Readings Flashcards
What instances make a patient a candidate for a more sophisticated pulmonary screening?
Pt who cannot climb one flicght of steps with out dyspnea or cannot blow out a match 8 inches away for their mouth with out the pursing of their lips
What is the loose cough test?
A rattle heard through the stethoscope when a patient forcible coughs = underlying pulm pathology
At the end of passive tidal exhalation where is the patient in regards to PFTs?
FRC- equal to the sum of expiratory reserve capacity and residual volume
What is closing volume?
the volume below which the alveoli become so structurally unstable that they cannot remain open, even with the benefit of a surfactant
When is CV greater than FRC?
in smokers and obese patients
What are the risks of a patient with severe lung pathology after surgery?
not only death and pneumonia, but also a life long req of a ventilator dependance
What tests do we run on a patient who is high risk pulmonary disease?
PFT and ABG
What is the most commonly used PFT?
FEV1
What is a quick way to determine post op FEV1 for a pilm resection pt?
pre-op FEV1 x %of lungs left
The patients ability to climb _____ flights of stairs shows they should be ok for pulmonary procedures.
> 2
What produces or exacerbates hemorrhoids in over 1/3 of pregnant women?
pelvic venous compression
If surgeries are necessary in a pregnant patient, when should they be preformed?
2nd trimester
What are the most common reasons for GI surgery in a pregnant pt?
appendicitis and biliary tract disease
What test has an increase in false-negatives during pregnancy?
mammography
What is the most common cause of nipple discharge?
duct ectasia- nonneoplastic condition characterized by multiple dilated ducts in the subareolar space
What gives a definitive histological diagnosis and eliminates the nipple discharge?
ductal excision via circumareolar incision
What is the most frequently diagnosed non skin cancer?
breast cancer
What is a very common benign tumor of the breast?
fibroadenoma, usually in young women
How do you diagnose a fibroadenoma?
fine needle aspiration or core biopsy
What may cause a rapid growth in a fibroadenoma?
hormonal stimulation in pregnancy, requires excision
What is the most common breast mass in women and when does it occur?
breast cyst, 4-5th decade
What causes a fluctuating in the size of he cyst?
menstrual cycle
What color is the fluid in the cyst? Do we need cytology?
straw colored or greenish; no
What constitutes 90 % of invasive breast cancers?
infiltrating ductal carcinoma