Ucsf: Video H 69 Part 2 Diffuse Airway Disease (Consolidation/ggo)

Front 1

What are two types of lung opacification on HRCT?

Back 1

consolidation or GGO

Front 2

What is the defition of consolidation

Back 2

increased lung opacity with obscuraton of underlying vessels

Front 3

What is the definition of GGO

Back 3

increased lung opacity without obscuraton of underlying vessels

Front 4

What are the acute causes of lung consolidation?
4

Back 4

pneumonia
edeam
hemorrhage
diffuse alveolar damage (DAD) which is most commonly ARDS.

Front 5

What are the chronic causes of lung consolidation?
3

Back 5

organizing pneumonia
chronic eosinophilic pneumonia
bronchioloalveolar carcinoma

(lymphoma, alveolar sarcoid, alveolar proteinosis)

Front 6

Can edema cause a consolidation

Back 6

yes

Front 7

What is the most likely cause of acute consolidation in a pt with SLE?

Back 7

hemorrhage

Front 8

What is the typical history for a patient with organizing pneumonia

Back 8

chronic consolidation in pt who is febrile for 6 wks

Front 9

What does organizing pneumonia look like on HRCT

Back 9

patchy areas of consolidation involving peripheral and peribronchial lung

Front 10

What is the difference between OP and bronchiolitis obliterans organizing pna (BOOP)

Back 10

same thing, but now we just say organizing pna

Front 11

Is organizing pna (OP or BOOP) common

What is the treatment for OP?

Back 11

yes

corticosteriods (DIP also)

Front 12

What are the common causes of organizing pna (OP or BOOP)

Back 12

organizing pna occurs in pt with overlying health problems like RA the causes include;
idiopathic
Bacterial infection
drugs (amiodarone)
CVD (RA, SLE, scleraderma, dermatomyocitis)
fumes

Front 13

What is the clinical picture of organizing pna (OP or BOOP)

Back 13

several months of cough, dyspnea, low grade fever?

Front 14

What is seen histologically with organizing pna (OP or BOOP)

Back 14

granulation tissue polyps in bronchioles and patchy organizing pna

Front 15

What is seen in 90% of cases of organizing pna (OP or BOOP)

Back 15

patchy air space consolidation or GGO

Front 16

What is seen in 15% of cases of organizing pna (OP or BOOP)

Back 16

large nodules or masses

Front 17

What is the typical distribution of organizing pna (OP or BOOP)

Back 17

peripheral and peribronchiole

Front 18

What is the typical shape of organizing pna (OP or BOOP)

Back 18

irregular in shape

Front 19

What is the atoll sign

Back 19

this is when there is a ggo in the middle of a consolidation

Front 20

What drug has been associated with organizing pna (OP or BOOP)

Back 20

amiodarone

Front 21

What is the halo sign?

Back 21

this is a dense central nodulare area surrounded by a ggo

Front 22

What percent of pt with cryptogenic organizing pna have a atoll sign?

Does OP consolidations typically have air bronchograms?

Back 22

20%

yes

Front 23

What are the 2 causes of chronic eosinophilic pna

Back 23

idiopathic
antigen

Front 24

Is there eosinophilia associated with chronic eosinophilic pna

Back 24

yes

Front 25

What is BOOP often confused with>

Back 25

chronic eosinophilic pna

Front 26

What are the SS of chronic eosinophilic pna

Back 26

months of fever, cough, weighloss

Front 27

What is eosinophilic pna associated with

Back 27

asthma history

Front 28

What is seen in chronic eosinophilic pna

Back 28

peribronchial and peripheral GGO and consolidation

Front 29

What part of the lung does chronic eosinophilic pna predominate

Back 29

the upper lobes

Front 30

can you see the atoll sign and reverse halo sign with chronic eosinophilic pna

Back 30

yes

Front 31

What is characterics appearance of appearance of chronic eosinophilic pna on CXR

Back 31

patchy consolidations in the upper lobes

Front 32

Does Bronchoalveolar carcinoma cause chronic lung consolidation

Back 32

yes

Front 33

What would be a typical appearance of Goodpastures syndrome

Back 33

GGO or consolidaton bc of pulmonary hemorrhage

Front 34

What causes ground glass opacification?
3

Back 34

alveolar wall thickening
partial alveolar filling
atelectasis

Front 35

What are some causes of acute GGO?
4

Back 35

pulmonary edema
hemorrhage
atypical pna (pcp or viral)
DAD (ARDS, cocaine)

Front 36

Can cocaine cause diffuse alveolar damage?

Back 36

yes

Front 37

What is the ddx of GGO that is chronic

Back 37

Interstial PNA (NSIP, LIP or DIP)
hypersensitivity pneumonititis
alveolar proteinosis

Things that cause a chronic consolidation:
Organizing pna
chronic eosinophilic pna
BAC

Front 38

What is the causes of hypersensitivity pneumonititis?

Back 38

inhalation or organic antigens

Front 39

Are hypersensitivity pneumonitis common?

Back 39

yes

Front 40

What percent of pt with hp have patchy GGO?

Back 40

75-90%

Front 41

What percent of pt with hp have ill defined centrilobular nodules

Back 41

50-60%

Front 42

What are the typical findings in alveolar proteinosison HRCT

Back 42

crazy paving

Front 43

What are 3 characteristics of chronic HP

What histologic patterns of interstitial pna are caused by HP
2

Back 43

upper lobe predominance
reticulations
bronchiectasis

if HP is end stage it causes UIP, it may also cause OP

Front 44

What is the mosaic pattern?

Back 44

patchy lucenies seen on HRCT bc of air trapping

Front 45

When does the mosaic pattern seen best

Back 45

expiratory phase

Front 46

Is the mosaic pattern present in HP

Back 46

yes

Front 47

Does HP have a subpleural predominance

Back 47

no

Front 48

What is crazy paving

Back 48

interlobular septal thickenig and GGO