cancer

Question 1

symptoms lung cancer

Answer 1

cough, haemoptysis, SOB, weight loss, hoarsness, superior vena cava syndrome // clubbing, wheeze, lymph

Question 2

what is hoarseness assoc with

Answer 2

pancoast tumours

Question 3

2 week cancer referral

Answer 3

CXR positive // 40+ w unexplained haemoptysis

Question 4

2 week CXR referral

Answer 4

40 with 2 symptoms non-smoker, or 1 if smoker // cough // fatigue // SOB // chest pain // weight loss // appetite loss

Question 5

what is SVC syndrome

Answer 5

oncological emergency –> compressed SVC by tumour

Question 6

symptoms SVC

Answer 6

SOB // swelling face, neck, arms // eye oedeme // headache // visual disturbance // jugular vein

Question 7

cause SVC

Answer 7

small cell lung cancer !!! // (lymphoma)

Question 8

mx SVC syndrome

Answer 8

stenting or chemo

Question 9

types of non-small cell lung cancer (NSCLC)

Answer 9

SCC, adenocarcinoma, large cell carcinoma, alveolar, bronchial carcinoid

Question 10

features adenocarcinoma lung

Answer 10

most common // peripheral // non-smoker // gynaecomastia // HPOA

Question 11

features SSC NSCLC

Answer 11

smokers!! // central tumour // finger clubbing // caviating lesions // hypertrophic pulmonary oesteoarthropathy

Question 12

endocrine features SSC NSCLC

Answer 12

PTH related protein –> hypercalcaemia // ectopic TSH –> hyperthyroid

Question 13

features large cell lung carcinoma

Answer 13

peripheral // poorly differentiated and poor prognosis // secrete hCG

Question 14

what are most bronchial adenomas

Answer 14

carcinoid (release serotonin –> flushing)

Question 15

which cells do SCLC come from

Answer 15

APUD cells

Question 16

features LCSC

Answer 16

ADH –> hyponatraemia // ACTH –> cushings // ACTH –> bilateral adrenal hyperplasia, hypoK alkalosis // LEMS syndrome

Question 17

mx SCLC

Answer 17

early disease = surgery // late = chemo + radio // palliative chemo

Question 18

mx NSCLC

Answer 18

mediastinoscopy prior to surgery // radiotherapy (not chemo)

Question 19

contraindications surgery NSCLC

Answer 19

stage IIIb or IV // FEV1<1.5L // malignant pleural effusion // vocal cord paralysis // SVC obstruction

Question 20

first invx lung cancer

Answer 20

CXR

Question 21

diagnosis lung cancer

Answer 21

CT!! // raised platelets // bronchoscopy // PET scan (NSCLC)