02b: Lung Flashcards
LDCT screening for lung cancer has high false (pos/neg) rate.
Pos
T/F: in study comparing CXR and LDCT for lung cancer screening, there was an immediate increase in lung cancer diagnosis with LDCT.
True
T/F: in study comparing CXR and LDCT for lung cancer screening, there was an immediate decrease in lung cancer deaths with LDCT.
False - not immediate (2y lag)
But CT screening reduces lung cancer mortality by 20%
Gene mutations in which two oncogenes play big role in adenocarcinomas of lung?
KRAS (35%) and EGFR (15%)
Patients with NSCLC (lung cancer) are treated based on:
The specific oncogenic mutations/drivers (KRAS, EGFR, ALK, ROS)
Most lung adenocarcinomas are located (centrally/peripherally) and follow (typical/atypical) (X) pattern.
Peripherally
Typical
X = acinar (with glandular differentiation)
NSCLC: histology shows large, irregular, peripheral nuclei and some highly eosinophilic cytoplasm, indicating (X). Which specific type of cancer?
X = keratinization
Squamous cell carcinoma
New p40 market is positive for (X) lung cancer with 100% sensitivity and 98% specificity
X = squamous cell carcinoma
Lung cancer (SCLC) usually present as (central/peripherally) tumors and most patients are (symptomatic/asymptomatic) at presentation.
Central
Symptomatic
SVC syndrome symptoms
- Neck/ arm swelling
- Distended brings over neck
- SOB, HA, hoarseness
Symptoms related to hepatic metastasis of lung cancer
Weight loss, weakness
Symptoms related to brain metastasis of lung cancer
HA, N/V, seizures, personality change, confusion
Symptoms related to bone metastasis of lung cancer
Bone pain
T/F: paraneoplastic syndromes are signs of metastasis
False - bio active substances secreted by or in response to tumor
Humeral hypercalcemia of Malignancy results due to secretin of (X) by which type of lung cancer?
X = PTHrP
Squamous cell carcinoma
Hypertrophic osteoarthropathy is paraneoplastic syndrome seen in which lung cancers? What are the symptoms?
Adenocarcinomas
Hand/leg pain, new bone formation, clubbing
List the paraneoplastic syndromes seen in SCLC
- SIADH
- Lambert-Eaton Syndrome
- Cushing (ectopic ACTH)
Stage I NSCLC treatment
Surg resection
Stage II NSCLC treatment
Surg resection + adjuvant chemo
Stage IIIA NSCLC treatment
Surg + adjuvant chemo or chemo radiation
Stage IIIB NSCLC treatment
Chemo and radiation
Stage IV NSCLC treatment
Palliative chemo and maybe radiation
All SCLC stages treated the same depending on:
Whether it’s a limited or extensive stage
SCLC “limited stage” criteria and treatment
Tumor confined to one area of the chest
Radiation and chemo simultaneously
SCLC “extensive stage” criteria and treatment
Not confined to one area of chest
Chemo alone
If chemo and radiation causes (X) lung tumor to disappear, preventative (Y) Rx should be given to prevent common brain metastasis
X = SCLC Y = radiation
