Deck 26: Miscellaneous Chest Diseases

Question 1

What is the term applied to a collection of air between the visceral and parietal pleura?

A) Hydrothorax
B) Pleural effusion
C) Pneumothorax
D) Vacuum phenomena of the chest

Answer 1

Pneumothorax

Question 2

Which of the following is not true of sarcoidosis?

A) It is more common among Asians.
B) It is known to cause mediastinal enlargement.
C) It is known to cause parenchymal nodules.
D) It is suggested by a positive Kveim test.

Answer 2

It is more common among Asians.

Question 3

Inorganic dust agents are to pneumoconiosis what organic dust agents are to __________.

A) black lung disease
B) adult respiratory distress syndrome
C) sarcoidosis
D) extrinsic allergic alveolitis

Answer 3

extrinsic allergic alveolitis

Question 4

"Black lung" associated with mining coal is an example of what inhalation disease?

A) Asthma
B) Bronchiectasis
C) Pneumoconiosis
D) Emphysema

Question 5

Which of the following causes of pneumoconiosis is associated with a fibrogenic tissue reaction throughout the lungs?

A) Tin
B) Barium
C) Iron
D) Silicon

Question 6

Which in the following is not associated with adult respiratory distress syndrome?

A) Silica
B) Heatstroke
C) Amniotic fluid embolism
D) Radiation pneumonitis

Question 7

Early stages of acute extrinsic allergic alveolitis usually are characterized by __________ radiodensities scattered bilaterally throughout the lung zones.

A) reversible, multiple, 1-3 mm
B) reversible, solitary, 1-3 mm
C) nonreversible, multiple, 1-3 cm
D) nonreversible, solitary, 1-2 cm

Question 8

On an upright PA chest radiograph, pneumothorax appears as __________.

A) superior migration of the involved side hilus
B) sickle-shaped radiolucent defect in the apex of the lung field
C) egg-shell hilar lymph node calcifications
D) blunting of the lateral costophrenic angle

Question 9

Patchy air-space disease in radiographs of a patient who suffered smoke inhalation is most consistent with which of the following?

A) Bacterial pneumonia
B) Pneumoconiosis
C) Adult respiratory distress syndrome
D) Extrinsic allergic alveolitis

Question 10

Eggshell calcifications of the hilar lymph nodes is most commonly seen with exposure to which of the following dusts?

A) Barium
B) Asbestos
C) Silicon dioxide
D) Iron

Question 11

Fluid leakage into the air space of the patient affected with adult respiratory distress syndrome is a result of increased permeability of __________.

A) arteries
B) veins
C) capillaries
D) lymph vessels

Question 12

Which of the following is an occupational lung disease associated with iron dust?

A) Stannosis
B) Siderosis
C) Silicosis
D) Asbestosis

Question 13

The radiographic presentation of extrinsic allergic alveolitis is independent of the type of organic dust inhaled, but varies according to __________.

A) length of exposure
B) age at exposure
C) intensity of exposure
D) ethnicity of the exposed individual

Question 14

Which of the following diseases is most likely to cause a chronic interstitial pulmonary pattern?

A) Connective tissue disorders
B) Pulmonary edema
C) Drug overdose
D) Viral pneumonia

Question 15

Extrinsic allergic alveolitis is also known as __________.

A) adult respiratory distress syndrome
B) organic pneumoconiosis
C) hypersensitivity pneumonitis
D) pyrogenic pneumonitis

Question 16

Caplan syndrome is coal workers' pneumoconiosis in a patient who also has __________.

A) rheumatoid arthritis
B) progressive systemic sclerosis
C) reactive arthritis
D) psoriatic arthritis

Question 17

A 63-year-old male construction worker presents with chronic dyspnea. Radiographic examination of the chest reveals a fibrogenic lung response with lymphadenopathy, interstitial parenchymal pattern, and pleural thickening with calcification. Which of the following inorganic dusts is most likely the causative factor?

A) Coal
B) Asbestos
C) Barium
D) Calcium carbonate

Question 18

Which term best characterizes the clinical progression of respiratory distress syndrome?

A) Indolent
B) Slow
C) Moderate
D) Rapid

Question 19

Which of the following pneumoconioses is classified as benign due to its less aggressive course?

A) Asbestos
B) Silicon
C) Coal dust
D) Iron

Question 20

Repeat exposures to provocative agents of extrinsic allergic alveolitis may result in which pattern of lung disease?

A) Air space
B) Chronic interstitial
C) Acute interstitial
D) Emphysema

Question 21

The typical age of presentation and patients with sarcoidosis is __________.

A) 10-19
B) 20-40
C) 41-50
D) 51-70

Question 22

Computed tomography examination of the chest of a 70-year-old male industrial pipe insulator reveals curvilinear calcific density paralleling the inner margins of the right posterior ribs. These findings are consistent with __________.

A) calcified pleural plaque
B) mesothelioma
C) benign pneumoconiosis
D) silicosis

Question 23

Which of the following is a multisystem disease of unknown etiology characterized by formation of noncaseating epithelioid granulomas?

A) Silicosis
B) Sarcoidosis
C) Wegener granulomatosis
D) Histoplasmosis

Question 24

Which of the following is the most common site of involvement in patients with sarcoidosis?

A) Thorax
B) Abdomen, retroperitoneal
C) Abdomen, intraperitoneal
D) Pelvis

Question 25

Conglomerate masses that progressively migrate towards the lung hilum in a bilateral but asymmetric pattern, in a patient with a history of occupational exposure to sandblasting, most likely represents __________.

A) progressive systemic sclerosis
B) progressive massive fibrosis
C) benign pneumoconiosis
D) adult respiratory distress syndrome

Question 26

Which of the following is the most likely clinical presentation for patients with spontaneous pneumothorax?

A) Cyanosis
B) Hypotension
C) Sudden onset ipsilateral chest pain and dyspnea
D) Tachypnea, tachycardia, and dyspnea

Question 27

The most serious complication of a tension pneumothorax is __________.

A) relaxation atelectasis
B) impaired venous return to the heart
C) pneumomediastinum
D) displaced hemidiaphragm

Question 28

Which of the following is the most appropriate terminology to describe the condition affecting a patient with air trapped within the pleural space, that increases with each respiration cycle, and displaces the mediastinum to the contralateral thorax?

A) Iatrogenic pneumothorax
B) Tension pneumothorax
C) Spontaneous pneumothorax
D) Hypertension pneumothorax

Question 29

Which patient group is most likely to be affected by primary spontaneous pneumothorax?

A) Infants with alpha I antitrypsin deficiency
B) Children
C) Young or middle-aged men
D) Seniors

Question 30

In addition to silicosis, eggshell hilar lymph node calcification can also be seen in patients with which of the following?

A) Coal worker pneumoconiosis
B) Asbestosis
C) Non-Hodgkin lymphoma
D) Adult respiratory distress syndrome

Question 31

Nonproductive cough, dyspnea, chest pain, and hemoptysis may be present in up to __________ percent of patients with sarcoidosis.

A) 25
B) 50
C) 70
D) 90

Question 32

A 23-year-old patient who is tall and gracile presents with chief complaint of dyspnea and right-sided chest pain. Chest radiographs reveal absence of lung vascular markings with the presentation of a radiodense mass at the right heart border. What is the most likely diagnosis?

A) Stage II sarcoidosis with prominent hilar lymphadenopathy
B) Ehlers-Danlos syndrome with lung sequestration
C) Marfan syndrome with atelectasis
D) Pulmonary hypertension secondary to embolism

Question 33

Which of the following patient positions on radiographic examination would cause the most difficulty with assessment for pneumothorax?

A) Supine
B) Lateral decubitus, involved side up
C) Inspiration, upright
D) Expiration, upright

Question 34

Which stage of sarcoidosis shows extensive bilateral lymphadenopathy within the thorax?

A) 1
B) 2
C) 3
D) 4

Question 35

Which of the following procedures provides definitive diagnostic criteria for sarcoidosis?

A) Kveim test
B) Biopsy
C) Chest radiographs
D) Computed tomography of the chest

Question 36

Endobronchial involvement with sarcoidosis may lead to physiologic evidence of airway obstruction in up to what percentage of patients?

A) 6%
B) 40%
C) 63%
D) 84%

Question 37

Fifteen percent of patients with sarcoidosis develop lace-like or honeycomb osteolytic bone lesions within the __________.

A) tarsals and carpals
B) long bones of the lower extremities
C) small tubular bones of the hand
D) ribs

Question 38

Sarcoidosis is more common in women and is __________ times more likely in black patients.

A) 1-2
B) 2-9
C) 10-20
D) 21-40

Question 39

Curvilinear density within the upper lung field in a patient with pneumothorax is representative of __________.

A) displaced visceral pleura
B) displaced parietal pleura
C) lung vascular markings
D) pleural plaquing

Question 40

Radiographic examination of the chest in patients with stage IV sarcoidosis will characteristically demonstrate __________.

A) no radiographic abnormalities
B) paratracheal lymphadenopathy
C) hilar adenopathy with diffuse nodular or reticulonodular parenchymal radiopacities
D) pulmonary fibrosis without lymphadenopathy