Flashcards in Thoracic Deck (129):
What causes obliteration of the Raider Triangle?
aberrant right subclavian artery
What cardiac valve is most superior?
What cardiac valve is most anterior?
What are the segments of the right upper lobe?
apical, posterior, anterior
What are the segments of the right middle lobe?
What are the segments of the right lower lobe?
superior, antero-basal, medial-basal, lateral, posterior
What are the segments of the left upper lobe?
What are the segments of the lingula?
What are the segments of the left lower lobe?
superior, antero-medial basal, posterior, lateral
What is the most common pulmonary vein anomaly?
Separate vein draining the right middle lobe
What is an interrupted left PA associated with? 2
TOF and truncus
What does strep pneumo look like?
What does legionella look like?
peripheral and sublobar opacity
What does actinomyces look like?
peripheral opacity in lower lobes
What does mycoplasma look like?
patchy opacity w/ tree in bud
What infections are seen with CD 4 > 200
bacterial infections and TB
What infections are seen with CD 4< 200
PCP, atypical mycobacterial
What infections are see with CD 4 <100
CMV, disseminated fungal, mycobacterial
GGO in AIDS?
AIDS +lung cysts=
hypervascular lymph nodes + AIDS= 2
castleman + kaposi
At what CD 4 count is reactive TB seen?
At what CD 4 count is primary progressive TB seen?
What are the features of hypersensitivity pneumonitis?
GG centrilobular nodules
Two signs in invasive aspergillus?
air crescent, halo
Sign in hyper immune ABPA?
finger in glove
Measles on CT
multifocal GGO with small nodules
Influenza on CT
coalescent lower lobe opacity
SARS on CT
lower lobe GGO
Varicella on CT
peripheral nodular opacities, become calcified
What met type might popcorn and central calcifications been seen?
Solid calcs seen in what met?
Ectopic PTH seen in which cancer type
SIADCH and ACTH seen in which cancer type?
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
What NM test can be done to evaluate for bronchopleural fistula?
Cannonball mets from which two?
renal cell or choriocarcinoma
What is the most common bronchial gland tumor?
adenoid cystic (cylindroma)
Which type of lymphoma most commonly involves the lungs?
What is PTLD?
B cell lymphoma- nodules/mass, halo sign, septal thickening
At what CD 4 is AIDS related lymphoma seen?
What is gallium avid- kaposi or lymphoma?
What is thallium avid- kaposi or lymphoma?
kaposi and lymphoma
When is a pulmonary AVM treated?
when afferent vessel >3mm
What does a persistent left SVC drain into?
What is the most common venous anomaly in the chest?
persistent left SVC
How does an intralobar sequestration present?
in adolescence with recurrent pneumonias
How does an extralobar sequestration present?
Where does an intralobar sequestration most commonly occur?
posterior segment LLL with own pleural covering
Type 1 CCAM=
Type 2 CCAM=
Type 2 CCAM=
What is a horseshoe lung?
posterior basilar segments fused behind heart
What is a horseshoe lung associated with? 1
What does pulmonary LCH look like?
bizarre cysts, centrilobular nodules with upper lobe predominance
What two diseases spare the costophrenic angles?
LCH and hypersensitivity pneumonitis
Birt Hogg Dube on CT
thin walled oval cysts
What two renal abnormalities are associated with Birt Hogg Dube?
bilateral oncocytomas, chromophobe RCCs
What disease is LAM seen in?
Thin walled oval cysts=
What disease is LIP associated with?
PCP on CT
GGO in perihilar zone
What NM scan will be hot for PCP
central dot sign=
Pan lobular emphysema seen in what two diseases?
alpha 1 antitrypsin, ritalin
Bullous disease occupying at least on third of hemithorax=
vanishing lung syndrome
What distinguishes abestos expsosure from UIP?
parietal pleural thickening
Silicosis on CT
multiple nodular opacities of upper lobes
Cancer vs PMF
PMF is T2 dark
What is PMF?
progressive massive fibrosis- seen in bad silicosis or coal workers pneumoconioses
Simple coal workers pneumoconioses on CT
nodular opacities with calcs- central nodular dot
Berylliosis on CT
upper lobe reticular opacity with granulomas diffusely
Silo Filler on CT
Talcosis on CT
hyperdense micronodules with conglomerate masses (like silicosis)
Perilymphatic nodule ddx 3
sarcoid, lymphangitic spread, silicosis
random nodules ddx 3
miliary TB, mets, fungal
centrilobule nodule ddx 3
infection, RB ILD, hypersensitivity pneumonitis
What is the first finding of UIP on CXR?
reticular pattern in posterior costophrenic angle
UIP on CT?
worst at lower lobes, traction bronchiectasis, honeycombing
lower lobe posterior peripheral predominance of GGO/reticulation with subpleural sparing
apical centrilobular GG + smoking history=
respiratory bronchiolitis ILD
RB ILD progresses to what?
DIP- desquamative interstitial pneumonitis
Sarcoid on CT
perilymphatic nodules with upper lobe predominance
Stage 1 sarcoid=
stage 2 sarcoid=
nodules + parenchymal disease
stage 3 sarcoid=
stage 4 sarcoid=
stage 1 chf wedge pressure=
stage 2 chf wedge pressure=
stage 3 chf wedge pressure=
air trapping on expiration after 6 months post transplant=
What primary disease is most commonly recurrent after lung transplant?
What are the two secondary causes of PAP?
cancer or inhalation/silicoproteinosis
What are PAP patients at increased risk of?
When PAP in chidren, associated with?
What is treatment for PAP?
COP on CT?
patchy consolidation in peripheral or peribronchial distribution
chronic eosinophilc pneumonia
hypersensitivity pneumonitis on CT=
What two diseases spare the posterior tracheal membrane?
relapsing polychondritis, TBO
What three diseases do not spare the posterior tracheal membrane?
amyloid, post intubation stricture, wegeners
Difference between relapsing polychondritis and TBO?
TBO has nodules
How to tell the difference between Wegeners and amyloid?
amyloid has calcs
lower tracheal tumor=
upper tracheal tumor=
What is Williams Campbell syndrome?
4-6th order bronchictasis
massive dilation of trachea=
What is the cause of swyer james?
Follicular bronchiolitis seen in what 2 diseases?
sjogrens or RA
bronchiolitis on CT
air trapping with tree in bud opacity
What is Mendelson's syndrome?
aspiration of gastric acid
scleroderm pulm findings
NSIP lower lobes w/ dilated esophagus
sjogrens pulm finding
ank spon pulm finding
upper lobe fibrobullous disease
What is Caplan syndrome?
RA + upper lobe nodules
shortness of breath when sitting up=
hepatopulmonary syndrome tcMAA shows shunting with tracer in brain
Wegener pulm findings
Fibrous tumor of the pleura associated with 2
hypoglycemia, hypertrophic osteoarthropathy
What is the most likely to met to the pleura?
How much fluid to be seen on frontal XR?
How much fluid to be seen on lateral XR?
Mediastinal teratoma associated with what disease?
What is fibrosing mediastinitis caused by?
What is hughes stovin syndrome?
similar to Behcet's recurrent thrombophelbitis, pulm artery aneurysm