Lecture 19

Question 1

What may lung diseases affect?

Answer 1

1. Pulmonary arteries e.g. vasculitis, pulmonary emboli.
2. Bronchi e.g. asthma, bronchitis, bronchiectasis.
3. Lung parenchyma e.g. pneumonia, lung cancer, emphysema, chronic interstitial lung diseases, inhalation diseases.

Question 2

What are common lung abnormalities?

Answer 2

1. Pneumonia.
2. Lung cancer - primary or metastases.
3. Trauma.
4. Pulmonary emboli.
5. Cardiac failure (CHF).
6. Chronic diffuse lung disease.

Question 3

Important questions when looking at chest x-rays?

Answer 3

1. Pattern of lung abnormality:
   - Focal.
   - Mutifocal.
   - Diffuse.
2. Acute or chronic (history is critical.
3. Other clues e.g. cardiomegaly.

Question 4

When doing a chest x-ray what else do you need to consider?

Answer 4

1. History; symptoms, time course.
2. Exam.
3. CXR appearance.

Question 5

Describe multifocal?

Answer 5

Acute:
-Infection specifically TB, staphylococcus pneumonia. 
Sub-acute or Chronic:
-Metastases.
-Sarcoidosis.

Question 6

Describe diffuse lung disease?

Answer 6

Acute:
-Fluid e.g. pulmonary oedema. 
-Pus e.g. pneumonia. 
-Blood e.g. good pastures. 
Chronic:
-Destruction e.g. emphysema. 
-Malignancy.
-Fibrotic lung disease >100.

Question 7

Describe the distribution of chronic diffuse lung diseases?

Answer 7

Upper Lobes:
-Tb
-Sarcoidosis
-Silicosis.
Lower Lobes:
-UIP (peripheral).
-Asbestosis. 
Anywhere:
-Lymphangitic metasases.

Question 8

What connective tissue diseases are associated with lung disease?

Answer 8

1. Rheumatoid arthritis.
2. Progressive systemic sclerosis/scleroderma.
3. Systemic lupus erythematosis (SLE).
4. Dermatomyositis/polymyositis.
5. Sjorgren’s syndrome.