Cardiothoracic

Question 1

steps to aubxsubxiphoid pericardial window (=(4)?

Answer 1

1. vertical incision over xiphoid to expose xiphoid and line alba
2. xiphoid removed and finger dissection to retro space
3. the diaphragmatic of pericardium is visualized and grasped with Allis
4. fluid aspirated and drainage tubing placed

Question 2

incidental posterior mediastinal mass on trauma. next step?

Answer 2

mri to r/o spinal cord involvement

Question 3

s/p EGD with chest pain and tachycardia with CT chest showing eso perf. definitive management?

Answer 3

need debridement of tissue with left Thoracitimy and layered suture repair with overlying intercostal flap

Question 4

66 M smoker with CA in lingula with DLCO is 38% if he gets Left Upper lobectomy

Answer 4

lobectomy is gold standard UNLESS patient would have poor lung functioning post op can do lung sparing anatomic resection such as segmentectomy

Question 5

25 M with second episode of PTX, best approach for this?

Answer 5

chest tube, admission and consult to CT surgery for VATS blebectomy and pleurodesis

Question 6

Internal thoracic srtery

Answer 6

first brnach of subclavian artery and provides blood ti abterior chest wall and breasts, then travels btw internal oblique and transverse thoracic muscles to become SUperior epigastrics

Question 7

NSC lung Cancer contraindication to resection?

Answer 7

contralateral mediastinal LNs