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How to Answer Jonathon Thompson Anesthesia Questions (Complete Guide)

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This question relates to jonathon thompson anesthesia and requires a structured academic response.

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Original Question

Sex: F AGE: 90 DOS: 1/1/20XX Jonathon Thompson, MD ANESTHESIA: General endotracheal. PREOPERATIVE DIAGNOSIS: Right middle lobe tumor. POSTOPERATIVE DIAGNOSIS: Malignant neoplasm of middle lobe lung and secondary malignancy left supraclavicular lymph node. TITLE OF OPERATION: Left supraclavicular lymph node biopsy. INDICATIONS: This is a female who presented with a cough of 6 weeks’ duration. On CT imaging, she was found to have a large mass in the right middle lobe centrally invading the mediastinum. On PET imaging, there was avid FDG uptake within the mass within the hilar lymph nodes and there was abnormal uptake as well and a left supraclavicular lymph node. A lymph node biopsy was indicated for tissue diagnosis and definitive lymph nodes staging. PROCEDURE: Under satisfactory general anesthesia, a small transverse incision was made between the sternal and clavicular heads of the sternocleidomastoid muscle on the left side. We dissected down to the internal jugular vein and carotid artery. We were unable initially to feel an abnormal lymph node although we knew one was there based on both CT and PET imaging. We finally found a hard lymph node approximately 5-6 mm in diameter immediately beneath the left internal jugular vein laterally. Using sharp and blunt and cautery dissection, we resected this lymph node. We obtained a frozen section diagnosis that was positive for malignancy. We then closed the sternocleidomastoid muscle with a Vicryl suture. The subcutaneous tissue was closed with running 2-0 Vicryl and the skin with a running 3-0 subcuticular suture.

 
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