Cardiothoracic Surgery and the Lung in Non-Malignant Situations

Question 1

RECAP-What is a lung abscess?

Answer 1

A collection of pus surrounded by granulation tissue.

Question 2

List some common causes of lung abscesses.

Answer 2

Inhalation of a foreign body
Pneumonia
PTE
Lung Cancer
Septic emboli

Question 3

RECAP- what is empyema?

Answer 3

Pus is the pleural cavity

Question 4

List some causes of empyema.

Answer 4

Post pneumonic
Post-operative
Oesophageal
Upper abdominal related
Osteomyelitis
Post-traumatic

Question 5

What are thymic tumours?

Answer 5

Malignant cancer cells forming in the thymus

Question 6

Name some thymic tumours

Answer 6

Thymoma
Thymolipoma
Carcinoid tumours of the thymus
Lymphoma

Question 7

What is a thymolymphoma a combination of?

Answer 7

Thyloma and lymphoma

Question 8

Name the most common benign lung tumour

Answer 8

Hamartoma

Question 9

What is meant by a primary pneumothorax?

Answer 9

No underlying abnormality in the lung tissue.
Usually affects a small portion of the lung, usually the apex.

Question 10

What is meant by a secondary pneumothorax?

Answer 10

Already widespread pathology throughout the lungs

Question 11

Name two common pathologies of the lung that can exist before a secondary pneumothorax.

Answer 11

COPD or Pulmonary fibrosis

Question 12

Which type of pneumothorax is surgery usually avoided and why?

Answer 12

Secondary because results are less successful

Question 13

Compare recurrent vs persistent pneumothorax.

Answer 13

Recurrent- more than two episodes of pneumothorax
Persistent- chest drain is still bubbling 7 days after it was put in.

Question 14

What is an open pneumothorax?

Answer 14

When there is a physical hole in the chest wall.

Question 15

What is a bulla?

Answer 15

Large blisters on the skin that are filled with clear fluid.

Question 16

What is pleurodesis?

Answer 16

Procedure that sticks your lung to your chest wall.

Question 17

What agent can be used during a pleurodesis?

Answer 17

Talcum powder

Question 18

What is bullous lung disease?

Answer 18

Very large abnormal air space in the lungs

Question 19

What should you warn someone with a large bulla not to do?

Answer 19

Travel by air

Question 20

How do you deal with a large bulla?

Answer 20

Operate on it to remove it

Question 21

When may you carry out a talc pleurodesis?

Answer 21

If pneumothorax was persistent meaning the air is leaking out seven days after the drain went in.

Question 22

After how many pneumothorax’s would you typically perform surgery?

Answer 22

2

Question 23

When may you perform surgery after one pneumothorax?

Answer 23

If the patient was-
-a diver
-in the army
-takes part in international travel in remote areas with few health facilities

Question 24

Therefore, what is the most common treatment for pneumothorax?

Answer 24

Talc pleurodesis

Question 25

Which surgery may be carried out after pneummothorax?

Answer 25

Pleurectomy

Question 26

How do bronchogenic cysts cause symptoms?

Answer 26

By pressing on the trachea or oesophagus

Question 27

Why are they called bronchogenic cysts?

Answer 27

Because they are lined w bronchial mucosa

Question 28

What can the bronchogenic cysts pressing on the trachea/oesophagus cause?

Answer 28

Stridor
Dysphagia- swallowing difficulties

Question 29

For which three conditions may lung transplantation be undertaken?

Answer 29

Cystic Fibrosis
Pulmonary fibrosis
Emphysema

Question 30

When may a single lung transplant be undertaken?

Answer 30

In older patients who don’t require the same physical exertion capabilities.

Question 31

What age must patients needing lung transplantation be under?

Answer 31

65

Question 32

List some other factors which contribute to whether a patient can have a lung transplantation or not.

Answer 32

Not overweight
Not diabetic
No renal failure
No mental illness
Good social support