procedures + findings

Question 1

causes bilateral hilar lymphadenopathy

Answer 1

sarcoid + TB!!! // lymphoma, pneumoconiosis, fungi

Question 2

cardiac causes clubbing

Answer 2

cyanotic congenital heart disease (tof, transposition) // endocarditis // atrial myxoma

Question 3

resp causes clubbing

Answer 3

lung cancer // CF, bronchiectasis, abscess // TB // asbestosis,

Question 4

systemic causes clubbing

Answer 4

crohns // cirrhosis // graves

Question 5

causes chronic SOB

Answer 5

HF // asthma // aortic stenosis // fibrosis // cancer // bronchiectasis // anaemia // obese

Question 6

indication chest drain

Answer 6

effusion +/- empyema // pneum/ heamothorax

Question 7

contraindication chest drain

Answer 7

INR >1.3 // platelets <75 // bullae // pleural adhesions

Question 8

where is chest drain inserted

Answer 8

patient at 45o // USS –> local lidocaine –> 5th intercostal midaxillarly line –> fix with stitch (seldinger technique)

Question 9

how is position of chest tube confirmed

Answer 9

CXR - swinging fluid on inspiration

Question 10

complication chest drain

Answer 10

failure // bleeding // infection // damage lung // re-expansion of pulm oedema

Question 11

how does re-expansion of pulm oedema occur

Answer 11

too rapidly draining fluid –> SOB + COUGH

Question 12

mx re-expansion of pulm oedema

Answer 12

clamp drain –> CXR

Question 13

removing chest drain

Answer 13

effusion = if no output for >24 hours + imaging // pneumothorax = no more bubbling + imaging

Question 14

safety triangle for chest drain insertion

Answer 14

Anterior edge latissimus dorsi // lateral border of pectoralis major // line superior to the horizontal level of the nipple // and the apex below the axilla.

Question 15

causes cavitating lung lesions CXR

Answer 15

abscess (staph A, kleb, pseudomona) / squamous lung cancer // TB // GPA // PE // RA // aspergillosis

Question 16

causes white lung lesions

Answer 16

consolidation // effusion // collapse // pneumonoectomy // pulm oedema

Question 17

white lesion with trachea pulled towards it

Answer 17

(other lung pushing it towards it) // pneumonectomy // lung collapse // hypoplasia

Question 18

white lesion with trachea pushed away from it

Answer 18

pleural effusion // diaphragmatic hernia // mass

Question 19

whit lesion + central trachea

Answer 19

consolidation, pulm oedema mesothlioma

Question 20

CXR pulmonary oedema

Answer 20

oedena // bats wing // upper lobe diversion // kerley B lines // effusion // cardiomegaly

Question 21

causes lobar collapse

Answer 21

cancer // asthma // foeign body

Question 22

CXR lobar collapse

Answer 22

trachea towards side of collapse // mediastinum towards sign of collapse // raised hemidiaphragm

Question 23

causes medastinum widening

Answer 23

aortica aneurysm // lymphoma // goitre // teratoma // thyoma

Question 24

common lung mets

Answer 24

breast // renal // colorectal // prostate // bladder // (Breathing Really beComes Pretty Bad)

Question 25

most common cause of cannon-ball mets

Answer 25

renal cancer

Question 26

where should NG tube be

Answer 26

below diaphragm