Diffuse alveolar hemorrhage syndromes and lung cancer

Question 1

Horner’s syndrome involves the ______ plexus being damage

Answer 1

sympathetic

Question 2

in Goodpasture syndrome, the autoantibodies are targeted against ________

Answer 2

α3 chain of collagen IV

Question 3

what are the manifestations of SVC syndrome?

Answer 3

compression of the SVC will lead to edema in the head, neck, upper chest and arms

Question 4

a patient comes with edema in the arms and upper chest, hoarseness of his voice and wasting of hand muscles. What is the diagnosis?

Answer 4

pancoast tumor: apical neoplasm. where T1/T2 destruction so it can involve the brachial plexus and compress on the ulnar nerve

Question 5

what are the paraneoplastic syndromes associated with small cell carcinoma of the lung

Answer 5

• excess ACTH
• SIADH
• myasthenia like syndrome (Lambert-Eaton)

Question 6

mutations in ______ is associated with BAD prognosis of adenocarcinoma of the lung

Answer 6

KRAS

Question 7

_______ is associated with BOTH small cell and non small cell carcinoma of the lung

Answer 7

3p deletion

Question 8

antibodies formed against the α3 chain of type IV collagen in seen in what disease

Answer 8

goodpasture

Question 9

linear deposits of ____ can be found along ______ in good pastures

Answer 9

IgG; glomerular basement membrane or the alveolar septa

Question 10

what is the most common site of metastasis of lung cancer?

Answer 10

lymph nodes

Question 11

patients with adenocarcinoma of the lung and have mutations in _______ are associated with good prognosis

Answer 11

EGFR; these patients respond better to tyrosine kinase inhibitors

Question 12

hyper/hyponatremia is associated with small cell carcinoma of the lung

Answer 12

hyponatremia due to SIADH

Question 13

what are the common sites of lung cancer metastasis

Answer 13

• lymph nodes
• adrenal glands
• liver
• brain
• bone

Question 14

describe the granulomas in wegener’s

Answer 14

they are palisaded and poorly formed
UNLIKE the granulomas formed in sarcoidosis with are well formed

pulmonary angiitis wit granulomatosis

Question 15

in terms of involvement of the respiratory tract what is the difference between Wegener’s and goodpasture?

Answer 15

• wegener involves the entire respiratory tract (upper and lower)
• goodpasture does not involve the upper respiratory tract

Question 16

what diseases are included in the diffuse alveolar hemorrhage syndromes

Answer 16

• goodpasture
• idiopathic hemosiderosis
• Wegener granulomatosis

Question 17

myc amplification, p53 mutation and Rb mutation are seen in ______ cell carcinoma of the lung

Answer 17

small cell carcinoma of the lung

Question 18

what are some clinical features of lung cancer?

Answer 18

• cardiac tamponade
• hoarseness (recurrent laryngeal never damage)
• SVC syndrome (edema in the head, upper chest and arms)
• Horner’s Syndrome: ipsilateral enophthalmos, ptosis, meiosis, anhidrosis

Question 19

diffuse alveolar hemorrhage syndromes manifest as at triad of what symptoms?

Answer 19

• hemoptysis
• anemia
• diffuse pulmonary infiltrates

Question 20

what are the treatment plans for goodpasture?

Answer 20

• plasmapheresis (get rid of the antibodies in the blood)

- immunosuppressive therapy (suppress the formation of more antibodies)

Question 21

_______ is a paraneoplastic syndrome associated with squamous cell carcinoma of the lung

Answer 21

hypercalcemia due to excess PTH

Question 22

what do you give for treatment of Wegener’s

Answer 22

cyclophosphamide, steroids, anti TNF, rituximab