02b: Lung

Question 1

LDCT screening for lung cancer has high false (pos/neg) rate.

Answer 1

Pos

Question 2

T/F: in study comparing CXR and LDCT for lung cancer screening, there was an immediate increase in lung cancer diagnosis with LDCT.

Answer 2

True

Question 3

T/F: in study comparing CXR and LDCT for lung cancer screening, there was an immediate decrease in lung cancer deaths with LDCT.

Answer 3

False - not immediate (2y lag)

But CT screening reduces lung cancer mortality by 20%

Question 4

Gene mutations in which two oncogenes play big role in adenocarcinomas of lung?

Answer 4

KRAS (35%) and EGFR (15%)

Question 5

Patients with NSCLC (lung cancer) are treated based on:

Answer 5

The specific oncogenic mutations/drivers (KRAS, EGFR, ALK, ROS)

Question 6

Most lung adenocarcinomas are located (centrally/peripherally) and follow (typical/atypical) (X) pattern.

Answer 6

Peripherally

Typical
X = acinar (with glandular differentiation)

Question 7

NSCLC: histology shows large, irregular, peripheral nuclei and some highly eosinophilic cytoplasm, indicating (X). Which specific type of cancer?

Answer 7

X = keratinization

Squamous cell carcinoma

Question 8

New p40 market is positive for (X) lung cancer with 100% sensitivity and 98% specificity

Answer 8

X = squamous cell carcinoma

Question 9

Lung cancer (SCLC) usually present as (central/peripherally) tumors and most patients are (symptomatic/asymptomatic) at presentation.

Answer 9

Central

Symptomatic

Question 10

SVC syndrome symptoms

Answer 10

1. Neck/ arm swelling
2. Distended brings over neck
3. SOB, HA, hoarseness

Question 11

Symptoms related to hepatic metastasis of lung cancer

Answer 11

Weight loss, weakness

Question 12

Symptoms related to brain metastasis of lung cancer

Answer 12

HA, N/V, seizures, personality change, confusion

Question 13

Symptoms related to bone metastasis of lung cancer

Answer 13

Bone pain

Question 14

T/F: paraneoplastic syndromes are signs of metastasis

Answer 14

False - bio active substances secreted by or in response to tumor

Question 15

Humeral hypercalcemia of Malignancy results due to secretin of (X) by which type of lung cancer?

Answer 15

X = PTHrP

Squamous cell carcinoma

Question 16

Hypertrophic osteoarthropathy is paraneoplastic syndrome seen in which lung cancers? What are the symptoms?

Answer 16

Adenocarcinomas

Hand/leg pain, new bone formation, clubbing

Question 17

List the paraneoplastic syndromes seen in SCLC

Answer 17

1. SIADH
2. Lambert-Eaton Syndrome
3. Cushing (ectopic ACTH)

Question 18

Stage I NSCLC treatment

Answer 18

Surg resection

Question 19

Stage II NSCLC treatment

Answer 19

Surg resection + adjuvant chemo

Question 20

Stage IIIA NSCLC treatment

Answer 20

Surg + adjuvant chemo or chemo radiation

Question 21

Stage IIIB NSCLC treatment

Answer 21

Chemo and radiation

Question 22

Stage IV NSCLC treatment

Answer 22

Palliative chemo and maybe radiation

Question 23

All SCLC stages treated the same depending on:

Answer 23

Whether it’s a limited or extensive stage

Question 24

SCLC “limited stage” criteria and treatment

Answer 24

Tumor confined to one area of the chest

Radiation and chemo simultaneously

Question 25

SCLC “extensive stage” criteria and treatment

Answer 25

Not confined to one area of chest

Chemo alone

Question 26

If chemo and radiation causes (X) lung tumor to disappear, preventative (Y) Rx should be given to prevent common brain metastasis

Answer 26

X = SCLC
Y = radiation