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CP Test 4 > B4-080 CBCL Approach to a Lung Nodule > Flashcards

B4-080 CBCL Approach to a Lung Nodule Flashcards

1
Q

well differentiated neuroendocrine tumors

A

carcinoid tumor

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2
Q

tobacco related neuroendocrine tumors

2

A

large cell and small cells

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3
Q
  • mitoses < 2 per 2 mm
  • no necrosis
A

typical carcinoid

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4
Q
  • mitoses 2-10 per 2 mm
  • or necrosis
A

atypical carcinoid

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5
Q
  • mitoses > 10 per 2 mm
  • cytologic features of SCLC
A

small cell carcinoma

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6
Q
  • mitoses >10 per 2 mm
  • cytologic features of NSCLC
A

large cell NET

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7
Q

chemotherapy is first line for […] and second line for […]

A

first: large and small cell
second: typical/atypical carcinoid

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8
Q

usually found in lung or GI tract

A

NET

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9
Q
  • well differentiated
  • 2% of lung neoplasms
  • metastatic potential 5-20%
A

typical carcinoid

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10
Q
  • intermediate grade
  • <1% of lung neoplasms
  • metastatic potential 30-40%
A

atypical carcinoid

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11
Q
  • high grade variant of large cell lung cancer
  • 3% of lung neoplasms
A

large cell NET

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12
Q
  • high grade
  • 15-20% of lung cancers
A

SCLC

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13
Q

functional NETs may present with

3

A
  1. carcinoid syndrome
  2. cushing syndrome
  3. acromegaly, hypercalcemia, hypoglycemia
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14
Q

carcinoid syndrome

3 symptoms

A

wheezing, cutaneous flushing, diarrhea

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15
Q

clinical presentation for large cell NET

4 symptoms

A

cough
hemoptysis
chest pain
dyspnea

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16
Q
  • present with cough, hemoptyisis, dyspnea, chest pain, wheezing, hoarseness
  • SVC syndrome
  • may have paraneoplastic syndromes
A

small cell lung cancer

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17
Q
A

typical carcinoid

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18
Q
A

atypical carcinoid

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19
Q
A

Large cell NET

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20
Q
A

small cell

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21
Q

used to differentiate carcinoids vs. large/small cell

cannot distinguish typical vs atypical

A

Ki67

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22
Q

more Ki67 indicates

A

high grade NET

small or large cell

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23
Q

least aggressive type of cancer with uniform, round to oval tumor cells

A

carcinoid

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24
Q

workup for carcinoid tumor includes

3

A
  • 24 hr urine for 5 HIAA
  • chromogranin A level
  • sometimes somatostatin receptor
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25
Q

has the poorest prognosis

A

small cell carcinoma

26
Q

the diagnosis of carcinoid syndrome includes

3 symptoms

A

flushing
diarrhea
bronchospasm

27
Q

ptosis, miosis, ipsilateral anhidrosis

A

horner’s syndrome

can be due to pancoast tumor

28
Q

has revolutionized the way many cancers are treated, including small cell lung cancer

A

immunotherapy

29
Q
A

small cell lung cancer

30
Q

number one cancer killer of women in US

A

lung cancer

31
Q

diarrhea, facial flushing, asthmatic symptoms

A

carcinoid tumor

32
Q

test for definitive diagnosis of cancer

tissue diagnosis is necessary

A

CT guided biopsy of lesion

33
Q

altered mental status
hyponatremia
lung mass in upper lobe

A

SIADH

paraneoplastic syndrome

34
Q

sympathetic ganglia invasion due to cancer may cause

A

horner’s syndrome

35
Q

ptosis, miosis, ipsilateral anhidrosis

A

horner’s

36
Q

apical lung tumors may cause impingement of what surrounding structures?

3

A
  1. brachial plexus
  2. recurrent laryngeal nerve
  3. sympathetic chain
37
Q

a mass effect on the brachial plexus could cause

A

upper extremity weakness

38
Q

a mass effect on the reccurent laryngeal nerve could cause

A

hoarse voice

39
Q

a mass effect on the sympathetic chain could cause

A

horner’s syndrome

40
Q

carcinoid syndrome is caused by increased

A

serotonin

41
Q

carcinoid syndrome is usually apparent after

A

metastasis, usually to liver

42
Q

what laboratory finding is most likely with carcinoid syndrome?

A

elevated 5-HIAA in urine

43
Q

shows some advantage in the treatment of low grade carcinoid tumors

drug

A

everolimus

44
Q

carcinoid tumors are most commonly in the

anatomic location

A

GI tract

45
Q

carcinoid tumors typically arise from the […] cells of the GI tract

A

enterochromaffin

46
Q

syndrome caused by excessive serotonin release via GI tumors

A

carcinoid syndrome

47
Q

generally, metastasis to the […] is required for carcinoid syndrome to occur

A

liver

48
Q

neurosecretory granules
necrotic debris
high mitotic count

A

small cell carcinoma

49
Q

obstructing mass of a bronchus

A

carcinoid tumor

50
Q

first line treatment for carcinoid tumors

A

surgical resection

51
Q

first line treatment for small cell lung cancer

A

combination chemotherapy

52
Q

treatment to control flushing and diarrhea

A

long acting octreotide therapy

53
Q

metabolite of serotonin that can be detected in urine

A

5-HIAA

54
Q

synthetic octapeptide analog of somatostatin

A

octreotide

55
Q

used to treat pancreatic secretory tumors and carcinoid syndrome

A

octreotide

56
Q

glucose intolerance
coarsening of facial hair
macroglossia
thickened fingers
fatigue
sweating

sign of

A

excessive growth hormone synthesis (acromegaly)

associated with carcinoid tumor

57
Q

altered mental status
convulsive episodes
hyponatremia

A

SIADH

small cell lung cancer

58
Q

may manifest with SIADH, cushings, or pancost tumor

A

small cell carcinoma

59
Q

may manifest with hypercalcemia, hypoglycemia, acromegaly

A

carcinoid tumor

60
Q

weight gain
abdominal striae
moon facies
poor wound healing
facial plethora

A

cushing syndrome

61
Q

high mitotic rate
large cells with nucleoli
necrosis
neuroendocrine differentiation

A

large cell neuroedocrine tumor

CP Test 4 (15 decks)

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