Anterior mediastinal masses: Causes
4 T's:
- Teratoma
- Thymoma
- Testicular-type
- T-cell / Hodgkin's lymphoma
Chest radiograph: checklist to examine
"Pamela Found Our Rotation Particularly Exciting; Very Highly Commended
- Mainly 'Cus She Arouses":
- Patient details
- Film details
- Objects (eg. lines, electrodes)
- Rotation
- Penetration
- Expansion
- Vessels
- Hila
- Costophrenic angles
- Mediastinum
- Cardiothoracic Ratio
- Soft tissues and bones
- Air (diaphragm, pneumothorax, subcut. emphysema)
Chest radiograph: checklist to examine
ABCDEFGHI:
- Aorta
- Bronchus
- Cord, spinal
- Diaphragm (look for hyperinflation)
- Eosphagus (look for foreign body)
- Fracture (ribs)
- Gas (look for pneumothorax)
- Heart (look for cardiomegaly)
- Iatrogenic (subclavian line, pacemakers)
Chest X-ray: cavitating lesions differential
"If you see HOLES on chest X-ray, they are WEIRD":
- Wegener's syndrome
- Embolic (pulmonary, septic)
- Infection (anaerobes, pneumocystis, TB)
- Rheumatoid (necrobiotic nodules)
- Developmental cysts (sequestration)
- Histiocytosis
- Oncological
- Lymphangioleiomyomatosis
- Environmental, occupational
- Sarcoid
*Alternatively: L=Left atrial myxoma
Chest x-ray: differential diagnoses of shadow on the upper zones of lung fields
5 Ts:
- Thymoma
- Thyroid (retrosternal)
- Tuberculosis
- Terrible lymphoma
- Teratoma
Chest X-ray interpretation
*Preliminary is ABCDEF:
- AP or PA
- Body position
- Confirm name
- Date
- Exposure
- Films for comparison
*Analysis is ABCDEF:
- Airways (hilar adenopathy or enlargement)
- Breast shadows/ Bones (rib fractures, lytic bone lesions)
- Cardiac silhoutte (cardiac enlargement)/ Costophrenic angles (pleural effusions)
- Diaphragm (evidence of free air)/ Digestive tract
- Edges (apices for fibrosis, pneumothorax, pleural thickening or plaques)/ Extrathoracic tissues
- Fields (evidence of alveolar filling)/ Failure (alveolar air space disease with prominent vascularity with or without pleural effusions)
Elbow ossification centers, in sequence
CRITOE:
- Capitellum
- Radial head
- Internal epicondyle
- Trochlea
- Olecranon
- External epicondyle
*In order: appear at 1, 3, 5, 7, 9, 11 years; each closes 2 years later.
Esophageal cancer: risk factors
ABCDEF:
- Achalasia
- Barret's esophagus
- Corrosive esophagitis
- Diverticuliis
- Esophageal web
- Familial
Head CT scan: evaluation checklist
"Blood Can Be Very Bad":
- Blood
- Cistern
- Brain
- Ventricles
- Bone
Lung cancer: main sites for distant metastases
BLAB:
- Bone
- Liver
- Adrenals
- Brain
Lung cancer: notorious consequences
SPEECH:
- Superior vena cava syndrome
- Paralysis of diaphragm (Phrenic nerve)
- Ectopic hormones
- Eaton-Lambert syndrome
- Clubbing
- Horner syndrome/ Hoarseness
Mole: signs of trouble
ABCDE:
- Asymmetry
- Border irregular
- Colour irregular
- Diameter usually > 0.5cm
- Elevation irregular
MR imaging/ spectroscopy: important metabolites
"Lying Lazy No Good Crooks Collected My insurance":
- Lipid: abnormal
- Lactate: abnormal
- NAA
- Glutamine/glutamate
- Creatinine/phosphocreatinine
- Choline containing compounds
- Myoinositol
Neck sagittal x-ray: examination checklist
ABCD:
- Anterior: look for swelling
- Bones: examine each bone for fractures
- Cartilage: look for slipped discs
- Dark spots: ensure not abnormally big, or could mean excess blood
Osteoarthritis: x-ray signs
LOSS:
- Loss of joint space
- Osteopyhtes
- Subcondral sclerosis
- Subchondral cysts
Pituitary endocrine functions often affected by pituitary-associated tumor
"Go Look For the Adenoma Please":
*Tropic hormones affected by growth tumor are:
- GnRH
- LSH
- FSH
- ACTH
- Prolactin function
Prognotic factors for cancer: general
PROGNOSIS:
- Presentation (time & course)
- Response to treatment
- Old (bad prog.)
- Good intervention (i.e. early)
- Non-compliance with treatment
- Order of differentiation (>1 cell type)
- Stage of disease
- Ill health
- Spread (diffuse)
TIGAN (Trimethobenzamide hydrochloride): indication
TIGAN:
This Is Good Against Nausea
- T2 vs. T1 MRI scan
- "WW 2" (World War II):
- *Water is White in a T2 scan.
*Conversely, a T1 scan shows fat as being whiter.
Upper lobe shadowing: causes
BREASTS:
- Beryllium
- Radiation
- Extrinsic allergic alveolitis
- Ankylosing spondylitis
- Sarcoidosis
- TB
- Siliconiosis
