Thoracic 22

A 65-year old man with epithelioid mesothelioma underwent right extrapleural pneumonectomy with pericardial patch reconstruction. On POD1 while in the ICU, he develops hypotension and subsequent cardiac arrest after being turned to the right in his bed. The most likely cause is:

A 70-year old man underwent right upper lobectomy for stage IIA lung cancer after neoadjuvant chemoradiation. He had a largely uneventful course. At his follow-up visit on postoperative day 10, there is a drop in the air fluid level on his CXR. A right chest tube was placed. Antibiotics were initiated and a bronchoscopy reveals a 8mm bronchopleural fistula. The next best step is:

18. A 65-year old man with non-small cell lung cancer underwent right pneumonectomy and mediastinal lymph node dissection 2 months ago. He returns with complaints of a productive cough of reddish-brown watery sputum and fatigue for the past week. On further questioning, he states the hemoptysis occurs at night when he is lying down. A CXR done prior to the visit shows a drop in the air fluid level in the pneumonectomy space. The next best step is

Which of the following is true with regards to right versus left pneumonectomy?

4. A 65-year-old man undergoes a difficult left upper lobectomy following induction chemoradiation for N2+ IIIA NSCLC. Station 5 and 6 lymphadenectomy is particularly difficult. Post-operatively, what complication should the astute cardiothoracic resident be mindful of?

While performing a right upper lobectomy, a rush of blood is encountered when dissection behind the right upper lobe bronchus. What structure has been injured?

Sub-lobar resection is considered an inappropriate operation for which of the following patient scenarios?

Which of the following hypercoagulable disorders are paraneoplastic syndromes associated with lung cancer?

All of the following are treatments for SIADH except for

Which of the following paraneoplastic syndromes from lung cancer are dermatologic in nature?

17. All of the following are neurological paraneoplastic syndromes associated with lung cancer except

Which of the following biological phenomena are not common causes of paraneoplastic syndromes

A 68 year old female undergoing treatment for a of 5.5cm small cell lung cancer of the right lung presents to the ED with severe hemoptysis and respiratory distress. Which of the following is the best next step in management of this patient?

Prophylactic brain irradiation increases the overall survival and decreases the incidence of brain metastases and is recommended in patients who have disease progression following their initially treatment.

In which of the following scenarios is surgery indicated for a patient with small cell lung cancer

9. A 74 year old female who is a current smoker presents to your office with fatigue, shortness of breath and worsening fatigue. Workup reveals she has a 5.4cm centrally located left lung mass. EBUS and transbronchial biopsy of the mass reveal N1 disease and small cell lung cancer, respectively. She is started on platinum-etoposide and atezolizumab. She is seen in clinic 3 months later at which time her lung mass is noted to be 2.1cm, no evidence of nodal involvement, limited disease. Which of the following is the most appropriate option for therapy?

A 72 year old male with history of heavy smoking presents with fatigue and weight loss. During workup, CT chest shows a 1.2cm mass centrally located in the right upper lobe. Biopsy is unable to be performed, however mediastinal staging via EBUS is negative. The patient undergoes a right upper lobectomy and final pathology reveals – small cell lung cancer, T1bN0M0, stage I. Which of the following is the appropriate post-surgical management?

Which of the following is true regarding resection of superior sulcus tumors

Immunotherapy treatment of NSCLC has demonstrated which of the following?

16. The rationale for neoadjuvant therapy in clinical Stage IIIA lung cancer include which of the following: