Thoracic 21

3. During routine screening for lung cancer in a 69-year-old male, the LDCT revealed a new benign appearing peripheral solid nodule of 5 mm. What is the recommended next approach according to Lung-RADS guidelines?

2. A 75-year-old male presents with an incidental 11mm solid lung nodule on a CT of the chest. The patient has 20 pack-year smoking history, however, reports no symptoms. What is the recommended approach according to American College of Chest Physicians (ACCP) guidelines?

Which multi-center study reported clinically significant improvements in lung function and quality of life out to at least 12 months with Zephyr one-way endobronchial valves?

For a 69 y.o. male with end-stage emphysema and otherwise acceptable cardiac and medical risk, which set of PFTs (% predicted) are appropriate for LVRS?

The NETT trial demonstrated an overall survival benefit for surgery in which subgroup of patients?

LVRS is a palliative procedure for end-stage emphysema that improves overall quality of life, but does not reverse the underlying progressive disease process

Bronchogenic cysts should be excised primarily because they:

20. _____ sequestration subtype has its own pleura and is separate from the adjacent lung

13. Esophageal atresia is often seen in combination with trachea-esophageal fistula. Which variant is most common?

12. In what stage of development are type II pneumatocytes produced?

True or False: Pulmonary metastatectomy is generally discouraged for any tumor size or number

Which of the following was identified in the International Registry of Lung Metastases to be a highly significant prognostic factor in relationship to metastectomy

The most common primary tumors metastasizing to the lungs include all of the following except:

You are operating on a 50 year old diabetic male for adenoid cystic carcinoma of his cervical trachea involving 4 tracheal rings. In the operating room you perform a transcervical resection of 4 tracheal rings, however frozen section reveals microscopic positive margins both proximally and distally. How will you proceed in this case?

14. You see a 45 year old male in your office presenting with a CT finding of a solid well circumscribed 9mm lesion in his left lower lobe periphery, without any other abnormal findings. CT guided biopsy reveals cells with 1 mitosis/ 2mm2. How should you manage this lesion?

A 34 year old previously healthy Caucasian male presented with hemoptysis of 3-day duration. Past medical and surgical histories were unremarkable. He smoked half a pack a day for 14 years, and uses marijuana daily. CT of the chest showed endobronchial mass of the bronchus intermedius containing dystrophic calcifications. Bronchoscopy revealed large endobronchial tumor obstructing the bronchus intermedius. Biopsy resulted in large volume of blood obstructing the visual field. Bleeding persists despite epinephrine injection and patient is now tachycardic. What is your next step?

A 40 year old male is referred with a CT finding of right main stem bronchus lesion described as smooth and homogenous. Bronchoscopy reveals a near obstructing lesion in the distal right main bronchus extending to the right upper lobe and biopsy reveals cells with 7 mitoses/ 2 mm2, with necrosis. PET/CT shows no evidence of metastatic disease. What is the treatment of choice?

A 55 year old female presents with cough, occasional hemoptysis and wheezing. Her medical and surgical history is unremarkable. A CT scan of the chest is obtained that shows an endobronchial smooth rounded nodule in the RLL bronchus with post-obstructive atelectatic changes. What should be your next step in management?

On postoperative day 1, your patient who underwent left side pneumonectomy develops shortness of breath and patchy infiltrates in the residual lung. He has been afebrile and has no cough. No consolidation of pneumonia is noted. A bedside echo shows preserved ejection fraction. The next best step is:

All of the following are risk factors for bronchopleural fistula except