Pulm and WH Surgery Flashcards
Etiologies of hemoptysis
Infection
PE
Cancer
TB
Transudative pleural effusion etiologies
Heart failure
Cirrhosis
Nephrotic syndrome
Exudative pleural effusion etiologies
Infection
Cancer
S/S of pleural effusion
SOB
CP
Cough
Diminished breath sounds
Dullness to percussion
Blunting of angles
Diagnosis of pleural effusion
CXR
Treatment of pleural effusion
If small and likely benign: observe
New onset without cause or atypical: thoracentesis
Recurrent: pleurodesis
How to determine exudative vs. transudative fluid?
Pleural protein/serum protein > 0.5
Pleural LDH/serum LDH > 0.6
Pleural LDH > 2/3 ULN
At least one positive = exudative
Etiologies of post-op pneumonia
Aspiration
Atelectasis
Impaired cough reflex
S/S of post-op pneumonia
Fever
Tachypnea
SOB
Crackles
Diminished breath sounds
Diagnosis of post-op pneumonia
CXR
Treatment of post-op pneumonia
Obtain sputum culture
No risk factors: Rocephin
Pseudomonas risk: Zosyn
MRSA risk: Vanc
What procedure is most associated with post-op pneumothorax?
Central line placement
S/S of pneumothorax
Sudden SOB
CP
Tachycardia
Tachypnea
Unequal breath sounds
Hyperresonance with percussion
Diagnosis of pneumothorax
CXR
Treatment of post-op pneumothorax
Chest tube and admission
Etiology of fibrocystic breast disease
Hormonal imbalance
S/S of fibrocystic breast disease
Pain and tenderness
Fluctuation in size
Multiple lesions
Diagnosis of fibrocystic breast disease
US
Treatment of fibrocystic breast disease
Reassurance
S/S of fibroadenoma
Round, firm, mobile, nontender mass
Diagnosis of fibroadenoma
US
Treatment of fibroadenoma
If asymptomatic: none
If symptoms or rapidly growing: surgery
Risk factors for breast cancer
Family hx
Nulliparity
Early menarche
HRT use
S/S of breast cancer
Painless breast mass
Fixed, hard, irregular shape
Skin changes
Diagnosis of breast cancer
Mammogram
Core needle biopsy
Treatment of breast cancer
Mastectomy
Chemotherapy
Hormone therapy
Physiologic nipple discharge
Multi-ductal
Only elicited following manual pressure
Surrounding pregnancy
Abnormal nipple discharge
Single duct
Spontaneous
MCC of abnormal nipple discharge
Intraductal papillomas
Etiologies of galactorrhea
Pregnancy
Medications
Pituitary adenomas
S/S of galactorrhea
Bilateral, multiductal, milky discharge from a nonlactating person
Diagnosis of pathologic galactorrhea
US or mammogram first
Subareolar duct excision
