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THORACIC – TCAR EXAM WITH ALL
ANSWERS CORRECT
Blood bsupply bupper b2/3 bof btrachea b- b bcorrect banswer- binferior bthyroid barteries Blood bsupply blower b2/3 bof btrachea b- b bcorrect banswer- bbronchial barteries Blood bsupply blung bparenchyma b- b bcorrect banswer- bbronchial barteries Pathway bof bazygous bvein bin bthe bthorax b- b bcorrect banswer- bruns balong bR bside band bdumps binto bsuperior bvena bcava Pathway bof bthoracic bduct bin bthe bchest b- b bcorrect banswer- bruns balong bR bside, bcrosses bmidline bat bT4-T5, bgoes binto bL bneck band bdumps binto bL bsubclavian bvein bat bjunction bwith bLIJ Pathway bof bphrenic bnerve bin bthorax b- b bcorrect banswer- bruns banterior bto bhilum Pathway bof bvagus bnerve bin bthorax b- b bcorrect banswer- bruns bposterior bto bhilum
What bfissures bexist bin bthe blungs? b- b bcorrect banswer- bMajor boblique bseparates bRLL bfrom bmiddle band bupper blobe Minor bseparates bupper bfrom bmiddle blobe Muscle bused bin bquiet brespiration b- b bcorrect banswer- bDiaphragm b80%, bintercostals b20% Accessory bmuscles bof brespiration b- b bcorrect banswer- bSCM Levators Serratus bposterior Scalenes Main bsurface bactive bagent bin bsurfactant b- b bcorrect banswer- bphosphatidylcholine Alveolar, barterial, band bvenous bpressures bin blung bzones bin bupright bperson b- b bcorrect banswer- bZone bI: bPA b> bPa b> bPv Zone bII: bPa b> bPA b> bPv Zone bIII: bPa b> bPv b> bPA Normal bpulmonary bartery bpressure b- b bcorrect banswer- b25/10 b(mean b15) What bpredicted bvalue bis bneeded bfor bpulmonary bresection? b- b bcorrect banswer- bPredicted bpostop bFEV1 b> b0.8L b(>40% bpredicted) What bcan bbe bdone bif bthe bpredicted bpostop bFEV1 bis bclose bto b0.8 b(40% bpredicted)? b- b bcorrect banswer- bObtain ba bV/Q bscan band bsee bhow bmuch bthat bsegment bactually bcontributes Single bbest bpredictor bof bbeing bable bto bwean boff bventilator bafter bpulmonary bresection b- b bcorrect banswer- bFEV Minimum bDLCO bfor blung bresection b- b bcorrect banswer- b>11-12 bml/min/mmHg bCO b(>50% bpredicted bvalue) What bsix bthings beffect bDLCO? b- b bcorrect banswer- bPulmonary bcapillary bsurface barea Hgb Alveolar barchitecture Dead bspace Low bCO Pulmonary bHTN What bpCO2 bis bnecessary bfor blung bresection? b- b bcorrect banswer- b<45 bat brest What bpO2 bis bnecessary bfor blung bresection? b- b bcorrect banswer- b>60 bat brest, bnot bon bO
What bshould bbe bexpected bwith bhypotension, bcyanosis, btachycardia, band bdisplaced bheart bon bCXR bafter bR bpneumnoectomy? b- b bcorrect banswer- bCardiac bherniation bthrough bpericardium Treatment band bprevention bof bcardiac bherniation bafter bR bpneumonectomy b- b bcorrect banswer- bPericarial bGortex bpatch What bshould bbe bexpected bwith bpooled bsecretions, brecurrent binfection, bor bbronchial bstump bblowout bafter bL bpneumonectomy? b- b bcorrect banswer- bLong bbronchial bstump bsyndrome How bis blong bbronchial bstump bsyndrome btreated? b- b bcorrect banswer- bShorten bbronchus band bcover bwith bflap Mortality bwith bwedge? blobectomy? bpneumonectomy? b- b bcorrect banswer- bwedge b- b1% lobectomy b- b3% pneumonectomy b- b6% b(R>L) Treatment bof bpersistent bair bleak bin bCT b- b bcorrect banswer- bCheck bsystem 2nd bCT banteriorly Bronch b(foreign bbody, bBPF, bmucous bplug) CT bchest Wait b 7 bdays bthen bmechanical bpleurodesis Treatment bof batelectasis bresistant bto busual bmeasures b- b bcorrect banswer- bBronch bto blook bfor bmucous bplugging Increase bTV bif balready bvented MCC bof badult bTEF b- b bcorrect banswer- bEsophageal bcancer beroding binto btrachea Treatment bof badult bTEF bcaused bby besophageal bcancer berosion b- b bcorrect banswer- bStent besophagus Treatment bof bpostop badult bTEF b- b bcorrect banswer- bRepair besophagus bprimarily Close bhole bin btrachea bor bbronchus Interpose btissue bso bTEF bwon't bcome bback b(pericardial bfat bpad bor bintercostal bmuscle) Primary bcause bof bARDS bpicture bafter bpneumonectomy b- b bcorrect banswer- bInflammatory breaction b(PMNs, bO2 bradicals, bcytokines, bvascular bpermeability) Increased bperfusion bto bremaining blung Tx blike bARDS MCC bof bempyema b- b bcorrect banswer- bpneumonia bwith bsubsequent binfection bof bparapneumonic beffusion
Symptoms bof bemypema b- b bcorrect banswer- bpleuritic bchest bpain, bfever, bcough, bSOB Pleural bfluid bin bempyema b- b bcorrect banswer- bWBC b> b 500 bcells/cc Bacteria
- bgram bstain 3 bstages bof bempyema b- b bcorrect banswer- bExudative Fibrinopurulent Organizing Treatment bof bstage bI b- bexudative bempyema b- b bcorrect banswer- bCT b+ babx b Send bcx bfor bdrainage band bcytology Treatment bof bstage bII b- bfibrinopurulent bempyema b- b bcorrect banswer- bCT b+ babx send bdrainage bfrom bcultures band bcytology failure bto bre-expand blung b- bVATS bdeloculation Treatment bof bstage bIII b- borganizing b(chronic) bempyema b- b bcorrect banswer- bDecortication b+/- bmuscle bflap send bfluid bfor bcultures band bcytology abx nutrition Eloesser bflap bif bcan't btolerate bdecort ballowing bdirect bopening bto bexternal benvironment bfor bdrainage MCC bof bearly bbronchopleural bfistula b- b bcorrect banswer- btechnical berror Treatment bof bearly b<7 bdays bbronchopleural bfistula b- b bcorrect banswer- breoperation bwith bintercostal bmuscle bflap bover bbronchus Presentation bof bearly bbronchopleural bfistula b- b bcorrect banswer- bmassive bair bleak bwith brespiratory bcompromise collapsed blung band bptx bon bxray MCC bof blate bpostop bor bnon-surgical bbronchopleural bfistula b- b bcorrect banswer- bpressure bfrom bempyema bmakes bhole bin bbronchus How bdo blate bpostop bor bnon bsurgical bbronchopleural bfistulas bpresent? b- b bcorrect banswer- babrupt bserosanguinous bor bpurulent bsputum bproduction b+/- brespiratory bdistress What bis bthe bkey bpreventative bmeasure bfor ba blate bpostop bor bnonsurgical bbronchopleural bfistula? b- b bcorrect banswer- bprotect bthe bcontralateral blung bfrom baspiration bof bempyema bfluid
What bis bthe bdifference bbetween btypical band batypical bbronchial bcarcinoids? b- b bcorrect banswer- bTypical b(90%) b5% bmets, bhomogenous; batypical bare bnecrotic band bdisorganized, bheterogenous, b>1 bmitosis bper bHPF Strongest brisk bfactor bfor bsurvival bfor bbronchial bcarcinoids b- b bcorrect banswer- bAtypical bvs. btypical What bdo badenoid bcystic bbronchial blesions bhave ba bpredilection bto binvade? b- b bcorrect banswer- bPerineural What bis bthe bbest btreatment bfor ban bunresectable badenoid bcystic bbronchial blesion? b- b bcorrect banswer- bXRT b- bvery bsensitive bto bXRT band bslow bgrowing Treatment bof bupper bairway btumors b- b bcorrect banswer- bResection bwith b 1 bcm bmargin bfor ball bresectable bprimary band bno bdistant bmets Except bhemangiomas band bpapillomas busually bresolve bon btheir bown Most bcommon blate bcomplication bafter btracheal bsurgery b- b bcorrect banswer- bGranulation btissue bformation Most bcommon bearly bcomplication bafter btracheal bsurgery b- b bcorrect banswer- blaryngeal bedema Most bcommon blocation bof bpost-intubation bstenosis b- b bcorrect banswer- bAt bstoma bsite bwith btracheostomy At bballoon bcuff bsite bwith bET btube Treatment bof bpost-intubation bstenosis b- b bcorrect banswer- bA bfew bserial bdilations bif bmild Tracheal bresection bwith bend-to-end banastomosis bif bmoderate bor bsevere Emergent b- brigid bbronch, bdilation, blikely bemergent btrach What bis bthe bmortality bfrom ba btracheoinnominate bfistula b- b bcorrect banswer- b90% Where bdoes bthe binnominate bartery bcross bthe btrachea? b- b bcorrect banswer- bAt bthe b5th bring Treatment boptions bfor btracheoinnominate bfistula b- b bcorrect banswer- bBlow bup bballoon bor bcompress bagainst bsterum Oral bintubation band bcompress bfistula bwith bfinger bthrough btrach bhole Rigid bscope bthrough bmouth bto bpush btrach btube bup bagainst bfistula Median bsternotomy band bsurgical bligation bwith bpartial binnominate bartery bresection. bTracheal brepair bwith bstrap bmuscle binterposition bbetween bligated binnominate bends band btrachea
Best bdiagnostic btest bfor ba btracheo-esophageal bfistula b- b bcorrect banswer- bBronch b- bpull btracheostomy bor bETT bback busually bsee ba bbig bhole b1-2 bcm bbelow bthe btracheal bstoma Treatment bof btracheo-esophageal bfistula b- b bcorrect banswer- bWait buntil bextubated bbefore brepair b- bkeep bETT bbelow bthe bfistula Tracheal bresection band bre-anastomosis Primary brepair bof besophagus band binterpose bstrap bmuscle bbetween besophagus band btrachea bso bit bdoesn't brecur Where bis bthe bideal btracheostomy blocation? bWhat boccurs bif bit's btoo bhigh? bToo blow? b- b bcorrect banswer- bBetween bthe b2nd band b3rd btracheal brings Too bhigh b- bvocal bcord bproblems Too blow b- btracheo-innominate bfistula What bis bthe bmain bissue bwith bhemoptysis bfrom bpulmonary bartery bcatheter? b- b bcorrect banswer- bSecuring bthe bairway b- bpts bdie bof basphyxiation, bnot bhemorrhage Treatment bof bhemoptysis bfrom bpulmonary bartery bcatheter b- b bcorrect banswer- bIncrease bPEEP Bronch band bmainstem bintubate bnon-affected bside bwith bsingle blumen btube band binflate bballoon Keep bbleeding bside bdown Correct bcoagulation T&S bfor b6U bPRBC Possible blobectomy What bis bmassive bhemoptysis bdefined bas? b- b bcorrect banswer- b>600 bcc bin b 24 bhours Causes bof bmassive bhemoptysis b- b bcorrect banswer- bTB b(MCC boverall bcauses bbronchial band bpulmonary bartery baneurysms) Bronchiectasis b(MC bfrom bcystic bfibrosis, bdilated bbronchial barteries) Lung babscess b(bronchial barteries) MCC bof bdeath bfrom bmassive bhemoptysis b- b bcorrect banswer- basphyxiation MC bsite bof bbleeding bwith bmassive bhemoptysis b- b bcorrect banswer- bhigh bpressure bbronchial barteries Treatment bof bmassive bhemoptysis b- b bcorrect banswer- bAffected bside bdown Rigid bbronch bon bnon-affected bside band bventilate Control bbleeding bon baffected bside bwith bcold bsaline birrigation, bepi bsoaked bgauzes, bcautery, bbronchial bblockers Place bdouble blumen btube bor bmainsten bsingle blumen Reverse banticoagulation
Risk bof brecurrence bof bspontaneous bpneumothorax b- b bcorrect banswer- bafter b1st b- b20% after b2nd b- b60% after b3rd b- b80% MC blocation bof ba bspontaneous bpneumothorax b- b bcorrect banswer- brupture bof ba blung bbleb bin bthe bupper blobe bapex bon bthe bR Treatment bof bspontaneous bpneumothorax. bIndications bfor bsurgery. b- b bcorrect banswer- bChest btube Surgical bindications b(thorascopy, bblebectomy, bmechanical bpleurodesis)
- brecurrence
- blarge bblebs bon bCT
- bair bleak b> b 7 bdays bdespite b 2 bgood bCT
- bnon-reexpansion bof blungs bdespite b 2 bgood bCT
- btension bpneumo
- bb/l bpneumo
- bhemothorax
- bprevious bpneumonectomy
- bhigh brisk bprofession: bpilot, bdiver, bmountain bclimber, blives bin bremote barea What bshould bbe bsuspected bwith btachypnea band bdiffuse bb/l binfiltrates bon bCXR bin ba bpatient bafter btalc bpleurodesis? b- b bcorrect banswer- bTalc binduced bpneumonitis How bcan brisk bof btalc binduced bpneumonitis bbe breduced? b- b bcorrect banswer- b<2g btotal bused Sterilized Medium bsized bparticles Thoracic boutlet banatomy b- b bcorrect banswer- bAnterior bto bposterior: Subclavian bvein Anterior bscalene bmuscle Subclavian bartery Brachial bplexus Middle bscalene bmuscle What bforms bthe bscalene btriangle? b- b bcorrect banswer- bAnterior bscalene, bmiddle bscalene, b1st brib Symptoms bof bthoracic boutlet bsyndrome b- b bcorrect banswer- bPain band bparesthesias b95% Motor bweakness band batrophy bof bhypothenar bmuscles Which bis bmore bcommonly binvolved bin bthoracic boutlet bsyndrome b- bneuro bor bvascular? b- b bcorrect banswer- bNeurologic
MCC banatomic babnormality bcontributing bto bthoracic boutlet bsyndrome b- b bcorrect banswer- bcervical brib MC bcause bof bpain bwith bthoracic boutlet bsyndrome b- b bcorrect banswer- bbrachial bplexus birritation Tinsel's btest bfor bthoracic boutlet bsyndrome b- b bcorrect banswer- btapping breproduces bsymptoms b(neurogenic bTOS) Adson's btest bfor bthoracic boutlet bsyndrome b- b bcorrect banswer- bDecreased bradial bpulse bwith bhead bturned btoward bipsilateral bside b(subclavian bartery bcompression b- barterial bTOS) Workup bfor bneurogenic bTOS b- b bcorrect banswer- bCXR b(cervical bribs, bbony bspurs, bcervical bspace bnarrowing) MRI b(cervical bspace bnarrowing) Nerve bconduction bvelocity b(abnormal b<60 bm/S bat bthoracic boutlet) What bis ban babnormal bnerve bconduction bvelocity bindicating bneurogenic bTOS? b- b bcorrect banswer- b<60 bm/S bat bthoracic boutlet Most bcommon bneurogenic bsymptoms bseen bwith bTOS b- b bcorrect banswer- bUlnar bnerve bdistribution b- bC8-T1 bweak b4th band b5th bfingers band bintrinsic bmuscles bof bthe bhand, bweak bwrist bflexion, btriceps bweakness band batrophy, bpain band bparesthesias bin bmedial bforearm Treatment bfor bneurogenic bTOS b- b bcorrect banswer- bphysiotherapy bfor b 3 bmonths change bjobs bPT/OT bdo bnot brush bto boperate if bfails band bNCV b<60 bm/S b- b1st brib bresection What busually bcauses bsubclavian bartery bcompression bin bTOS? b- b bcorrect banswer- bAnterior bscalene bhypertrophy Tests bfor barterial bTOS b- b bcorrect banswer- bAdson's, bhyper-abduction, bcostoclavicular ball bresult bin bloss bof bradial bpulse bhand bis bcold band bpale Diagnosis bof barterial bTOS b- b bcorrect banswer- bangio Treatment bof barterial bTOS b- b bcorrect banswer- bEmergent b+ bthreatened- bbrachial bartery bdissection band bfogarty, b1st brib bresection Emergent b+ bNon-threatened b- bcatheter bdirected bintra-arterial bthrombolytics Non-emergent b- b1st brib band bcervical brib bresection
Criteria bfor blow brisk bwith bsolitary bpulmonary bnodule b(6) b- b bcorrect banswer- b1. bage b<
- bnever bsmoked bor bquit b>7 byears bago
- bsmooth blesion
- bsize b<1.5 bcm
- bpopcorn bcalcification b(hamartoma) bor blaminated bcalcification b(granuloma)
- bno bchange bin bCXR bin b 2 byears Criteria bfor bintermediate brisk bwith bsolitary bpulmonary bnodule b(4) b- b bcorrect banswer- b1. bage b45-
- bsize b1.5-2.2 bcm
- bscalloped
- bcurrent bsmoker bor bquit b<7 byears bago Management bof bsolitary bpulmonary bnodule bin bintermediate brisk bpatient b- b bcorrect banswer- btranspleural bor btransbronchial bneedle bbx b(10% brisk bPTX, b1% brisk bCT) VATS bwedge bresection bif babove bnon bdiagnostic bor bnot baccessible Serial bchest bCTs bq b 3 bmonths bx b 4 bthen bq b 6 bmonths bx b 2 Management bof bsolitary bpulmonary bnodule bin bhigh brisk bpatient b- b bcorrect banswer- bVATS bwedge bresection bif bpatient bcan btolerate Criteria bfor bhigh brisk bwith bsolitary bpulmonary bnodule b(4) b- b bcorrect banswer- b1. bage b>
- bsize b>2.2 bcm
- bspeculated
- bcurrent bsmoker What bpercentage bof bsolitary bpulmonary bnodules bare bmalignant? b- b bcorrect banswer- b5-10% age b<50 b- b<5% bmalignant age b>50 b- b>50% bmalignant MC blesion boverall bcausing ba bsolitary bpulmonary bnodule b- b bcorrect banswer- bGranuloma b(histoplasmosis bMC, bcocci, bTB) MC btumor boverall bcausing bsolitary bpulmonary bnodule b- b bcorrect banswer- bHamartoma b(benign, b10% bof ball bcases) MC bmalignant btumor bpresenting bas bsolitary bpulmonary bnodule b- b bcorrect banswer- bBronchogenic bcarcinoma b(MC badenocarcinoma) #2: bmets b(breast bcancer bMC) MC bcancer brelated bdeath bin bthe bUS b- b bcorrect banswer- blung bcancer MC btype bof blung bcancer b- b bcorrect banswer- badenocarcinoma
Strongest binfluence bof bsurvival bin bpatients bwith blung bcancer bwithout bsystemic bmets b- b bcorrect banswer- bnodal bstatus MC bsite bof bmets bfrom blung bcancer b- b bcorrect banswer- bBrain 5-YS bafter bresection bof bsolitary bbrain bmet bfor blung bcancer b- b bcorrect banswer- b20% What bsided blung btumors bhave bincreased bN3 brate? b- b bcorrect banswer- bLeft bsided Overall b5-YS bfor blung bcancer? b- b bcorrect banswer- b10% b 35% bwith bresection bfor bcure What bpercentage bof blung bcancer brecurrences boccur bwithin b1-2 byears? b- b bcorrect banswer- b80% What btype bof blung bcancer bis balmost bnever bresectable bsecondary bto bearly bspread? b- b bcorrect banswer- bSmall bcell blung bcancer Diagnosis band bevaluation bfor boperability bfor blung bcancer b- b bcorrect banswer- bCXR CT bC/A/P Chest bMRI b- bbest bfor bspinal bcord binvasion band bsuperior bsulcus btumors Head bMRI bonly bif bsx b(headache) bone bscan bfor bbone bpain bor belevated balk bphos bonly Bronchoscopy Labs b(LFTs) PET bscan EKG b(stress btest bif bnecessary) PFTs, bABG, bDLCO Methods bto bimprove bpulmonary bfunction bpreop b- b bcorrect banswer- bAlbuterol/atrovent Abx's D/C bsmoking IS Pulmonary brehab What bshould bbe bdone bif bworkup bfor blung bcancer breveals bmets? b- b bcorrect banswer- bTissue bdx What bshould bbe bdone bif bworkup bfor blung bcancer breveals bmediastinal badenopathy b(>1.0 bcm) bor bcentral bmass? b- b bcorrect banswer- bMediastinoscopy bto bassess bipsilateral b(N2) band bcontralateral b(N3) bnodes b- bif beither bpositive bthen bunresectable Left-sided bstructures bwhen blooking binto bmiddle bmediastinum bwith bmediastinoscopy b- b bcorrect banswer- bRLN
Malignant bpleural bor bpericardial beffusion OR Satellite btumor bnodules binvolving bthe bsame blobe b(different blobe bis bM1) N1 blung bcancer b- b bcorrect banswer- bresectable Ipsilateral bperibronchial bor bhilar N2 blung bcancer b- b bcorrect banswer- bunresectable bipsilateral bmediastinal bor bcarinal N3 blung bcancer b- b bcorrect banswer- bunresectable bcontralateral bmediastinal bor bhilar, bsupraclavicular, bor bscalene Lung bcancer bstage bIA b- b bcorrect banswer- bT1N0M Lung bcancer bstage bIB b- b bcorrect banswer- bT2N0M Lung bcancer bstage bIIA b- b bcorrect banswer- bT1N1M Lung bcancer bstage bIIB b- b bcorrect banswer- bT2N2M T3N0M Lung bcancer bstage bIIIA b- b bcorrect banswer- bT3N1M0, bT1-3N2M Lung bcancer bstage bIIIB b- b bcorrect banswer- bany bT4 bor bN Treatment bof blung bcancer bstages bI band bII b- b bcorrect banswer- bformal blung bresection b(lobe bor bpneumonectomy, bif bno bcancer bdx byet bthen bwedge) Mediastinal blymph bnode bdissection bif bmediastinoscopy bnto bdone Adjuvant bchemo b- bcarboplatin band bpaclitaxel b(cisplatin band bpemetrexed bfor blung bSCCA) Treatment bof blung bcancer bstage bIIIA b- b bcorrect banswer- bT3N1M0 b- bresectable, busually bneoadjuvant bchemo bXRT N2 bunresectable Chest bwall binvasion bresect band breconstruct bwith bPTFE bfor banterior b>5 bcm band bposterior b>10 bcm bdefect Treatment bof blung bcancer bstage bIIIB b- b bcorrect banswer- bT4 btumors boften bneed bpneumonectomy, bbut busually bunresectable Treatment bof bStage bIV blung bcancer bwith bsolitary bbrain bmet band bresectable blung bcancer b- b bcorrect banswer- bResect bbrain bmet bfirst lung bresection chemo-XRT whole bbrain bXRT
Does bchemo bor bradiation bchange b5-YS bfor blung bcancer? b- b bcorrect banswer- bNO MCC bof bSVC bsyndrome b- b bcorrect banswer- bNon bsmall bcell blung bcancer What bpercentage bof bSVC bis bsecondary bto bmalignancy? b- b bcorrect banswer- b90% b(lung bcancer, blymphoma, bgerm bcell btumor) MC bbenign bcause bof bSVC b- b bcorrect banswer- bmediastinal bfibrosis Treatment bof bSVC bsyndrome b- b bcorrect banswer- bemergent bXRT b- beffect bin b 12 bhours plus braise bhead, bO2, bLasix, bsteroid chronic b- bPTA b+ bstent bto bSVC Treatment bof bHorner's bsyndrome bcaused bby ba bpancoast btumor b- b bcorrect banswer- bneoadjuvant bchemo bxrt bfollowed bby bresection Paraneoplastic bsyndrome bassociated bwith bsquamous bcell bcarcinoma b- b bcorrect banswer- bPTH-related bpeptide Paraneoplastic bsyndrome bassociated bwith bsmall bcell blung bcancer b- b bcorrect banswer- bACTH, bADH MC bparaneoplastic bsyndrome bseen bwith blung bcancer b- b bcorrect banswer- bsmall bcell bACTH When bis bclubbing bseen bwith blung bcancer? b- b bcorrect banswer- bsquamous, badenocarcinoma What bis bhypertrophic bpulmonary bosteoarthropathy? b- b bcorrect banswer- bsymmetric bpolyarthritis band bproliferative bperiostitis bof blong bbones bseen bwith blung badenocarcinoma What bis bthe bsyndrome bassociated bwith bsmall bcell blung bcancer bthat bpresents bas bperipheral bneuropathy, bcerebellar bdegeneration, bweakness, band bfatigue? b- b bcorrect banswer- bsmall bcell blung bcancer What bis bthe bincreased brisk bof bmesothelioma bassociated bwith basbestos bexposure? b- b bcorrect banswer- b90x What bis bthe bmost bmalignant bthoracic btumor? b- b bcorrect banswer- bMesothelioma Duration bof btime bbetween bexposure band bdevelopment bof bmesothelioma b- b bcorrect banswer- b 30 byears
Normal bstructures bin bthe bposterior bmediastinum b- b bcorrect banswer- bEsophagus Descending baorta Vertebral bbodies Thoracic bduct Azygous bvein Hemi-azygous bvein What bpercentage bof bmediastinal bmasses bare bmalignant? b- b bcorrect banswer- b25% Most bcommon bmediastinal btumor bin badults band bchildren b- b bcorrect banswer- bneurogenic b- bmore bcommonly bposterior Most bcommon blocation bfor bmediastinal btumor bin badults band bchildren b- b bcorrect banswer- bAnterior MC banterior bmediastinal bmass bin badults b- b bcorrect banswer- bthymoma MC banterior bmediastinal bmass bin bchildren b- b bcorrect banswer- bgerm bcell MC bmiddle bmediastinal bmass bin bchildren band badults b- b bcorrect banswer- bcyst Anterior bmediastinal btumors b- b bcorrect banswer- bT's Thyroid Parathyroid T-cell blymphoma Thymoma Teratoma Cystic bhygroma Middle bmediastinal btumors b- b bcorrect banswer- bCysts lymphoma teratoma Posterior bmediastinal btumors b- b bcorrect banswer- bneurogenic lymphoma enteric bduplication bcysts Treatment bof bthymomas b- b bcorrect banswer- bRESECT bALL What bpercentage bof bthymomas bare bmalignant b- b bcorrect banswer- b50% b- bRESECT bALL What btype bof bthymoma bhas bthe bworst bprognosis? b- b bcorrect banswer- bepithelial btype
What bpercentage bof bthymomas bare bsymptomatic? b- b bcorrect banswer- b50% What bpercentage bof bpatients bwith bthymomas bhave bmyasthenia bgravis? b- b bcorrect banswer- b50% What bpercentage bof bpatients bwith bmyasthenia bgravis bhave bthymomas? b- b bcorrect banswer- b10% MC blymphoma bin bthe bmediastinum b- b bcorrect banswer- bNHL MC bgerm bcell btumor bin bthe bmediastinum b- b bcorrect banswer- bTeratoma Treatment bof bmediastinal bteratoma b- b bcorrect banswer- bResection band bchemotherapy bif bmalignant MC bprimary bmalignant bgerm bcell btumor bin bmediastinum b- b bcorrect banswer- bseminoma What bpercentage bof bpatients bwith bmediastinal bseminoma bhave bbeta-hcg? b- b bcorrect banswer- b10% Primary btreatment bof bmediastinal bseminoma b- b bcorrect banswer- bXRT b- bextremely bsensitive b Chemo bfor b+ bnodes bor bresidual bdisease bafter bXRT What bpercentage bof bnon-seminoma bgerm bcell btumors bin bthe bmediastinum bhave belevated bbeta-hcg band bAFT? b- b bcorrect banswer- b90% Treatment bof bnon-seminoma bgerm bcell btumors bin bthe bmediastinum b- b bcorrect banswer- bcisplatin-based bchemotherapy XRT Surgery bfor bresidual bdisease bnot bresolved bby bchemo b+ bXRT Chemotherapy bfor bgerm bcell btumors bof bthe bmediastinum b- b bcorrect banswer- bCisplatin Bleomycin Etoposide What bis ban bindependent bprognostic bmarker bfor bmalignant bgerm bcell btumors? b- b bcorrect banswer- bLDH What btype bof bmediastinal bcysts bshould bbe bresected? bLeft balone? b- b bcorrect banswer- bResect b- bBronchogenic band benteric bposterior bto bcarina bbecause bthey bcan bget binfected band bhave ba bsmall bmalignancy brisk Leave bpericardial bcysts b(usually bright bcostophrenic bangle)
