NEET SS Medicine Pulmonology: High-Yield One-liners for Rapid Revision

Essential Radiology Images in Pulmonology

Respiratory Tract

Upper Respiratory tract

• Nose
• Oropharynx
• Pharynx
• Larynx

Lower Respiratory tract

• Trachea
• Bronchi
• Bronchioles
• Alveoli

Also read: Types Of Respiratory Failure

Klebsiella

• On the right upper lobe - Some degree of opacity.
• Nosocomial pneumonia is a possibility.
• Air bronchogram is observed, it may be a possibility for consolidation with the given history.
• The fissure appears delineated or bulging inferiorly or convex inferiorly - Bulging Fissure Sign. Normally, linear.
• Bulging Fissure Sign is typical of the lobar pneumonia caused by Klebsiella.

Luftsichel Sign is seen in Lt UL collapse

Left lower lobe X-Ray

• Clear loss of normal cardiac contour - Flat waist sign. Obscuring the heart border.
• Wedge or triangular opacity within the cardiac silhouette.
• Whenever the Left lower lobe collapses, it collapses towards the heart.

Hilum Overlay Sign

• Chest X-Ray showing the mass originating from Hilum towards the lung, but Hilum overlay sign is absent. The Hilum convergence sign is seen.
  • Vasculature is converging towards the rim of the opacity.
  • Suggesting the enlarged PA.

Also read: Sleep Disorders - OSA, Obesity Hypoventilation Syndrome

Lobar Pneumonia

Lobar Pneumonia (Typical) or

• Definitive sign on consolidation: Air bronchogram
• Localization: Silhouette sign
• Tracheal and esophageal shadows are obscured by white opacity

Pneumatocele

• Seen in staphylococcus infections.
• Seen in the pediatric population.
• Rare in adults

Bulging Fissure sign

Indicates Klebsiella Pneumonia

• Clues can be chronic alcoholism and red currant jelly sputum.
• Upper lobe consolidation: Interlobar Fissure is bulging downwards

Also read: Extracorporeal Therapies In Poisoning

Atypical Pneumonia

Bilateral diffuse alveolar opacity

Finger in glove sign

• The airway is loaded with mucus.
• Gives an opaque appearance.

Tram track sign

• Tram track sign: Thickened and dilated bronchial tree parts
• Cylindrical bronchiectasis

Bronchiectasis Classification

• Cylindrical or tubular bronchiectasis
  • Parallel
  • Less severe
  • Not tapering down.
• Cystic bronchiectasis
  • Most severe
  • Cyst or grape bunch like
• Varicose bronchiectasis
  • Varicosity like dilatation
• In normal, tapered branching is seen.
  • Keeps narrowing down.

Also read: Important MCQ’s in Rheumatology For NEET SS Medicine

Fleischner's sign

• Pleura based wedge shaped opacity.
• Called Hampton's hump.

Bubble Contrast Echo

• In interatrial or ventricular septal defect, bubbles may enter the left side of the heart much earlier.
• <3 Cardiac cycles indicate intracardiac shunting.
• 4-6 Cardiac cycles, intrapulmonary shunting.

Important One-liners in Pulmonology 

Treatment of Bronchoconstriction:

• β2 selective agonist 
• Nitric oxide
• Parasympathetic blocker
  • Ipratropium bromide (short acting)
  • Tiotropium (Long acting Antimuscarinic Agent: LAMA)

To Remember:

• Note: For example, if everything goes in favor of consolidation, like the patient presenting with fever, bronchial breath sounds, and an X-ray with an air bronchogram, it confirms consolidation.
• Consolidation can be detected via ultrasound.
• Consolidated lungs are solidified or hepatized (appear like the liver).
• Hepatization of USG signals of lungs is suggestive of consolidation.
• If any part of the lung is not perfused or ventilated, then there will be no tracer uptake.

Also read: NEET SS Pediatric Neonatology Important Topics

Frequently Asked Questions

Q1. (Lymphangiomyomatosis) LAM is typically seen in patients with

Ans. Tuberous sclerosis

Q2. Rheumatoid arthritis is more in

Ans. Females

Q3. Idiopathic Interstitial fibrosis is common in which age group?

Ans. 50-70 years

Q4. Most employed markers for PLCH is?

Ans. Cd1a

Q5. Most common pathological abnormality: Bronchiectasis (HRCT)

Ans.

• Up to 30% in newborns
• 60% in 3 years old
• Most common part affected: Bilateral Upper lobe bronchiectasis.

Q6. Most common organ affected in cystic fibrosis?

Ans. Lungs followed by pancreas

Q7. Cepacia syndrome is usually seen in?

Ans. Cystic fibrosis

Q8. Most common species of Burkholderia cepacia?

Ans. Burkholderia cenocepacia (worst prognosis)

Q9. Median life expectancy in patients with cystic fibrosis is?

Ans. >30 years

Q10. Chest discomfort syndrome is seen with?

Ans. Lumacaftor

Q11. USFDA approved Triple therapy (Trikafta) which is

combination of ?

Ans. Potentiator: Lumacaftor. Corrector: Tezacaftor, Elexacaftor (Delta F508 mutations in 85% of CF cases).

Also read: Pediatric Neonatology High Yield One Liners

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