Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Written Boards - Final > Thoracic > Flashcards

Thoracic Flashcards

1
Q

Initial tx for chylothorax?
How long can obs continue?
Treatment if obs fails for good surg cand
Poor Cand

A

CT
5-7d
Ligation
Embolization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

3 Lights Criteria? what does this tell us

A

pleural:serum protein >0.5
Plearual : serum LDH>0.6
pleural LDH>2/3 normal

Exudative effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Causes of pleural effusion
1 inc pleural membrane perm
2 inc hydrostatic p
3 hypoalb

A

sepsis, malign, pe, panc

CHF, renal, iatrogenif fluid overload
cirrhosis, nephrotic, malnut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how big is a visible effusion on cxray at minimum

A

300

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

MC extra pelvic location for endometriosis?

What complication can this cause

A

thoracic
ectopic implants cause ptx – catamenial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

secondary ptx definition

A

underlying cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

indications for surgical pleurodesis for ptx

A

Persistent air leak (≥ 4 days)

Failure of the lung to fully expand with adequate chest tube placement

Prevention of recurrent pneumothorax
After a first (or second) spontaneous pneumothorax in patients with no underlying pulmonary disease

In an individual in a high-risk profession (ie, scuba diver, pilot) after a first spontaneous pneumothorax

After a first pneumothorax in a patient with limited access to hospital care for geographic or social reasons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

pleurodesis for poor surgical candidates?

A

talc or doxy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

chance of ptx recurrence after first?

risk after pleurectomy?
vats with bleb?

A

60

1
2 to 5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what muscle is spared during a muscle sparing thoracotomy

A

lat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

3 non small cell ca in lung

A

adeno, large cell, squamous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

leading cause of cancer related death in us?

A

lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

lung cancer 5y survival per stage

A

Five-year survival is 45% to 50% at stage I, 30% at stage II, 5% to 14% at stage III, and less than 5% at stage IV.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

single nodule mets to lung (2)

A

sarcoma and melanoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

multifocal mets for lung

A

head and neck, breast, colon, renal, lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

current lung ca screening guidelines

A

55 to 80 years who have a 30-pack year smoking history and currently smoke or have quit within the past 15 years.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what bearing does a malignant effusion have on surgical indication

A

usually precludes with poor prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

lung mets work up

A

markers - cca 19-9, cea, afp, bhcg

CT CAP, PET

colonoscopy

biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

t staging for lung

A

T1 tumors: ≤ 3 cm in diameter
T2 tumors: > 3 but ≤ 5 cm in diameter
T3 tumors: > 5 but ≤ 7 cm in diameter (or invading the parietal pleural/chest wall, phrenic nerve, or pericardium, or two tumors in the same lobe)
T4 tumors: > 7 cm in diameter (or invading the mediastinum, diaphragm, heart, great vessels, trachea/carina, esophagus, recurrent laryngeal nerve, or spine, or separate nodules within the same lung but separate lobes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

supraclavicular or cervical lymphadenopathy concerning lung cancer?

what needs to be performed?

A

poor prognosis, N3

needs FNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

% of lung cancer with adrenal mets

A

7

22
Q

high met area for small cell lung and pancoast

A

brain

23
Q

what lung cancer stage gets neoadjuvant

A

stage 3

24
Q

what are the FEv1 and dlco values assoc with good surgical candidates

what needs to be performed if too low? values?

A

80%

predicted post op 40%

25
Q

cervical nerve roots in arm

A
26
Q

what needs to be performed prior to pancoast tumor resection

A

chemo rads

27
Q

only rad onc emergency

A

pancoast

28
Q

main chemo reg for lung ca

mab tx? mech?

A

paclitaxel or plat based

bevacizumab; VEGF inhib

29
Q

pulm nodule work up per size

A
30
Q

MC ant mediastinal tumor

followed by…

A

thymoma

T cell lymphoma

31
Q

posterior mediastinal tumors

A

neurogenic

32
Q

thymoma paraneoplastic percent and specific diseases

A

Associated with paraneoplastic syndromes in 30% to 50% of cases
The most common is myasthenia gravis, followed by hypogammaglobulinemia and pure red cell aplasia.

33
Q

who is hodgkin medistinal lymphoma found in

germ cell tumors: MC ____ site is mediastinum

A

bimodal peds and young women

extragonadal

34
Q

MC malignant germ cell tumor of mediastinum

A

seminoma

35
Q

MC middle medistinal mass

A

Cysts

bronchogenics are the issue not cardiac

36
Q

4 neurogenic mediastinal tumors? what compartment?
whish is malignant

A

neuroblastoma - mal
neurofibroma
schwannoma
paraganglioma

posterior

37
Q

mc posterior mediastinal tumor specifically

A

schwannoma

38
Q

MC mediastinal peds tumors per compartment

A

ant - lymphoma
mid - cysts
post - neurogenic

39
Q

MG thymoma patient presentation?

medical management?

A

Affected patients often present with ocular symptoms (eg, ptosis, diplopia), fatigue, and weakness.
Medical management may include anticholinesterases (pyridostigmine, neostigmine), glucocorticoids, and plasmapheresis.

40
Q

thymoma staging and resectability, next steps

A

Stage I: encapsulated tumor
Resectable
Stage II: capsular invasion into adjacent mediastinal fat or pleural tissue
Resectable
Stage III: invasion into neighboring structure (pericardium, great vessel, lung)
Possible thymectomy based on preoperative evaluation; otherwise induction chemotherapy
Stage IV
Stage IVa (pleural or pericardial dissemination): generally unresectable; possibly surgical debulking and chemoradiation
Stage IVb (lymphatic-hematogenous metastases): generally unresectable; possibly surgical debulking and chemoradiation

41
Q

biopsy for thymoma?

A

only if considering chemo

42
Q

Describe borders for thymectomy and blood supply

A
43
Q

chamberlain procedure

A
44
Q

surgical concept regarding pericardial fat v thymus during thymectomy

A

take all fat anterior to pericardium as it all looks the same

45
Q

2 complications to worry about for thymectomy and their treatments

A

Myasthenic crisis: respiratory failure and bulbar weakness
Provide urgent therapy with plasmapheresis or intravenous immunoglobulin.
Cholinergic crisis: increased secretions, urination, defecation, and emesis
Counteract muscarinic activation with atropine or glycopyrrolate.

46
Q

3 sources of mediastinitis

A

tooth, trach, esoph

47
Q

operative sternal mediastinitis bugs

posterior mediastinal bugs

A

Sternal mediastinitis after sternotomy is most commonly associated with Staphylococcus, followed by Pseudomonas and Acinetobacter.

strep and staph

48
Q

3 causes of chronic medistinitis

A

histoplasma, autoimmun or malignancy

49
Q

what arteries feed sternum

A

internal mamm

50
Q
A

Written Boards - Final (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions