ABSITE ch 25 thoracic.txt

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alshada
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ABSITE ch 25 thoracic.txt
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2010-01-11 11:07:10
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thoracic ABSITE
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ABSITE ch 25 thoracic
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  1. Course of azygous vein; what it drains into
    Right thorax along esophagus; drains into SVC
  2. Course of thoracic duct
    Right side, crosses at T5-7, dumps into LSC at junction of LIJ
  3. Longest mainstem bronchus
    Left
  4. Longer main pulmonary artery trunk
    Right
  5. Nerve running anterior to lung hilum
    Phrenic
  6. Nerve running posterior to lung hilum
    Vagus
  7. Normal lung volume of right lung
    55%
  8. Normal lung volume of left lung
    45%
  9. Accessory respiratory muscles
    SCM, scalenes, levators
  10. Pnuemocytes important in gas exchange
    Type I pneumocytes
  11. Pneumocytes important in surfactant production
    Type II pneumocytes
  12. Openings allowing direct exchange of air between alveoli
    Pores of Kahn
  13. Amount of pleural fluid produced per day
    1-2L
  14. Needed predicted postop FEV1 to justify lung resection
    >0.8
  15. Diagnostic test if FEV1 is lower than expected
    VQ scan
  16. Needed DLCO to justify lung resection
    >11-12
  17. Needed predicted postop FVC
    >1.5L
  18. Needed preop PCO2 and PO2
    <45 and >50
  19. Most common cause of cancer-related death in us
    Lung cancer
  20. Most common site of lung metastasis
    Brain
  21. Overall lung ca 5-year survival rate
    10%
  22. Most common type of lung cancer
    Adenocarcinoma
  23. Primary types of non small cell cancer (2)
    Squamous, adenocarcinoma
  24. Cancer type found more often centrally
    Squamous
  25. Cancer type found more often peripherally
    Adenocarcinoma
  26. NSCLC with more common local recurrence
    Squamous cell
  27. NSCLC with more common distant metastasis
    Adenocarcinoma
  28. T staging for lung cancer
    T1<3cm, T2>3cm, T3 invasion of chest wall, pericardium, diaphragm or <2cm from carina, T4 invasion of mediastinum, esophagus, trachea, vertebra, heart, malignant effusion
  29. N staging for lung cancer
    N1 ipsi hilar nodes, N2 ipsi mediastinal nodes, N3 contralateral nodes or supraclav nodes
  30. Type of cancer causing 20% of lung ca; typically neuroendocrine
    Small cell
  31. Treatment of SCLC
    Chemotherapy and XRT
  32. Paraneoplastic syndrome associated with squamous cell CA
    PTH-related peptide
  33. Paraneoplastic syndrome associated with SCLC
    ACTH, ADH release
  34. Most common paraneoplastic syndrome in SCLC
    ACTH production
  35. Lung tumor associated with asbestos
    Mesothelioma
  36. Standard chemotherapy in NSCLC
    Carboplatin, taxol
  37. Standard chemotherapy in SCLC
    Cisplatin, etoposide
  38. Tumors in which mediastinoscopy is used
    Central, LN>0.8cm, subcarinal LN>1.0cm
  39. Left sided structures when looking down a mediastinoscope
    RLN, esophagus, aorta, main PA
  40. Right sided structures when looking down a mediastinoscope
    Azygous, SVC
  41. Anterior structures when looking down a mediastinoscope
    Innominate vein and artery, right PA
  42. Surgical technique to assess aortopulmonary window nodes
    Chamberlain procedure
  43. Tumor invading the apex of the chest wall; often causes horner�s syndrome
    Pancoast tumor
  44. Cancer type that mimics pneumonia; grows along alveolar walls
    Bronchialveolar carcinoma
  45. Neuroendocrine tumor with 90% 5-year survival
    Carcinoid
  46. Malignant bronchial tumors (3)
    Adenoid cystic adenoma, mucoepidermoid adenoma, mucous gland adenoma
  47. Most common benign adult lung tumor
    Hamartoma
  48. Popcorn lesion on CT of chest
    Hamartoma
  49. Most common site for mediastinal tumors
    Thymus
  50. Tumors found in anterior mediastinum (4)
    Thymoma, Tcell lymphoma, Teratoma, parathyroid adenoma
  51. Tumors found in middle mediastinum (4)
    Bronchiogenic cyst, pericardial cyst, enteric cyst, lymphoma
  52. Structures found in middle mediastinum (3)
    Heart, trachea, ascending aorta
  53. Structures found in posterior mediastinum (2)
    Esophagus, descending aorta
  54. % of thymomas that are malignant
    50
  55. % of thymoma patients with myasthenia gravis
    50
  56. % of patients with myasthenia gravis with thymoma
    10
  57. % of patients with myasthenia gravis who get improvement with thymectomy
    80
  58. Most common form of lymphoma
    Tcell
  59. Most common form of Hodgkins lymphoma
    Nodular sclerosing
  60. Most common germ cell tumor in mediastinum
    Seminoma
  61. Cyst posterior to carina
    Bronchiogenic cyst
  62. Treatment of bronchigenic cyst
    Resection
  63. Cyst found at right costophrenic angle
    Pericardial cyst
  64. Most common neurogenic tumor
    Neurolemoma
  65. Neurogenic tumors that produce catecholamines
    Paraganglioma
  66. % of symptomatic mediastinal masses that are malignant
    50
  67. % of asymptomatic mediastinal masses that are benign
    90
  68. Most common benign tracheal tumors in adults
    Papilloma
  69. Most common benign tracheal tumor in children
    Hemangioma
  70. Most common malignant tracheal tumor
    Squamous cell
  71. Most common late complication after tracheal surgery
    Granulation tissue
  72. Treatment of laryngeal edema
    Intubation, racemic epi, steroids
  73. Potential treatments of postintubation stenosis (2)
    Resection, laser ablation
  74. Risk of tracheostomy, esp when below 3rd cricoid ring
    Tracheoinnominate fistula
  75. Most common area of lung abscess
    Posterior segment of RUL, superior segment of RLL
  76. Common cause of empyema
    Pneumonia
  77. First phase of empyema, lasts 0-24h
    Exudative phase
  78. Second phase of empyema, lasts 24-72 hours
    Fibroproliferative phase
  79. Third phase of empyema, >72h
    Organized phase
  80. Treatment of organized phase empyema
    Decortication or Eloesser
  81. Treatment of exudative and fibroproliferative phase of empyema
    Chest tube, antibiotics
  82. Lab tests that diagnose chylothorax
    Lymphocytes and TAGs
  83. Location where thoracic duct crosses from right to left
    T5-7
  84. Conservative therapy for chylothorax
    Chest tube, octreotide, TPN (or low-fat diet)
  85. Optimal location to ligate thoracic duct
    Low in mediastinum
  86. Most common source of massive hemoptysis
    Bronchial arteries
  87. Treatment of massive hemoptysis
    Mainstem intubation of unaffected side, OR for lobectomy or pneumonectomy, bronchial artery embolization
  88. Recurrence risk of spontaneous PTX after first occurance
    20%
  89. Recurrence risk of spontaneous PTX after second occurance
    60%
  90. Recurrence risk of spontaneous PTX after third occurance
    80%
  91. Most common side of spontaneous PTX
    Right
  92. Treatment of multiple spontaneous PTX
    Thoracoscopy, blebectomy, mechanical pleurodesis
  93. Most common mediastinal cyst
    Bronchiogenic cyst
  94. Abnormal lung tissue not connected into bronchial system
    Bronchiogenic cysts
  95. Lung tissue not connected to bronchial vasculature
    Sequestration
  96. Treatment of pulmonary sequestration
    Lobectomy
  97. Solitary pulmonary nodule with h/o sarcoma or melanoma: new primary or met??
    More likely to be met
  98. Solitary pulmonary nodule with h/o breast or H&N cancer: new primary or met??
    More likely to be new primary
  99. Most likely cause of arrest after blunt trauma
    Tension pneumothorax
  100. Endometrial implants on visceral lung pleura that causes PTX in relation to menstruation
    Catamenial PTX
  101. Treatment of residual hemothorax despite 2 well-placed chest tubes
    Thoracoscopic drainage
  102. Whiteout on CXR with mediastinal shift toward whiteout: dx and tx
    Atelectasis: do bronch
  103. Whiteout on CXR with mediastinal shift away from whiteout: dx and tx
    Effusion: chest tube
  104. Causes of bronchiectasis (3)
    Infection, tumor, cystic fibrosis
  105. Parenchymal lung lesion + enlarged hilar nodes in TB
    Gohn complex
  106. Noncaseating granulomas common in:
    Sarcoidosis
  107. Caseating granulomas common in:
    TB
  108. Protein level in exudate
    >3
  109. LDH pleural fluid:serum in exudate
    >0.6
  110. Glucose in exudate
    Low
  111. Treatment of recurrent pleural effusion
    Mechanical pleurodesis
  112. Treatment of malignant pleural effusions
    Talc pleurodesis
  113. Connections between pulmonary arteries and veins; common in Osler Weber Rendu
    AVMs
  114. Tx of lung AVMs
    Embolization
  115. Most common benign chest wall tumor
    Osteochondroma
  116. Most common malignant chest wall tumor
    Chondrosarcoma

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