Haemoptysis and SOB

Question 1

What are three respiratory causes of clubbing?

Answer 1

Suppurative lung disease

Interstitial lung disease - idiopathic lung disease, asbestosis (not sarcoidosis)

Bronchogenic cancer

Question 2

How can lung cancer present?

Answer 2

Local complications

• Cough, change in voice
• Pruritic chest pain
• SOB (effusion, pneumothorax, PE, SVC obstruction)
• Haemoptysis

Metastatic Disease

• Bone pain
• CNS signs

Systemic symptoms

• Fatigue, LOW
• Hypercalcaemia

Question 3

Pathophysiologically, what causes haemoptysis and what are some DDx for this?

Answer 3

Disruption of the alveolar membrane or airways

DDx

• Infections - bronchitis, pneumonia, bronchiectasis, TB
• Carcinoma
• PE

Question 4

What are some risk factors for the development of lung Ca?

Answer 4

Smoking

Radiation exposure

Second hand smoke

Abestos

Radon

Pulmonary fibrosis

Question 5

Outline staging for lung cancer

Answer 5

I - Primary with no nodal metastasis

II - Primary with ipsilateral nodal metastasis to peribronchiolar or hilar LNs

III - Local invasion plus mediastinal LN spread or local invasion to adjacent organs

IV - Distant organ metastasis

Question 6

What treatment options are available in lung Ca? Which has the best chance of cure in lung cancer?

Answer 6

Surgery (best)

Chemotherapy

Radiotherapy

Target biological

Palliation

Question 7

What are some targeted biological therapies for lung Ca?

Answer 7

EGFR receptor antagonist