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Surgery > Thoracic > Flashcards

Thoracic Flashcards

1
Q

Recite the light’s criteria for exudative effusion

A

EXUDATIVE if

  1. Pleural protein/serum protein >0.5
  2. Pleural LDH/Serum LDH >0.6
  3. Pleural LDH > 2/3 of the upper limit of serum LDH
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2
Q

What is the mainstay CXR view in the evaluation of pleural effusion

A

CXR PA

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3
Q

What is the volume of effusion which presents with CP angle blunting?

A

200 to 500mL

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4
Q

Diagnostic modality that is able to characterize pleural effusion and detect septations

A

Chest UTZ

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5
Q

What diagnostic modality can be used for unclear etiology of pleural effusion

A

Throacoscopy/VATS

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6
Q

[Etiology based on the color of pleural fluid]

black

A

aspergillus

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7
Q

[Etiology based on the color of pleural fluid]

chocolate sauce

A

Anaerobic liver abscess

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8
Q

[Etiology based on the color of pleural fluid]

yellow-greenish

A

Rheumatoid

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9
Q

[Stage of Empyema]

swelling of pleura, presence of discharge, thin exudative fluid

A

Stage I

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10
Q

[Stage of Empyema]

Heavy fibrin deposit with turbid or purulent fluid; fibrin layer becomes heavier and pleural fluid is grossly turbid/purulent

A

Stage II

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11
Q

[Stage of Empyema]

loculations are seen during this stage

A

Stage II

transitional stage

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12
Q

[Stage of Empyema]

thick pus; presence of fibroblast and capillaries with lung trapping

A

Stage III

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13
Q

___ refers to the condition where there is dissection of pus into the chest wall

A

Empyema necessatatis

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14
Q

What are the clinical factors that favor a benign solitary pulmonary nodule

A
  1. Age <40
  2. Nonsmoker
  3. No history of malignant disease
  4. Previous history of TB, Wegener granulomatosis
  5. Lives in area endemic for histoplasmosis
  6. Immunosuppressed
  7. Nodule size is unchanged for 2 years or more
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15
Q

What are the clinical factors in favor of malignant solitary pulmonary nodule

A
  1. Age >40 years
  2. History of cigarette smoking >20-25 years
  3. Previous history of malignant disease
  4. Family history of lung CA
  5. Presence of cough, hemoptysis
  6. Presence of constitutional symptoms
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16
Q

What are the radiologic features that favor a benign SPN?

A
  1. Stability for 2 years
  2. Diameter <3cm
  3. Well-defined border
  4. Heavier density
  5. Specific patterns for calcifications
17
Q

What are the radiographic features that favor malignant SPN?

A
  1. Evidence of growth of the lesion within 2 years or less
  2. Volume doubling time 1-8 months
  3. Size >3cm
  4. Irregular contours and margins
  5. Umbilication of border
18
Q

What is the range of Hounsfield unit that is most suspicious for malignancy

A

50 to 150

Low HU unit

High HU unit = generally benign

19
Q

What are reliable signs suggesting that the lesion is benign based on CT

A
  1. Dense central core of calcification
  2. Laminated pattern with calcium in concentric layers
  3. Popcorn type o calcification
20
Q

What is the most appropriate approach for diagnosis of indeterminate SPN

A

Invasive methonds

  1. Video assisted thoracoscopic surgery
  2. Open lung biopsy
21
Q

[Paraneoplastic syndromes]

SIADH

A

Small cell lung CA

22
Q

[Paraneoplastic syndromes]

Hypercalcemia

A

Squamous cell Ca

23
Q

___ triangle where the brachial artery and subclavian artery pass through this space

A

interscalene triangle

24
Q

Prior to entering the subcoracoid space, the subclavian vein and artery, and brachial plexus pass through this space

A

Costoclavicular triangle

25
Q

Most common location of abdominal aortic aneurysm

A

Infrarenal aorta

26
Q

What is the most important predictor of AAA?

A

size of the aneurysm

27
Q

What is the preferred imaging study used to screen AAA because of its high sensitivity and specificity?

A

Abdominal UTZ

28
Q

What imaging modality is preferred to detect and measure the diameter of an AAA?

A

CT Aortogram (abdominal CT)

29
Q

What is the recommended screening for AAA for both sexes?

A
  1. Men >65 years old
30
Q

What is the recommended screening for AAA in patient’s with history of ruptured AAA?

A

55 years old in both men and women

31
Q

Repair of asymptomatic AAA is reserved for ___ diameter

A

5 to 5.5cm in diameter

32
Q

Where is the most common location of thoracic aortic aneurysm?

A
  1. Aortic root or ascending aortic aneurysm
33
Q

What are the CXR findings suggestive of Thoracis AA?

A
  1. Widened mediastinum
  2. Prominent aortic knob
  3. Displaced trachea
34
Q

What imaging modality that is widely used for detection of aortic dissection?

A

Transesophageal echocardiography

Surgery (19 decks)

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