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Respiratory > Clinical Aspects of Bronchial Carcinoma > Flashcards

Clinical Aspects of Bronchial Carcinoma Flashcards

1
Q

Key characteristics of cancer?

A

Uncontrolled growth of tumour cells
Invasion
Malignant growth

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2
Q

What is the presentation of lung cancer?

A

Primary tumour
local invasion
metastases
non-metastic (paraneoplastic)

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3
Q

what are early symptoms of lung cancer?

A 
Cough for 3 weeks or more
Breathlessness for no reason
Persistent chest infection
Coughing blood
unexplained weight loss
chest/shoulder pains
unexplained tiredness or lack of energy
hoarse voice
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4
Q

what is haemoptysis?

A

coughing up blood

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5
Q

why is recurrent pneumonia a problem with lung cancer?

A

Consolidation can block screening of tumours

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6
Q

what is stridor?

A

wheeze on inhalation

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7
Q

what could cause shortness of breath?

A

A tumour blocking airway

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8
Q

Local invasion sites of lung cancer?

A 
recurrent laryngeal nerve
pericardium
oesophagus
brachial plexus
pleural cavity
superior vena cava
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9
Q

symptoms of pericardial local invasion?

A

Breathlessness
Atrial fibrillation
Pericardial effusion

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10
Q

Symptoms of oesophageal local invasion?

A

Dysphagia

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11
Q

what tumour invades the brachial plexus?

A

Pancoast tumour

wasting of the arm

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12
Q

whats a pleural effusion?

A

excess fluid in pleural space

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13
Q

what can a primary tumour in the pleural space cause?

A

pleural effusion

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14
Q

what can a tumour obstructing the superior vena cava cause?

A

Significant dilated veins on face/neck

high pressure in the head

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15
Q

what can tumours encasing pulmonary arteries cause?

A

clotting- embolism

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16
Q

common sites for metasteses?

A 
liver
brain
bone
adrenal
skin
lung
17
Q

common sites for metastases?

A 
liver
brain
bone
adrenal
skin
lung
18
Q

cerebral metastases symptoms?

A 
Insidious onset
weakness
visual disturbance
headaches (worse in morning, sneezing, leaning forward/not photophobic)
fits
19
Q

what would a ring enhancing lesion on CT indicate?

A

Cerebral metastases

20
Q

what would help improve symptoms of cerebral metastases?

A

High dose corticosteroid therapy

21
Q

what can metastases in the bone present as?

A
  1. new localised aches/pains worse at night

2. pathological fracture

22
Q

what do isotope bone scans show?

A

multiple skeletal metasteses

23
Q

What are some paraneoplastic syndrome?

A 
Finger clubbing
Hypertrophic pulmonary osteoarthtopathy (expansion of periostium on lng bone lining) -can cause finger clubbing
Weight loss
thrombophlebitis
hypercalcaemia
hyppnatraemia- SIADH
Weakness- Eaton Lambert syndrome
24
Q

what is associated with hypercalcaemia?

A

Stones (renal/bilaiary calculi)
Bones
Groans (aabdominal pain/constipation, N+V)
Thrones (Polyuria)
Psychiatric overtones (depression, anxiety, reduced GCS)
Cardiac arrhythmias

25
Q

initial treatment of hypercalcaemia?

A

Rehydration

IV Bisphosphate used for very high calcium/ if fluid doesnt correct it

26
Q

what is SIADH?

A

syndrome of ina[pproprite antidiuretic hormone- causes low sodium concentrationd

27
Q

what are some symptoms of SIADH?

A

Nausea/vomiting
Myoclonus
Lethargy/confusion
Seizures/coma

28
Q

What are some investigations for lung cancer?

A 
Full blood count
coagulation screen
Na, K, Ca, Alk Phos
Spirometry, FEV1
Chest X ray
CT of thorax
PET scan
bronchoscopy
endobronchial ultrasound
29
Q

how can a PET scan detect cancers?

A

tissues with high metabolic activity will light up

30
Q

How to get a tissue diagnosis for lung cancer?

A 
Bronchoscopy
CT guided biopsy (RISK OF PNEUMOTHORX)
Lymph node aspirate
Aspiration of pleural fluid
Endobronchial Ultrasound
Thoracoscopy (looking into pleural space)
31
Q

What are some cause of smoker, haemoptysis, abnormal chest X-ray?

A 
Lung cancer
TB
Vasculitis
PE
Secondary cancer
Lymphoma
Bronchiectasis

Respiratory (19 decks)

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