Pbr 2 > Pulmo > Flashcards

Pulmo Flashcards

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1
Q

What is the effect of glucocorticoid administration to mothers before preterm delivery?

A

Accelerates surfactant maturation and decreases incidence and severity of respiratory distress syndrome (RDS)

RDS is also known as hyaline membrane disease.

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2
Q

What does RDS stand for in the context of newborn diseases?

A

Respiratory distress syndrome

RDS is a common condition in preterm infants due to surfactant deficiency.

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3
Q

Name the common medical diseases of the newborn chest.

A
  • RDS
  • Pneumonia
  • CHF (Congestive heart failure)
  • TTN (Transient tachypnea of the newborn)

RDS, CHF, and TTN tend to be symmetric, while aspiration and hemorrhage tend to be asymmetric.

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4
Q

What lung disease is characterized by hazy granular patterns on imaging?

A

RDS

This pattern indicates respiratory distress syndrome in newborns.

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5
Q

What lung disease is indicated by confluent alveolar patterns?

A
  • RDS
  • Pneumonia
  • CHF

These conditions can present with confluent alveolar patterns on imaging.

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6
Q

What lung disease is indicated by patchy opacities on imaging?

A
  • Aspiration
  • Pneumonia
  • Hemorrhage

These conditions can present with patchy opacities in the lungs.

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7
Q

What lung disease is indicated by streaky interstitial patterns?

A

TIN (Transient tachypnea of the newborn)

This pattern can also be seen in pneumonia and CHF.

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8
Q

True or false: Aspiration and hemorrhage tend to be symmetric in lung disease patterns.

A

FALSE

Aspiration and hemorrhage tend to be asymmetric, while RDS, CHF, and TTN are symmetric.

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9
Q

What is laryngeal atresia?

A

A congenital condition causing high airway obstruction syndrome

It leads to respiratory distress despite strong respiratory effort and is associated with various anomalies.

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10
Q

What are some associated anomalies with laryngeal atresia?

A
  • Tracheoesophageal fistula
  • Esophageal atresia
  • Urinary tract abnormalities
  • Limb defects
  • Low-set ears

These anomalies often accompany laryngeal atresia in affected infants.

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11
Q

What is the most common reason for congenital high airway obstruction syndrome (CHAOS)?

A

Laryngeal atresia

CHAOS causes fluid entrapment within the enlarged trachea and lungs, leading to respiratory complications.

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12
Q

What imaging technique can diagnose laryngeal atresia prenatally?

A

Prenatal ultrasound

It identifies signs of CHAOS, such as enlarged hyperechogenic lungs and a flattened diaphragm.

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13
Q

What are the signs of congenital high airway obstruction syndrome detectable by ultrasound?

A
  • Enlarged hyperechogenic lungs
  • Flattened or inverted diaphragm
  • Dilated and fluid-filled trachea
  • Fetal hydrops
  • Polyhydramnios

These signs indicate potential airway obstruction in the fetus.

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14
Q

What is the immediate treatment required after birth for laryngeal atresia?

A

Emergent tracheostomy

This procedure is essential to secure an airway for infants diagnosed with laryngeal atresia.

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15
Q

What is the purpose of the ex utero intrapartum treatment (EXIT) procedure?

A

To secure an airway during delivery for infants with laryngeal atresia

This procedure may improve survival chances for affected infants.

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16
Q

What is laryngeal atresia?

A

A congenital condition causing high airway obstruction syndrome

It leads to respiratory distress despite strong respiratory effort and is associated with various anomalies.

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17
Q

What are some associated anomalies with laryngeal atresia?

A
  • Tracheoesophageal fistula
  • Esophageal atresia
  • Urinary tract abnormalities
  • Limb defects
  • Low-set ears

These anomalies often accompany laryngeal atresia in affected infants.

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18
Q

What is the most common reason for congenital high airway obstruction syndrome (CHAOS)?

A

Laryngeal atresia

CHAOS causes fluid entrapment within the enlarged trachea and lungs, leading to respiratory complications.

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19
Q

What imaging technique can diagnose laryngeal atresia prenatally?

A

Prenatal ultrasound

It identifies signs of CHAOS, such as enlarged hyperechogenic lungs and a flattened diaphragm.

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20
Q

What are the signs of congenital high airway obstruction syndrome detectable by ultrasound?

A
  • Enlarged hyperechogenic lungs
  • Flattened or inverted diaphragm
  • Dilated and fluid-filled trachea
  • Fetal hydrops
  • Polyhydramnios

These signs indicate potential airway obstruction in the fetus.

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21
Q

What is the immediate treatment required after birth for laryngeal atresia?

A

Emergent tracheostomy

This procedure is essential to secure an airway for infants diagnosed with laryngeal atresia.

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22
Q

What is the purpose of the ex utero intrapartum treatment (EXIT) procedure?

A

To secure an airway during delivery for infants with laryngeal atresia

This procedure may improve survival chances for affected infants.

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23
Q

What is congenital tracheal stenosis characterized by?

A

Complete cartilaginous rings with an absent or deficient posterior membranous portion

This condition renders the tracheal lumen smaller and less pliable.

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24
Q

In which year of life do affected pediatric patients typically present with symptoms of congenital tracheal stenosis?

A

First year of life

Symptoms include expiratory stridor, wheezing, and respiratory distress.

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25
What are the **three types** of congenital tracheal stenosis?
* Focal (50%) * Generalized (30%) * Funnel shaped (20%) ## Footnote These classifications indicate the severity and presentation of the condition.
26
Name some **congenital anomalies** often associated with congenital tracheal stenosis.
* Tracheoesophageal fistula * Pulmonary agenesis or hypoplasia * Pulmonary artery sling type 2 * Bronchial stenosis ## Footnote These anomalies can complicate the clinical picture of congenital tracheal stenosis.
27
What imaging modalities may lead to the suspicion of **congenital tracheal stenosis**?
* Neck and chest radiographs * Fluoroscopy ## Footnote These methods may show a narrowed trachea in pediatric patients with respiratory symptoms.
28
What is the **current imaging modality of choice** for diagnosing congenital tracheal stenosis?
CT (Computed Tomography) ## Footnote CT provides detailed images that are crucial for diagnosis.
29
What are the **imaging characteristics** of a **Hamartoma**?
Smooth or slightly lobulated, sharply defined mass, occasionally calcified ('popcorn') ## Footnote Hamartomas are benign lung neoplasms that can be identified by their distinct imaging features.
30
What is diagnostic for a **Chondroma** on computed tomography?
Fat and calcification in solitary pulmonary mass ## Footnote Chondromas are characterized by specific imaging findings that aid in diagnosis.
31
What percentage of **Respiratory papillomatosis** cases are commonly calcified?
45% ## Footnote Respiratory papillomatosis may present as solitary or multiple nodules.
32
What are the imaging characteristics of **Lymphatic malformation**?
Bilateral, multiple subpleural solid or cystic nodules; may be associated with bronchiectasis or atelectasis ## Footnote Lymphatic malformations can present with various imaging features.
33
True or false: **Lymphatic malformation** is rarely intrapulmonary.
TRUE ## Footnote It is characterized by well-marginated, nonenhancing cystic mass.
34
What may a **Lymphatic malformation** simulate in neonates?
Congenital pulmonary airway malformation or diaphragmatic hernia ## Footnote In older children, it may present as a solid, low-attenuation mediastinal or pulmonary mass.
35
What is the **basis** for the diagnosis of atelectasis?
A combination of findings ## Footnote Diagnosis relies on various radiographic signs.
36
Name the **direct signs** of atelectasis due to lobar volume loss.
* Displacement of fissures * Crowding of vessels ## Footnote These signs indicate a direct effect of volume loss in the affected lobe.
37
What are the **indirect signs** of atelectasis secondary to volume loss?
* Diaphragmatic elevation * Mediastinal shift * Compensatory overinflation of normal lung * Hilar displacement * Reorientation of the hilum or bronchi * Approximation of the ribs * Increased lung opacity * Absence of air bronchograms * Shifting granuloma sign ## Footnote Indirect signs reflect changes in surrounding structures due to the loss of volume.
38
What are **Sarcoid** and **berylliosis** examples of?
Granulomatous diseases ## Footnote Both conditions involve the formation of granulomas in tissues.
39
In patients with a **hilar mass** and bronchial obstruction, what can obscure the margins of the nodule?
Consolidation of the distal lung ## Footnote This can make diagnosis challenging.
40
Bilateral lymph node enlargement
Sarcoid or berylliosis Silicosis Amyloidosis Collagen vascular disease Lymphoma Lymph nodes metastasis
41
What is the **incidence** of pulmonary lymphomas?
<1% incidence of pulmonary lymphomas ## Footnote This indicates that pulmonary lymphomas are quite rare.
42
What type of lymphoma is referred to as **low grade (MALToma)**?
* Arises from MALT * Solitary nodule or focal consolidation * Multiple nodules or areas of consolidation * Air bronchograms in 50% * Lymph node enlargement in 5%-30% * Good prognosis ## Footnote MALToma is associated with mucosa-associated lymphoid tissue.
43
What are the characteristics of **high grade (non-MALT)** pulmonary lymphomas?
* Solitary or multiple nodules * Air bronchograms common * Multifocal consolidation ## Footnote High grade lymphomas typically present with more aggressive features.
44
True or false: **Air bronchograms** are common in high grade pulmonary lymphomas.
TRUE ## Footnote Air bronchograms are indicative of underlying pathology in the lungs.
45
What is the **prognosis** for low grade (MALToma) pulmonary lymphomas?
Good prognosis ## Footnote Low grade lymphomas generally have a better outcome compared to high grade lymphomas.
46
What is the follow-up recommendation for a **nodule size** less than **4 mm** in a **low-risk patient**?
No follow-up needed (f/u is optional) ## Footnote This indicates that for nodules under 4 mm, monitoring is not mandatory.
47
For a **nodule size** between **4-6 mm** in a **low-risk patient**, what is the follow-up protocol?
f/u at 12 mo; if unchanged, no further f/u ## Footnote This means that after 12 months, if the nodule has not changed, additional follow-up is not required.
48
What is the follow-up procedure for a **nodule size** between **6-8 mm** in a **low-risk patient**?
f/u CT at 6-12 mo, then at 18-24 mo if no change ## Footnote This indicates a structured imaging follow-up to monitor for changes.
49
What is the follow-up recommendation for a **nodule size** less than **4 mm** in a **high-risk patient**?
f/u at 12 mo; if unchanged, no further f/u ## Footnote Similar to low-risk patients, but emphasizes the importance of monitoring in high-risk individuals.
50
For a **nodule size** between **4-6 mm** in a **high-risk patient**, what is the follow-up protocol?
f/u CT at 6-12 mo, then at 18-24 mo if no change ## Footnote This follows a similar imaging schedule as for low-risk patients.
51
What is the follow-up procedure for a **nodule size** between **6-8 mm** in a **high-risk patient**?
f/u CT at 3-6 mo, then at 9-12 and 24 mo if no change ## Footnote This indicates a more frequent follow-up schedule due to the higher risk.
52
How is the **nodule size** determined?
Average of length and width ## Footnote This method provides a standardized way to assess nodule size.
53
What is the **range of doubling times** associated with carcinoma?
* 1 month * 16 months * 1 month to 200 days encompasses most cancers ## Footnote Reported values for doubling times can vary significantly.
54
What is the estimated **average doubling time** for small cell carcinoma?
30 days ## Footnote This is the fastest average doubling time among lung cancer types.
55
What is the estimated **average doubling time** for squamous cell and large cell carcinomas?
100 days ## Footnote This average is slower than that of small cell carcinoma.
56
What is the estimated **average doubling time** for invasive adenocarcinoma?
180 days ## Footnote This type of carcinoma has a slower growth rate compared to small cell carcinoma.
57
What is the doubling time for **slow-growing adenocarcinomas** characterized by lepidic growth?
More than 1,000 days ## Footnote These tumors exhibit significantly slower growth rates.
58
True or false: Nearly all **carcinomas** will show some growth over a follow-up period of 2 years.
TRUE ## Footnote This is generally true, although growth may be difficult to detect in lepidic adenocarcinomas.
59
What may make growth detection of **lepidic adenocarcinomas** difficult over a 2-year period?
* Slow growth * Poorly defined margins * Appearance as nonsolid nodules (GGO or GGO with a solid component) ## Footnote These factors complicate the assessment of growth via CT scans.
60
What does **LUNG-RADS** stand for?
Lung-RADS (Lung Cancer Screening Reporting and Data System) ## Footnote It is a system for categorizing findings from lung cancer screening CT scans.
61
What is the **descriptor** for LUNG-RADS category 0?
Prior CT being located: part of additional screening CT ## Footnote This category indicates that the findings cannot be evaluated.
62
What findings are classified as **Category 1** in LUNG-RADS?
No nodules or definitely benign nodules ## Footnote This indicates a negative result for lung cancer screening.
63
What is the management recommendation for **Category 2** in LUNG-RADS?
Short-term follow-up suggested ## Footnote This includes nodules with a low likelihood of becoming clinically active cancer.
64
What size of **solid nodules** falls under LUNG-RADS category 4A?
Solid nodule(s): 8 to <15 mm at baseline or growing <8 mm or new 6 to <8 mm ## Footnote This category indicates a higher suspicion for malignancy.
65
What is the follow-up recommendation for **Category 3** nodules in LUNG-RADS?
Continue annual screening ## Footnote This category includes nodules that are unchanged for 2-3 months.
66
True or false: LUNG-RADS includes criteria for follow-up of **solid and nonsolid nodules**.
TRUE ## Footnote However, follow-up intervals and size criteria differ from those recommended by the Fleischner Society.
67
What is the management recommendation for **Category 4B** in LUNG-RADS?
PET and/or tissue sampling recommended ## Footnote This category indicates findings for which additional diagnostic testing is necessary.
68
What does a **Purple flag** indicate in the context of beach safety?
Dangerous marine life ## Footnote This includes warnings for jellyfish or sharks.
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