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Respiratory > Clinical Aspects of Lung Cancer > Flashcards

Clinical Aspects of Lung Cancer Flashcards

1
Q

give 5 general features of cancer

A 
malignant growth
uncontrolled replication
local invasion
metastasis
non-metastatic systemic effect
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2
Q

d: paraneoplastic features

A

is the consequence of cancer in the body but that, unlike mass effect, is not due to the local presence of cancer cells

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3
Q

why is the prevalence of Lung cancer low/

A

patients do not live for long

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4
Q

what is one reason for poor prognosis of lung cancer?

A

lung cancer tends not to cause any symptoms until the disease has become too advanced for any hope of cure

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5
Q

give some common symptoms of a common potential cancer

A 
cough of 3 weeks or more
feeling breathless for no reason
a chest infection that doesn't clear up
coughing blood
unexplained weight loss
chest/shoulder pains
unexpected tiredness or lack of energy
a prevalent hoarse voice
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6
Q

d: haemoptysis

A

coughing up blood

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7
Q

what is haemoptysis a direct consequence of?

A

primary tumour

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8
Q

which lung is normally the diseased lung in an X ray?

A

the smaller one

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9
Q

what may recurrent pneumonia be a sign of?

A

primary lung cancer

causing a partial obstruction of the upper lobe bronchus

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10
Q

What is a shrinking lung explained by?

A

a shrinking lung is explained by the obstruction of proximal divisions of the bronchial tree. When a lobe becomes obstructed, all of the air beyond the obstruction is absorbed and the lung tissue shrinks down to a much smaller size. The net effect is a reduction in size.

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11
Q

d: stridor

A

distressing symptom of breathing in; a coarse audible wheeze during inspiration

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12
Q

why may a patient with lung cancer be SOB?

A

tumour may block bronchioles narrowing airway

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13
Q

why might someone have a hoarse voice?

A

paralysis of the left vocal cord and a tumour at the origin of the left upper lobe. The primary tumour had invaded the recurrent laryngeal nerve

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14
Q

medical term for hoarse voice

A

recurrent laryngeal nerve palsy

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15
Q

d: atrial fibrillation

A

irregular and rapid heart beat
the heart’s two upper chambers (the atria) beat chaotically and irregularly — out of coordination with the two lower chambers (the ventricles) of the heart

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16
Q

d: pericardial effusion

A

fluid around the heart

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17
Q

d: dysphagia

A

pain whilst swallowing

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18
Q

what symptom may indicate a tumour in the oesophagus?

A

dysphagia for solids eg bread

19
Q

d: Pancoast tumour

A

tumour in the pulmonary apex

20
Q

why may a man who had hand pain have a lung tumour?

A

The wasting of the small muscles of the hand is due to T1 root infiltration by a primary lung cancer in the apex of the left lung. The tumour has eroded through the ribs and into the lower part of the brachial plexus
the tumour destroys the bone

21
Q

d: pleural effusion

A

in cancer, condition in which a tumour invades plural space it often generates a large volume of pleural fluid

22
Q

why may a patient have a distended external jugular vein?

A

a local invasion of the superior vena cava obstructs drainage of the blood from the arms and head

23
Q

if the patient describes localised chest wall pain which is worse with movement and the pain is worse at night, what may have happened?

A

primary tumour has grown through the intercostal spaces and we can see the mass lying deep to the pectoralis muscle
if bone has be eroded, there has been destruction of part of the adjacent ribs

24
Q

name the 6 common sites for metastases

A 
liver
brain
bone
adrenal
skin
lung
25
Q

why may a patient with cerebral metastasis experience an epileptic fit?

A

metastasis involves the cortex

26
Q

what does a cerebral metastasis look like on a CT scan?

A

ring surrounds

dark halo of swollen brain

27
Q

name 7 non-metastatic(paraneoplastic) features

A 
Finger clubbing
Hypertrophic pulmonary osteoarthropathy - HPOA
Weight loss
Thrombophlebitis
Hypercalcaemia
Hyponatraemia - SIADH
Weakness - Eaton Lambert syndrome
28
Q

what does HPOA stand for and what does it show? what are the symptoms?

A

Hypertrophic pulmonary osteoarthropathy - bone scan
Symptoms of pain and tenderness of the long bones near the adjacent joints are due to elevation of the periosteum away from the bone surface

29
Q

why do patients with a tumour experience unexplained weight loss?

A

tumour requires energy using up stores

30
Q

d: hypercalcaemia

A

abnormally high level of calcium in the blood

31
Q

name the effects of hypercalcaemia

A 
stones
bones
groans
thrones
pscychiatric overtones
32
Q

treatments of hypercalcaemia

A

initial is rehydration
then IV Bisphosphate
treat underlying cancer- usually squamous epithelium

33
Q

d: SIADH

A

– Syndrome of inappropriate antidiuretic hormone

34
Q

d:diuresis

A

excessive urine production

35
Q

what are the generalized symtoms of SIADH and what is it normally caused by?

A 
Nausea/vomiting
Myoclonus
Lethargy/confusion
Seizures/coma
usually small lung cancer
results in low sodium concentration
36
Q

treatment of SIADH

A

teat the cancer
fluid restriction
drugs- demeclocycline

37
Q

what colour is the sputum that smokers normally cough up?

A

clear

38
Q

if the patient tells you that they try to cough something up but cant, what is this a sign of?

A

In lung cancer, the sensation which triggers a desire to cough is distortion of the normal bronchial mucosa by the tumour

39
Q

name some lung cancer tests

A 
FBC
Coagulation screen
Na K Ca Alk Phos
spirometry, FEV1
Chest X ray
CT scan of the Thorax
PET scan
Bronchoscopy
Endobronchial US
40
Q

what does PET scan assess?

A

function over structure
analysis of tissue uptake of radiolabelled glucose
tissues with high metabolic activity light up

41
Q

what bits always shine bright on PET? Why?

A

brain
urine
tumours
glucose content

42
Q

name some ways we can make a tissue diagnosis

A 
Bronchoscopy
CT guided biopsy
Lymph node aspirate
Aspiration of pleural fluid
Endobronchial Ultrasound
Thoracoscopy
43
Q

describe how the endobronchial US works

A

Bronchoscope with ultrasound tip
Enables visualisation of hilar and mediastinal structures
Target and sample lymph nodes

Respiratory (27 decks)

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