Thoracic – TCAR Questions AND Correct Answers EXAM
3 stages of empyema - ✔✔ Exudative
Fibrinopurulent
Organizing
5 Criteria of a solitary pulmonary nodule - ✔✔ 1. single
2. <3 cm
3. surrounded by normal lung
4. no adenopathy
5. no pleural effusion
5-YS after resection of solitary brain met for lung cancer - ✔✔ 20%
Accessory muscles of respiration - ✔✔ SCM
Levators
Serratus posterior
Scalenes
Adson's test for thoracic outlet syndrome - ✔✔ Decreased radial pulse with head turned toward
ipsilateral side (subclavian artery compression - arterial TOS)
Alveolar, arterial, and venous pressures in lung zones in upright person - ✔✔ Zone I: PA > Pa > Pv
Zone II: Pa > PA > Pv
Zone III: Pa > Pv > PA
Anterior mediastinal tumors - ✔✔ T's
Thyroid
Parathyroid
T-cell lymphoma
Thymoma
Teratoma
,Cystic hygroma
Anterior structures when looking into middle mediastinum with mediastinoscopy - ✔✔
Innominate vein
Innominate artery
right PA
Best diagnostic test for a tracheo-esophageal fistula - ✔✔ Bronch - pull tracheostomy or ETT back
usually see a big hole 1-2 cm below the tracheal stoma
Best diagnostic test for lung abscess - ✔✔ CT chest - air fluid levels
Best surgical approach for arterial TOS - ✔✔ Supraclavicular
Best surgical approach for neurogenic and venous TOS - ✔✔ Transaxillary
Blood supply lower 2/3 of trachea - ✔✔ bronchial arteries
Blood supply lung parenchyma - ✔✔ bronchial arteries
Blood supply upper 2/3 of trachea - ✔✔ inferior thyroid arteries
Borders of scalene triangle - ✔✔ SCM anterior
Trapezius posterior
Subclavian vein inferior
IJ medial
Omohyoid superior
Causes of massive hemoptysis - ✔✔ TB (MCC overall causes bronchial and pulmonary artery
aneurysms)
Bronchiectasis (MC from cystic fibrosis, dilated bronchial arteries)
, Lung abscess (bronchial arteries)
Chemotherapy for germ cell tumors of the mediastinum - ✔✔ Cisplatin
Bleomycin
Etoposide
Claggett procedure - ✔✔ for bronchopleural fistula after pneumonectomy - fill post
pneumonectomy space with permanent abx solution and bronchus coverage with intercostal
muscle flap
Criteria for high risk with solitary pulmonary nodule (4) - ✔✔ 1. age >60
2. size >2.2 cm
3. speculated
4. current smoker
Criteria for intermediate risk with solitary pulmonary nodule (4) - ✔✔ 1. age 45-60
2. size 1.5-2.2 cm
3. scalloped
4. current smoker or quit <7 years ago
Criteria for low risk with solitary pulmonary nodule (6) - ✔✔ 1. age <45
2. never smoked or quit >7 years ago
3. smooth lesion
4. size <1.5 cm
5. popcorn calcification (hamartoma) or laminated calcification (granuloma)
6. no change in CXR in 2 years
Diagnosis and evaluation for operability for lung cancer - ✔✔ CXR
CT C/A/P
Chest MRI - best for spinal cord invasion and superior sulcus tumors
Head MRI only if sx (headache)
3 stages of empyema - ✔✔ Exudative
Fibrinopurulent
Organizing
5 Criteria of a solitary pulmonary nodule - ✔✔ 1. single
2. <3 cm
3. surrounded by normal lung
4. no adenopathy
5. no pleural effusion
5-YS after resection of solitary brain met for lung cancer - ✔✔ 20%
Accessory muscles of respiration - ✔✔ SCM
Levators
Serratus posterior
Scalenes
Adson's test for thoracic outlet syndrome - ✔✔ Decreased radial pulse with head turned toward
ipsilateral side (subclavian artery compression - arterial TOS)
Alveolar, arterial, and venous pressures in lung zones in upright person - ✔✔ Zone I: PA > Pa > Pv
Zone II: Pa > PA > Pv
Zone III: Pa > Pv > PA
Anterior mediastinal tumors - ✔✔ T's
Thyroid
Parathyroid
T-cell lymphoma
Thymoma
Teratoma
,Cystic hygroma
Anterior structures when looking into middle mediastinum with mediastinoscopy - ✔✔
Innominate vein
Innominate artery
right PA
Best diagnostic test for a tracheo-esophageal fistula - ✔✔ Bronch - pull tracheostomy or ETT back
usually see a big hole 1-2 cm below the tracheal stoma
Best diagnostic test for lung abscess - ✔✔ CT chest - air fluid levels
Best surgical approach for arterial TOS - ✔✔ Supraclavicular
Best surgical approach for neurogenic and venous TOS - ✔✔ Transaxillary
Blood supply lower 2/3 of trachea - ✔✔ bronchial arteries
Blood supply lung parenchyma - ✔✔ bronchial arteries
Blood supply upper 2/3 of trachea - ✔✔ inferior thyroid arteries
Borders of scalene triangle - ✔✔ SCM anterior
Trapezius posterior
Subclavian vein inferior
IJ medial
Omohyoid superior
Causes of massive hemoptysis - ✔✔ TB (MCC overall causes bronchial and pulmonary artery
aneurysms)
Bronchiectasis (MC from cystic fibrosis, dilated bronchial arteries)
, Lung abscess (bronchial arteries)
Chemotherapy for germ cell tumors of the mediastinum - ✔✔ Cisplatin
Bleomycin
Etoposide
Claggett procedure - ✔✔ for bronchopleural fistula after pneumonectomy - fill post
pneumonectomy space with permanent abx solution and bronchus coverage with intercostal
muscle flap
Criteria for high risk with solitary pulmonary nodule (4) - ✔✔ 1. age >60
2. size >2.2 cm
3. speculated
4. current smoker
Criteria for intermediate risk with solitary pulmonary nodule (4) - ✔✔ 1. age 45-60
2. size 1.5-2.2 cm
3. scalloped
4. current smoker or quit <7 years ago
Criteria for low risk with solitary pulmonary nodule (6) - ✔✔ 1. age <45
2. never smoked or quit >7 years ago
3. smooth lesion
4. size <1.5 cm
5. popcorn calcification (hamartoma) or laminated calcification (granuloma)
6. no change in CXR in 2 years
Diagnosis and evaluation for operability for lung cancer - ✔✔ CXR
CT C/A/P
Chest MRI - best for spinal cord invasion and superior sulcus tumors
Head MRI only if sx (headache)
