ABSITE CH 25 Thoracic

ABSITE ch 25 thoracic
1. Course of azygous vein; what it drains into
Right thorax along esophagus; drains into SVC
2. Course of thoracic duct
Right side, crosses at T5-7, dumps into LSC at junction of LIJ
3. Longest mainstem bronchus
Left
4. Longer main pulmonary artery trunk
Right
5. Nerve running anterior to lung hilum
Phrenic
6. Nerve running posterior to lung hilum
Vagus
7. Normal lung volume of right lung
55%
8. Normal lung volume of left lung
45%
9. Accessory respiratory muscles
SCM, scalenes, levators
10. Pnuemocytes important in gas exchange
Type I pneumocytes
11. Pneumocytes important in surfactant production

Type II pneumocytes
12. Openings allowing direct exchange of air between alveoli
Pores of Kahn
13. Amount of pleural fluid produced per day
1-2L
14. Needed predicted postop FEV1 to justify lung resection
>0.8
15. Diagnostic test if FEV1 is lower than expected
VQ scan
16. Needed DLCO to justify lung resection
>11-12
17. Needed predicted postop FVC
>1.5L
18. Needed preop PCO2 and PO2
<45 and >50
19. Most common cause of cancer-related death in us
Lung cancer
20. Most common site of lung metastasis
Brain
21. Overall lung ca 5-year survival rate
10%
22. Most common type of lung cancer

Adenocarcinoma
23. Primary types of non small cell cancer (2)
Squamous, adenocarcinoma
24. Cancer type found more often centrally
Squamous
25. Cancer type found more often peripherally
Adenocarcinoma
26. NSCLC with more common local recurrence
Squamous cell
27. NSCLC with more common distant metastasis
Adenocarcinoma
28. T staging for lung cancer
T1<3cm, T2>3cm, T3 invasion of chest wall, pericardium, diaphragm or <2cm

from carina, T4 invasion of mediastinum, esophagus, trachea, vertebra, heart,
malignant effusion
29. N staging for lung cancer
N1 ipsi hilar nodes, N2 ipsi mediastinal nodes, N3 contralateral nodes or

supraclav nodes
30. Type of cancer causing 20% of lung ca; typically neuroendocrine
Small cell
31. Treatment of SCLC
Chemotherapy and XRT
32. Paraneoplastic syndrome associated with squamous cell CA
PTH-related peptide
33. Paraneoplastic syndrome associated with SCLC
ACTH, ADH release
34. Most common paraneoplastic syndrome in SCLC
ACTH production
35. Lung tumor associated with asbestos
Mesothelioma
36. Standard chemotherapy in NSCLC
Carboplatin, taxol
37. Standard chemotherapy in SCLC
Cisplatin, etoposide
38. Tumors in which mediastinoscopy is used
Central, LN>0.8cm, subcarinal LN>1.0cm
39. Left sided structures when looking down a mediastinoscope
RLN, esophagus, aorta, main PA
40. Right sided structures when looking down a mediastinoscope
Azygous, SVC
41. Anterior structures when looking down a mediastinoscope
Innominate vein and artery, right PA
42. Surgical technique to assess aortopulmonary window nodes
Chamberlain procedure
43. Tumor invading the apex of the chest wall; often causes horner�s syndrome
Pancoast tumor
44. Cancer type that mimics pneumonia; grows along alveolar walls
Bronchialveolar carcinoma
45. Neuroendocrine tumor with 90% 5-year survival
Carcinoid
46. Malignant bronchial tumors (3)
Adenoid cystic adenoma, mucoepidermoid adenoma, mucous gland adenoma
47. Most common benign adult lung tumor
Hamartoma
48. Popcorn lesion on CT of chest
Hamartoma
49. Most common site for mediastinal tumors
Thymus
50. Tumors found in anterior mediastinum (4)
Thymoma, Tcell lymphoma, Teratoma, parathyroid adenoma
51. Tumors found in middle mediastinum (4)
Bronchiogenic cyst, pericardial cyst, enteric cyst, lymphoma
52. Structures found in middle mediastinum (3)
Heart, trachea, ascending aorta
53. Structures found in posterior mediastinum (2)
Esophagus, descending aorta
54. % of thymomas that are malignant
50
55. % of thymoma patients with myasthenia gravis
50
56. % of patients with myasthenia gravis with thymoma
10
57. % of patients with myasthenia gravis who get improvement with thymectomy
80
58. Most common form of lymphoma
Tcell
59. Most common form of Hodgkins lymphoma
Nodular sclerosing
60. Most common germ cell tumor in mediastinum
Seminoma
61. Cyst posterior to carina
Bronchiogenic cyst
62. Treatment of bronchigenic cyst
Resection
63. Cyst found at right costophrenic angle
Pericardial cyst
64. Most common neurogenic tumor
Neurolemoma
65. Neurogenic tumors that produce catecholamines
Paraganglioma
66. % of symptomatic mediastinal masses that are malignant
50
67. % of asymptomatic mediastinal masses that are benign
90
68. Most common benign tracheal tumors in adults
Papilloma
69. Most common benign tracheal tumor in children
Hemangioma
70. Most common malignant tracheal tumor
Squamous cell
71. Most common late complication after tracheal surgery
Granulation tissue
72. Treatment of laryngeal edema
Intubation, racemic epi, steroids
73. Potential treatments of postintubation stenosis (2)
Resection, laser ablation
74. Risk of tracheostomy, esp when below 3rd cricoid ring
Tracheoinnominate fistula
75. Most common area of lung abscess
Posterior segment of RUL, superior segment of RLL
76. Common cause of empyema
Pneumonia
77. First phase of empyema, lasts 0-24h
Exudative phase
78. Second phase of empyema, lasts 24-72 hours
Fibroproliferative phase
79. Third phase of empyema, >72h
Organized phase
80. Treatment of organized phase empyema
Decortication or Eloesser
81. Treatment of exudative and fibroproliferative phase of empyema
Chest tube, antibiotics
82. Lab tests that diagnose chylothorax
Lymphocytes and TAGs
83. Location where thoracic duct crosses from right to left
T5-7
84. Conservative therapy for chylothorax
Chest tube, octreotide, TPN (or low-fat diet)
85. Optimal location to ligate thoracic duct
Low in mediastinum
86. Most common source of massive hemoptysis
Bronchial arteries
87. Treatment of massive hemoptysis
Mainstem intubation of unaffected side, OR for lobectomy or pneumonectomy,

bronchial artery embolization
88. Recurrence risk of spontaneous PTX after first occurance
20%
89. Recurrence risk of spontaneous PTX after second occurance
60%
90. Recurrence risk of spontaneous PTX after third occurance
80%
91. Most common side of spontaneous PTX
Right
92. Treatment of multiple spontaneous PTX
Thoracoscopy, blebectomy, mechanical pleurodesis
93. Most common mediastinal cyst
Bronchiogenic cyst
94. Abnormal lung tissue not connected into bronchial system
Bronchiogenic cysts
95. Lung tissue not connected to bronchial vasculature
Sequestration
96. Treatment of pulmonary sequestration
Lobectomy
97. Solitary pulmonary nodule with h/o sarcoma or melanoma: new primary or met??
More likely to be met
98. Solitary pulmonary nodule with h/o breast or H&N cancer: new primary or met??
More likely to be new primary

99. Most likely cause of arrest after blunt trauma
Tension pneumothorax
100. Endometrial implants on visceral lung pleura that causes PTX in relation to
menstruation
Catamenial PTX
101. Treatment of residual hemothorax despite 2 well-placed chest tubes
Thoracoscopic drainage
102. Whiteout on CXR with mediastinal shift toward whiteout: dx and tx
Atelectasis: do bronch
103. Whiteout on CXR with mediastinal shift away from whiteout: dx and tx
Effusion: chest tube
104. Causes of bronchiectasis (3)
Infection, tumor, cystic fibrosis
105. Parenchymal lung lesion + enlarged hilar nodes in TB
Gohn complex
106. Noncaseating granulomas common in:
Sarcoidosis
107. Caseating granulomas common in:
TB
108. Protein level in exudate
>3
109. LDH pleural fluid:serum in exudate
>0.6
110. Glucose in exudate
Low
111. Treatment of recurrent pleural effusion
Mechanical pleurodesis
112. Treatment of malignant pleural effusions
Talc pleurodesis
113. Connections between pulmonary arteries and veins; common in Osler

Weber Rendu
AVMs
114. Tx of lung AVMs
Embolization
115. Most common benign chest wall tumor
Osteochondroma
116. Most common malignant chest wall tumor
Chondrosarcoma

ABSITE CH 25 Thoracic

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ABSITE ch 25 thoracic

1. Course of azygous vein; what it drains into

Right thorax along esophagus; drains into SVC

2. Course of thoracic duct

Right side, crosses at T5-7, dumps into LSC at junction of LIJ

3. Longest mainstem bronchus

4. Longer main pulmonary artery trunk

5. Nerve running anterior to lung hilum

6. Nerve running posterior to lung hilum

7. Normal lung volume of right lung

8. Normal lung volume of left lung

9. Accessory respiratory muscles

SCM, scalenes, levators

10. Pnuemocytes important in gas exchange

11. Pneumocytes important in surfactant production

12. Openings allowing direct exchange of air between alveoli

13. Amount of pleural fluid produced per day

14. Needed predicted postop FEV1 to justify lung resection

15. Diagnostic test if FEV1 is lower than expected

16. Needed DLCO to justify lung resection

17. Needed predicted postop FVC

18. Needed preop PCO2 and PO2

<45 and >50

19. Most common cause of cancer-related death in us

20. Most common site of lung metastasis

21. Overall lung ca 5-year survival rate

22. Most common type of lung cancer

23. Primary types of non small cell cancer (2)

24. Cancer type found more often centrally

25. Cancer type found more often peripherally

26. NSCLC with more common local recurrence

27. NSCLC with more common distant metastasis

28. T staging for lung cancer

T1<3cm, T2>3cm, T3 invasion of chest wall, pericardium, diaphragm or <2cm

29. N staging for lung cancer

N1 ipsi hilar nodes, N2 ipsi mediastinal nodes, N3 contralateral nodes or

30. Type of cancer causing 20% of lung ca; typically neuroendocrine

31. Treatment of SCLC

Chemotherapy and XRT

32. Paraneoplastic syndrome associated with squamous cell CA

ACTH, ADH release

34. Most common paraneoplastic syndrome in SCLC

35. Lung tumor associated with asbestos

36. Standard chemotherapy in NSCLC

37. Standard chemotherapy in SCLC

38. Tumors in which mediastinoscopy is used

Central, LN>0.8cm, subcarinal LN>1.0cm

39. Left sided structures when looking down a mediastinoscope

RLN, esophagus, aorta, main PA

40. Right sided structures when looking down a mediastinoscope

41. Anterior structures when looking down a mediastinoscope

Innominate vein and artery, right PA

42. Surgical technique to assess aortopulmonary window nodes

45. Neuroendocrine tumor with 90% 5-year survival

46. Malignant bronchial tumors (3)

Adenoid cystic adenoma, mucoepidermoid adenoma, mucous gland adenoma

47. Most common benign adult lung tumor

48. Popcorn lesion on CT of chest

49. Most common site for mediastinal tumors