CHEST Pathology Flashcards

(39 cards)

1
Q

This XRay shows enlarged heart w/ upper apical prominent pulmonary vz? What is this pathology?

A

CHF w/ cephalization
Intersital edema- bilateral
Alveolar-if really bad- bronchograms

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2
Q

This XRay has K B lines, fluid in fissures, pleural effusion, perobroncihal cuffy and cardiolmegaly? What does this indicate?

A

Cardiogenic Pulmonary edema

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3
Q

This XRay has effusion with normal size heart? What does this indicate?

A
NON cardiogenic pulmonary edema
Drowning
Fluid overload -ARF
High altitude PE
OD-heroin
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4
Q

What are sign of Late CHF?

A

Alveolar

Bil fluffy patchy, bat wing, pleural effusion

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5
Q

What are signs of early CHF?

A
Interstitial
Fluid in fissures
KBlines
Pleural effusion
Peribronchial cuffing, teeny donuts
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6
Q

What pulls structure to same side when there is volume loss in the lung?

A

Atelectasis
fissures displaced
Atelectasis +effusion= ominous tumor+effusion

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7
Q

What is discoid plate-like, elevated hemidiaphragm, seen in post op, post trauma?

A

Sub segmental ateltectasis

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8
Q

On CT may see wisp of a lung d/t effusion or penumothorax?

A

Compressive atelectasis

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9
Q

Tumor, peanuts, mucus plug, misplaced ET tube may cause this? Xray look like
OPACIFIED area
Fissure, heart, hemidiaphragm displaced
RUL- inverted triangle, d/t fissure moved up
RLL, LLL- triangle sitting on medial 1/2 of diaphragm, pulling down minor/major
Spine sign Lateral film
LUL-tenting of diaphragm, opacified hilum
Major fissure shifted forward on Lat film
RML- Triangle, silhouetting R heart

A

Obstructive atelectasis

Lobar collapse d/t block of bronchus

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10
Q

What follows a hemithorax, pseudotumor. Comet tailing on CT, sticking to pleura?

A

Round atelectasis
Lung cannot expand after pleural effusion
Stuck in scar tissue

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11
Q

What is lucent area on one side of lungs with no markings?

A

Complete pneumothorax

Check close to spine

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12
Q

Pt is afebrile with pleuritic chest pain? What should be observed carefully?

A

Incomplete pneumothorax
Look for thin white line paralleling thoracic curvature
Absent lung markings
SCAN peripherally and apices

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13
Q

What are structures not to get confused with for pneumothorax?

A

Ignore scapula, curves opposite of thoracic, BIL
Bullous, round, curves opposite
skin fold- lung field distal
Poss lung markings

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14
Q

What can be requested to see PNEumothorax?

A

Expiratory film
LLD
Deep sulcus sign-supine, displaces costophrenic angle superiorly
CT-small thorax

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15
Q

What is characteristic of meniscus sign, blunted costophrenic angles, structure move away?

A

Pleural effusion

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16
Q

What type of effusion is lemon shaped, seen in the minor fissure?

A

Round effusion

17
Q

What is an apparent hemi diaphragm w/o meniscus?

A

Subpulmonic effusion
Edema- air space, infx, tissue
Effusion- between spaces

18
Q

Are perfect horizontal lines normal, what do they indicate?

A

Hydropneumothorax

Air+fluid in pleural space-gunshot

19
Q

What is lucent space btwn diaphragm and liver?

A

Pneumoperitoneum
bowel perforation
R side MC seen 1st

20
Q

What does a ruptured trachea, alveolus, emphysema bleb, mechanical ventilation, trauma, all lead to?

A

Pneumomediastinum
Lucent around heart+great vessels
May see continuous diaphragm sign- lucency under heart

21
Q

What cause free air post mediastinum, and push heart superiorly in CXR?

A

Hiatal Hernia
Painless
Superior stomach pushes through diaphragm

22
Q

Pt c/c SOB, hx of smoking, w/ retractions? What would his CXR look like?

A
Darker, 
HYPERinflated
Flattened diaphragm
Narrow cardiac silouette
Large retrosternal space-Lateral
Blunted angles
Bullae on CT-alien llik
23
Q

What are special about pulmonary mass or nodule?

A
They make mediastinum and hilar region wider
Cause Lobar atelectasis
Mass obstructive PNA
Malignant effusion exudative
Chest wall mass
Mets all over
24
Q

Which two nodule are central and faster?

A

Small cell- Central ACT, SIADH
Squamous cell- central obstructive
S-speed

25
Which two nodules are peripheral and slower?
Adenocarcioma- solitary | Large cell- DX of exclusion
26
What imaging is best for staging and DX?
CT PET, fluoroscopy Biopsy
27
What conditions make a heart look bigger than 50% of thoracic cavity on PA! film only?
``` Magnification, AP, apical lordotic Rotation Squishing, preg, obese, expiration Pectus excavatum, kyphosis Pericardial effusion ```
28
What are Gold standard imaging for PE DX?
``` #1CT w/ contrast VQ if cannot do contrast Pulmonary angiogram ```
29
What are signs of PE on CXR?
Atelectasis Effusion Elevated Hemidiaphragm Hamptons Hump- wedge shaped ipsilateral on pleura space Westermarks sign- triangle like observed by vessels. CT vessels disappear Golden S
30
How can you distinguish btwn diff TBs?
Primary is Upper Lobar + Ipsilateral hilar adenophathy/wide
31
What is MC TB in the apical upper lobes, superior LL, cavitation, hilar adenophathy, w/ effusion?
Reactivation
32
What is innumerable 1mm nodules on CXR and starry night on CT?
Miliary TB-primary or reactive
33
What are the terrible 4t of Ant. Mediastinal Mass? Restrosternal Latera?
Thyroid Terrible Lymphoma Thymoma Teratoma
34
What is DDX C.A.L for Medial Mediastinal Mass?
Cancer Aortic Aneurysm Lymphadenopathy
35
What is DDX P.A.N for Post mediastinal Mass?
Aortic aneurysm | Neurogenic tumor
36
Pt hs FH of aorta ruptures. Their c/c is chest and back pain, ripping. What may be seen on Xray?
Aortic Aneurysm Wide mediastinum Tortuous aorta L pleural effusion
37
Which ribs are commonly fractured?
Rib 4-9 Check for pneumothorax Pulmonary contusion missed as aveloar/airspace dz
38
Damage to spleen is caused by which rib?
Ribs 10-12
39
Which ribs are uncommonly fractured and may cause other tissue damage?
Rib 1-3