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Old 11-23-2012
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Default Surgery question ?

A 2-year-old girl with tricuspid atresia has increasing respiratory distress for 2 days. She has been recovering uneventfully from an operation 10 days ago to join systemic venous return with pulmonary arterial circulation. Over the past 4 days, she has been weaned off mechanical ventilation, started on oral feedings, and is receiving chest physiotherapy for atelectasis. Her temperature is 37.4 C (99.3 F),blood pressure is 98/64 mm Hg, pulse is 120/min, and respirations are 46/min.Examination shows nasal flaring, grunting, and intercostal retractions. An x-ray film of the chest shows large bilateral pleural effusions. Thoracentesis yields 300 mL of whitish-yellow fluid. The supernatant remains uniformly opaque on centrifugation. Which of the following is the most likely cause of the pleural effusions?

A) Chylothorax

B) Congestive heart failure

C) Empyema

D) Pulmonary embolism

E) Superior vena cava obstruction

Please explain ??
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Old 11-23-2012
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A) Chylothorax

The thoracic duct which traverses posteriorly from cisterna chyli to drain at the junction of the left jugular/subclavian veins is at risk for injury.
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Old 11-23-2012
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Novobiocin when you are sitting for exam ?? You have good concepts.
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Old 11-23-2012
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Quote:
Originally Posted by aknz View Post
Novobiocin when you are sitting for exam ?? You have good concepts.
soon............
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Old 11-23-2012
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I gave NBME 2 today,just passed it,really depressed,exam in one month
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