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Pulmo Defn & Imaging
Pulmonology
| Question | Answer |
|---|---|
| Rapid, deep labored breathing | Kussmaul breathing – DKA, Metabolic acidosis |
| Deep breathing alternating w/ apnea | Cheyne-Stokes breathing – heart failure, brain damage |
| Cavitations, patchy infiltrates on CXR | Infections – lung abscess, TB (Gohn focus) |
| Pleural thickening on CXR | Mesothelioma |
| Hilar mass on CXR | Lung Ca |
| Eggshell pattern on CXR | Silicosis (Sandblasters) |
| Ground glass appearance on CXR | Asbestosis (shipbuilders, building demolition) |
| CXR: reticular-nodular pattern, diffuse rounded opacities; Upper lung zones are primarily affected | Coal Miner’s lung |
| Patchy fibrosis on CXR | Farmers lung |
| Pediatric wheezing | lower respiratory FB, asthma |
| Thumbprint sign | Epiglottitis |
| Steeple sign | FB, viral croup (laryngotracheobronchitis) |
| Inspiratory stridor | FB, viral croup (laryngotracheobronchitis) |
| Premature infant with respiratory distress | Hyaline Mb Disease |
| CXR of premature infant w/ hypoexpansion (ATX), air bronchograms: | Hyaline Mb Disease |
| Smoker, chronic productive cough. NO hemoptysis, weight loss = | Bronchitis (COPD) |
| Smoker, DOE, cough = | COPD |
| Hyperinflation on CXR, tear drop heart | Emphysema |
| Wheezing, prolonged expiration | Asthma |
| Airway edema with eosinophils, neutrophils, lymphocytes | Asthma |
| Pediatric with Hx of recurrent lung infections, pancreatitis, reproductive problems, FTT = | Cystic fibrosis (Staph & Pseudomonal infections usually cause of death) |
| < 2 days post-op with fever = | Atelectasis |
| Stab wound, hyperresonance to percussion, decreased breath sounds, tympany = | Pneumothorax |
| Stab wound, dullness to percussion, decreased breath sounds = | Hemothorax |
| Tall, skinny, male, band student, acute onset one-sided chest pain, dyspnea = | Spontaneous PTX |
| Stab wound to chest. Hypotension, tracheal shift = | Tension PTX |
| Poor sleeping, obese, daytime fatigue & drowsy, snoring, HTN, PM wakening | Obstructive sleep apnea |
| s/p thoracic trauma. Multiple rib fractures. Chest wall moves in with inspiration, out with expiration. | Flail chest (pain control, incentive spirometry, pulmonary toilet, intubation) |
| Irreversible dilation of bronchi resulting from damage of airway wall: | bronchiectasis; usuallu 2/2 repeat infxn; dz of airways (not parenchyma) |
| ARDS on CXR = | bilateral widespread pulmonary infiltrates |
| CXR: infiltrates in mid or lower lung fields, hilar adenopathy, cavitation = | tuberculosis |
| CXR with upper lobe infiltrates, esp apical / posterior segments, cavitation common = | reactivated TB |
| Saddle Nose deformity = | Wegener’s Granulomatosis |
| A change in structure and function of the right ventricle of the heart as a result of a respiratory disorder = | cor pulmonale |
| In Pulmonary HTN, mean pulmonary pressure is __ at rest | >25 mmHg |
| Patients with pulmonary hypertension also have: | low cardiac output |
| The most common secondary cause of pulmonary hypertension = | connective tissue disease (scleroderma) |
| This should be performed in all patients suspected of pulmonary hypertension: | right ventricular catheterization |
| Median survival after diagnosis of pulmonary hypertension = | 3 years |
| ARDS on CXR = | bilateral widespread pulmonary infiltrates |
| On CXR: infiltrates in mid or lower lung fields, hilar adenopathy, cavitation = | tuberculosis |
| CXR with upper lobe infiltrates (especially apical & posterior segments); cavitation common = | reactivated TB |
| Viral pneumonia on CXR = | diffuse interstitial infiltrates & hyperinflation |
| Mycoplasma pneumoniae on CXR = | interstitial or bronchopneumonic infiltrates, frequently in the middle or lower lobes |
| Hampton's hump on CXR = | shallow wedge-shaped opacity in lung periphery with its base against pleural surface |
| Hampton's hump on CXR: Dx = | PE |
| Westermark sx on CXR = | oligemia (vasoconstriction) distal to a PE |
| Deer antler on CXR (large branching opaque mass, usually in L upper abdomen) = | PNA 2/2 proteus |
| PNA on CXR = | segmental infiltrates, atelectasis, pleural effusions; possible empyema |
| Pleura anatomy | Visceral (no sensory nerves) covers lungs, parietal (+sensory nerves) outside that & covering inside of chest wall |
| Decreased breath sounds & tactile fremitus, decreased diaphragmatic excursion on affected side, DTP, egophony = | pleural effusion |
| CXR in chronic bronchitis = | increased AP diameter, thickened bronchial markings, large right side of heart |
| CXR in emphysema = | low flat diaphragm, increased retrosternal space, pruning of vascular markings, long narrow heart, bullae |
| Most sensitive CXR view for smaller pleural effusion: | Lateral. PA may miss up to 300mL |
| ILD on CXR | Early: ground-glass appearance; later: nodular, linear, and/or honeycombed appearance |
| Respiratory failure (hypoxia) on CXR = | small "white" lungs, patchy, diffuse infiltrates, signs of consolidation, and/or lobar atelectasis |
| Respiratory failure (hypercapnia) on CXR = | hyperinflation, large "black" lungs, bullae, increased vascular markings (COPD); in NM dz / drug toxicity, may see small black lungs & hypoinflation |
| Volume to which lungs can be expanded with greatest inspiratory effort | TLC (total lung capacity) |
| volume of air inhaled and exhaled in a minute | MV (minute volume) |
| Part of TV that does not participate in alveolar gas exhange | Dead space |
Created by:
Abarnard
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