Clinical: Pulmonary Neoplasm Flashcards

1
Q

What does intracellular bridging seen on histology indicate?

A

Squamous cells

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2
Q

How can a pulmonary adenocarcinoma be identified on microscopy?

A

The tumor will contain glands.

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3
Q

What does a “school of fish” pattern with “salt and pepper” nuclei pattern on microscopy indicate?

A

Small Cell Lung Carcinoma

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4
Q

Risk factor for lung cancer

A

Smoking

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5
Q

What is the major occupational risk factor that can lead to lung cancer?

A

Asbestos inhalation

though this mostly causes mesothelioma rather than lung cancer

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6
Q

What causes clubbing in the fingers with lung cancer?

A

Chain of events

  • tumors increase alveolar pressure in the lungs
  • the increase in alveolar pressure causes an increase in vascular pressure
  • the increase in vascular pressure results in vessel dilation and possible edema due to increased hydrostatic pressure
  • the increased volume from the vessel distension and edema is minimal but is easily seen in the small vessels in the finger tips
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7
Q

What are the only OMM techniques approved for use in lung cancer?

A

Lymphatic drainage and soft tissue

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8
Q

Where in the lungs do most adenocarcinomas form and where do they commonly metastasize?

A

They form mostly in the lung periphery

They metastasize to the brain

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9
Q

Where do most squamous cell carcinomas form?

A

Endobronchial (airways)

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10
Q

What condition are small cell lung carcinomas associated with and what is a common lab finding because of this association?

A

Lambert Eaton syndrome

-hypercalcemia

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11
Q

What cancer is associated with Brachial plexus dysfunction and/or Horner Syndrome?

A

Pancoast Tumor

  • found at lung apex
  • non small cell type
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12
Q

Why is surgery not an option to treat small cell lung carcinoma?

A

If typically forms too close to the carina. Tumors must be at least 2cm away from the carina to consider surgery.

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13
Q

Describe bronchoalveolar cell cancer.

A

Presents like pneumonia

  • very slow growing
  • located peripherally
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14
Q

How is bronchoalveolar cell cancer monitored?

A

Once a growth is detected it is monitored by CXR for 2 years to determine if it needs to be removed.
(Watchful waiting: used for nodules less than 1 cm that are suspicious)

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15
Q

What size lung nodule requires intense radiologic monitoring for both high and low risk patients?

A

Greater than 8cm diameter

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16
Q

What size nodule only requires radiologic monitoring in high risk patients for a year?

A

Less than 4cm diameter

17
Q

What are the 3 limitations for PET scans?

A
  1. False readings for nodules smaller than 1cm
  2. False negatives with uncontrolled diabetes
  3. False positives with inflammation or infection
18
Q

What type of pulmonary lesions does bronchoscopy have the highest yield?

A

Central lesions

-easiest ones to “get to” with an endotracheal scope

19
Q

What technique has improved yield on peripheral lesions with bronchoscopy?

A

Electromagnetic Navigational Bronchoscopy

20
Q

What is endoscopic Bronchial Ultrasound mainly used for?

A

Sampling Lymph Node tissue

21
Q

Which technique has the highest yield to identify lung cancers?

A

Surgical Intervention

22
Q

When staging lung cancers, which ones are not resected with surgery?

A

Stage IIIB - Stage IV