Thoracic Surgery Question Bank

Thoracic Surgery  Question Bank

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1. The best way to determine whether a needle tip is in the pericardium or intramyocardial is to:

a. perform the procedure under fluoroscopy

b. observe the needle for evidence of pulsation

c. determine if the aspirated blood clots

d. connect the exploring needle to the chest lead of the electrocardiograph

e. observe the blood coming from the hub of the needle for pulsatile flow

2. The left atrial pressure, in a non stressed heart is:

a. 0 to 5 mm Hg

b. 0 to 5 cm H2O

c. 5 to 10 mm Hg

d. 5 to 10 cm H2O

e. 10 to 15 mm Hg

3. A 48-year-old male presents with history of progressively increasing dysphagia interspersed with asymptomatic periods. Upper endoscopy demonstrated a smooth filling defect in the upper third of the esophagus with an intact mucosa. The next step in management should be:

a. followup EGD in 6 months

b. Ivor Lewis resection of the esophagus, incorporating the mass

c. segmental resection of the esophagus with end to end anastomosis

d. enucleation of the mass through a left thoracotomy

e. enucleation of the lesion through a right thoracotomy

4. After CPB which compartment is increased in fluids?

a. interstitial

b. intracellular

c. extracellular

d. intravascular

5. Atrial myxomas:

a. commonly metastasize to the lungs

b. rarely cause any systemic symptoms

c. most commonly arise from the right atrium

d. demonstrate specific echocardiographic changes

e. have specific EKG changes

6. In a patient with heparin induced thrombocytopenia and thrombosis of the arteries, the treatment is all of the following EXCEPT:

a. low molecular weight heparin

b. warfarin

c. surgical embolectomy

d. hirudin

7. Of all the plasma proteins, the first to be adsorbed to the CPB circuit is:

a. fibrinogen

b. plasmin

c. factor 8

d. albumin

8. In a patient with heparin induced thrombocytopenia, associated with bleeding, the treatment is:

a. FFP

b. Vitamin K

c. platelets

d. cryoprecipitate

9. Which of the following leads to the greatest reduction in myocardial oxygen during CPB?

a. hyperkalemic cardiac arrest

b. hypothermic arrest

c. fibrillating heart

d. empty beating heart

10. The best way to confirm proper positioning of an endotracheal tube is:

a. Monitor the color of the blood.

b. Monitor ABG.

c. CXR Monitor end-tidal CO2.

d. Monitor pulmonary artery oxygen content.

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