Lung Flashcards
Most important characteristic of solitary pulmonary nodule
size ( 1% of lesions < 5 mm are cancer, while 80% of lesions > 2 cm are cancer)
Guidelines for lung cancer screening
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
work up for lesions 5-8 mm
PET CT
work up for lesions > 8 mm with high risk features
PET CT and surgical biopsy/resection
work up for lesions > 8 mm with low or moderate risk features
non surgical biopsy
Work up for confirmed cancer
mediastinal staging with medistinoscopy or EBUS
5 year survival of stage 1 resected lung CA
80% (whereas 5 year survival for advanced is 5%)
2 classifications of spontaneous PTX
primary (tall young men) and secondary (previous lung disease or infection)
2 rare forms of spontaneous PTX in young women
Lymphagiomyomatosis (LAM) (PTX of pregnancy) Catamenial PTX (endometrium that migrates and causes PTX during menses)
Indications for blebectomy and pleurodesis after spontaeous PTX
after 2nd episode.
thoracic duct located between what 2 structures
azygos vein and esophagua
thoracic duct starts at what level and crosses right to left at what level
L5, T5
which pneumocytes make surfactant
type 2 pneumocytes
FEV1 needed for lung resection
0.8 (best predictor of post op complications)
DLCO needed for lung resection
< 10 mm/min (40% predicted)
LIghts criteria for exudate
Pleural to serum protein ration > 0.5 Pleural to serum LDH > 0.6 Pleural LDH > 2/3 serum LDH
chylothorax
> 110 mg/dL TG, stain postive for sudan red
Rule of 50s for thymoma
50% malignant, 50% have MG (though 10% of MG have thymoma)
Most common anterior mediastinal tumor in Adults and children
Adults: thymoma; children: teratoma
Treatment for pulmonary mucormycosis
Intubation, antifungals, and surgical debridement
Functional residual capacity
Total lung capacity - inspiratory capacity
4 lung volumes
Tidal volume Inspiratory reserve volume Expiratory reserve volume Residual volume
4 lung capacities
Total lung capacity = IRV + VT + ERV + RV
Inspiratory capacity = IRV + TV
Functional residual capacity = TLC - IC
Vital capacity = TLC - Residual volume
Treatment for bronchial carcinoid
Surgical resection with mediastinal LN sampling.
Which level mediastinal nodes are most difficult to access (EBUS or med)
Level 5
FEV1 of contralateral lung required to proceed with pneumonectomy
800 cc
