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Thoracic – TCAR Exam Questions With Complete Solutions
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Thoracic – TCAR Exam Questions With Complete Solutions3 stages of empyema Correct Answer Exudative
Fibrinopurulent
Organizing
5 Criteria of a solitary pulmonary nodule Correct Answer 1.
single
2. <3 cm
3. surrounded by normal lung
4. no adenopathy
5. no pleural effusion
5-YS after resection of solitary brain met for lung cancer
Correct Answer 20%
Accessory muscles of respiration Correct Answer SCM
Levators
Serratus posterior
Scalenes
Adson's test for thoracic outlet syndrome Correct Answer
Decreased radial pulse with head turned toward ipsilateral side
(subclavian artery compression - arterial TOS)
Alveolar, arterial, and venous pressures in lung zones in upright
person Correct Answer Zone I: PA > Pa > Pv
Zone II: Pa > PA > Pv
Zone III: Pa > Pv > PA
Anterior mediastinal tumors Correct Answer T's
,Thyroid
Parathyroid
T-cell lymphoma
Thymoma
Teratoma
Cystic hygroma
Anterior structures when looking into middle mediastinum with
mediastinoscopy Correct Answer Innominate vein
Innominate artery
right PA
Best diagnostic test for a tracheo-esophageal fistula Correct
Answer Bronch - pull tracheostomy or ETT back usually see a
big hole 1-2 cm below the tracheal stoma
Best diagnostic test for lung abscess Correct Answer CT chest -
air fluid levels
Best surgical approach for arterial TOS Correct Answer
Supraclavicular
Best surgical approach for neurogenic and venous TOS Correct
Answer Transaxillary
Blood supply lower 2/3 of trachea Correct Answer bronchial
arteries
Blood supply lung parenchyma Correct Answer bronchial
arteries
,Blood supply upper 2/3 of trachea Correct Answer inferior
thyroid arteries
Borders of scalene triangle Correct Answer SCM anterior
Trapezius posterior
Subclavian vein inferior
IJ medial
Omohyoid superior
Causes of massive hemoptysis Correct Answer TB (MCC
overall causes bronchial and pulmonary artery aneurysms)
Bronchiectasis (MC from cystic fibrosis, dilated bronchial
arteries)
Lung abscess (bronchial arteries)
Chemotherapy for germ cell tumors of the mediastinum Correct
Answer Cisplatin
Bleomycin
Etoposide
Claggett procedure Correct Answer for bronchopleural fistula
after pneumonectomy - fill post pneumonectomy space with
permanent abx solution and bronchus coverage with intercostal
muscle flap
Criteria for high risk with solitary pulmonary nodule (4) Correct
Answer 1. age >60
2. size >2.2 cm
3. speculated
4. current smoker
, Criteria for intermediate risk with solitary pulmonary nodule (4)
Correct Answer 1. age 45-60
2. size 1.5-2.2 cm
3. scalloped
4. current smoker or quit <7 years ago
Criteria for low risk with solitary pulmonary nodule (6) Correct
Answer 1. age <45
2. never smoked or quit >7 years ago
3. smooth lesion
4. size <1.5 cm
5. popcorn calcification (hamartoma) or laminated calcification
(granuloma)
6. no change in CXR in 2 years
Diagnosis and evaluation for operability for lung cancer Correct
Answer CXR
CT C/A/P
Chest MRI - best for spinal cord invasion and superior sulcus
tumors
Head MRI only if sx (headache)
bone scan for bone pain or elevated alk phos only
Bronchoscopy
Labs (LFTs)
PET scan
EKG (stress test if necessary)
PFTs, ABG, DLCO
Diagnosis of arterial TOS Correct Answer angio
Diagnosis of venous TOS Correct Answer duplex U/S
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