Pestana-Cardiothoracic Surgery

lizruns33's version from 2016-01-22 02:39


Question Answer
Vascular ringsCongenital anomaly with compression of trachea and esophagus
Symptoms of vascular rings Baby who is in stridor and respiratory distress. Baby assumed a hyperextended position
How are cardiac anomalies diagnosed?Echo
Faint pulmonary flow systolic murmor and fixed split second heart rate ASD
Management of small VSDs low in the septumLikely to close spontaneously within the first 2-3 years of life
Loud pansystolic murmurVSD
Where is a VSD murmur best heard?Left sternal border
Increased pulmonary vascular markings on chest XrayVSD
Continuous machine-like heart murmurPDA
Bounding peripheral pulsesPDA
Closure of a PDA Indomethacin
Murmur with diminished vascular markings Right to left shunt (the 5 T's)
5 or 6 year old becomes cyanotic Tetralogy of Fallot
Symptoms of tetralogy of fallotChildren are small, bluish hue in lips and tips of fingers, clubbing, spells of cyanosis relieved by squatting
Tetrology of Fallot murmurSystolic ejection in the left third intercostal space
Small heart and diminished vascular markings Tetrology of Fallot
EKG signs of right ventricular hypertrophyVSD
1 or 2 day old child with cyanosisTransposition of the great vessels
Kids kept alive by an ASD, VSD, or PDATransposition of the great vessels
Angina and exertional syncopal episodes Aortic stenosis
Aortic stenosis murmurHarsh midsystolic best heard at right second intercostal space along left sternal border
When is surgical valvular replacement indicated for aortic stenosis?Gradient of more than 50 mm Hg or the first indication of CHF, angina, or syncope
Blowing, high pitched diastolic murmur heard best at 2nd intercostal space and along left lower sternal borderChronic aortic insufficiency
When should a patient get surgery for chronic aortic insufficiency?At the beginning of left ventricular dilatation
Who is acute aortic insufficiency seen in?Young drug addicts
What do patients with a prosthetic valve need?Antibiotic prophylaxis for subacute bacterial endocarditis
What causes mitral stenosis?Rheumatic fever
What valve abnormality causes cough, hemoptysis, dyspnea, orthopnea?Mitral stenosis
Low pitched, rumbling diastolic apical heart murmurMitral stenosis
Progression of mitral stenosisCachetic and develop a. fib
Treatment of mitral stenosisSurgical commissurotomy or balloon valvuloplasty
What percent stenosis before surgery needed?70%
Single vessel diseaseNot the left main or LAD
Treatment for single vessel diseaseAngioplasty and stent
What vessel most commonly used for triple bypassInternal mammary
Post op care for heart surgery patientsMonitor cardiac output: if low pulmonary wedge pressure (0-3), give fluids. If high (20 or above), suggests ventricular failure
Chronic constrictive pericarditis symptomsDyspnea, hepatomegaly, ascites
Equalization of heart pressuresConstrictive pericarditis
Chance of malignancy for coin lesion80% for those older than 50
Workup for possible lung cancer after positive chest XraySputum cytology and CT scan of lung, chest, and liver
Diagnosis of lung cancerCytology... if inconclusive, biopsy via bronchoscopy for central lesions of percutaneous biopsy for peripheral lesions
VATSVideo assisted thoracic surgery
When do you not operate for lung cancer?If they don't have good pulmonary function, or mets to the mediastinal or carinal nodes, the other lung, of the liver
Are cancerous lung nodules likely calcified or non-calcified?Non-calcified
Do you operate for small cell cancer?No
PneumonectomyCentral lesion
LobectomyPeripheral lesion
What minimum of FEV is needed to operate on lung for lung cancer?800
How do you determine what fraction FEV comes from each lung?Ventilation-perfusion scan
What node involvement can you still do surgery on? (lung cancer)Hilar
What does potential cure of cancer by surgical removal of lung depend on?Extent of metastasis

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