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YEAR 3 Manchester Medicine > 17 - lung cancer > Flashcards

17 - lung cancer Flashcards

1
Q

What are the red flags for lung cancer?

A

Haemoptysis

weight loss

Persistant cough

SoB

pain

hypertrophic osteoarthropathy

> 40 years with unexplained haemoptysis

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2
Q

What is hypertrophic oestoarthropathy?

A

Clubbing and pain in the small joints of the hands, the is most commonly from lung cancers.

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3
Q

What is the acronym SPIKE used for?

A

breaking bad news

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4
Q

What does SPIKES stand for?

A

Setting

Perception

Invitation

Knowledge

Emotions/ Empathy

Stratergy amd Summary

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5
Q

What is ment by perception in SPIKES?

A
  • understand the events leading up to the diagnosis
  • understand patients current knowledge
  • explain why the test is being done
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6
Q

What to say during invitaition of SPIKES?

A

Would you like me to explain the results to you now

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7
Q

What to do in knowledge of SPIKES

A

Feed infomation with chunking and pausing and eventually revealing the diagnosis.

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8
Q

What stage of SPIKES way the prognosis be revealed?

A

Emotions and Empathy

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9
Q

What does bat wings sign on a CXR indicate?

A

Acute heart failure, This is an emergency

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10
Q

What are the complication of lung cancer?

A

Pancostal tumour - pain in arm, horners syndrome

Superior vena cava obstruction

metastesis

Immune responce and inflammation

Hormones - PTH, ADH, ACTH

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11
Q

Which type of lung cancer is associated with hypertrophic osteoarthropathy?

A

Squamous cell carcinoma

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12
Q

What type of lung cancer is associated with hypercalcaemia?

A

squamous cell carcinoma

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13
Q

How does squamous cell carcinoma cause hypercalcaemia?

A

Secretion of parathyroid hormone-related protein (PTHrP)

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14
Q

A CXR shows an opacity on the lung which is thought to be a potential lung cancer. What investigation is most appropriate next?

A

CT

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15
Q

Why might PET be used during lung cancer investigations?

A

Establish if cancer is currable and assment of distal or local metastesis has occured?

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16
Q

What is Lambert-Eaton syndrome?

A

Autoimmune condition against calcium channels from Hu antibodies released by small cell carcinoma. This results in peripheral neuropathy.

17
Q

What can exposer to asbestosis cause?

A

Plaques on CXR

Asbestosis

Mesothelioma

18
Q

A patient has SoB. On examination the left chest is dull to precussion with decreased breath sounds and vocal resonance. What is the clinical diagnosis?

A

Pleural effusion

19
Q

A patient has a pleural effusion and undergoes thoracocentesis. How is it established that the fluid is a transudate or exudate?

A

Light’s criteria

20
Q

What symptoms are there for hypercalcaemia?

A

STONES, BONES, GROANS, MOANS, THRONES, AND PSYCHIATRIC MOANS

21
Q

Why is the corrected calcuim used and not just calcium on the whole.

A

Serum calcium is carried by albumin and therefore calcium levels are effected by albumin availibitly.

22
Q

What can cause a raised ALP when investigating hypercacaemia?

A

Thyrotoxicosis

Bone mets

lithium (increased bone turnover)

muiltiple myeloma etc..

23
Q

What are the causes of exudative pleural effusion?

A

Inflammation

malignancy

infection

24
Q

What are the causes of tansudative pleural effusion?

A

hypoalbuminuria - cirrhosis, nephrotic syndrome

CCF + fluid overload
hypothyroidism

25
Q

How does an exudate cause a pleural effusion?

A

protein is against its concentration gradient as they are released into the pleural space.

26
Q

What is Talc pleurodesis?

A

Used to managed a pleural effusion, causes inflammation leading to a fussion of the pleura. This sticks the lung to the thorax

27
Q

What is hereditary haemorrhage talengecia

A

venous-arterial malformation

Seen on lips

28
Q

What to ask when risk stratisfication for HIV.

A

Travel history - where, length, water supply, swimming, medical care

Sexual history - new partners last 3 months, protection, same sex, type of sex, paid for sex.

IVDU

“considering what we talked about today I think it would be sensible to do a HIV test. This is would involve taking blood from your arm…”

29
Q
A

YEAR 3 Manchester Medicine (34 decks)

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