronchitis, bronchiectasis

Lung Parenchyma: Pneumonia, lung cancer, emphysema

Question 4

Common Lung Abnormalities

Answer 4

Pneumonia
Lung Cancer- primary or metastases
Trauma (not always clear)
Pulmonary Emboli
Cardiac Failure (CHF)
Chronic Diffuse Lung Disease

Question 5

Important Questions

Answer 5

1) pattern of Lung abnormality
     Focal
     Multifocal
     Diffuse
2) Acute or Chronic (history)
2) Other; eg) cardiomegaly

Question 6

Noule in middle of lung

Answer 6

Calcified Nodule, ‘granuloma’

NZ: TB

Question 7

Pace Maker means the Heart is..

Answer 7

BIG

Question 8

Focal abnormality, poorly marginated. Symptoms and potential causes

Answer 8

Cancer or Pneumonia

Productive cough
Crackles of Auscultation
Fever
Leans towards pneumonia

Question 9

Well defined, Focal adhesion

Answer 9

Patient more likely to have haemoptosis, weight loss&raquo_space;> cancer

Question 10

LOBAR COLLAPSE

Answer 10

Pneumonia more likely to cause partial or complete lobar collapse.

BUT if there’s a tumor in the lower lobe bronchus then your gonna get obstruction behind it.

Bronchoscopy or CT scan.

Question 11

Pneumonia vs Cancer

Answer 11

History: symptoms, time course
Exam
CXR appearance

Question 12

Lobar collapse is due to a

Answer 12

Obstruction

Question 13

Multifocal (including nodules)

Answer 13

Acute: Infection such as staph or TB

Subacute or Chronic: metastases, sarcoidosis

Question 14

Staph multifocal disease

Answer 14

Multiple Nodule

IV Drug abuser

Question 15

TB looks like

Answer 15

• Big cavitating mass
• Can be asymptomatic
• Multiple nodules, mainly in UPPER lobes
• cavitary lesion
• lympadenopathy
• Can also have pleural effusion or mediostina, lymphadenopathy

Strange in terms of symptoms

Question 16

Diffuse Lung Disease

Answer 16

+200 diffuse lung diseases

• Acute vs Chronic
• Patterns of distribution

Question 17

Acute diffuse lung disease

Answer 17

FLUID: pulmonary oedema/CHF
PUS: Pneumonia
BlOOD: Good pastures

If asymmetric more likely to be pneumonia

Question 18

Chronic Diffuse lung diseases

Answer 18

Destruction: Emphysema, malignancy and Fibrotic lung disease >100

Upper Lobes: TB, radiation, eosinophillic pneumonia, sarcoidosis, silicosis

Lower Lobes: UIP (peripheral), asbestosis, lymphangitic metastases

Anywhere: Metastases

Question 19

Only a few ways the lungs can respond to trauma. In regards to upper lobe diffuse issues

Answer 19

1) Fibrosis or scarring: there are some disease that really like to scar in the upper lobes (less airated, less blood clearance)
Eg; in TB there can be scarring whilst the lungs are healing
Sarcoidosis
Silicosis

Question 20

UIP/IPF:

Answer 20

Most common chronic diffuse fibrotic lung disease.
Hard to take a breath.
Clinicians hear dry crackles in lower chest.
Peripheral ‘honeycomb’ lung, normal centrally.

Question 21

Common CT disease with peripheral honeycomb appearance

Answer 21

• Ideopathic*
• Rhematoid Arthritis*
• Progressive systemic sclerosis/scleroderma*
• SLE
• Aspestosis

These lead to UIP

Question 22

Bronchopulmonary Segment (secondary lobule)

Answer 22

Smallest lung unit that is regularly visible on CXR and CT scans
-unit of lung within interlobular septae, supplied by 3-5 terminal bronchi

Lymphandritic cancer> thickened interlobular septae