Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Respiratory core conditions > Bronchial Carcinoma > Flashcards

Bronchial Carcinoma Flashcards

1
Q

How common is bronchial tumour?

A

2nd most common cancer in the UK

Most common malignant cancer worldwide

5th most common cause of death in the UK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the most common cause of bronchial carcinoma?

What are the other causes of bronchial carcinoma?

A

Cigarette smoking = 80% in men and 90% in women

Other causes

Environmental: 
Passive smoking
Asbestos exposure
Radon exposure
Polycyclic aromatic hydrocarbons 
Ionizing radiation 
Occupational exposure to arsenic, chromium, nickel, petrolium & oils

Host factors:
Pre-existing lung disease i.e. pulmonary fibrosis, HIV, genetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Who does bronchial tumour most commonly affect?

A

Smoker - both men and women equally

Urban > rural

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the two broad types of lung cancer?

*The distinction is based on the behaviour of the tumour and useful for prognostic information and determining the best treatment.

A

Small cell carcinoma

Non small cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 3 sub-types of non-small cell carcinoma?

A

Adenocarcinoma (27%)

Squamous carcinoma (35%)

Large cell carcinoma (10%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where do small cell carcinoma arise from and which syndrome do they result in?

A

Small cell carcinoma arise from endocrine cells (kulchitsky cells) => secreting polypeptide hormones => resulting in paraneoplastic syndrome.

*70% of small cell carcinoma disseminated at presentation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are bronchial carcinomas?

A

Bronchial carcinoma = malignant neoplasm of the lung arising from the epithelium of the bronchus or bronchiole.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the symptoms of bronchial carcinoma?

A

Cough (80%)

Haemoptysis (70%) => tumour bleeding into the airway

Dyspnoea (60%) => central tumours occlude large airways => lung collapse and breathlessness on exertion

Chest pain (40%) => peripheral tumour invading into chest wall/pleura (both innervated) => sharp pleuritic chest pain

Monophonic Wheeze => partial obstruction of airway by tumour

Hoarse voice => mediastinal tumour impinging on left recurrent laryngeal nerve

Recurrent or slow-resolving pneumonia

Nerve compression => pan coast tumours in the apex of the lung
=> compression of sympathetic chain = horner’s syndrome
=> compression of brachial plexus C8/T1 palsy = muscle wasting in hand, weakness and pain radiating down the arm

Lethargy
Anorexia
Weightloss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the signs of bronchial carcinoma?

A

Cachexia

Anaemia

Clubbing

Supraclavicular or axillary nodes

Hypertrophic pulmonary osteoarthropathy

Chest signs:
Consolidation

Collapse

Pleural effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the signs of metastatic bronchial carcinoma?

A

Bone tenderness

Hepatomegaly

Confusion ; fits

Focal CNS signs

Cerebellar syndrome - impaired muscle coordination

Proximal myopathy

Peripheral neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which nodes and organs does bronchial carcinoma commonly spread too?

A

Mediastinum, cervical and axillary nodes

Liver, 
Adrenal glands (Addison's) 
Bones (bone pain, anaemia, increased calcium) 
Brain,
Skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the complications of bronchial carcinomas?

A

Local:
Recurrent laryngeal nerve palsy = hoarseness

Phrenic nerve palsy

Superior vena cava obstruction

Horner’s syndrome (pancoast tumour in apex of lung)

Rib erosion

Pericarditis

Atrial fibrillation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the most common type of non-small cell carcinoma?

A

Squamous cell carcinoma - most common in europe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What tissue does squamous cell carcinoma arise from and what are its characteristic features?

A

Arises from epithelial cells assoc. with production of keratin

Features:
Central necrosis cavity

Causes obstructing lesions of bronchus with post-obstructive infection i.e. pneumonia

Local spread common ; metastasises late

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the most common type of non-small cell carcinoma in non-smokers?

A

Adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What tissue does adenocarcinoma arise from and what are its characteristic features?

A

Arises from mucus-secreting glandular cells

Features:
Peripheral lesions on CXR/CT

Metastases common i.e. pleura, lymph nodes, brain, bones, adrenal glands

17
Q

What tissue does large cell carcinoma arise from and what are its characteristic features?

A

Poorly differentiated

Metastasises early

18
Q

What tissue does small cell carcinoma arise from and what are its characteristic features?

A

Arises from neuroendocrine cells

Features:
Secretes polypeptide hormones

Arises centrally and metastasises early

19
Q

Investigations are important to stage the extent of the disease, make a tissue diagnosis i.e. small cell or non-small cell carcinoma and plan treatment.

What investigations are carried out when suspecting a bronchial cancer?

A

Blood tests: FBC for anaemias, LFT for liver involvement, hypercalcaemia and hyponatraemia

Chest X-ray: peripheral nodules, hilar enlargement, consolidation, pleural effusion, collapse

CT: to stage the tumour => image should include adrenal glands and liver (common sites for metastases)

Cytology: sputum & pleural fluid

Fine needle aspiration or biopsy of peripheral lesions/lymph nodes

F-deocyglucose PET: helps with staging

Radionucleide bone scan: suspected metastases

Lung function test to assess suitability for lobectomy

20
Q

Which test assesses suitability for lobectomy?

A

Lung function test ± cardiopulmonary exercise testing, stress echo

21
Q

What is the staging used for non-small cell carcinoma?

A

TNM staging => assesses the extent of spread

22
Q

What is palliative radiation treatment?

A

Radiation therapy => symptomatic control of lung cancer for bone and chest pain from metastases or direct invasion, haemoptysis, occluded bronchi and superior vena cave obstruction

23
Q

What is the treatment for non-small cell carcinoma?

A
  1. Lobectomy (open or throacoscopic) = treatment of choice in medically fit patients => curative
  2. Parenchymal sparing operation => borderline fit patients and smaller tumours (T1, N0, M0)
  3. Radical radiation therapy for stage I, II, III
  4. Chemotherapy ± radiation for advanced disease
  5. Palliative radiotherapy => bronchial obstruction, super vena cava obstruction, haemoptysis, bone pain and cerebral metastases
24
Q

What is the treatment for small cell carcinoma?

A
  1. Surgery in limited stage disease
  2. Chemotherapy ± radiotherapy if well enough
  3. Palliative radiotherapy => bronchial obstruction, superior vena cava obstruction, haemoptysis, bone pain and cerebral metastases
  4. Superior vena cava stent + radiotherapy and dexamethasone for superior vena cava obstruction
  5. Endobronchial therapy => tracheal stenting, cryotherapy, laser, brachytherapy (radioactive source placed near the tumour) => these are palliative techniques used on inoperable tumours
  6. Pleural drainage/pleurodesis for symptomatic pleural effusion
  7. Drugs: analgesia, steroids, anti-emetics, cough linctus, bronchodilators, anti-depressants
25
Q

What is the prognosis for non-small cell carcinoma and small cell carcinoma?

A

Non-small cell carcinoma = 10 years survival without spread ; 2 years with spread

Small cell carcinoma = 3 months ; 1/1.5 years if treated

26
Q

What are the differential diagnosis for a nodule found in the lung on a chest x-ray?

A

Primary or secondary malignancy

Abscess

Granuloma

Carcinoid tumour

Pulmonary hamargtoma

Arteriovenous malformation

Encysted effusion (fluid, blood, pus)

Cyst

Foreign body

27
Q

Mesothelioma cases have increased since mid-1800’s.

What is mesothelioma and what is it’s clinical presentation?

A

Mesothelioma = malignant tumour arising from visceral and parietal mesothelial lining of the lung.

Common presentation = pleural effusion with persistent chest wall pain => raise suspicion even if initial pleural fluid/biopsy samples non-diagnostic.

28
Q

What investigations are carried out for diagnosis in a suspected mesothelioma and how is it managed?

A

CT/ultrasound guided biopsy or pleural biopsy => need sufficient tissue for diagnosis

Limited management for patients

29
Q

Which cancers commonly metastasise to the lungs?

A 
Prostate
Breast
Bone 
Gastrointestinal tract 
Cervix
Ovary
Kidney
30
Q

What are bronchial carcinoid tumours?

What are its related symptoms?

A

Slow-growing, low-grade malignant neoplasms, arising from neuro-endocrine tumours. As foregut derivates, they secrete adrenocorticotrophic hormone.

Symptoms are related to obstruction, recurrent infection or haemoptysis.

31
Q

How is bronchial carcinoid tumours managed?

Which staging system is used?

A

Surgery = treatment of choice + long term surveillance

Staging system used is same as non-small cell carcinoma (TNM staging).

32
Q

What is the most common benign lung tumour?

A

Pulmonary hamartoma => well defined on x-ray, extremely slow growing

33
Q

What is bronchial adenoma?

A

Benign lung tumour arising from mucus glands and ducts of the windpipe.

Respiratory core conditions (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions