Resident Case Review CHEST. Daria Manos CAR 2016
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1 Resident Case Review CHEST CAR 2016 Daria Manos
2 Disclosure Speakers bureau, Roche CAR 2016 Daria Manos
3 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. CAR 2016 Daria Manos
4 Best diagnosis? A. Loculated pleural effusion B. Hilar mass C. Diaphragmatic paralysis D. Pneumonia
5
6 Best method for tissue?
7 Where is the lesion? A. Pleura B. Lung C. Mediastinum D. Hilum
8 A. Pleura B. Lung C. Mediastinum D. Hilum
9 Differential? A. Malignancy B. Abscess C. Vasculitis D. Angioinvasive aspergillosis
10
11 A. Vascular redistribution B. Cystic Fibrosis C. Langerhans cell histiocytosis D. Mycoplasma Pneumonia
12 A. Vascular redistribution B. Cystic Fibrosis C. Langerhans cell histiocytosis D. Mycoplasma Pneumonia
13
14 A. Artifact of low lung volumes B. Pulmonary Fibrosis C. Cardiogenic pulmonary edema D. Noncardiogenic pulmonary edema
15 A. Collagen Vascular Disease B. Idiopathic Pulmonary Fibrosis C. Sarcoid D. COPD
16 23 year old with 4 weeks fever and night sweats A. Tuberculosis B. Sarcoid C. Eosinophilic Pneumonia D. Community Acquired Pneumonia
17 23 year old with 4 weeks fever and night sweats How can serology help?
18
19 Chronic Eosinophilic Pneumonia Reverse halo, atoll sign, perilobular consolidation, lobular sparing How can serology help? CAR 2016 Daria Manos Daria Manos
20 35 year old man A. UIP B. Interstitial edema C. Lymphangitic carcinomatosis D. Langerhans cell histiocystosis
21 A. LAM B. Empysema C. Sarcoid D. Langerhans cell histiocystosis
22 HIV, IVDU, fever, respiratory distress What micronodular pattern? A. perilymphatic B. centrilobular C. random D. subpleural
23 Tree-in-bud nodularity Centrilobular small artery or small airway
24 HIV, IVDU, fever, respiratory distress Most likely diagnosis? A. Bacterial B. Pneumocystis jiroveci pneumonia C. Septic emboli D. IV talcosis
25 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
26 1 year earlier A. Pulmonary edema B. NSIP C. DIP D. Infectious E. Pulmonary hemorrhage
27 A. Pulmonary edema B. NSIP C. DIP D. Infectious E. Pulmonary hemorrhage How confirm diagnosis?
28 A. Hemothorax B. Pneumothorax C. Diaphragmatic injury D. Pulmonary contusion E. Massive aspiration
29
30 35 year old woman
31 A. Bronchopneumonia B. Multifocal adenocarcinoma C. Pneumocystis jiroveci D. Sarcoid E. NSIP
32 A. Bronchopneumonia B. Multifocal adenocarcinoma C. Pneumocystis jiroveci D. Sarcoid E. NSIP
33 45 yo with increasing fatigue, some fever
34 2 months later A. Adenocarcinoma B. Lipoid pneumonia C. Lymphoma D. Organizing Pneumonia
35 50 year old male, nonsmoker with hemoptysis, no known comorbidities A. Granulomatosis with polyangitis B. Metastatic colon cancer C. Angioinvasive apergillosis D. Bronchogenic carcinoma
36 Why is the left lung hyperlucent? A. Swyer James B. Pulmonary embolism C. Mediastinal mass D. Atelectasis
37 A. Swyer James B. Pulmonary embolism C. Mediastinal mass D. Atelectasis CAR years Daria earlier Manos
38
39 45 year old woman, incidental finding on Abdominal series A. Lung B. Hilar nodes C. Left main pulmonary artery D. Mediastinum
40 Most likely diagnosis?
41 What is the pattern? A. Organizing Pneumonia B. NSIP C. UIP D. DIP
42 What is the pattern? A. Organizing Pneumonia B. NSIP C. UIP D. DIP
43 35 yo with increasing dyspnea A. Metastases B. Tuberculosis C. Langerhans cell histiocytosis D. Mycoplasma Pneumonia
44 A. Metastases B. Tuberculosis C. Langerhans cell histiocytosis D. Mycoplasma Pneumonia
45 Challenge eye test
46 Challenge eye test
47
48 Thank you and good luck! For questions about these cases or information about our fellowships:
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