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lungs Flashcards

1
Q

horners syndrome

A

miosis-constriction of pupil
anhidrosis- absence of sweating on face
ptysis-drooping of eyelid

all due damage of sympathetic nerves

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2
Q

fine tremor and flapping tremmor

A

fine- can be a side effect of b 2 agonist use (salbutamol)
flapping - asterixis sign which indicates co2 retention

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3
Q

pectus and carinatum

A

excavatium: caved in (funnel chest)
carinatum: sternum is pushing out (pigeon chest)

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4
Q

apex beat

A

Normal position is 5th intercostal space

Mid-clavicular line

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5
Q

where is apex of the lung found

A

supraclavicular fossa

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6
Q

when is the loudest sound heard when breathing

A

inspiration due to more turbulent air flow

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7
Q

adenocarcinoma

A

cancer that starts in the glands that line the inside of one of your organs. could be the lungs,breast etc. if in lungs its most often found in the outer parts of the lungs and grows more slowly than other types of lung cancers

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8
Q

techniques in the past for tb

A

induce a pneumothorax

thoracoplasty - break several ribs to make lungs deflate

phrenic nerve paralysis

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9
Q

types of lung resection

A

wedge - not anatomically based and is the smallest portion
segment - the smallest anatomical diviison of the lung
lobe
bilobectomy
sleeve resection - remove a lobe + part of main airway

pneumoectomy - entire lung

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10
Q

what determines if someone can have lung cancer surgery

A
  1. has the lung spread? is it containesd
  2. can the patient physically handle it are they physicallys strong enough
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11
Q

which type of resection has a higher reccurrence rate

A

wedge

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12
Q

decortication

A

surgical procedure to remove the fibrous tissue covering the lung to help them funcntion normally again done using thoracoscopy

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13
Q

causes of echinococcus

A

e. granulosis
e. multilocularis

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14
Q

symptoms of lung empyema

A

s.o.b ( pus is pressing agaiants the lung ) and chest pain PLEURITC
dry cough - cant cough it out as its oUTSIDE THE LUNG
VERY TOXIC APPEARNACE

night sweats
malais/fever

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15
Q

tx of lung empyema

A
  1. drain the pus like thorocostomy + AB;S
  2. VATS - minimally invasisve
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16
Q

what is thoroscopy uuslaly used for /associated with

A

PLEURAL DISEASES so it allows you to look inot the pleural space

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17
Q

pleurodesis

A

when you get rid of pleaural space- so no reaccumulaitng fluids

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18
Q

rf for lung empyema

A

infection like penumonia
having a lung absvess esp a peripheral one
thoracic surgery

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19
Q

rf for lung empyema

A

infection like penumonia
having a lung absvess
thoracic surgery
bronchopleural fistula

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20
Q

stages for empyema

A
  1. exudation - low celld , simple effusion
  2. fibrino purrulant - more cells, and wbc pMN
  3. oragnisation - fibroblasts

Evenutally causing the 2 layers to come into contact with each others whihc hsouldnt normally happen

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21
Q

why do people feel the ysmptoms of empyema most important

A

it prevents the lungs from expanding properley

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22
Q

classifcation of bronhcieactasis

A
  1. cylindrical/tublar
  2. varicose/mixed
  3. sacular
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23
Q

symptoms AND SIGNS OF BRONCHIACTASIS

A

cough- prodcutive - nb PURRULENT SPUTUM
loss of weight
fever
hempotysis- nb!

SIGNS:
clubbing - chronic
wheezing
Coarse inspiratory crepitations

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24
Q

pseudobronchieactatsis

A

REVERSIBLE dilation of bronchi so no need for surgical intervention because no permanent damage

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25
what is the main mechanis of bronchieactasis
imparied mucus clearance
26
what happens to the bronchie in bronchieactatsis
you have permant dilation so the structure is now affected the elsatic and muscle layers
27
diagnoss
ct- gold standar x ray - not reliable because changes may not be seen some lungs look normal but there is the 'tram lines' bronchoscopy - cant reach that far so not a routine
28
what part of the lung isi affectis in Bronhcieactais
bronchi and bronchioles
29
what are he maiwith n organisms patients are infected with in bronchiectasis
The main organisms patients are infected by include: Haemophilius Influenzae, Pseudomonas aeruginosa, Streptococcus Pneumoniae, Staphylococcus aureus.
30
tx of bronchiactasis
conservative 1. expectorants such as hypetonic saline 2. AB'S in an excervation surgical resection - when conservative has failed - patients with hemoptysis are
31
rf for bronchiactasis
1. congenital such as CF, PCD 2. Bronhcial pathology - tumour, foreign body 3. post infectious - TB, pneumonia 4. Allergic bronchopulmonary aspergillous
32
gold standard bronchiactasis
CT -
32
gold standard bronchiactasis
CT -
33
complications of bronchieactais
MASSIVE HEMPOTYSIS- medical emergency !!!!!!! pneumonia and its consequences brain absecss- rare reistance to ab due to chronic use secondary amyloudos due to chronic inflammation affecting the kidneys ( AA)
34
pathognomic bronchiactasis
signet ring cell
35
what are some elctrolyte distrubances we find in lung cancer
hypercalcemia is associated with small cell lung cancer and squamous cell cancer hyponatremia - due to increase in ADH secretion
36
when is surgery indicated in lung cancer
for non small cell cancers from stage 1-3
37
gold standard in lung cancer surgery
lobecttomy with LN disection
38
IF someone has reached stage 4 what are the options
target therapy - mutations immunotherapy target the defective immune checkonts chemo palliative
39
types of non small cell
1. adeno 2. squamous 3. mixed 4. large cell carcinoma
40
adenocarcinomas
most common we see in non smokers more peripherally located compared to squamous gives early metastasis
41
which type of cancer is associated with high metasissi to the brain
small cell so we have to do porphylactic cranial irradiation
42
common sites of metatsis for lung cancer
BBL bone brain liver and adrenals (hence why addisons can be a complication )
43
pareneoplastic syndrome with lungs
ACTH - cushings syndrome ADH- causing hyponatremia Eaten lambert syndrome (immune system attacks the NMJ so similar to MG suggest SMALL CELL
44
horners syndrome
pancoast tobias stumour the tumour compresses the brahcial plexus ptosis anhydosison miosis enopthalmos as well as atrophy of the muscles of the arms cos brachial plexus
45
what sort of complications can lung tumours cause
horners SVC syndrome - facial swelling and distended neck veines obstruction of lymphatics
46
TNM of lung
t1 - contained within the visceral pleura has not yet invaded bronchus t2 - now has invaded bronchi t3- invoves chest wall or now paritetal pleura or phrenic nerve t4- invaded the great vessels, or other mediastinal structures
47
rf for lung cancer
smokers passive smoking occupational - asbestos, silica organ transplanation - immunosuppresants and etc
48
which tumour is associated with hyperparathyroidism
squamous hence hwy causes hypercalcemai
49
signs with lung cancer
clubbing hypertrophic osteoarthropathy horners - if apical anemia atypical physical exam e.g stony dull for effusion , atelactasis,, absent breath sounds paraneoplastic symptoms
50
Non-metastatic manifestations
pain - invades pleura dyspnea - invades airways hemoptyiss- friable vessels in ariways pneuomthorax atelecatasis
51
which cancer can present as cavities
squamous
52
which type of cancer is mor elikely to cause pleaural effusions
obvs mesothelioma but also adenocarcinomas in comparison to tothers
53
pemberton test
he diagnostic test for superior vena cava obstruction is called Pemberton’s test, where lifting the arms over the head for more than 1 minute will precipitate facial plethora and cyanosis.
54
what does a tension pneumothorax ultimately lead to
obstructive shock
55
physicla exam penumonthoaax
weak vesicular breathing on affected side diminished breath sounds distended veins hyperresonance The vocal resonance (or tactile vocal fremitus) is reduced on the affected side. ( sound travels faster in less air ) reduced expansion
56
MOST COMMON CAUSE OF SPONANTOEUS PRIMERY
rupture of apical subpleaural bleb- NOVY
57
MOST COMMON CAUSE OF SPONANTOEUS secondary
rupture of a bulla (which usually occure as a result of detsruction of the walls of the alveoli as seen in COPD
58
small pneumorthroax
visceral pleura is less than 3 cm from chest well or on radiology there is less than 2-3 cm distance between P + V pleaure
59
bleb
collection of air subpleaurally - less than
60
what causes blebs and locaation
the alveoli rupture and the air gets trapepd mostly apex of lungs or apex of lower lobes
61
Five most common complications of a spontaneous pneumothorax- novvy
1. tension 2. pneumomediastimu 3. hemopneumorhorax 4.bilateral pneumothoad 5. recurrence after inital tx
62
surgical tx of spontanous primary pneumorthorax - novvy
rescet the blebs/bullae pleuroectomy to remove the pleuarl space so you obliterate the pleural space
63
surgical tx of spontanous primary pneumorthorax - novvy
rescet the blebs/bullae pleuroectomy to remove the pleuarl space so you obliterate the pleural space
64
PHYSICAL FINDINGS OF PLEURAL EMPYEMA
dullness to percussion decreased chest expansion on affected side decreased breath sounds
64
PHYSICAL FINDINGS OF PLEURAL EMPYEMA
dullness to percussion decreased chest expansion on affected side decreased breath sounds
65
chylothorax
is lymphaitc fluid and emulsified fat its quite rare and caused by malignancy and trauma
66
histological types of mesothelioma
epithelioid sarcomatoid mixed
66
histological types of mesothelioma
epithelioid sarcomatoid mixed
67
malignant pleural effusion - novvy
an effusion that contains malignant cells
68
fibrohemothroax - novvy
fibrous tissue in the pleural space, usually found as a complication of clotted hemothorax, chronic empyema or tb
69
pleural fluid exudate transudate
ex- from inflammation , more cells, more specific gravity trans- heart failure, kidney failure
70
Most common benign plural tumour
solitary fibrous tumour
71
lights criteria
to determine if pleural effusion is transudate or exudate it looks at your protein levels and LDH levels
72
trapped lung
failure of the lung to re-expand after thoracentesis
72
trapped lung
failure of the lung to re-expand after thoracentesis
73
tx of malignant pleural mesothelioma
chemo, radio, extrapleural pneumonectomy
74
signs of advance local cancer - NOVY
hoarseness of voice pleural effusions pericardial SVC syndrome pancoast
75
anothy name for pancoast tumour- novs
superior sulcus tumour
76
most common bening lesion of lung
hamartoma
77
3 indications for palliative resection - NOVY
1.an unresolving lung abscess 2, massive hemoptysis 3. painful invasion of chest wall
78
TYPES OF SMALL CELL- novyy tx
1. limited - limited to one hemithroax and ipsilateral ln and supraclavicular TX chemo, radio and prophylactic cranial 2. extensive - metastasi outside the hemithorax tx - just chemo
79
which sympto m of lung cancer is frequently overlooked i
cough
80
mcqs women which place die from lung cancer
1
81
primary lung abscess
no previou sunderlying lung pathology or currently infected with pneumonia
82
secondary
have a disease which makes it easier for them to have an abscess, or obstructive symptoms or they are immunocompimised
83
acute subacute chronic abscess
<6 weeks 6-12 weeks >12 weeks
84
what could have caused a abcess
infection of the lung hematogenous spread i.e right sided endocarditis, BRONCHIAL OBSTRUTCION-NB aspiration alcoholics
84
what could have caused a abcess
infection of the lung hematogenous spread i.e right sided endocarditis, BRONCHIAL OBSTRUTCION-NB aspiration alcoholics
85
compplications of lung abscess
rupture bronchopleural fistula pneumothroax can casue a brain absess internal hemmorgae
86
which complication of abscess is needed for emergency surgery
Massive bleeding in thorax b. Formation of fistulas c. In cases of empyema
87
what causes a bronchopleural fistual
rupture of lung abscess the erosion of a bronchus by carcinoma post operative on lungs

General surgery (5 decks)

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