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+====== Nick's Chest Mnemonics ======
+===== Upper Lobe Interstitial Disease (RadioCASSET) =====
+  * XRT
+  * Cystic Fibrosis
+  * Ankylosing Spondylitis
+  * Silicosis
+  * Sarcoid
+  * EG
+  * Tuberculosis - post 1°, not miliary (miliary is lower lobe)
+===== Lower Lobe Interstitial Disease (BADAS RIDL) =====
+  * Bronchiectasis
+  * Aspiration
+  * Drugs (Ritalin, Bleomycin)/Dermatomyositis
+  * Asbestosis
+  * Scleroderma
+  * Rheumatoid
+  * IPF
+  * DIP
+  * Lymphangitic Carcinomatosis
+===== Upper Lobe Predominant Fibrosis =====
+  * Sarcoidosis
+    * Upper lung perilymphatic nodules
+      * Interlobular
+      * Peribronchial
+    * Coalescent masses secondary to fibrosis
+  * Silicosis/Coal Worker's Pneumoconiosis
+    * Upper lung nodules
+      * Subpleural
+      * Centrilobular
+    * Progressive massive fibrosis (PMF)
+    * Paracicatricial emphysema
+  * Idiopathic pleuroparenchymal fibroelastosis
+    * Extensive subpleural and pleural fibrosis
+  * Familial pulmonary fibrosis
+    * Upper lung or diffuse zonal distribution
+  * Hypersensitivity pneumonitis
+    * Ground glass
+    * Air trapping
+    * Exposure history
+===== Lower Lobe Predominant Fibrosis =====
+  * Aspiration (mimic)
+    * Ground-glass or consolidation
+    * Often dependent
+    * May be peribronchovascular
+    * Transient bronchial dilation
+  * Usual interstitial pneumonitis/Idiopathic pulmonary fibrosis
+    * Subpleural and basilar predominant
+    * Reticular opacities
+    * Bronchiolectasis
+    * Honeycombing
+  * Diffuse pulmonary hemorrhage
+    * Ground-glass consolidation
+    * Spares lung periphery
+    * May progress to fibrosis if recurrent
+  * Nonspecific interstitial pneumonitis
+    * Ground-glass and reticulation
+    * Basilar
+    * Peripheral sparing highly suggestive
+    * Usually secondary
+      * Collagen vascular disease
+      * Drugs
+      * Chronic hypersensitivity pneumonitis
+  * Organizing pneumonia (not cryptogenic)
+    * Consolidation
+    * Transient bronchial dilation
+    * Reverse halo sign
+    * Perilobular pattern
+    * Usually secondary
+      * Collagen vascular disease (Myopathies and RA)
+      * Aspiration
+      * Radiation
+      * Drugs
+      * Lung or stem cell transplant
+===== Collagen Vascular Disease Patterns in Interstiital Lung Disease =====
+^Patterns^Rheumatoid^Scleroderma^PM/DM^Sjogren^
+|UIP|++|++|+|+|
+|NSIP|+|++++|++|+|
+|Organizing Pneumonia|++|+|++|-|
+|Obliterative Bronchiolitis|++|-|-|-|
+|Bronchiectasis|++|-|-|++|
+|LIP|-|-|-|+++|
+  * Obliterative Bronchiolitis
+    * Air trapping
+    * Mosaic attenuation
+    * Bronchial wall thickening and dilation
+  * Lymphocytic Interstitial Pneumonitis
+    * Peribronchovascular cysts
+    * Pericystic dots
+===== Cysts (LEP LIP) =====
+  * LAM - uniform cysts
+  * EG (Call it Langerhans Cell Histiocytosis, the chest guys like that) - bizarre cysts w/ small nodules
+  * PCP
+  * LIP
+  * IPF (honeycombing)
+  * Papillomatosis
+===== Bronchiectasis (CIT KAM) =====
+  * Cystic Fibrosis
+  * Immunodeficiency
+    * The most common congenital conditions involve B-lymphocyte functions—specifically, hypogammaglobulinemia. An aggressive form of bronchiectasis has been described in patients with acquired immunodeficiency syndrome (AIDS).
+  * Traction
+    * Associated with pulmonary fibrosis
+  * Kartagener's
+  * ABPA
+  * Mournier-Kuhn/Williams-Campbell (both are lower lobe; Mournier-Kuhn has tracheal widening, Williams-Campbell does not)
+  * Others
+    * Infection: Typical organisms include Klebsiella species, Staphylococcus aureus, Mycobacterium tuberculosis, Mycoplasma pneumoniae, nontuberculous mycobacteria, Mycobacterium avium-intracellulare complex, measles, pertussis, influenza, respiratory syncytial virus, herpes simplex virus, and certain types of adenovirus.
+    * Bronchial obstruction: Obstruction occurs as a result of endobronchial tumors, broncholithiasis, bronchial stenosis resulting from infections, encroachment of hilar lymph nodes, and foreign body aspiration.
+    * Young syndrome
+    * Alpha-1 Antitrypsin deficiency
+    * Lung and bone marrow transplants
+    * Rheumatoid arthritis and Sjögren syndrome
+    * Bronchopulmonary sequestration
+    * Swyer-James syndrome (unilateral hyperlucent lung)
+    * Yellow nail syndrome
+===== Patchy Peripheral Airspace Disease (RRECH DB) =====
+  * Resolving Edema
+  * Resolving Multifocal PNA
+  * Eosinophilic Pneumonia/Loffler's
+  * COP (has peripheral clear zone)
+  * Hypersensitivity Pneumonitis
+  * Drug Toxicity
+  * Bronchioloalveolar CA
+===== Cavitary Lesions (CAVITY) =====
+  * Carcinoma (SCC, colon, TCC, sarcoma, melanoma, cervical)
+  * Autoimmune (Rheumatoid, Wegeners)
+  * Vascular
+  * Infection (abscess, fungal, TB, echinococcus)
+  * Trauma
+  * Young (congenital)
+===== Crazy Paving (PEPPAH) =====
+  * Pulmonary Alveolar Proteinosis
+  * Edema
+  * PCP
+  * Pneumonia
+  * ARDS
+  * Hemorrhage
+===== Miliary Pattern (FAT SPAM) =====
+  * Fungal
+  * Amyloid
+  * TB
+  * Sarcoid
+  * Pneumoconiosis
+  * Alveolar Microlithiasis
+  * Mets (ThRAB - thyroid, renal cell, any adenoCA, breast)
+===== Pleural Mets (GIBT) =====
+  * GI Adenocarcinomas
+  * Breast
+  * Thymoma
+====== Other Differentials ======
+===== Chronic Patchy Consolidation =====
+  * BAC
+  * Lymphoma
+  * Eosinophilic Pneumonia
+  * COP
+  * Sarcoid
+  * Infarct
+  * Metastatic Pulmonary Calcification
+  * TB
+  * Lipoid Pneumonia
+  * Pulmonary Alveolar Proteinosis
+===== Tree-In-Bud =====
+  * Endobronchial Spread of Infection (esp TB)
+  * Bronchiolitis
+  * Viral/Fungal Infection
+  * ABPA
+  * Aspiration
+  * Atypical Mycobacteria
+  * Mycoplasma
+===== Reverse Batwing =====
+  * Loffler's
+  * Parasitic Infection
+===== Air Crescent Sign =====
+  * Aspergilloma
+  * Echinococcus
+===== Honeycombing =====
+  * IPF
+  * Collagen Vascular Disease
+  * Asbestosis
+  * Drugs
+===== Unilateral Pulmonary Edema =====
+  * Reexpansion Edema
+  * Gravity
+  * Mass Obstructing Pulmonary Veins
+  * Large Contralateral PE
+===== Solitary Pulmonary Metastasis =====
+  * Colon
+  * Sarcomas
+  * Renal Cell
+  * Testicular
+  * Breast
+  * Melanoma
+===== Cannonball Lesions =====
+  * Mets
+    * Renal Cell
+  * Lymphoma
+  * Sarcoid
+===== Mets Causing Bilateral Hilar Adenopathy =====
+  * Renal Cell
+  * Melanoma
+  * Breast
+  * GU Tumors
+===== Centrilobular Nodules =====
+  * Hypersensitivity Pneumonitis
+  * RB-ILD
+  * TB/Atypical Infection
+  * LIP
+  * Sarcoid
+===== Peribronchovascular Nodules =====
+  * Sarcoid
+  * Lymphangitic Carcinomatosis
+  * Lymphoma
+  * Kaposi's Sarcoma
+  * Plus Tree-In-Bud DDx
+===== Endobronchial Masses =====
+  * Carcinoid
+  * Adenoid Cystic CA
+  * Mucoepidermoid CA
+  * Papilloma
+  * Fibrous tumors
+  * Leiomyomas
+  * Neurofibromas
+  * SCC (trachea)
+===== Endobronchial Mets =====
+  * Breast
+  * Renal
+  * Melanoma
+===== Causes of Diffuse Pulmonary Hemorrhage =====
+  * Immune-mediated
+    * antiglomerular basement membrane antibody disease (Goodpasture syndrome)
+    * systemic lupus erythematosus (SLE)
+    * Wegener granulomatosis
+    * immune complex disease
+    * polyarteritis nodosa
+    * rheumatoid arthritis
+    * Henoch-Schonlein purpura
+  * Non-immune
+    * idiopathic pulmonary hemorrhage (IPH)
+    * coagulopathies
+    * drugs (penicillamine)
+===== Causes of Hypertrophic Pulmonary Osteoarthropathy =====
+  * Pulmonary Neoplasm (Benign or Malignant)
+  * Chronic Infection (CF, TB)
+  * R -> L Shunt
+  * Congenital Heart Disease
+===== Cardiac Mets =====
+  * Lung
+  * Breast
+  * Melanoma
+  * Lymphoma
+===== Lymphangitic Mets =====
+  * Lung
+  * Breast
+  * Gastric
+  * Pancreatic
+  * Esophageal
+===== Causes of Pulmonary Edema =====
+==== Cardiogenic ====
+  * LV failure
+  * mitral valve dz
+  * pulmonary venous occlusion
+  * pericardial dz
+  * beta blockers
+==== Non-cardiogenic ====
+  * Renal Failure
+  * Fat Emboli
+  * Neurogenic
+  * Sepsis
+  * Volume Overload
+  * Hypoproteinemia
+  * Increased Capillary Permeability
+    * Aspiration
+    * Near-drowning
+    * Anaphylaxis
+===== Diffuse Tracheal Narrowing =====
+  * COPD (saber sheath trachea)
+  * radiation Δ
+  * Tracheobronchopathia Osteochondroplastica
+  * Relapsing Polychondritis
+  * Tracheomalacia
+===== Chronic Consolidation =====
+  * COP
+  * Eosinophilic PNA
+  * Lymphoma
+  * Bronchioloalveolar CA
+===== Halo Sign =====
+  * Hemorrhagic Mets
+    * Kaposi's
+    * Renal Cell
+    * Choriocarcinoma
+  * Invasive Aspergillus
+===== Chest Wall Mass =====
+  * Benign
+    * Lipoma
+    * Fibrous Tumor of Pleura
+    * Desmoid
+    * Hemangioma
+    * Pleural Plaque (i.e. asbestos related pleural disease)
+    * Trauma with hematoma
+  * Malignant
+    * Mets
+    * Chondrosarcoma
+    * Liposarcoma
+    * Leiomyosarcoma
+    * MFH/Fibrosarcoma
+    * Neurogenic Tumors
+  * Infectious
+    * Staph
+    * TB
+    * Actinomycosis
+    * Nocardia
+===== Vascular Rings =====
+  * Pulmonary Sling -> L pulm art travels behind trachea
+  * Right Arch w/ Aberrant L Subclavian
+====== Approach to Mosaic Lung Attenuation ======
+Perform expiratory CT -> Is there air trapping?
+  * Yes -> Small Airway Disease (CHABB)
+    * Cystic Fibrosis
+    * Hypersensitivity Pneumonitis
+    * Asthma
+    * Bronchiolitis
+    * Bronchiolitis Obliterans/Obliterative Bronchiolitis
+  * No -> Compare Vessel Disease
+    * Equal -> Ground Glass Abnormal
+      * Hemorrhage
+      * PCP
+      * NSIP/DIP
+      * Hypersensitivity Pneumonitis
+      * Edema
+      * ARDS
+      * Bronchioloalveolar CA
+      * Pulmonary Alveolar Proteinosis
+    * Ground Glass Vessels Large/Dark Vessels Small -> Dark Areas Abnormal
+      * Chronic PE
+      * Pulmonary HTN
+====== Situs ======
+  * Solitus = normal
+  * Inversus = everything inverted; asymptomatic
+  * Ambiguous = L cardiac apex, R stomach
+===== Polysplenia =====
+  * Multiple spleens
+  * Bilateral L-sidedness
+  * No IVC; azygous continuation
+===== Asplenia =====
+  * No spleen
+  * Bilateral R-sidedness
+  * Bilateral liver
+====== Facts ======
+  * Int__er__lobular Septa = Kerley B lines
+  * Int__ra__lobular Septa = reticular lines
+  * Shaggy Heart Sign = Interstitial Lung Disease
+  * Semisolid Lesion suggests Bronchioloalveolar CA
+  * Aortic Nipple = L Superior Intercostal Vein
+  * Azygous Line Placement = High Risk of Rupture
+  * Luftsickle Sign = LUL Collapse
+    * lucent crescent representing SS LLL
+  * Abnormal Rotation of Heart -> Think Congenital Absence of Pericardium
+  * Don't forget the relationship b/w osteosarcoma mets and PTX
+===== Types of Bronchiectasis =====
+  * Cylindrical -> bronchi are minimally dilated and straight and regular
+    * CXR will show tram tracking or ring shadows in the distribution of bronchi
+  * Varicose -> string of pearls, with alternating dilation and narrowing
+  * Cystic -> a cluster of cysts ± air fluid levels
+===== False Negative Tumors on PET =====
+  * BAC
+  * mucinous tumors
+  * GI mets
+====== Diseases ======
+===== Legionella Pneumonia =====
+  * begins w/ large, focal, ill-defined opacity
+  * progresses to bilateral lung involvement w/i first few days
+  * pleural effusion may be present (30-60%)
+  * cavitation and lymphadenopathy are rare
+===== Hypersensitivity Pneumonitis =====
+  * acute -> lower lobe consolidation
+  * subacute -> upper lobe nodules
+  * chronic -> upper lobe interstitial fibrosis
+===== Causes of Emphysema =====
+  * Smoking
+  * Chronic Fibrosis
+  * XRT
+===== Metastatic Pulmonary Calcification =====
+  * Associated with ESRD
+  * Looks like edema on CXR
+  * MDP bone scan shows extensive uptake
+===== Mediastinal Fibrosis =====
+  * also known as chronic fibrosis, fibrosing mediastinitis, chronic mediastinal fibrosis, or cryptogenic mediastinal fibrosis
+  * histoplasmosis is the most common cause
+  * can cause SVC obstruction
+===== Churg-Strauss =====
+  * Eosinophilia
+  * Severe Asthma
+  * Systemic Vasculitis
+===== Hepatopulmonary Syndrome =====
+  * Triad of
+    - Chronic liver disease
+    - Increased alveolar-arterial oxygen gradient on room air
+    - Intrapulmonary arteriovenous shunting
+===== Carney's Triad =====
+  * pulmonary chondroma
+  * gastric leiomyosarcoma
+  * extra-adrenal paraganglioma
+===== Cowden's Disease =====
+  * pulmonary and GI hamartomas
+  * multiple mucocutaneous lesions
+====== Lung Cancer Staging ======
+__Tumor__
+  * T1 <3 cm, limited to lung
+  * T2 >3 cm, >2 cm distal to carina
+  * T3 any size, direct extension into chest wall, superior sulcus, diaphragm, pleura, pericardium, or within 2 cm of carina
+  * T4 mediastinal (heart, great vessels, esophagus), carinal, brachial plexus, vertebral body invasion or malignant pleural effusion -> **unresectable**
+__Nodes__
+  * N0 no LN involvement
+  * N1 ipsilateral hilar nodes
+  * N2 ipsilateral mediastinal or subcarinal nodes
+  * N3 contralateral hilar or mediastinal nodes; supraclavicular nodes -> **unresectable**
+__Mets__
+  * M0 none
+  * M1 distant mets -> **unresectable**
+__Important Stages__
+  * Tumor unresectable if T4, N3, or M1
+  * Stage 3b
+    * N3, M0, any T
+    * T4, M0, any N
+  * Stage 4
+    * M1, any T, any N
+====== Recommended Followup for Pulmonary Nodules ======
+Fleischner Society Criteria
+^Nodule Size^Low-Risk Patient^High-Risk Patient^
+|< 4 mm|No follow-up needed|Follow-up CT at 12 mo; if unchanged, no further follow-up|
+|4-6 mm|Follow-up CT at 12 mo; if unchanged, no further follow-up|Initial follow-up CT at 6-12 mo then at 18-24 mo if no change|
+|6-8 mm|Initial follow-up CT at 6-12 mo then at 18-24 mo if no change|Initial follow-up CT at 3-6 mo then at 9-12 and 24 mo if no change|
+|> 8 mm|Follow-up CT at around 3, 9, and 24 mo, dynamic contrast enhanced CT, PET, and/or biopsy|Same as for low-risk patient|
+====== Features of Solitary Pulmonary Nodules suspicious for malignancy ======
+  * Microlobulated or spiculated margins
+  * Bubbly or cystic lucencies; air bronchograms
+  * Mixed ground glass/solid attenuation; subsolid (mixed attenuation)
+  * Airway component
+  * Relatively rapid growth
+* Recommend biopsy or resection in pts with moderate to high risk of lung CA or solitary metastasis