20 - Lung Cancer Clinical

Question 1

signs/sx of lung cancer

Answer 1

cough*
dyspnea
hemoptysis - not severe
wheeze/stridor
post obstructive PNA
chest discomfort (ill defined)

Question 2

pancoast syndrome

Answer 2

local extension of lung tumor at apex
usual cause of horner’s
shoulder pain radiating in ulnar distribution

Question 3

characteristics of malignant effusion

Answer 3

moderate to large
may be bloody
lymphocytes predominate
low pH and glucose - bad sign

Question 4

where does lung CA like to spread?

Answer 4

bones, liver, adrenals, brain/spine

Question 5

endocrine paraneoplastic syndromes

Answer 5

ectopic ACTH - assoc w/ small cell, more lyte disturbances than pure cushing’s
hypercalcemia - due to bone mets, more w/ squamous
SIADH - small cell assoc
also can get acromegaly and gynecomastia

Question 6

neurologic/neuromuscular paraneoplastic syndromes

Answer 6

Eaton Lambert - myasthenia gravis like, but strength gets better w/ exercise. Seen w/ small cell
retinal blindness - small cell
subacute cerebellar degeneration
polymyositis

Question 7

vascular and skeletal paraneoplastic syndromes

Answer 7

Trousseau - migratory recurrent thrombophlebitis
clubbing
pulm hypertrophic osteoarthropathy - new bone formation in distal joints, pain

Question 8

dermatologic paraneoplastic syndrome

Answer 8

acanthoses nigricans - hyperpigmented/hypertrophic skin usually in axilla/neck

Question 9

mainstays of small cell vs non small cell lung CA tx

Answer 9

small cell - chemo

non small - surgery