Carcinoma of the Lung

Question 1

How many people does lung cancer kill in the UK per year

Answer 1

34000

Question 2

What are most lung cancers caused by

Answer 2

Smoking

Question 3

Studies by who estabilished the causative link between smoking and lung cancer?

Answer 3

Doll and Hill

Question 4

What are some other causes of carcinoma of the lung

Answer 4

Passive smoking 
Genetic factors
Ionising radiation (radon gas) 
Asbestos exposure 
Diffuse lung fibrosis 
Lack of dietary fruit and vegetables

Question 5

Family history of Lung cancer is a risk factor. True or false

Answer 5

True

Question 6

What are the 2 main groups of lung cancer

Answer 6

Small cell and non small cell

Question 7

What are 3 types of non small cell carcinomas

Answer 7

Squamous cell carcinoma
Adenocarcinoma
Large cell (undifferentiated) carcinoma

Question 8

Where do small cell carcinoma usually arise from

Answer 8

Neuro-endocrine cells of the bronchial tree and its endocrine potential is sometime manifest clinically by ectopic hormone production

Question 9

What is the most common type of lung cancer

Answer 9

Squamous cell carcinoma

Question 10

What type of lung cancer has the greatest tendency to cavitate

Answer 10

Squamous cell

Question 11

Define large - cell undifferentiated carcinomas

Answer 11

Lung cancers that do not show squamous or glandular differentiation

Question 12

What do central lung cancers usually present with

Answer 12

chest symptoms (haemoptysis)

Question 13

What do peripheral tumours present with

Answer 13

More often general symptoms or effects of metastases

Question 14

Where do paraneoplastic syndromes arise

Answer 14

At sites distant from the tumour or its metastases

Question 15

The syndrome of inappropriate anti diuretic hormone secretion is most common with which type of lung cancer

Answer 15

Small cell cancer

Question 16

What might hypercalcaemia in patients with lung cancer be indicative of

Answer 16

Bone metastases

Question 17

What might cause paralysis of the phrenic nerve

Answer 17

Direct invasion of the mediastinum

Question 18

What can cause facial oedema, headache, distended pulseless jugular veins and enlarged collateral veins over the chest and arms

Answer 18

Obstruction of the superior vena cava

Question 19

What is a pancoast tumour

Answer 19

A carcinoma situated in the superior sulcus of the lung where the subclavian artery forms a groove over the lung apex

Question 20

How many lung cancers are visible during bronchoscopy

Answer 20

2/3rds

Question 21

How can samples from a tumour be taken during bronchoscopy

Answer 21

Biopsy forceps or cytology brush can be passed through the channel

Question 22

Who is bronchoscopy contra-indicated in?

Answer 22

Those with uncontrolled angina or recent MI

Question 23

What does endobronchial ultrasound allow

Answer 23

Needle aspiration to be performed

Question 24

What does endobronchial ultrasound allow

Answer 24

Needle aspiration to be performed

Question 25

Treatment of lung cancer depends on what 3 things

Answer 25

the cell type and stage of the disease and the fitness of the patient

Question 26

What is the main treatment for small cell carcinoma

Answer 26

Chemotherapy

Question 27

Are untreated patients with small cell carcinoma usually symptomatic or asymptomatic

Answer 27

Very symptomatic

Question 28

How long is the chance of survival for untreated small cell carcinoma

Answer 28

3 months

Question 29

Describe limited disease

Answer 29

When the small cell cancer has spread minimally and radiotherapy can be used

Question 30

Describe extensive disease

Answer 30

When the small cell ccarcinoma has spread beyond a radiotherapy port (distant metastases)

Question 31

Where is consolidation radiotherapy usually given

Answer 31

To the site of the tumour and mediastinal nodes

Question 32

Where is a common place for metastases

Answer 32

Cerebral

Question 33

What is the best chance of cure in non-small cell carcinoma

Answer 33

Surgical resection

Question 34

What is the staging system used in lung cancer

Answer 34

TNM

Question 35

What is the key radiological investigation for staging lung cancer

Answer 35

CT scanning

Question 36

What can be used to investigate the active disease in mediastinal nodes

Answer 36

PET (positron emission tomography )

Question 37

What can be used to investigate the active disease in mediastinal nodes

Answer 37

PET (positron emission tomography )

Question 38

Over expression of what receptor is a feature of non-small cell lung cancer

Answer 38

Epidermal growth factor receptor (EGFR)

Question 39

Over expression of what receptor is a feature of non-small cell lung cancer

Answer 39

Epidermal growth factor receptor (EGFR)

Question 40

What does palliative care focus on

Answer 40

Improving the patient's functioning and psychosocial wellbeing with relief of symptoms

Question 41

What should opiates be prescribed with

Answer 41

Laxatives and an anti-emetic

Question 42

What drug might be helpful in bossting the appetite

Answer 42

Prednisolone

Question 43

Where does alveolar cell carcinoma spread

Answer 43

It arises in the alveoli of the lung and spreads along the alveolar and bronchiolar epithelium

Question 44

What does alveolar cell carcinoma resemble histologically

Answer 44

Adenocarcinoma

Question 45

What is required to diagnose alveolar cell carcinoma

Answer 45

A transbronchial biopsy of alveolar tissue

Question 46

What is the treatment of choice when the tumour in alveolar cell carcinoma is confined to one lobe

Answer 46

Surgical resection

Question 47

Carcinoid tumours are less likely to metastasis. True or false

Answer 47

True

Question 48

What age are patients with a carcinoid tumour likely to be affected at?

Answer 48

Young age

Question 49

Are carcinoid tumours related to smoking

Answer 49

No

Question 50

What are the two common presentations of carcinoid tumours

Answer 50

Haemoptysis and wheeze

Question 51

What is the treatment of choice for a carcinoid tumour

Answer 51

Surgical resection

Question 52

How does a superior vena caval obstruction present?

Answer 52

With headache, distended neck veins that are non-pulsatile, oedema of the face and arms, dilated collateral veins over the chest

Question 53

What is the most common cause of SVCO

Answer 53

Lung cancer

Question 54

What is sometimes useful in reducing oedema and inflammation around a tumour

Answer 54

Dexamethasone