BAMC Thoracic Surgery Jeopardy

Thoracic Anatomy

100

Number of segments in the Left / Right lung?

8 / 10

Picture J

200

Dark blood arising after biopsy during mediastinoscopy; 3 possible structures

SVC

Azygous

PA

Picture H

300

1. What are the layers of the esophagus

2. Airway structure most at risk during esophagectomy

1. mucosa, submucosa, circular / longitudinal muscle

2. Membranous portion of carina, Bronchus intermedius

400

Nodes accessible from Mediastinoscopy

4R, 7, 4L

Picture I

500

Describe course of the Thoracic Duct?

G

Tubes & Drains

100

What are the 3 primary risks of subclavian line placement?

1. pneumothorax
2. hemothorax
3. infection

200

1. Absolute contraindication to removing a chest tube

2. Daily chest tube output needed for removal  

1. Air leak

2. 200-300 mL per day

300

Simple para-pneumonic effusion:

1. Size of drain

2. Medications that can be instilled into drain

1. 14Fr, or larger

2. Dornase 5mg, tPA 5-10mg -- twice daily

400

This device (F) and what is its purpose?

DLT, lung isolation

500

What is the diameter of a 24 Fr chest tube?

8mm

X-Ray Vision

100

A

PTX

200

B

Anterior mediastinal mass

Thymoma, Teratoma, Lymphoma, Thyroid

300

C

RML

400

D 

Pneumomediastinum

500

E

Sequestration

Critical Care

100

Name the Pressor that is best to give during a long esophagectomy case?

NONE!!!

200

What are the 5 causes of post-operative fever in order of usual time course?

1. Atelectasis
2. UTI
3. DVT
4. Infection
5. Drug reaction

300

1. Volume for Massive Hemoptysis definition

2. Three Etiologies

3. Treatment

1. 600 mL in 24 hours

2. Infection (Aspergillosis), Bronchiectasis, Tumor erosion, PA rupture, trauma

3. Affected side down, Intubation, DLT, Cold irrigation, Epinephrine injection, Angiography, Surgery

400

1. Most common Arrhythmia associated with non-cardiac thoracic surgery.

2. Treatment

1. Atrial fibrillation, Atrial flutter

2. Amiodarone, BB, diltiazem, digoxin, cardioversion, EP ablation

500

1. Milky-white effusion

2. What test / value is required for diagnosis

1. What is a chylothorax?

2. TG >110mg/dl

Surgical Eponyms

100

Effort rupture of the esophagus

Boerhaave's Syndrome

200

The technique used to insert a pigtail catheter 

Modified Seldinger technique

300

What are the 3 types of esophagectomy techniques? 

Ivor Lewis, Transhiatal, McKeown

400

This syndrome describes venous thoracic outlet obstruction 

What is Pagett-Schroetter?

500

Crepitus in sync w/ heartbeat but not respiration

Hamman's Sign

(Oesophageal perforation w/ pneumomediastinum)