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