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Surgery > Thoracic Surgery > Flashcards

Thoracic Surgery Flashcards

1
Q

What diagnostic procedure is used to visualize vascular lesions or involvement within the thorax

A

MRI

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2
Q

Which procedure diagnoses lung carcinoma and also recurrent laryngeal nerve involvement

A

Laryngoscopy

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3
Q

What can be used to remove a foreign body, remove secretions and drain infections in the lung

A

Bronchoscopy

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4
Q

Used to confirm lung/tracheobronchial tumor, source of hemoptysis, obtain lung biopsies, diagnose atelectasis or pneumonitis

A

Bronchoscopy

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5
Q

Can be used to biopsy paratracheal and subcarinal lymph nodes

A

Mediastinoscopy

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6
Q

Can be used to diagnose sarcoidosis, lymphoma and fungal infections

A

Mediastinoscopy

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7
Q

Used to detect organisms and suspected malignancies in pleural effusions

A

Thoracentesis

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8
Q

What does it mean when cytology is positive in a thoracentesis

A

The tumor is inoperable

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9
Q

Used to obtain tissue for tumor diagnosis, negative result does not rule out diagnosis

A

CT-directed fine needle aspiration biopsy

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10
Q

Necessary if needle biopsy fails, often is required

A

Open lung biopsy

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11
Q

Exposes heart, pericardium, ascending aorta and pulmonary artery

A

Median sternotomy

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12
Q

Exposes lung, esophagus, posterior mediastinum

A

Posterolateral thoracotomy

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13
Q

Used for upper lobe biopsy and sympathectomy

A

Axillary thoracotomy

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14
Q

Rapid exposure for patients with thoracic trauma

A

Anterolateral thoracotomy

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15
Q

Minimally invasive procedure that allows avoidance of a thoracotomy. Useful for effusions, diffuse lung diseases, recurrent pneumos, pulmonary nodules

A

Video-assisted thoracic surgery

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16
Q

Causes mediastinal shift away from air collection

A

Tension pneumothorax

17
Q

Process in which air escapes the lung parenchyma into the pleural space

A

Tension pneumothorax

18
Q

Complication of inadequately drained hemothorax

A

Empyema or fibrothorax

Requires thoracotomy and decortication

19
Q

Tx of tension pneumothorax

A

Needle decompression and chest tube with underwater seal (48 hrs) and suction (24 hrs)

20
Q

Tx for open pneumothorax

A

Cover the wound, thoracostomy tube

21
Q

Tx for hemothorax

A

IV resuscitation and thoracostomy tube

22
Q

Signs of cardiac tamponade

A

Hypotension and neck vein distension

23
Q

Tx for cardiac tamponade

A

Pericardiocentesis
Median sternotomy
or left anterior thoracotomy

24
Q

Tx for flail chest

A 
Pain control (intercostal block or epidural narcotics)
Aggressive pulmonary toilet
possible mechanical ventilation
25
Q

Persistent lung collapse after chest tube, persistent air leak, massive progressive subcutaneous emphysema

A

Tracheobronchial disruption

26
Q

Used to diagnose tracheobronchial disruption

A

Bronchoscopy

27
Q

Widened mediastinum, indistinct aortic knob, tracheal deviation to the right, left plural effusion

A

Aortic disruption

28
Q

Used to diagnose aortic disruption

A

Aortogram

29
Q

Tx of aortic disruption

A

Interposition graft

w/ or w/o method of distal perfusion

30
Q

CXR shows evidence of stomach or colon in chest

A

Diaphragmatic disruption

radial tear begins at esophageal hiatus

31
Q

Tx for diaphragmatic disruption

A

NG tube
Urgent transabdominal repair
(adhesions to lung may form within 7-10 days)

32
Q

Signs of rapidly progressive mediastinitis

A

Esophageal disruption

requires drainage, primary closure

33
Q

New onset arrhythmia, myocardial rupture, ventricular septal rupture or left ventricular failure after trauma

A

Cardiac contusion

34
Q

Most common thoracic trauma causing edema, small airway obstruction

A

Pulmonary contusion

35
Q

Tx for pulmonary contusion

A

O2, fluid restriction, pain control, chest physiotherapy and possible chest tube

36
Q 
Stridor, episodes of respiratory distress
Dysphagia
Barium shows extrinsic compression
Bronchoscopy shows segmental compression
Tx?
A

Vascular rings

Surgery divides smaller of two aortic arches

37
Q

Workup of a coin lesion on CXR starts with what

A

Seeking old CXR

38
Q

First noninvasive tests if lung cancer is suspected

A

Sputum cytology

CT scan

Surgery (17 decks)

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