Assessment and Surgical Treatment of Lung Cancer

Question 1

history of lung cancer

Answer 1

pain (especially in bones)

headaches

haematuria

Question 2

Haematuria

Answer 2

blood in urine

Question 3

Clinical examination findings in lung cancer

Answer 3

Recurrent laryngeal nerve palsy

brachial plexus palsy

lymph nodes enlarged

chest wall masses

pleural/pericaridal effusion

hepatomegaly

collapsed lung or lobe

Question 4

Palsy

Answer 4

paralysis

Question 5

Pleural effusion

Answer 5

water on the lungs

build up of fluid in the pleural cavity

Question 6

Hepatomegaly

Answer 6

abnormal enlargement of liver

Question 7

Chest X-ray findings

Answer 7

Pleural effusion

chest wall invasion

phrenic nerve palsy

collapsed lobe or lung

Question 8

Blood tests for lung cancer

Answer 8

anemia

abnormal LFTs (Liver function tests)

abnormal bone profile

Question 9

CT scan findings in lungs cancer

Answer 9

size of tumour

mediastinal nodes

metastatic disease (other parts of lungs, adrenals, kidneys, liver)

pleural/pericardial effusion

Question 10

Pericardial effusion

Answer 10

fluid in the pericardium (fluid around the heart basically)

Question 11

Other tests used in determining lung cancer

Answer 11

MRI (degree of vascular and neurological involvement)

Bones scans (bony metastases etc)

ECHO - will show presence/absence of significant pericardial effusion

Question 12

Surgical techniques

Answer 12

bronchoscopy

mediastinoscopy

Question 13

Fitness for surgery

Clinical investigations (eg smoking) - CVS

Answer 13

Angina

Heart problems

Smoking

Stroke

Carotid bruits

heart murmurs

Question 14

Fitness for surgery

clinical assessments - Respiratory

Answer 14

Barrel-chested

still smoking

asthmatic

recent URTI

On oxygen

exercise capacity

Question 15

Respiratory Function testing

Answer 15

spirometry

diffusion suites

V/Q scan

Question 16

Cardiac Assessment (fitness for surgery) tests

Answer 16

ECG

ECHO

CT scan

ETT (exercise tolerance test)

Coronary angiogram

Question 17

coronary angiogram

Answer 17

X-ray that visualises the coronary arteries

Question 18

Surgical treatment of lung cancer

Answer 18

curative resection is the goal

remove minimum amount of lung tissue

Question 19

Lung cancer surgery - reasons for peri-operative death

Answer 19

bronchopneumonia

myocardial infarction

pneumothorax

intrathoracic bleeding

Question 20

Commonest problems with staging of lung nacre

Answer 20

collapse of a lobe or lung makes tumour size difficult to assess

presence of another (smaller) pulmonary nodule

adrenal nodule

Question 21

operative mortality

pneumonectomy

Answer 21

8-12%

Question 22

operative mortality

lobectomy

Answer 22

3-5%

Question 23

operative mortality

wedge resection

Answer 23

2-3%

Question 24

operative mortality

open/close thoractomoy

Answer 24

5%

Question 25

penumoectomy

Answer 25

surgical removal or part of (or all of) the lung

Question 26

thoractomoy

Answer 26

incision into the pleural cavity to gain access to the lungs

Question 27

Phrenic Nerve

Answer 27

Originates in the neck (C3-C5) and passes down between the lung and the heart to reach the diaphragm