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Flashcards in Thoracic Deck (128):
1

What causes obliteration of the Raider Triangle?

aberrant right subclavian artery

2

What cardiac valve is most superior?

pulmonic

3

What cardiac valve is most anterior?

tricuspid

4

What are the segments of the right upper lobe?

apical, posterior, anterior

5

What are the segments of the right middle lobe?

lateral, medial

6

What are the segments of the right lower lobe?

superior, antero-basal, medial-basal, lateral, posterior

7

What are the segments of the left upper lobe?

apical-posterior, anterior

8

What are the segments of the lingula?

superior, inferior

9

What are the segments of the left lower lobe?

superior, antero-medial basal, posterior, lateral

10

What is the most common pulmonary vein anomaly?

Separate vein draining the right middle lobe

11

What is an interrupted left PA associated with? 2

TOF and truncus

12

What does strep pneumo look like?

lobar consolidation

13

bulging fissure=

klebsiella

14

What does legionella look like?

peripheral and sublobar opacity

15

What does actinomyces look like?

peripheral opacity in lower lobes

16

What does mycoplasma look like?

patchy opacity w/ tree in bud

17

What infections are seen with CD 4 > 200

bacterial infections and TB

18

What infections are seen with CD 4< 200

PCP, atypical mycobacterial

19

What infections are see with CD 4 <100

CMV, disseminated fungal, mycobacterial

20

GGO in AIDS?

PCP

21

AIDS +lung cysts=

LIP

22

hypervascular lymph nodes + AIDS= 2

castleman + kaposi

23

At what CD 4 count is reactive TB seen?

> 200

24

At what CD 4 count is primary progressive TB seen?

<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