pestana: cardiothoracic surgery Flashcards
inspiratory wheezing seeni n
tracheomalacia
what is this: child has difficulty swallowing, episodes of resp distress, stridor, hyperextension of neck
vascular ring- congneital anomaly where trachea and esophagus encircled by abnl blood vessels
manage vascular ring
extrinsic compression- barium swallow, bronchoscopy
surgery divides two aortic arches
cardiac anomalies diagnosed with…
echo
ASD presentation
low pressure, low volume shunt- heard in late infancy
faint pulmonary systolic murmur
fixed split second heart sounds
frequent colds
VSD presentation if low vs high in muscular septum
low: minor, closes spontaneously in age 2-3
high: FTT, pansystolic murmur
most common cyanotic cardiac anomaly
tetralogy of fallot
tet of fallot presentation
small for age (5-6 yo)
bluish hue
clubbing
cyanosis relieved by squatting
transpoition of great vessels die within few days , but can be kept alive temporarily from
ASD, VSD, PDA
what is this: harsh midsystolic heart murmur heard best at right second intercostal space along left sternal border, producing angina and syncope
aortic stenosis
what is this: wide pulse pressure and a blowing, high pitched diastolic heart murmur best heart at second intercostal space along LLSB
chronic aortic insufficiency
when should people with chronic aortic insufficiency get valve replacement:
echo: LV dilatation
what is this: endocarditis seen in young drug addicts who suddenly develop CHF and new, loud diastolic murmur
acute aortic insufficiency
which murmur does rheumatic fever cause
mitral stenosis
mitral stenosis presentation (and regurg)
SOB on exertion orthopnea parozysmal nocturnal dyspnea cough hemoptysis
low pitched diastolic murmur
causes afib
what is this: high pitched holosystolic murmur that radiates to axilla and back
mitral regurgitation
mitral regurgitation occurs from
valvular prolapse
intervention necessary for what percent stenosis for coronary disease
70%
how do you manage simple (single vessel) vs complex (multiple vessel) coronary artery dz?
simple: angioplasty and stent
multiple: surgery- multiple coronary bypass
what is this: SOB on exertion, hepatomegaly, ascites, “square root sign,” and equalization of pressures
chronic constrictive pericarditis
what percent chance is a coin lesion found on CXR is malignant
80%
whats first thing to do if you find a coin lesion
find an older CXR (year or 2)
if unchanged, it’s probably not cancer. leave alone
diagnosis of lung cancer requires
cytology
bronchoscopy and biopsy
or percutaneous biopsy
treatment of small cell lung cancer
chemo/RT (not surgery)
how to resect non-small cell lung cancers if central vs peripheral lesion
central: pneumonectomy
peripheral: lobectomy
minimum of FEV1 in each lung to do a pneumonectomy
800 mL
how to remove hilar mets vs nodal mets at carina or mediastinum
hilar: pneumonectomy
nodal mets at carina or mediastinum: unresectable, endobronchial US
