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Yr3 RESP > Condition- Lung Cancer > Flashcards

Condition- Lung Cancer Flashcards

1
Q

What is lung cancer?

A

Lung cancer is a malignant epithelial neoplasm arising from cells lining the lower respiratory tract

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2
Q

What are the two classifications of lung cancer? and state each of their rates of incidence

A

Small cell Lung cancer- 20%

Non-small cell lung cancer- 80%

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3
Q

List some of the causes of lung cancers

A
  1. Smoking
  2. Occupational Exposure:
    • Asbestos
    • Radon Gas
    • Heavy Metals: Lithium
    • Aromatic hydrocarbons and amines
  3. Air pollution
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4
Q

Lung cancer is the _____ most common cancer worldwide

A

Lung cancer is the most common cancer worldwide

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5
Q

List some of the presenting symptoms of lung cancer- go in order

A

Symptoms due to PRIMARY:

  • cough
  • haemoptysis
  • dyspnoea
  • chest pain

Symptoms due to LOCAL INVASION:

  • dysphagia
  • hoarsness (left recurrent laryngeal nerve invasion)
  • Horner’s syndrome
  • Shoulder/ arm pain (brachial plexus invasion)

Symptoms due to METASTASIS/ SYSTEMIC:

  • Weight loss
  • Fatigue
  • Fractures/ bone pain
  • Confusion, nausea, vomitting, headache (brain)
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6
Q

List some of the signs of lung cancer on physical examination…

A
  • May hear monophonic wheeze if single obstruction
  • Signs of lobar collape/ pleural effusion
  • Signs of metastasis- lymphadenopathy, hepatomegaly, bone tenderness, seisures, confusion etc)
  • Cachexia
  • Anaemia
  • Clubbing
  • Hypertrophic pulmonary osteoarthropathy (clubbing + pain swelling of joints/ long bones)
  • supraclavicular/ axillary lymphadenopathy
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7
Q

Other than bloods, which investigations might you conduct on someone with lung cancer?

A
  • Sputum- malignant cells in sputum
  • CXR
  • Bronchoscopy with biopsy
  • CT/ MRI to stage the cancer
  • Radionuclide bone- if bony mets suspected
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8
Q

What might you see in a CXR of someone with lung cancer?

A
  • Mass/ nodules
  • Hilar enlargement due to lymphadenopathy
  • pleural effusion
  • Lung collapse
  • Cavitatig lesions- usually SqCC
  • Coin lesion- if secondary lesion
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9
Q

What are the three main types of non-small cell lung cancer?

A
  • adenocarcinoma (30-40%)
  • squamous cell carcinoma (20-30%)
  • large cell carcinoma (10%)
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10
Q

Describe the difference in location of small cell and non-small cell lung cancers

A
  • Small-cell: central
  • Non-SC: peripheral
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11
Q

Describe the difference in prognosis of small cell and non-small cell lung cancers

A
  • Small-cell worse prognosis than non-sc
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12
Q

Which type of lung cancer is often associated with SAIDH?

A

Small cell lung cancer

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13
Q

Which type of cancer is a pancoast tumour?

A

NON-SMALL CELL usually

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14
Q

List some of the presenting symptoms of a pancoast tumour

A
  • ipsilateral Horner’s if it presses on the sympathetic plexus in the neck
  • Hoarsness if it compresses the left recurent laryngeal nerve
  • Flushing and oedema of face and arms if it compresses the SVC
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15
Q

Smoker, presents with chronic productive cough. Blood test show low Na+ and high K+ and urine shows high Na+ and low K+. Which cancer caused this?

A

Small Cell lung cancer

SIADH (ectopic ACTH production)

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16
Q

Resp causes of clubbing

A
  1. Bronchiectasis (caused by CF)
  2. IPF
  3. TB
  4. Lung cancer
17
Q

Lung cancer staging

A
  1. Stage 1= cancer
  2. Stage 2 = tumour + local lymph nodes
  3. Stage 3= tumur + central lymph node involvement
  4. ??
18
Q

Which type of lung cancer is more likely to present with haemoptysis and why?

A

Squmous cell cancer

Because it often affects lung tissue closer to the hilar region so blood has relatively little distance to travel before being coughed up

19
Q

Which type of lung cancer is derived from the lungs endocrine cells

A

Small Cell Cancer

20
Q

Lung cancers can produce hormones, which hormones are produced by cancer and which types of cancers secrete these hormones?

A
  • Small Cell lung cancer:
    • ADH => SIADH
    • ACTH => Cushing’s syndrome
  • Squamous Cell lung cancer:
    • PTHrP => Hypercalcaemia
21
Q

Which type of cancer is often found in the periphery of the lung?

A

Adenocarcinomas

22
Q

How are the different cancer types managed and why?

A
  • Small Cell lung cancer- responds well to chemo but not surgery because it meastasises early
  • Non-small cell lung cancer- responds well to radiotherapy and surgery because it is often locally contained
    • Note if disseminated- has a poor prognosis
23
Q

Which neuromuscular syndrome is often seen in patients with Small Cell Cancers?

A

Lambert Eaton syndrome= proximal muscle weakness with improves with repetition (unlike Myaesthenia Gravis)

Yr3 RESP (16 decks)

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