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Surgery > Chest Wall, Lung, and Mediastinum > Flashcards

Chest Wall, Lung, and Mediastinum Flashcards

0
Q

Unilateral absence of costal cartilages, pectoralis muscle and breast

A

Poland’s syndrome

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1
Q

Exceedingly depressed sternum, most common chest wall deformity

A

Pectus excavatum

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2
Q

Compression of neurovascular bundle (pain and paresthesia in neck, shouler, arm, hand)
Brachial plexus compression (often ulnar n parasthesia)
Uncommonly vascular compression

A

Thoracic outlet syndrome

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3
Q

Etiology of thoracic outlet syndrome

A

Compression by fibromuscular bands, anterior scalene muscle, first rib or cervical ribs

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4
Q

Tx for thoracic outlet syndrome

A

PT for 3-6 months

Supraclavicular scalenectomy, brachial plexus neurolysis, or first rib resection

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5
Q

Tx of chest wall tumors

A

Wide excision

Reconstruction using autologous and/or prosthetic grafts

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6
Q

Etiology of spontaneous pneumothorax

A

Subpleural bleb

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7
Q

Tx of spontaneous pneumothorax

A

Chest tube

Stapling of blebs if recurrent or persistent air leak for 3-5 days, or hemopneumothorax

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8
Q

Which pleural effusion is protein-rich and which is protein-poor

A

Rich: exudative
Poor: transudative

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9
Q

Used to diagnose pleural empyema

A

Thoracentesis and culture

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10
Q

If thoracentesis fails to resolve empyema

A

Intercostal tube

Thoracotomy, debridement, decortication

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11
Q

Risk factor and location of malignant mesothelioma

A

Asbestos exposure, parietal pleura

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12
Q

Etiology of lung abscess

A

Aspiration

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13
Q

Tx for lung abscess

A

IV antibiotics (penicillin) 90% success
Transbronchial drainage via bronchoscopy
CT-directed catheter drainage
Surgery

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14
Q

Caused by repeated pulmonary infections, excessive sputum production

A

Bronchiectasis

Do CT, antibiotics

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15
Q

Popcorn-like calcification, no change for 2 yrs, well circumscribed on CT

A

Benign pulmonary nodule (coin lesion)

May still require biopsy

16
Q

Which paraneoplastic syndromes can be caused by small cell carcinoma

A

ACTH, SIADH, Lambert Eaton myasthenic syndrome

17
Q

Which paraneoplastic syndrome can be caused by squamous cell carcinoma of the lung

A

Hyperparathyroidism (PTHrP)

18
Q

Horner’s syndrome, brachial plexus involvement, vertebral collapse

A

Pancoast tumor

19
Q

Tx for bronchogenic carcinoma

A

Lobectomy

Extensive mediastinal lymph node involvement or surrounding tissue involvement may contraindicate

20
Q

Adjuvant therapy for non small cell carcinoma

A

Post lobectomy chemotherapy

21
Q

Adjuvant therapy for advanced local lung ca

A

Preoperative chemotherapy

22
Q

Which lung tumor is located peripherally

A

Adenocarcinoma

Most others are centrally

23
Q

Tx of small cell carcinoma

A

Chemotherapy and radiation

24
Q

Which are the most common tumors with mets to the lung (4)

A

Colorectal
Breast
Melanoma
Renal

25
Q

Diagnostic study for congenital lesions of the trachea

A

Air tracheography (tomography)
Bronchoscopy
Angiography

26
Q

Tx of tracheal tumor

A

Preop antibiotics

Tracheal resection with end to end anastamosis

27
Q

Elevated beta HCG, AFP and mediastinal mass

A

Germ cell tumor

Seminomas most common, radiosensitive and treated with resection
Others respond to chemotherapy

28
Q

First thing done in workup of coin lesion

A

Seek old CXR

29
Q

Noninvasive tests done first when lung cancer suspected

A

Sputum culture

CT scan

30
Q

Tx small cell cancer of the lung

A

Chemotherapy and radiation only

31
Q

How is operability of lung cancer assessed

A

Predicted residual function after resection

Measure FEV1, get V/Q scan for fractions and determine remainder

32
Q

What is lower limit for residual pulmonary function after pneumonectomy

A

800mL

33
Q

How is potential cure by resection assessed

A

Metastasis to carinal or mediastinal nodes,
Mets to other lung or liver
By CT, PET, or endobronchial ultrasound

Surgery (17 decks)

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