4 respiratory malignancies

Question 1

What is the angle of Louis?

Answer 1

Bifurcation of the trachea, at the start of the aortic arch

Question 2

Where do the pleura meet, and diverge?

Answer 2

meet at the 2nd rib, and diverge at the 4th

Question 3

What are the clinical features of lung cancer? (7)

Answer 3

smoking
haemoptysis
weight loss
dyspneoa
cough
chest pain
hoarse voice

Question 4

What might stop you from seeing tumours in a CT scan?

Answer 4

the mediastinum

Question 5

What are the 3 stages of a bronchoscopy?

Answer 5

brushing
washing
biopsy

Question 6

Name 3 ways to get tissue samples

Answer 6

bronchoscopy
EBUS (endobronchial ultrasound)
cervical medistinoscopy

Question 7

What is the difference in prognosis between squamous and adenocarcinoma?

Answer 7

adenocarcinoma patients have a poorer prognosis

Question 8

What are 4 examples of specific tumour markers?

Answer 8

targeted antibodies
immunomodulators
EGFR (epidermal growth factor)
ALK (anaplastic lymphoma kinase)

Question 9

What are 2 examples of immunomodulators?

Answer 9

PD1
PD1 inhibitors
Programmed cell Death

Question 10

Name one antagonist of Epidermal Growth Factor Receptors?

Answer 10

Gefitinib

Question 11

Name one inhibitor of Anaplastic lymphoma kinase

Answer 11

crizotinib

acts competitively on the ATp - binding pocket of target kinases

Question 12

What is NSCLC?

Answer 12

non small cell lung carcinoma, accounting for 85% of lung cancers

Question 13

How are NSCLC’s managed? (3)

Answer 13

surgery
radiotherapy
chemotherapy

Question 14

How are small cell carcinoma managed

Answer 14

chemotherapy

radiotherapy isn’t so effective

Question 15

Name 4 local complications of lung cancer

Answer 15

horner’s syndrome
SVC obstruction
Recurrent laryngeal nerve palsy
pleural effusion

Question 16

What causes pleural effusion?

Answer 16

leaking into pleural space
decreased removal from pleural space
pathology to pleural space