thoracic Flashcards
(177 cards)
1
Q
What opacity can be seen in Raider Triangle?
A
aberrant right subclavian
2
Q
A pacemaker wire going through a valve makes it what valve?
A
tricuspid
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
4
Q
Where does a cardiac bronchus arise from?
A
bronchus intermedius
5
Q
What is the most common pulmonary vein anatomy?
A
separate vein draining RML
6
Q
Is the distal vasculature usually present in UAPA?
A
yes
7
Q
What is a UAPA usually opposite of?
A
the aortic arch
8
Q
Masses above the cervicothoracic junction are located in what part of the mediastinum?
A
posterior
9
Q
What pneumonia causing bug is associated with recent dental procedures and/or jaw osteomyelitis?
A
actinomyces
10
Q
Flame shaped perihilar opacity in AIDS pt should make you think what?
A
kaposi sarcoma
11
Q
What are the four most common cystic causing lung diseases?
A
LIP
LAM
DIP
BHD
12
Q
Lung cysts + GGOs + ptx = what disease?
A
PCP
13
Q
Hypervascular lymph nodes in an AIDS pt should make you think what?
A
kaposi or castleman
14
Q
What is a ghon focus?
A
TB granuloma
15
Q
What is a ranke complex?
A
calcified ghon focus
16
Q
What feature accompanies primary progression?
A
cavitation
17
Q
What feature accompanies primary progression?
A
cavitation
18
Q
What is the most common cause of primary progression of TB?
A
immunosuppression
19
Q
What two surgeries can cause primary progression of TB?
A
jejuno-ileal bypass
subtotal gastrectomy
20
Q
What environmental exposure can cause primary progression of TB?
A
silicosis
21
Q
How is immune reconstitution reactivation syndrome treated?
A
steroids
22
Q
How does one diagnose pleural involvement of TB?
A
pleural biopsy
23
Q
An old man with upper lobe predominant cavitary lesions and adjacent nodules should raise the concern for what disease?
A
MAC
24
Q
What are the two signs for angioinvasive aspergilloma?
A
halo sign
air crescent sign
25
What does the halo represent regarding the halo sign of angioinvasive aspergilloma?
halo = represents invasive component
26
What does the air crescent sign represent?
healing
27
ABPA can occur in what patient class in addition to chronic ashmatics?
CF
28
Lung Screen CT should have a CT dose less than what?
3 mGy
29
Growth is considered greater than what size in one year?
1.5 mm
30
What is the lung rads for an endobronchial lesion?
4a
31
What type of calcification of SPNs is the most suspicious?
eccentric
32
Central "popcorn" calcs can be suspicious in the setting of what type of cancer?
GI cancer
33
Where is a lung cancer most likely to arise in a patient with pulmonary fibrosis?
peripheral/basilar
34
What paraneoplastic syndrome can be associated with squamous cell lung cancer?
hyper-parathyroid-ism
35
Is large cell lung cancer more often found centrally or peripherally?
peripheral
36
What lung cancer is a known associate of pulmonary fibrosis?
adeno
37
Does adeno prefer a peripheral or central location?
peripheral
38
What imaging modality to stage a pancoast tumor? Why?
mri
brachial plexus
39
Can a pulmonary hamartoma be hot on PET?
yes
40
Is kaposi thallium hot or cold?
thallium hot
41
Is thallium gallium hot or cold?
cold
42
What is the triad of AIDS related pulmonary lymphoma?
nodules
pleural effusion
lymphadenopathy
43
How can poland syndrome look on a chest Xray?
hyper-lucent lung
44
Will a lung be hyperinflated or deflated distal to a bronchial atresia? Why?
hyperinflated
collateral flow through pores of Kohn
45
Will a lucent lobe cause by bronchial atresia be hyper-vascular or hypo-vascular?
decreased vascularity
46
Mucoid impaction is generally below what HU?
< 25 HU
47
Even though contested, treating an afferent vessel feeding a pulmonary AVM occurs at what size?
> 3mm
48
Where does a persistent left SVC drain into?
coronary sinus
49
What is the pathological term for Swyer James?
post infectious obliterative bronchiolitis
50
Is the lung effected by swyer james bigger or smaller than the unaffected lung?
smaller
51
What is horseshoe lung associated with?
scimitar syndrome
52
Pulmonary LCH exclusively effects which type of patient?
smokers
53
is Pulmonary LCH upper or lower lobe predominate?
upper
54
What two lung diseases spare the CP angles?
pulmonary LCH
hypersensitivity pneumonitis
55
What disease is LAM associated with?
tuberous sclerosis
56
What shape are BHD cysts?
oval
57
What two things happen in the kidney with BHD?
renal oncocytomas
chromophobe RCC
58
What disease is seen with LIP 25% of the time?
sjogrens
59
What drug can cause pan-lobular emphysema?
IV ritalin
60
What is the pathophysiology behind vanishing lung syndrome?
avascular necrosis
61
What % of patients with vanishing lung have A1AT?
20%
62
The interstitial pattern of asbestosis looks like what interstitial disease?
UIP
63
Is PMF T2 bright or T2 dark?
bright
64
Silo Fillers disease is caused by what compound?
nitrogen dioxide
65
What does Silo Fillers Disease look like on CT?
edema
66
What two structures run in the middle of the secondary pulmonary lobule?
artery and airway
67
What two structures run in the periphery of the secondary pulmonary lobule?
vein and lymphatics
68
What is the plain film equivalent of interlobular septal thickeing?
kerley B line
69
Is UIP homogenous or heterogenous inflammation?
heterogenous
70
Is NSIP homogenous or heterogenous inflammation?
homo
71
GGO alone in NSIP is what flavor of classification?
cellular
72
What finding needs to be present to call it fibrotic type NSIP?
traction bronchiectasis
73
How does DIP look like on CT?
lower lobe, peripheral GGO with small cystic spaces
74
What is Stage 1 Sarcoidosis?
hilar and mediastinal nodes only
75
What is Stage 2 sarcoidosis?
nodes and parechymal disease
76
What is Stage 3 Sarcoidosis?
parenchyma only
77
What is Stage 4 Sarcoidosis?
fibrosis
78
Does sarcoid produce upper or lower lobe fibrosis?
upper
79
Are the perilymphatic nodules in sarcoid upper or lower lobe predominant?
upper
80
Swan Ganz catheters are an indirect measurement of what cardiac chamber?
left atria
81
What is the most common opportunistic infection in a lung transplant PT?
CMV
82
What disease most commonly recurs in transplanted lungs?
sarcoid
83
What type of infection is associated with PAP?
nocardia
84
What exposure is highly associated with PAP?
smoking
85
What type of interstitial pneumonia looks like PAP?
Acute Interstitial Pneumonia
86
What is the pathophysiology of endogenous lipoid pneumonia?
obstructive process causing build up of lipid laden macrophages
87
What is the pathophysiology of organizing pneumonia?
build up of granulation tissue within alveolar spaces from fibroblasts
88
What is the classic sign of COP?
reverse halo or atoll
89
Does eosinophilic pneumonia favor the upper or lower lobes?
upper
90
What interstitial lung disease does chronic hypersensitivity pneumonitis look like?
UIP + air trapping
91
Where are the fibrotic changes of chronic HP?
mid to upper lobe predoominant
92
What two diseases spare the posterior trachea?
relapsing polychondritis
TBO
93
Which disease can produce calcifications, TBO or RP?
TBO
94
How does RP present?
recurrent pna
95
Which disease classically involves the posterior trachea?
amyloidosis
96
Can amyloidosis form calcs?
yes
97
Does pulmonary carcinoid tend to effect the left or right heart valves?
left
98
What is more likely to be in the trachea, adenoid cystic or carcinoid?
adenoid cystic
99
A single papilloma in the trachea should make you think what?
single = smoking
100
Multiple papilloma in the trachea should make you think what?
HPV
101
CF begins as what type of bronchiectasis? Progresses to what type?
cylindrical
progresses to varicoid
102
What can happen reproductively to girls with CF?
ectopics
103
Does CF or PCD have absent vas deferens?
CF
104
How does Williams Campbell Syndrome present?
peripheral, cystic bronchiectasis presenting in 4-6th decade
105
Bronchiolitis obliterans should make you think of what two diseases?
post-transplant rejection of lung
asthma/bronchiolitis
106
Follicular bronchiolitis is seen with what two diseases?
sjogrens and RA
107
How does ankylosing spondylitis look when it manifests in the lungs?
"upper lobe fibrobullous disease"
108
How does Caplan syndrome look like in the lungs?
upper lobe nodules that can cavitate, with out without a pleural effusion
109
Shrinking Lung should make you think of what disease?
lupus
110
What does hepatopulmonary look like in the lung bases?
engorged vessels extending into periphery
111
Solitary Fibrous Tumor of the Pleura can cause what 30% of the time?
hypertrophic osteoarthropathy
112
What is the latin term for when an empyema eats through the chest wall?
empyema necessitans
113
What will have fat in it, lymphoma or a large thymus?
large thymus
114
Will calcs in a thymus make you think a benign or aggressive course?
aggressive
115
Where do thymomas drop met?
retroperitoneum or pleura
116
Are immature germ cell tumors of the mediastinum more common in men or women?
men
117
What three conditions can a thymic cyst be seen with?
after thoracotomy
HIV
chemo
118
Non-granulomatous mediastinal fibrosis can be associated with what medication?
methylsergide
119
What are the three neurogenic tumors that can occur in the posterior mediastinum?
schwannoma
neurofibroma
malignant peripheral nerve sheath tumor
120
What is the Fleischner sign?
enlarged PA
121
What are the three most common causes of pulmonary artery pseudoaneurysm?
swan
bechet
chronic PE
122
What causes the hot quadrate sign?
SVC obstruction
123
What muscle separates the tricuspid valve from the pulmonic valve?
crista supraventricularis
124
Do the papillary muscles of the mitral or tricuspid valve insert on the septum?
tricuspid
125
What heart structure will lipomatous hypertrophy spare?
fossa ovalis
126
What heart structure will a interatrial lipoma not spare?
fossa ovalis
127
What coronary artery gives off the conus branch? What does the conus branch supply?
RCA
ventricular outflow tract
128
What artery gives off the diagonals?
LAD
129
What artery gives off the obtuse marginals?
circumflex
130
What is the definition of a coronary fistula?
abnormal connection between coronary artery and ventricular chamber or great vessels
131
How does a coronary fistula most often manifest?
coronary aneurysm
132
HR under what for coronary CT?
60
133
Is prospective coronary CT axial or helical?
axial
134
Is retropective coronary CT axial or helical?
helical
135
Bicuspid aortic valve is an independent risk factor for what abnormality? (something other than stenosis)
aortic aneurysm
136
What is Ortners syndrome?
LA enlargement compressing recurrent laryngeal nerve
137
MItral regurgitation can cause isolated pulmonary edema to what lobe?
right upper lobe
138
Where does ToF cause pulmonic stenosis?
subvalvular
139
Other than ToF, what two inherited diseases can cause pulmonic stenosis?
williams syndrome and noonan syndrome
140
Where does Williams syndrome cause pulmonary stenosis?
valvular
141
Where does Noonas syndrome cause pulmonary stenosis?
supra-valvular
142
Multivalve pathology should make you think what disease?
post-rheumatic
143
Does TR cause RV dilation or hypertrophy?
dilation
144
What is the most common cause of TR in adults?
pulmonary arterial hypertension
145
What ventricle is hypoplastic with tricuspid atresia?
RV hypoplastic
146
What type of right arch anatomy has the highest likelihood of other congenital abnormalities? Which anamoly specifically?
mirror image
ToF
147
What is the most common vascular ring?
double aortic arch
148
What two congenital anamolies are most common with a right arch?
1. ToF
| 2. Truncus
149
What is the most common cause of CHF in a newborn?
TAPVR
150
What is the most common congenital heart disease?
VSD
151
When does a PDA close functionally? Anatomically?
functional = 24 hours
anatomic = 1 month
152
What maternal infection can cause a PDA?
maternal rubella
153
What is the most common type of ASD?
secundum
154
What is the only type of ASD that may close w/o surgery?
secundum
155
Can primum type be closed with a closure device?
no
156
What are the two findings of holt oram?
ASD
hand/thumb defects
157
What type of ASD do Downs patients most commonly have?
ostium primum
158
What type of ASD do PAPVR patients most commonly have?
sinus venosus
159
What are the two findings of Scimitar Syndrome?
1. right sided PAPVR
| 2. lung hypoplasia
160
How does type III TAPVR present?
full blown pulmonary edema
161
What is the most common cyanotic HD?
ToF
162
What is the most common complication follow ToF repair?
pulmonary regurgitation
163
What cyanotic heart disease is associated with DiGeorge Syndrome?
truncus arteriousus
164
Cor Triatriatum sinistrum can be the otherwise unexplained cause of what?
pediatric pulmonary hypertension
165
What does perfusion look like regarding stunned myocardium? Contractility?
perfusion = normal
contractility = bad
166
Will hibernating myocardium take up thalium and FDG?
yes
167
Which would occur first, ventricular pseudoaneurysm or aneurysm? What is the typical time frame?
pseudo-aneurysm
3-7 days
168
What cardiac process may need to use a long Time to Inversion? What buzz phrase?
amyloid
"difficult to suppress myocardium"
169
Biventricular thrombus should make you think what disease process?
eosinophilic (loeffler) cardiomyopathy
170
What size defines a thickened pericardium?
> 4mm
171
Myocarditis will not effect which part of the myocardium?
subendocardial
172
Will Takotsubo have delayed enhancement?
no
173
What finding on cardiac MR is an independent risk factor for sudden death in HCM?
patchy midwall late Gd enhancement
174
Will a left atrial myxoma enhance?
yes
175
What is the most common fetal cardiac tumor? Where is it located? What disease is it associated with?
rhabdomyoma
LV
TS
176
What is the most common cardiac neoplasm to involve the valves? What is a known complication?
fibroelastoma
systemic emboli
177
Where is the most common location for congenital absence of the pericardium? What heart structure is most common to be herniated?
overlying left atrium
left atrial appendage
