MCQ FRCR PG-----ALVEOLAR PROTEINOSIS

2.30 year old male patients presented with exertional dyspnoea 

 and non-productive cough and showed evidence of digital clubbing

 and inspiratory crackes.X ray showed bilateral  airspace

  opcification pronounced in central area.The  broncho-alveolar 

lavage revealed periodic acid-Schiff-positive lipoproteinaceous

 material .What is the expected chararacheristic HRCT finding is 

this case?

a. miliary lesions

 b.honeycombing

c. crazy-paving pattern

d.diffuse emphysema

e.multiple holes

mcq frcr and pg---

1.A 10 year old child suffering from parasitic infection with 

minimal symptoms  shows peripheral blood eosinophilia .X ray 

shows transient bilateral airspace opacification which resolves 

within a week.Which of following is the most likely diagnosis

a. Simple pulmonary eosinophilia (Löffler's syndrome)

b. Acute eosinophilic pneumonia

c. Chronic eosinophilic pneumonia

d. Wegener's granulomatosis

e. Hypereosinophilic syndrome

1.----a

The airspace opacification in Löffler's syndrome is fleeting and

 may be either uni- or bi-lateral. Resolution of opacities within a 

period of days and, by definition, within a month is the rule

Although spontaneous resolution of acute eosinophilic pneumonia 

occur without therapy,patients with Acute eosinophilic pneumonia

 has more fulminant clinical course . The clinical improvement 

with corticosteroids is often dramatic, fever and radiographic 

changes resolve within days and with very little risk of relapse on 

withdrawal of therapyThe plain radiographic abnormalities in 

chronic eosinophilic pneumonia reveals  patchy, nonsegmental 

areas of consolidation  typically  in the mid and upper zones. A

 distinctive feature in x ray is that the opacities are peripheral and 

seem to parallel the chest wall (the ‘photographic negative of 

pulmonary oedema’)

IMAGING FOR SWINE FLU

IMAGING FOR SWINE FLU

CXR is usually the first imaging test performed for the assessment of acute respiratory symptoms.
The predominant findings are bilateral consolidation and reticular opacities .

INDICATION OF CHEST CT -----

1. high clinical suspicion of pneumonia in the presence of normal or questionable radiological findings. 

2.Chest CT is also helpful in assessing complication or evidence of mixed infection.

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The predominant CT findings at presentation of illness are unilateral or more often bilateral multi-focal asymmetric ground-glass opacities, either alone or associated with areas of consolidation.

The abnormalities have a predominantly peripheral and subpleural distribution:

Patients who exhibit consolidation on chest CT have a more severe clinical course compared with those who present with ground-glass opacities.

The crazy-paving pattern is a common finding on chest CT of the lungs: Some authors presume that crazy-paving pattern is also closely related to an adverse course,

Multifocal bilateral distribution and Opravil CXR score are directly correlated with the severity of the illness: