Bronchogenic carcinoma

Question 0

Paraneoplastic syndrome NSCLC

Answer 0

Hypercalcemia
Carcinoiid syndrome
Carcinoid related ectopic ACTH- Cushing’s
Clubbing/Hypertrohic osteoarthropathy

Question 1

Paraneoplastic syndromes SCLC

Answer 1

SIADH
Cushing syndrome- ectopic ACTH
Lambert- Eaton Myasthenic syndrome
Limbic encephalitis
Encephalomyelitis
Paraneoplastic opsoclonus
Retinal blindness

Question 2

Paraneoplastic syndrome- all cell types

Answer 2

Hyperaldosteronism
Paraneoplastic cerebellar degeneration
Polymyositis/Dermatomyositis
Acanthosis Nigricans
Trousseau syndrome (migratory thrombophlebitis)
Fever, Cachexia, Anorexia, Diminished immunity

Question 3

PET scans

Answer 3

management of the Solitary pulmonary nodule

False positive: Aspergilloma

Question 4

Dx of lung cancer

Answer 4

Cell type MUST be defined as treatment modalities differ.
NSCLC: staging is very IMP.
Bronchoscopy: 1st line.

Question 5

Stage 0

Answer 5

Carcinoma in situ

Question 6

Stage IA

Answer 6

less than 3cm wide not involving main bronchus

Question 7

Stage IB

Answer 7

> 3cm but <5cm wide, not involving main bronchus

Question 8

Stage IIA

Answer 8

> 5cm but <5cm with spread to nearby lymph nodes

Question 9

Stage IIB

Answer 9

> 5cm but 7cm with or without lymph node spread and may or not have invaded visceral pleura

Question 10

Stage IIIA

Answer 10

Any tumor that has invaded mediastinum, or within 2cm of tracheal carina

Question 11

Stage IIIB

Answer 11

Any tumor with contralateral or mediastinal lymph node spread, or diaphragm, pericardium, or pleural involvement

Question 12

Stage IV

Answer 12

Any tumor that involves heart or great vessels, carina, trachea or esophagus, or associated with a malignant pleural or pericardial effusion or vertebral bodies, or with satellite nodules in ipsilateral lung.

Question 13

SCLC staging

Answer 13

Limited stage: similar to I-IIIB in NSCLC

Extensive stage: IV in NSCLC with greater propensity to spread to Bone Marrow

Question 14

NSCLC- tx

Answer 14

Curative intent: 0-IIB
Palliative/ Curative? intent: IIIA-IIIB
Palliative: IV (no advantage in continuing chemo beyond 4 cycles

Question 15

SCLC- tx

Answer 15

Limited: Curative intent (Cisplatin/Etoposide with Radiation)
Extensive: Palliative intent (Cisplatin/Etoposide without PCI or Thoracic radiation. Radiation only for meta)- no benefit more than 4 cycles.

Question 16

Follow up: 1-2 yrs

Answer 16

History and Physical q 3months with CXR

Question 17

Follow up: 3-5 yrs

Answer 17

History and Physical q 6 months with CXR

Question 18

Follow up: 5 yrs

Answer 18

CT: Brain, Lungs, Liver, Adrenals

-If apparently free of disease, no regular F/U.