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70 Cards in this Set

  • Front
  • Back
CXR for best seeing pneumothorax
expiratory
PTX in supine Radiographs
air along mediastinum and/or deep sulcus sign
six most common causes of diffuse interstitial pulmonary fibrosis
idiopathic (IPF, >50% of cases), collagen vascular disease, cytotoxic agents and nitrofurantoin, pneumoconioses, radiation, and sarcoidosis
IPF Sx
progressive exertional dyspnea and a nonproductive cough
Radiography of IPF
ground glass, volume loss, Bilateral linear opacities progressing to honeycomb.
IPF prognosis
progression to pulmonary failure with death within 3-6 years unless transplant.
Saber sheath tracheal deformity
coronal diameter < 2/3 sagital diameter. seen in emphysema
Emphysema in alpha 1 antitrypsin vs. smokers
alpha-1: lower lung zones
smokers: upper
Rib frx a/w aortic injury
first 3 (due to excessive force necessary to break these ribs)
Rib frx a/w liver or spleen injury
lower 3
Anterior Mediastinal Mass
4 T's + others
Terrible Lymphadenopathy, Thymic Tumors, Teratoma, Thyroid mass. Aortic aneurysm, pericardial cyst, epicardial fat pad.
Middle Mediastinal Mass
lymphadenopathy 2.2 mets or primary tumor, hiatal hernia, aortic aneurysm, thyroid mass, duplication cyst, bronchogenic cyst.
Pulmonary fibrosis and which CA?
Adenocarcinoma
TB Tx pre-Rx
Repeatedly induced PTX under flouroscopy-->Breast CA risk. Thoracoplasty-->cave in chest. Oleothorax-->Oil into lungs.
CCAM
Cystic Congenital Adenomatoid Malformation. Indication for pneumonectomy in kids.
Lipoid pneumonia
oily aspirate that mimics a mass.
Bronchiectasis site in CF
Upper Lobes
Bronchiectasis in Lower Lobes
Aggamaglobulinemia, Kartegener's, Chronic aspiration
Eggshell calcification
up to 2mm thick. Present in at least 2 LNs. Ddx: Sarcoidosis (5% of pts with Sarcoid), Silicosis, Treated Lymphoma (Postirradiation Hodgkins 1-9 yrs post), coal-workers pneumoconiosis, scleroderma, amyloid, blasto, histo
Swyer-James syndrome
postinfectious obliterative bronchiolitis-->affected lung doesn't grow normally-->smaller than contralat lung.
Causes of Swyer-James syndrome
Postinfectious: M.pneumoniae, Strep pneumoniae, RSV
Scimitar Syndrome
mild hypoplasia of right lung.
Cleidocranial dysostosis
hereditary 2/2 haploinsufficiency CBFA1 gene.
missing collarbones,underdeveloped or persistent fontanelles, small stature, supernumerary teeth. Emmett Furrow.
Nummular Sarcoidosis
multiple well-circumscribed pulmonary nodules. aka Nodular Sarcoid. Galaxy sign
ANCA positive Vaculitides
Wegeners, Churg-Strauss, Microscopic polyangiitis
Sx of Wegeners
Rhinitis, nose pain or bleeds, hearing loss, ginivivitis and ulcers, scleritis, conjunctivitis, uveitis, subglottal stenosis, cavitary lung lesions, pulmonary hemorrhage, glomerulonephritis, arthritis (ddx RA, mononeuritis multiplex.
cANCA
proteinase 3 in Neutrophils. a/w Wegeners.
Causes of thymic hyperplasia
Graves, Immunosuppression
Angiomyolipoma
Benign renal tumor. Variable amts fat, vascular, smooth muscle. Fat density on CT is pathognomonic. Seen in Tuberous Sclerosis
Renal tumor a/w Tuberous Sclerosis
Angiomyolipoma
Renal tumor associated with lymphangioleiomyomatosis (LAM)
Angiomyolipoma
LAM=Lymphangioleiomyomatosis
A/w Tuberous sclerosis. Disorderly smooth muscle in bronchioles, septa, lymphatics-->obstruct small airways.
Type of Effusion a/w LAM
chylothorax
6 causes of air bronchograms
lung consolidation, pulmonary edema, nonobstructive pulmonary atelectasis, severe interstitial disease, neoplasm, and normal expiration
benign nodule
2 years with no change, if completely calcified, central or stippled calcification.
Pulmonary nodules suspicious
multiple nodules, irregular or off-center calcifications-->PET or Bx
Atelectasis (Etiology)
Mucus plug, tumor, extrinsic compression centrally (LNs), pleural effusion
Cicatricial Atelectasis
2/2 scarring, TB, s/p radiation
Atelectasis (Appearance)
linear, cuvilinear, or wedge-shaped density with volume loss
Luftsichel sign
LUL collapse on CXR 2/2 LUL atelectasis a/w bronchogenic CA. Lucency seen between mediastinum and collapsed LUL = LLL
pneumonic for non-cardiogenic edema
NOT CAAARDIAC: N-near drowning, O2 Tx, Transfusion or Trauma, CNS disorder, ARDS aspiration or altitude sickness, Renal dz or resuscitation, Drugs, Inhalants, Allergic alveolitis, Contrast or contusion
Signs of Cardiogenic Pulm Edema
Cephalization, Kerley Bs, Peribronchial cuffing, Bat wing, air bronchogram, cardiomegaly
Atypical Patterns of Cardiogenic Pulm Edema
nilateral, miliar, lobar, lower zone (however patterns can be seenin when lying prolonged one side or in COPD)
Cephalization at PCWP of?
12 to 18
Interstitial Edema at PCWP?
18 to 24
Alveolar Edema above PCWP?
24- often bat-winged
Thickened Interlobular Spta
Kerley B
Disorders with Kerley B
Pulm Edema, Lymphangitis Carcinomatosa, Malignant Lymphoma, Viral/Mycoplasmal pneumonia, IPF, Pneumoconiosis, Sarcoidosis
Pattern seen in near drowning
None if laryngospasm reflex complete. Otherwise batwing
Ddx of Consolidation (no volume loss)
pneumonia, inflammatory fluid, cells (cancer), alveolar proteinosis, blood.
Lobar Pneumonia
Classically Pneumococcal
Lobular Pneumonia
Often Staph. Mulftifocal, patchy
Interstial
Viral or Mycoplasma
Viral vs Mycoplasma
Mycoplasma starts perhilar but can become confluent and or patchy.
Air bronchograms in Atelectasis or in Pneumonia?
Either
Ghon focus
primary lesion of TB. area of consolidation most common in med and lower lung zones
Ghon Complex
Ghon focus + nodal involvement with calcifications
Bronchiectasis Predisposing factors
CF, Karatageners, Agammaglobulinemia, TB, Asthma
Sx Bronchiectasis
cough, sputum, bad breath, heymoptysis
Simon's foci
Apical lesions in TB after dissemination
Broncholithiasis
Histoplasmosis
Aspergillus Fumigatus
most comon cause of fatal fungal dz in Hospitalized pts. Seen in neutropenia. Target lesions with necrotizingvasculitis
endobronchial TB leads to
circatrical stenosis
Causes of Pulmonary Hemorrhage
trauma, Goodpastures, coagulopathy, altitude, mitral stenosis
Appearance of Pulmonary Hemorrhage
Space-filling ddx pneumonia, with bronchograms. Resolves more quickly
Westermark's sign
Oligemia of invovled PE
Signs in PE
Westermarks, Increased Hilar size, Atelectasis with hemidiaphragmatic elevation, effusion, consolidation, Hamptons hump
Si of Pulmonary infarction
multifocal consolidation at pleural bases
Amt fluid needed to see Effusion on PA? Lateral?
200mL, 75mL
Effusion likely to be malignanacy
Large, Unilateral