General Pearls Flashcards
Pre-thoracotomy PFT
give FEV1 cutoffs for pneumonectomy/lobectomy/wedge resection?
What is minimum predicted postop FEV1?
FEV1 > 2L / 1L / 0.6L
Need predicted postop FEV1 > 0.8
Classically hamartoma CXR description
Popcorn lesion with calcifications
Thoracic outlet syndrome
most common symptom
rarely involves artery or vein (1-3%), generally ulnar n paresthesias
SVC syndrome
definition, symptoms, diagnosis and treatment
Lung Ca compressing SVC
flushing, cough, jvd
bronchoscopy
chemoradiation (no anti-coagulation)
Treatment for Massive hemoptysis
rigid bronchoscopy and airway packing
Acute lobar torsion
What is typical presentation?
post- RUL lobectomy; acute fever, tachycardia and opacification of RUL
Give three indications for a tissue valve replacement
- pregnant
- tricuspid replacements
- other contraindication to anticoagulation
Proctocolectomy cures most extracolonic manifestations of UC except: (2)
sclerosing cholangitis and arthritis
Treatment for Perianal abscess in Crohn’s
incision and drainage as with any abscess
Treatment for perforated esophageal cancer
- stable patient
- unstable patient
Should try to get GI to stent first.
never primary repair; OK to reconstruct if stable. Resect with delayed reconstruction if unstable
Indications and procedure
for esophageal Leiomyoma
if symptomatic or > 5cm excise by enucleation via thoracotomy (R if middle, L if lower esophagus). Do not biopsy on EGD.
Parotitis
typical presentation?
treatment?
Dehydrated elderly patient;
Observe with antibiotics alone.
Surgical drainage for abscess of failure to improve.
Tracheoinnominate fistula
Most common presentation?
How to avoid?
Present w/small heraldic bleed.
Avoid by making tracheostomy no lower than 3rd tracheal ring
Hydatid/Echinococcal cyst
preoperative tests? (2)
What operation?
+Casoni skin test, +indirect hemagglutination
resect (pericystectomy) cyst without spillage (causes anaphylaxis)
Diabetes Insipidus
two causes and mechanism:
Alcohol and head injury inhibit ADH
