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ABSITE 2019 > Cardiothoracic > Flashcards

Cardiothoracic Flashcards

(79 cards)

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1
Q

Azygous v anatomy

A

runs along right, dumps into SVC

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2
Q

Thoracic duct anatomy

A

runs along right, crosses at T4, dumps into left subclavian at junction w/ internal jugular vein

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3
Q

Phrenic n anatomy

A

runs anterior to hilum

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4
Q

Vagus n anatomy

A

runs posterior to hilum

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5
Q

Pneumocyte responsible for gas exchange

A

Type I

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6
Q

Pneumocyte responsible for surfactant production

A

Type II (phosphatidylcholine)

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7
Q

Direct air exchange between alveoli

A

Pores of Kahn

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8
Q

Most common cause of cancer-related death in US

A

Lung cancer

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9
Q

Most common site of brain metastasis

A

brain

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10
Q

Best predictor of pulmonary complications and being able to wean off ventilator

A

FEV1

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11
Q

Most common complication after pneumonectomy

A

arrhythmias

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12
Q

Most common lung cancer

A

adenocarcinoma

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13
Q

T staging of lung cancer

A

1 <3cm
2 >3cm but >2cm away from carina
3 local invasion or <2cm away from carina
4: distant invasion or malignant effusion (unresectable)

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14
Q

N staging of lung cancer

A

1 ipsilateral hilum nodes
2 ipsilateral mediastinal/subcarinal/aortopulmonary window (unresectable)
3: CL mediastinal, supraclavicular (unresectable)

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15
Q

Staging for lung cancer

A 
I: T1-2, N0
IIa: T1, N1
IIb: T2, N1 or T3, N0
IIIa T1-3, N2
IIIb T4, N3
IV: M1
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16
Q

Paraneoplastic syndrome associated w/ squamous cell

A

PTH-related peptide

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17
Q

Paraneoplastic syndrome associated w/ small cell

A

ACTH, ADH

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18
Q

Non-small cell cancer chemo

A

Carboplatin, Taxol

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19
Q

Small cell cancer chemo

A

cisplatin, etoposide

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20
Q

Best test for T/N status lung cancer

A

CT chest/abdomen

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21
Q

Best test for M status lung cancer

A

PET

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22
Q

Chamberlain procedure

A

anterior thoracotomy or parasternal mediastinotomy assessed enlarged AP window nodes

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23
Q

Most common coin lesion

A

granuloma

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24
Q

Most common coin lesion tumor

A

hamartoma

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25
Most common coin lesion cancer
lung adenocarcinoma
26
What makes lung tumor operable
FEV1 > 0.8 DLCO >10 No N2, N3, M disease
27
Treatment for adenoid cystic adenoma
Resect, XRT
28
Treatment for mucous gland adenoma
Resect
29
Most common benign adult lung tumor
hamartoma (made from fat, cartilage, connective tissue)
30
Appearance of hamartoma on CT
calcifications + popcorn lesion
31
Anterior Mediastinal Tumor
``` T's -Thymoma Thyroid cancer T-cell lymphoma Teratoma parathyroid Thymus ```
32
Middle mediastinal tumor
``` Heart, trachea, ascending aorta -Bronchiogenic cysts Pericardial cysts Enteric cysts lymphoma ```
33
Posterior mediastinal tumor
Esophagus, descending aorta enteric cysts neurogenic tumors lymphoma
34
Treatment for thymoma
all thymomas require resection
35
50% rule w/ thymoma
50% malignant 50% symptomatic 50% associated w/ myasthenia gravis
36
ME/TX of myasthenia gravis
Antibody to ACh receptor | TX: neostigmine, steroids, plasmapharesis
37
Most common germ cell tumor in mediastinum
Teratoma (Tx resect +/- chemo)
38
Most common malignant germ cell tumor in mediastinum
Seminoma (Tx: XRT +/- chemo)
39
Seminoma lab tests
10% Beta-HCG + | AFP -
40
Non-seminoma lab test
90% Beta-HCG + | AFP +
41
Bronchiogenic cyst tx
posterior to carina --> resect
42
Pericardial cyst tx
at right costophrenic angle --> leave alone
43
Most common benign tumor of trachea
Papilloma (adults), Hemangioma (children)
44
Most common malignant tumor of trachea
SCC (adult), Carcinoid (children)
45
Rapid exsanguination after tracheostomy
trachea-innominate artery fistula -place finger in hole, hold pressure Median sternotomy ligation and resection of innominate artery (no graft) **avoided by keeping tracheostomy between 2nd-3rd ring**
46
Mangement of trachea-esophageal fistula
Place large volume cuff ET below fistula, decomprssive gastrostomy, repair after weaned from ventilator
47
Most common site/source of lung abscess
superior segment of RLL, s. aureus
48
Tx of empyema depending on week
1: chest tube antibiotics 2 (fibro-proliferative phase): chest tube, antibiotics, VATS/deloculation if no re-expansion 3-4: decortication, fibrous peel occurs around lung (can require intra-pleural tPA, Eloesser flap)
49
Dx of chylothorax
Sudan red, increased lymphocyts, TAG >110
50
Tx of chylothorax
chest tube, octreotide, low fat diet if that fails --> ligation of thoracic duct on right If 2/2 to malignancy will need talc pleurodesis
51
Result of r--> L shunt
cyanosis (tetralogy of Fallot)
52
Result of L --> R shunt
CHF (VSD, ASD, PDA)
53
Eisenmenger's syndrome
L-->R shunt to R-->L shunt
54
Ductus arteriosus
connection between descending aorta & left pulmonary artery, shunts blood away from lungs
55
Ductus venosum
connection between portal vein and IVC, shunts blood away from liver
56
Fetal circulation
2 umbilical arteries | 1 umbilical vein
57
Tx of VSD
Diuretics, Digoxin | Repair (if large @ 1yr, If medium @ 5yr) - earlier if failure to thrive
58
ASD defects
``` Ostium secundum (most common, central) Ostium primum (frequent in Down's syndrome) ```
59
Tx of ASD
diuretics, digoxin, repair at 1-2 years of age
60
Tetralogy of Fallot (4 parts)
VSD Pulmonic stenosis Overriding aorta RV hypertrophy
61
Most common congenital heart defect that results in cyanosis
Tetralogy of Fallot
62
Tx of Tetralogy of Fallot
B-blocker | Repair (3-6 months): RV outflow tract obstruction removal & enlargement, VSD repair
63
PDA tx
Indomethacin causes PDA to close (surgical repair through left thoracotomy if it persists)
64
Left main coronary anatomy
branches into left anterior descending and circumflex
65
Best conduit for CABG
Internal mammary artery off subclavian artery, place next to LAD, collaterizes w/ superior epigastric artery
66
what protects heart during CABG
Potassium and cold solution cardioplegia - arrests heart in diastole
67
Indications for CABG
L main disease (>50% stenosis) 3 vessel disease 2 vessel disease involving LAD lesions not amenable to stenting
68
Symptoms of aortic stenosis
dyspnea on exertion, angina, syncope
69
Effect of mitral regurgitation
LV dilated, afib, pulmonary congestion
70
Effect of mitral stenosis
``` Rare now (used to be from rheumatic fever) Pulmonary edema and dyspnea ```
71
Tx of mitral stenosis
Balloon commissurotomy to open valve
72
Most common site of endocarditis on prosthetic valves
aortic valve
73
Most common site of endocarditis on naïve valve
mitral valve
74
Most common bug of endocarditis in drug users
pseudomonas
75
Most common benign tumor of heart
myxoma (75% in LA)
76
Most common malignant tumor of heart
angiosarcoma
77
Most common metastatic tumor to heart
lung cancer
78
Where is lowest oxygen tension of any tissue in the body
coronary veins
79
TX of SVC syndrome
Emergent radiation

ABSITE 2019 (8 decks)

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