July 10, 2009 | In: CARDIOTHORACIC SURGERY
79 LUNG CANCER Jamie M. Brown M.D. 1. How common is lung cancer? Show answer The incidence of lung cancer is approximately 180,000 new cases annually or 54.2 per 100,000 patients. More than 162,000 patients die annually, so the overall...
July 10, 2009 | In: CARDIOTHORACIC SURGERY
EMPYEMA 10. What is an empyema, and what causes it? Show answer An empyema is a purulent (infected) effusion. Fluid or blood in the pleural space can be directly innoculated (with bugs) during surgery or trauma (33%) or by contamination from...
July 10, 2009 | In: CARDIOTHORACIC SURGERY
PLEURAL EFFUSION 6. What is a pleural effusion? Show answer Pleural fluid is generated in normal adults at a rate of 5-10 L per 24 hours in the combined hemithoraces, but normal adults have only 20 mL of pleural fluid present at any time....
July 10, 2009 | In: CARDIOTHORACIC SURGERY
TUBERCULOSIS 1. What are the clinical manifestations of pulmonary tuberculosis? Show answer They can be almost anything or nothing (it has been stated that if you know tuberculosis, you know all of medicine), but the most common symptoms and...
July 10, 2009 | In: CARDIOTHORACIC SURGERY
CONTROVERSIES 27. Should the Ross procedure ever be performed? Show answer For: The Ross procedure provides excellent, long-term (sometimes lifelong) hemodynamic relief of aortic stenosis and avoids the need for mechanical valves, thus...
July 10, 2009 | In: CARDIOTHORACIC SURGERY
77 AORTIC VALVULAR DISEASE Christopher D. Raeburn M.D., Alden H. Harken M.D. 1. What are the most common causes of aortic stenosis? Show answer Rheumatic heart disease is now a rare cause of aortic stenosis, so the most common causes are now...
July 10, 2009 | In: CARDIOTHORACIC SURGERY
BONUS QUESTION 16. What is systolic anterior motion (SAM) of the mitral valve? Show answer SAM is a complication of mitral valve repair. After mitral valve repair, the anterior leaflet of the mitral valve may billow into the left ventricular...
July 10, 2009 | In: CARDIOTHORACIC SURGERY
76 MITRAL REGURGITATION David A. Fullerton M.D., Glenn J.R. Whitman M.D. 1. List the causes of mitral regurgitation. Show answer * Rheumatic fever * Endocarditis * Ruptured chordae tendineae * Senile mitral annular...
July 10, 2009 | In: CARDIOTHORACIC SURGERY
BONUS QUESTION 19. What is the Lutembacher syndrome? Show answer Mitral stenosis associated with an atrial septal defect. This results in a left-to-right shunt and overworks the right ventricle. References WEB...
July 10, 2009 | In: CARDIOTHORACIC SURGERY
75 MITRAL STENOSIS David A. Fullerton M.D., Glenn J.R. Whitman M.D. 1. What causes mitral stenosis? Show answer Rheumatic fever. 2. Which gender most commonly gets mitral stenosis? Show answer Women by a ratio of 3:2. 3....
July 10, 2009 | In: CARDIOTHORACIC SURGERY
CONTROVERSIES 15. Is there an advantage to surgical revascularization with all arterial conduits? Show answer The logical extension of the observation that an internal mammary artery has superior patency to a saphenous vein has sparked an...
July 10, 2009 | In: CARDIOTHORACIC SURGERY
74 CORONARY ARTERY DISEASE Joseph C. Cleveland Jr., M.D. 1. What is angina, and what causes it? Show answer Angina pectoris reflects myocardial ischemia. Patients often describe the sensation as pressure, choking, or tightness. Angina is...
July 10, 2009 | In: VASCULAR SURGERY
CONTROVERSIES 15. Can carotid endarterectomy be performed on the basis of duplex study alone? Show answer The argument for elimination of arteriography in selected cases is persuasive because the carotid arteriogram alone has a morbidity rate >...
July 10, 2009 | In: VASCULAR SURGERY
PERIPHERAL ARTERIAL OCCLUSIVE DISEASE 11. What is the primary test for diagnosis of lower extremity ischemia? Show answer The ankle brachial index (ABI) or systolic pressure ratio is normally greater than or equal to 1.0. Typically, Doppler...
July 10, 2009 | In: VASCULAR SURGERY
VENOUS DISEASE 7. What noninvasive test is used to diagnose acute DVT? Show answer Duplex ultrasound has replaced venous occlusion plethysmography as the accepted standard. Colorflow duplex is useful because it helps to identify small veins...