Lung

Question 1

Most important characteristic of solitary pulmonary nodule

Answer 1

size ( 1% of lesions < 5 mm are cancer, while 80% of lesions > 2 cm are cancer)

Question 2

Guidelines for lung cancer screening

Answer 2

Adults 55-74 with 30 pack year hx of smoking, or 50 year olds with 20 pack year and additional risk factors get annual low dose CT scans

Question 3

work up for lesions 5-8 mm

Answer 3

PET CT

Question 4

work up for lesions > 8 mm with high risk features

Answer 4

PET CT and surgical biopsy/resection

Question 5

work up for lesions > 8 mm with low or moderate risk features

Answer 5

non surgical biopsy

Question 6

Work up for confirmed cancer

Answer 6

mediastinal staging with medistinoscopy or EBUS

Question 7

5 year survival of stage 1 resected lung CA

Answer 7

80% (whereas 5 year survival for advanced is 5%)

Question 8

2 classifications of spontaneous PTX

Answer 8

primary (tall young men) and secondary (previous lung disease or infection)

Question 9

2 rare forms of spontaneous PTX in young women

Answer 9

Lymphagiomyomatosis (LAM) (PTX of pregnancy) Catamenial PTX (endometrium that migrates and causes PTX during menses)

Question 10

Indications for blebectomy and pleurodesis after spontaeous PTX

Answer 10

after 2nd episode.

Question 11

thoracic duct located between what 2 structures

Answer 11

azygos vein and esophagua

Question 12

thoracic duct starts at what level and crosses right to left at what level

Answer 12

L5, T5

Question 13

which pneumocytes make surfactant

Answer 13

type 2 pneumocytes

Question 14

FEV1 needed for lung resection

Answer 14

0.8 (best predictor of post op complications)

Question 15

DLCO needed for lung resection

Answer 15

< 10 mm/min (40% predicted)

Question 16

LIghts criteria for exudate

Answer 16

Pleural to serum protein ration > 0.5 Pleural to serum LDH > 0.6 Pleural LDH > 2/3 serum LDH

Question 17

chylothorax

Answer 17

> 110 mg/dL TG, stain postive for sudan red

Question 18

Rule of 50s for thymoma

Answer 18

50% malignant, 50% have MG (though 10% of MG have thymoma)

Question 19

Most common anterior mediastinal tumor in Adults and children

Answer 19

Adults: thymoma; children: teratoma

Question 20

Treatment for pulmonary mucormycosis

Answer 20

Intubation, antifungals, and surgical debridement

Question 21

Functional residual capacity

Answer 21

Total lung capacity - inspiratory capacity

Question 22

4 lung volumes

Answer 22

Tidal volume Inspiratory reserve volume Expiratory reserve volume Residual volume

Question 23

4 lung capacities

Answer 23

Total lung capacity = IRV + VT + ERV + RV

Inspiratory capacity = IRV + TV

Functional residual capacity = TLC - IC

Vital capacity = TLC - Residual volume

Question 24

Treatment for bronchial carcinoid

Answer 24

Surgical resection with mediastinal LN sampling.

Question 25

Which level mediastinal nodes are most difficult to access (EBUS or med)

Answer 25

Level 5

Question 26

FEV1 of contralateral lung required to proceed with pneumonectomy

Answer 26

800 cc