THORACIC

Question 1

Dx of chylothorax

Answer 1

Fluid triglyceride >110 mg /dL
If triglyceride level does not meet diagnostic criteria the presence of chlomicrons in pleural fluid would also make the dx
Also seen: predominance of lympocytes >70%

Question 2

Where should incision be made for subxiphoid pericardial window

Answer 2

verticlal incision 5-8 cm long made over xiphoid toward abdomen and linea alba is incised

Question 3

Incision for thoracotomy approach in establishing pericardial woindow is through?

Answer 3

inframammary skin. Rhis allows division of pectoralis muscle to expose pleural space and pericardium through intercostal space

Question 4

MC tumor of anterior mediastinum

Answer 4

thymoma

Question 5

MC tumor o fanterior mediastinal tumor in children

Answer 5

teratoma

Question 6

MC posterior mediastinal tumor

Answer 6

Neurogenic tumor

Question 7

What else do you need to check in a male who presents with a mediastinal mass

Answer 7

Scrotum (germ cell tumor)

Question 8

MCC mediastinal adenopathy

Answer 8

Lymphoma

Question 9

MC overall mediastinal tumor in adults and children

Answer 9

Neurogenic (posterior mediastinum)

Question 10

MC malignant chest wall tumor

Answer 10

Chondrosarcoma

Question 11

BiBx shows disorganized hypercellular cartilage and increased nuclear detail

Answer 11

Chondrosarcoma

Question 12

Tx of chondosarcoma

Answer 12

Wide local excision

Question 13

Standard tx for localized PAncoast tumor

Answer 13

Concurrent chemoXRT followed by resection

Question 14

What paraneoplastic syndrome assoc with squamous cell lung CA

Answer 14

parathyroid hormone related paraneoplastic syndromes

Question 15

NEedle decompression site for kids <15 years old

Answer 15

2nd intercosta lspace, midclavicular line

Question 16

Needle decompression site for adutls

Answer 16

4th-5th intercostal space, anterior axillary line

Question 17

MC long term sequelae seen in repair of TEF

Answer 17

reflux (30-60%)

Question 18

Hypercalcemia is seen in which lung CA

Answer 18

SCC

Question 19

Trousseau syndrome (migratorry thrombophlebitis) ius a/w which lung CA

Answer 19

adenoCA

Question 20

T2 lung CA

Answer 20

Tumor 3-5 cm or tumor wich involvement of main bronchus, invading visceral pleura, a/w atelectasis or obstructive pneumonitis

Question 21

N2 disease in lung CA

Answer 21

positive ipsilateral mediastinal lymph node

Question 22

Which level nodes are localized superior to innominate artery

Answer 22

2

Question 23

Which level nodes are localized inferior to innominate artery

Answer 23

4

Question 24

Which nodal level are lateral to ligamentum arteriosum

Answer 24

level 5. these are subaoritc LN (Aortopulmonary window)

Question 25

Accessible nodal station in EBUS

Answer 25

2,3, 4, 7, 10, 11 and even 12 sometimes

Question 26

functional residual capacity is defined as

Answer 26

total lung capacity minus inspiratory capcacity

Question 27

inspiratory capacity is defined as

Answer 27

inspiratory reserve volume + tidal volume

Question 28

vital capacity is defined as

Answer 28

total lung capacity minus residual volume (total amount of air you can move!)

Question 29

exudative effusions - lights criteria

Answer 29

pleural:serum fluid protein >0.5 pleural:serum fluid LDH >0.6 pleural fluid LDH > 2/3 upper limit of normal

Question 30

pleural effusion must be larger than what to be detectable on CXR

Answer 30

300 mL

Question 31

adverse effect of bleomycin

Answer 31

commonly used to treat lymphoma and germ cell tumor PNA and eosinophilic hypersensitivity pneumonitis life threatening interstitial fibrosis

Question 32

MC fungi causing mucor

Answer 32

rhizopus, mucor, and rhizomucor

Question 33

describe mucor fungi microscopically

Answer 33

broad irregularly branching WITHOUT regular septations

Question 34

Describe aspergillus microscopically

Answer 34

narrower, regular branching, many septations

Question 35

Mgmt of mucormycosis

Answer 35

aggressive surgical debridement of involved tissue, IV liposomal amphotericin B followed by posaconazole or isavuconazole

Question 36

Anterior mediastinum boundaries

Answer 36

sternum (anterior) and great vessels and pericardium posterior

Question 37

Boundaries of middle mediastinum

Answer 37

pericardium anterior and anterior surface of thoracic spine posterior