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What is the functional unit of the lung?
Secondary pulmonary lobule
What are the components of a secondary pulmonary lobule?
Pulmonary artery branch
Pulmonary veins at periphery
What is the difference between bronchi and bronchioles?
Bronchi have cartilaginous support
What is the difference between a terminal and a respiratory bronchiole?
Respiratory bronchioles contain alveoli
Terminal bronchioles are the airways right before the first respiratory bronchioles
What is the pulmonary acinus?
The part of the lung distal to the terminal bronchiole
What does the right main stem bronchus divide into?
Right upper lobe bronchus
Bronchus intermedius (supplies RML + RLL)
What does the left main stem bronchus divide into?
Left upper lobe bronchi
Left lower lobe bronchi
What are the different types of cells that line the pulmonary alveolus?
Type I and type II pneumocytes
What is the difference between a type I and type II pneumocyte?
Type I pneumocytes - squamous epithelial cells that line 95% of alveolar surface, do NOT regenerate
Type II pneumocytes - source of new type I pneumocytes
What are the most commonly seen accessory fissures?
Inferior accessory fissure
Superior accessory fissure
What does the inferior accessory fissure separate?
Separates medial basal segments from rest of the lower lobe
What does the azygous fissure separate?
Invagination of right apical pleura by azygos vein
What does the superior accessory fissue separate?
Right superior segments from right lower segments of lower lobe (looks like continuation of minor fissure)
What is the "aortic nipple"?
Left superior intercostal vein
Connects left brachiocephalic with accessory hemiazygos
What is Mendelson's syndrome?
Acute massive aspiration of gastric acid in patients with CNS impairment (trauma, alcoholics, etc) leading to severe alveolar hemorrhage
What are the primary sites of involvement for Wegener's granulomatosis?
What the chest film findings in hypersensitivity pneumonitis?
Mid and lower bilateral pulmonary opacities
What are the methods by which Talc can cause injury to the lungs?
What is the difference between asbestosis and asbestos?
Asbestosis is lung disease due to asbestos exposure
What are findings of Stage IV sarcoidosis?
Linear opacities radiating from hila
Upper and mid lung distribution
What are characteristic radiographic thoracic findings in lupus?
Pleural and pericardial effusions
- Acute lupus pneumonitis
- - Bibasilar retiular opacities
- - Improve with corticosteroids
What are the categories and types of drugs that cause pulmonary toxicity?
- -Bleomycin, Cyclophosphamide, Methotrexate, Carmustine, Busulphan
- -Amiodarone, Nitrofurantoin, Gold, Penicillamine, Sulfasalazine
What is the distribution of pathology in IV pulmonary talcosis?
Nodules in centrilobular distribution
What are the top two types of primary tracheal neoplasms?
- Squamous cell CA
- Adenoid cystic carcinoma
How does non-specific interstial pneumonia involve the region adjacent to the pleural compared with usual interstial pneumonia?
NSIP typically spares the subpleural region
What are typical findings in NSIP?
Bilateral lower lobe ground glass
Reticular interstitial abnormalities
What are ways to differentiate asbestos exposure from malignant mesothelioma?
What disease is associated with lower lung predominant emphysema?
Alpha a1 antitrypsin deficiency
What is the most common pleural tumor in teenagers/young adults?
What are the four types of disease patterns that can result from aspergillus infection?
What are the top 2 causes of pulmonary ARTERIAL hypertension?
Chronic thromboembolic disease
What is the most common pleural neoplasm?
What are characteristic plain film findings of scleroderma involvement of the lungs?
Interstitial pattern at the bases
What region is the recurrent laryngeal nerve found on a chest film?
What is tracheobronchomalacia?
Excessive collapse of the trachea and bronchi
Where are bronchogenic cysts most commonly found?
Around the carina
What is the treatment for pulmonary alveolar proteinosis?
Whole lung lavage
What are classic imaging findings in mycobacterium avium complex infection?
Right middle lobe and lingula bronchiectasis
When do opportunistic infections tend to occur in post-transplant patients?
What types of infections tend to occur in patients in the first 30 days post lung transplant?
What types of infections tend to occur in patients 30-90 days after lung transplant patients?
What is the major risk factor for invasive aspergillosis?
What are two of the major complications after transplantion?
- Bronchioliits obliterans (BOOP)
- Cryptogenic organizing pneumonia
What is scimitar syndrome?
Right lung hypoplasia
Pulmonary vein entering into IVC
What is the pathophysiology of lymphangiomyomatosis?
Proliferation of smooth muscle cells along lymphatics leading to cystic destruction of lung parenchyma
What is the demographic profile of a patient with lymphangiomyomatosis?
Woman of child bearing age
What is the pathophysiology of the tree in bud sign?
Mucous plugging of distal airways followed by wall thickening and bronchial dilatation
Which connective tissue disorder is associated with pericardial or pleural effusions?
What types of workers develop berylliosis?
Workers in aircraft and space industries
What is the pathogenesis of silicosis?
Inhalation of inorganic mineral dusts
What are the imaging findings of bronchial atresia?
Round perihilar mass with distal hyperinflation
What is the most common location for bronchial atresia?
Left upper lobe
What are characteristic imaging findings of langerhans cell histiocytosis?
Irregular nodular pattern in upper and mid lungs
Spontaneous pneumothorax in 25%
What types of patients get Langerhans cell histiocytosis of the lungs?
Ages between 20-40s
What are the imaging findings associated with neurenteric cysts?
Vertebral fusion/segmental abnormalities
What are the major broad categories of lung cancer?
Non-small cell lung cancer (85%)
Small cell lung cancer (15%)
What are the different types of non-small cell lung cancers?
Squamous cell carcinoma (30%)
Large cell carcinoma (15%)
What types of diaphragm tears are more common - left or right?
Left sided diaphragm tears are more common
What is the most common site of involvement of AIDS related lymphoma?
Central nervous system
How can one differentiate AIDS related lymphoma of the chest from Kaposi's sarcoma?
Kaposi's sarcoma - No uptake of gallium
What is the most common cause of spontaneous pneumothorax?
Rupture of apical bleb
Mounier-Kuhn syndrome - dilatation of trachea and mainstem bronchi
What is the definition of a thoracic aortic aneurysm?
Location - right paratracheal, subcarinal
History of metastatic disease - likely primary?
- Calcified metastases
- - Mucinous cancer (colon, ovary)
- - Thyroid
- - Osteosarcoma
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