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AMBOSS (BA) > Respiratory-Surgery > Flashcards

Respiratory-Surgery Flashcards

1
Q

SOB, 12hr post op, diminished breath sound on LLL, homogeneous opacification on CX-ray

A

Atelectasis

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2
Q

Post op dyslexia, opacity on CX-ray, fever, cough productive, crackles

A

Pneumonia (usually 3-5 days after surgery)

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3
Q

newborn, cyanotic, dyspneic, tachypneic, absent lung sound on Left, abd concave (scaphoid abd). Dx? NSIM?

A

Congenital diaphragmatic hernia (CDH), Intubation & mechanical ventilation

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4
Q

Nasal whistling around 6 months after sustaining a nasal fracture, Dx? Prevention?

A
  • Nasal septal perforation

- Nasal septal hematoma drainiage

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5
Q

Massive hemoptysis and pulmonary nodules on x-ray. NSIM?

A
  • Bronchoscopy (actively bleeding)

- CT scan of the chest (if pt has stopped bleeding)

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6
Q

Tx for active TB

A
  • Isoniazid, rifampin, pyrazinamide, and ethambutol for 2 months ( kill bacteria, minimize the risk of resistance)
  • followed by, isoniazid and rifampin for 4 months (to reduce the risk of relapse).
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7
Q

The most common deep neck infection in adolescents and young adults? tx?

A
  • Peritonsillar abscess (PTA)

- I & D, with IV abx (ampicillin-sulbactam)

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8
Q

Decreased breath sounds, increased airway pressure, respiratory alkalosis and deep sulcus sign on chest x-ray in a mechanically ventilated pt indicates? NSIM?

A
  • Pneumothorax

- Insertion of chest tube

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9
Q

Fever, painful swallowing, drooling, asymmetrical neck position, inspiratory stridor, and a bulge in the posterior pharyngeal wall in a child suggests? NSIM?

A
  • retropharyngeal abscess

- Endotracheal intubation

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10
Q

pt with flair chest who have respiratory distress refractory to noninvasive assistance (face mask, analgesic) are indicated for

A

intubation with positive pressure ventilation

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11
Q

a child with acute onset cough, SOB, unilateral wheezing and hyperlucency of the lung fields indicates? NSIM?

A

Foreign body aspiration (FBA)

Bronchoscopy

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12
Q

If pts are allergic to amoxicillin you can’t give penicillin for strep/tonsillitis but you can give

A

Macrolides like erythromycin

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13
Q

Retropharyngeal abscess is a polymicrobial disease caused by which bacterias (4 listed) & TX?

A 
Streptococci
Staphlyococci
Haemophilus influenzae
Oral anaerobes
TX: Ampicillin-sulbactam
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14
Q

Ventilated pt with Pa02 54 & pC02 31, respitaroty alkalosis , NSIM?

A
  • Increased PEEP - to improve oxygenation

- decrease TV to normalize PaC02

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15
Q

What is the purpose of increasing PEEP?

A
  • Helps expand collapsed alveoli and decreases fluid within alveoli (in pt with pulmonary edema) to increase oxygenation
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16
Q

increased oxygen transfer to pulmonary capillaries does

A
  • alleviate diffuse hypoxic pulmonary vasoconstriction

- help correct V-Q mismatch

17
Q

Imaging for high possibility of PE (Wells’ score >4)

A

spiral CT angiogram (visible intraluminal filling defect of the pulmonary arteries & wedge-shaped infraction)

18
Q

Imaging for pt who cannot tolerate IV contrast or allergic, with possible PE

A

V/Q scans

- takes long time and requires a nuclear medicine tech

19
Q

Testing for low possibility of PE (Wells’ score <2)

A

D-dimer level

20
Q

D-dimer can be elevated by other reasons (false positive result) like (5 listed)

A 
recent surgery
malignancy
renal diseaese
pregnance
sepsis
21
Q

NSIM for suspected traumatic diaphragmatic rupture after MVA

A

CT of the chest, abd and pelvis (X-ray is not sufficient)

22
Q

MVA, crepitation on palpation of the R thorax, decreased breath sounds on R, crunching sound synchronous with the heartbeat best heard over the percordium, DX?

A

Bronchial rupture (air leakage into the mediastinum)

23
Q

Crunching sounds synchronous with the heartbeat is called

A

Hamman’s sign

24
Q

Spitting/foaming, drooling of new born unsuccesful NG tube insertion, cyanotic attacks immediately after birth, coughing spells. Chest and Abd x-ray with air bubble(gas) in the stomach Dx?

A

Esophageal atresia with tracheoesophageal fistual to the distal esophageal segment

25
Q

Spitting/foaming, drooling of new born unsuccesful NG tube insertion, cyanotic attacks immediately after birth, coughing spells. Chest and Abd x-ray with NO air bubble(gas) in the stomach Dx?

A

Esophageal atresia with tracheoesophageal fistual to the proximal esophageal segment

26
Q

79F, chronic fatigue, non-productive cough, wt loss, nodular pleural lesions, work as a seamstress in a textile factor for 50years with exudate pleural effusion. Dx?

A

Mesothelioma

asbestos exposure

27
Q

79F, chronic fatigue, non-productive cough, wt loss, nodular parenchymal lung lesions, work as a seamstress in a textile factor for 50years with exudate pleural effusion. Dx?

A

Bronchial adenocarcinoma

28
Q

Critaria for exudate effusion

A

Light’s criteria

Effusion protein: serum protein ration >0.5
Effusion LDH:Serum LDH ration >0.6

29
Q

MVA, dyspnea and hypoxia worsens after giving fluids indicates

A

pulmonary vasulature damage= pulmonary contusion

30
Q

Managment of severe epistazis and associated hematemesis

A

hematoemesis suggests posterior bleeding

-Endoscopic ligation of the sphenopalatine artery

31
Q

Ulcerating tonsillar mass and cervical lymphdenopathy in a heavy smoker. Dx? NSIM?

A
  • Oropharyngeal cancer

- Panendoscopy- evaluation of entire upper airway & digestive tract

32
Q

CP, dyspnea, decreased breath sounds, dullness to percution over the left lung base following a rib tracture, increased opacity and tracheal deviation on cxray. Dx? NSIM?

A
  • Hemothorax

- Chest tub in the 5th intercostal space at the midaxillary line

33
Q

CP, dyspnea, decreased breath sounds, hyperresonant to percution over the left lung base following a rib tracture, and On chest x-ray-decreased lung marking, increased radiolucency, hemidiaphragmatic elevation and contralateral tracheal deviation. Dx? NSIM?

A
  • Tension pneumothorax

- Needle thoracostomy in the second intercostal space at the midclavicular line

34
Q

Pt with gunshot wound to the neck with stable VS and normal physcial exam. NSIM?

A

CT angiography

35
Q

Pt with penetrating neck injury with signs of decompensation, an expaning hematoma or tracheal/esophageal injury. NSIM?

A

Surgical exploration

36
Q

Pt with stab wound to chest, dyspnea and tachypena with decreased breath sound and hyperresonance to percussion with bubbling of blood, NO JVD, and hemodynamicly stable with midline trachea. DX? NSIM?

A
  • open pneumothorax

- Partially occulusive dressing (pt stable rules out tension pneumothorax)

AMBOSS (BA) (9 decks)

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