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Crack the Core > Cardiothoracic > Flashcards

Cardiothoracic Flashcards

1
Q

Segments in the right lung

A

10 total
upper lobe: apical, posterior, anterior
middle lobe: medial, lateral
lower lobe: superior, anterior basal, lateral basal, medial basal, posterior basal

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2
Q

segments in the left lung

A

8 total
upper lobe: apico-posterior, anterior
lingula: superior, inferior
lower lobe: superior, anteromedial basal, lateral, posterior

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3
Q

most common pulmonary vein anatomy variant

A

separate vein draining the right middle lobe (30%)

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4
Q

What population gets lung cancer screening CT?

A

asymptomatic
age 55-80
30 pack year history
currently smoke or quit within past 15 years

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5
Q

differential for feeding vessel sign?

A

septic emboli

hematogenous mets

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6
Q

most common location for bronchial atresia

A

apico-posterior segment of left upper lobe

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7
Q

what is associated with horseshoe lung?

A

scimitar syndrome

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8
Q

what spares the costophrenic angles?

A
  • pleural plaques
  • LCH
  • hypersensitivity pneumonitis
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9
Q

What can mimic alpha 1 antitrypsin/ pan lobular emphysema

A

IV ritalin use

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10
Q

Vanishing lung syndrome

A

idiopathic cause of giant bullous emphysema, results from avascular necrosis of the lung parenchyma and hyper inflation

  • favors bilateral upper lobes
  • defined as bullous disease occupying at least 1/3 of a hemithorax
  • most common in young men
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11
Q

Ddx for perilymphatic nodules

A
  • silicosis
  • sarcoidosis
  • lymphangitic spread of cancer
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12
Q

Ddx for centrilobular nodules

A
  • RB- ILD
  • infection
  • hypersensitivity pneumonitis
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13
Q

Ddx for random nodules

A
  • miliary TB
  • mets
  • fungal infection
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14
Q

DDx for Atoll (Reverse halo)

A
  • Organizing pneumonia
  • fungal pneumonia
  • TB
  • Wegener’s
  • pulmonary infarct
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15
Q

Williams Campbell syndrome

A

congenital cystic bronchiectasis from deficeincy of cartilage in 4th-6th order bronchi

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16
Q

when is a superior sulcus tumor unresectable?

A
  • involvement of brachial plexus above T1
  • diaphragm paralysis (C3,4,5)
  • greater than 50% of vertebral body
  • distal nodes or mets
17
Q

Hughes Stovin syndrome

A
  • recurrent thrombophlebitis and pulmonary artery aneurysm formation and rupture
18
Q

ddx for CHF in newborn

A
  • TAPVR (infracardiac)
  • congenital aortic or mitral stenosis
  • hypoplastic left heart
  • cor triatriatum
  • Infantile (pre-ductal) coarctation
19
Q

ddx for small heart

A
  • Addison’s disease
  • cachectic state
  • constrictive pericarditis
20
Q

associations with PDA

A
  • prematurity
  • Maternal rubella
  • cyanotic heart disease
21
Q

Holt Oram

A

hand/thumb defects +ASD

22
Q

Norwood procedure

  • when is it done?
  • what does the procedure entail?
A
  • within days of birth (HLHS)
  • tiny aorta is anastomosed to pulmonary trunk and arch is augmented with a graft
  • ASD is enlarged
  • PDA is ligated (to prevent overshunting)
  • BT shunt between Right subclavian artery and right pulmonary artery
23
Q

Sano procedure

A
  • same as norwood, but using conduit to connect right ventricle to pulmonary artery instead of a B-T shunt
24
Q

Glenn

  • Classic
  • Bi directional
A

Classic: SVC to Right pulmonary artery (end to end)
bidirectional: shunt between SVC and right pulmonary artery (end to side); RPA is left open, letting blood flow to both lungs

25
Q

Fontan

A

Glenn + closure of ASD + shunt between right atrium to left PA

26
Q

complications of Fontan

A
  • right atriomegaly and arrhythmia

- plastic bronchitis

27
Q

Blalock Taussig shunt

A
  • classically done for TOF
  • shunt between sublcavian artery and pulmonary artery
  • done on opposite side of ortic arch
  • modified B-T shunt uses a Gortex shunt
28
Q

Rastelli procedure

A
  • used to correct TGA, pulmonary outflow obstruction, or VSD
  • VSD used as the LVOT - baffle is placed in RV to divert flow as VSD to aorta
  • pulmonary valve is oversewn and conduit is inserted between RV and PA
29
Q

Jatene procedure

A
  • aorta and pulmonary trunk are transected at level of sinuses and switched so that LV becomes systemic ventricle
  • coronaries are removed and re-implanted to new aorta (PA)
  • no conduit used
30
Q

Ross procedure

A
  • used for disease aortic valves in children
  • native pulmonary valve is used to replace the aortic valve
  • cyroperserved pulmonary valve homograft is used to replace pulmonary valve
31
Q

Bentall procedure

A

composite graft replacement of aortic valve, aortic root, and ascending aorta with re-implantation of coronary arteries into graft
- used to treat combined aortic valve and ascending aorta disease, including Marfans

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