Carcinogenesis and CA

Question 1

Pts with COPD are at a _____x increased risk of developing lung CA.

Answer 1

4-5x

Question 2

Name a tumor suppressor gene whose mutation is important in lung CA carcinogenesis.

Answer 2

p53

Question 3

Name 3 oncogenes important in for lung CA carcinogenesis.

Answer 3

1. MYC
2. JUN
3. FOS

Question 4

Lung cancer is classified into two main categories, ____ and ____.

Answer 4

non-small cell (NSCLC) and small cell (SCLC)

Question 5

Adenocarcinoma in-situ was previously called _____.

Answer 5

bronchoalveolar cell

Question 6

Cough, anorexia, weakness and weight loss are the most common presenting symptoms in patients with ______.

Answer 6

undiagnosed lung cancer

Question 7

____, _____, _____, and _____ are the most common presenting symptoms in patients with undiagnosed lung cancer.

Answer 7

Cough, anorexia, weakness and weight loss

Question 8

What is Horner’s Syndrome?

Answer 8

ptosis, anhidrosis, and miosis from inferior cervical ganglion and sympathetic chain involvement

Question 9

This is ptosis, anhidrosis, and miosis from inferior cervical ganglion and sympathetic chain involvement.

Answer 9

Horner’s Syndrome

Question 10

What is bronchorrhea?

Answer 10

copious amounts of ‘salty’ sputum

Question 11

This is copious amounts of ‘salty’ sputum.

Answer 11

bronchorrhea

Question 12

Lung cancer commonly spreads to ____, ____, ____, and ____.

Answer 12

the adrenal glands, liver, brain, and bone

Question 13

Name 6 endocrinologic effects of lung CA paraneoplastic syndromes.

Answer 13

Hypercalcemia
Hyponatremia
Cushing’s syndrome
Gynecomastia
Acromegaly
Hypoglycemia

Question 14

Name 5 neurologic effects of lung CA paraneoplastic syndromes.

Answer 14

Lambert-Eaton Myasthenic syndrome
Peripheral Neuropathy
Cerebellar Degeneration
Limbic Encephalitis
Encephalomyelitis

Question 15

Name 4 MSK effects of lung CA paraneoplastic syndromes.

Answer 15

Clubbing
Hypertrophic Pulmonary Osteoarthropathy
Dermatomyositis
Polymyositis

Question 16

Name 6 hematologic effects of lung CA paraneoplastic syndromes.

Answer 16

Anemia
Autoimmune Hemolytic Anemia
Leukocytosis/Thrombocytosis
Vasculitis
Noninfectious Thrombotic Endocarditis
Idiopathic Thrombocytopenic Purpura

Question 17

How is lung CA diagnosed?

Answer 17

biopsy or testing of other tissue samples

Question 18

Elevated ______ suggests bone metastases.

Answer 18

alkaline phosphatase

Question 19

Elevated alkaline phosphatase suggests ______.

Answer 19

bone metastases

Question 20

Due to the high incidence of micrometastases early in the disease state, small cell lung cancer is divided into two stages: ______ (25-30%; tumor is limited to ipsilateral hemithorax including contralateral mediastinal nodes); and ______ (70-75%; tumor extends beyond the hemithorax including pleural effusions).

Answer 20

limited disease; extensive disease

Question 21

Due to the high incidence of micrometastases early in the disease state, small cell lung cancer is divided into two stages: limited disease (25-30%; tumor is limited to ______ including contralateral mediastinal nodes); and extensive disease (70-75%; tumor extends beyond the hemithorax including ______).

Answer 21

ipsilateral hemithorax; pleural effusions

Question 22

Due to the high incidence of micrometastases early in the disease state, small cell lung cancer is divided into two stages: limited disease (25-30%; tumor is limited to ipsilateral hemithorax including contralateral ______); and extensive disease (70-75%; tumor extends beyond _____ including pleural effusions).

Answer 22

mediastinal nodes; the hemithorax

Question 23

SCLC is typically treated with _____ and ______.

Answer 23

chemotherapy, radiation

Question 24

What is the tx for NSCLC?

Answer 24

surgery

Question 25

Dx?

A solitary mass, typically

Answer 25

a solitary pulmonary nodule/coin lesion

Question 26

What is a solitary pulmonary nodule?

Answer 26

a solitary mass, typically

Question 27

What are the s/s of a solitary pulmonary nodule?

Answer 27

usually none

Question 28

_______ is a soil organism endemic to the desert southwest, southern California, and northern Mexico that can cause solitary pulmonary nodules.

Answer 28

Coccidiodomycosis

Question 29

Coccidiodomycosis is a soil organism endemic to the desert southwest, southern California, and northern Mexico that can cause ______.

Answer 29

solitary pulmonary nodules

Question 30

_______ is a fungus that lives in soil fertilized by bird or bat droppings and is commonly found in the central and south-central United States that can cause solitary pulmonary nodules.

Answer 30

Histoplasmosis

Question 31

Histoplasmosis is a fungus that lives in soil fertilized by bird or bat droppings and is commonly found in the central and south-central United States that can cause _______.

Answer 31

solitary pulmonary nodules

Question 32

What is the most common cause of multiple pulmonary nodules?

Answer 32

metastatic disease