Resident Case Review CHEST - Home - CAR Lifelong Learning... · • Daria Manos • 1. Recognize common and critical chest radiograph and computed tomography signs and use these clues

Daria Manos CAR 2016

Resident Case Review

CHEST

CAR 2016 • Daria Manos

Disclosure

•  Speakers bureau, Roche


•  1. Recognize common and critical chest radiograph and computed tomography signs and use these clues to formulate an appropriate differential diagnosis.

•  2. Choose a single most likely diagnosis based on imaging appearance and provided clinical information.

•  3. Provide management recommendations influence by imaging interpretation.

•  All objectives address CanMEDS medical expert, communicator, health advocate and collaborator roles.

•  Presentation Summary •  Rapid fire chest radiographs and CTs will be presented in a lively multiple

choice, single best answer format followed by a brief discussion of each case. The focus will be on common and critical imaging patterns relevant for both certification exams and independent practice.


A.  Loculated pleural effusion B.  Hilar mass C.  Diaphragmatic paralysis D.  Pneumonia

Best diagnosis?



Best method for tissue?


Where is the lesion? A.  Pleura B.  Lung C.  Mediastinum D.  Hilum


A.  Pleura B.  Lung C.  Mediastinum D.  Hilum


Differential? A.  Malignancy B.  Abscess C.  Vasculitis D.  Angioinvasive aspergillosis



A.  Vascular redistribution B.  Cystic Fibrosis C.  Langerhans cell histiocytosis D. Mycoplasma Pneumonia


A.  Vascular redistribution B.  Cystic Fibrosis C.  Langerhans cell histiocytosis D. Mycoplasma Pneumonia



A. Artifact of low lung volumes B. Pulmonary Fibrosis C. Cardiogenic pulmonary edema D. Noncardiogenic pulmonary edema


A.  Collagen Vascular Disease B.  Idiopathic Pulmonary Fibrosis C.  Sarcoid D. COPD


23 year old with 4 weeks fever and night sweats

A. Tuberculosis B. Sarcoid C. Eosinophilic Pneumonia D. Community Acquired Pneumonia


23 year old with 4 weeks fever and night sweats

How can serology help?


CAR 2016 • Daria Manos Daria Manos

Chronic Eosinophilic Pneumonia

Reverse halo, atoll sign, perilobular consolidation, lobular sparing

How can serology help?


A. UIP B. Interstitial edema C. Lymphangitic carcinomatosis D. Langerhans cell histiocystosis

35 year old man


A. LAM B. Empysema C. Sarcoid D. Langerhans cell histiocystosis


HIV, IVDU, fever, respiratory distress

A. perilymphatic B. centrilobular C. random D. subpleural

What micronodular pattern?


Tree-in-bud nodularity Centrilobular – small artery or small airway


HIV, IVDU, fever, respiratory distress

A. Bacterial B. Pneumocystis jiroveci pneumonia C. Septic emboli D. IV talcosis

Most likely diagnosis?


45 yo in ED with 3-day history of increasing dyspnea but no cough or chest pain.

A. Pulmonary edema B. NSIP C. DIP D. Infectious E. Pulmonary hemorrhage



1 year earlier



How confirm diagnosis?


A. Hemothorax B. Pneumothorax C. Diaphragmatic injury D. Pulmonary contusion E. Massive aspiration



35 year old woman


A. Bronchopneumonia B. Multifocal adenocarcinoma C. Pneumocystis jiroveci D. Sarcoid E. NSIP


A. Bronchopneumonia B. Multifocal adenocarcinoma C. Pneumocystis jiroveci D. Sarcoid E. NSIP


45 yo with increasing fatigue, some fever


A. Adenocarcinoma B. Lipoid pneumonia C. Lymphoma D. Organizing Pneumonia

2 months later


A.  Granulomatosis with polyangitis

B.  Metastatic colon cancer C.  Angioinvasive apergillosis D.  Bronchogenic carcinoma

50 year old male, non-smoker with hemoptysis, no known comorbidities


A. Swyer James B. Pulmonary embolism C. Mediastinal mass D. Atelectasis

Why is the left lung hyperlucent?


A. Swyer James B. Pulmonary embolism C. Mediastinal mass D. Atelectasis

2 years earlier



45 year old woman, incidental finding on Abdominal series

A. Lung B. Hilar nodes C. Left main pulmonary artery D. Mediastinum


Most likely diagnosis?


A. Organizing Pneumonia B. NSIP C. UIP D. DIP

What is the pattern?


A. Organizing Pneumonia B. NSIP C. UIP D. DIP

What is the pattern?


A.  Metastases B.  Tuberculosis C.  Langerhans cell histiocytosis D. Mycoplasma Pneumonia

35 yo with increasing dyspnea


A.  Metastases B.  Tuberculosis C.  Langerhans cell histiocytosis D. Mycoplasma Pneumonia


Challenge eye test


Challenge eye test



For questions about these cases or information about our fellowships:

[email protected]

Thank you and good luck!

Resident Case Review CHEST - Home - CAR Lifelong Learning... · • Daria Manos • 1. Recognize common and critical chest radiograph and computed tomography signs and use these clues

Documents