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Transport > Haemoptysis/ Lung Ca > Flashcards

Haemoptysis/ Lung Ca Flashcards

1
Q

how can malignant primaries in the lung be classified

A

SMALL CELL (20-30%) - endocrine (kulchitsky cells)

NON-SMALL CELL
squamous
large cell
adenocarcinoma 
bronchoalveolar
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2
Q

where else in the body are SCCs found

A

oesophagus, stomach and cervix

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3
Q

SCCs are endocrine cells which secrete polypeptides causing endocrine disturbance such as

A

Addison’s
Cushings
Hypercalcaemia

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4
Q

why are SCCs often inoperable

A

early spread

respond well to chemo but poor prognosis

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5
Q

which electrolyte disturbance can be caused by lung squamous carcinoma

A

hypercalcaemia

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6
Q

which type of lung cancer cavitates with a jagged edge on CXR

A

squamous cell carcinoma

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7
Q

why does large cell lung cancer have a poor prognosis

A

metastasizes early

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8
Q

from which cells to lung adenocarcinomas develop

A

mucous cells in the bronchial epithelium causing excessive mucus production

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9
Q

which lymph nodes to adenocarcinomas spread to

A

mediastinal and pleural –> spreads to brain

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10
Q

which type of lung primary cancer can cause pleural effusions

A

adenocarcinoma

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11
Q

which lung primary cancer involves type II pneumocytes

A

bronchoalveolar

can cause bronchorrhoea and histologically tombstone/bobnail cells

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12
Q

in which demographic is lung adenocarcinoma more common in non-smokers

A

women

far east

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13
Q

whcih is the most common cause of cancer death

A

bronchial carcinoma

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14
Q

which type of lung cancer is particularly linked with smoking

A

squamous, small cell and large cell cancer

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15
Q

which type of asbestos is associated with mesothelioma

A

blue asbestos

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16
Q

what are paraneoplastic syndromes

A 
non metastatic complications
HORMONAL:
- hyper calcaemia (squamous)
- SIADH
- ACTH

NEUROMUSCULAR

  • lambert eaton myaesthenic syndrome
  • cerebellar sydromes
  • neuropathies
17
Q

which way does the trachea deviate in pleural effusion caused by lung Ca

A

TOWARDS the tumour occluding the main bronchus

18
Q

what is SVC obstruction

A

swelling of hands and face and arms
headaches worse when leaning forwards
dilated veins

19
Q

wht are the signs of a Pancoast’s tumour

A

rib destruction/pain in shoulder
atrophy of hand muscles in C8 T1 dist
Horner’s syndrome (ptosis and small puplis)

20
Q

progressive consolidation on CXR may be suggestive of which type of lung Ca

A

alveolar cell carcinoma

21
Q

what is the DDx of consolidation on CXR

A 
infection
water
blood
inflammation
tumour
22
Q

what are the 4 Ts of anterior mediastinal masses

A

teratoma
thyroid
T cell lymphoma
Thymoma

23
Q

which conditions is thymoma associated with

A 
Myasthenia gravis
red cell aplasia
SLE
hypogammaglobinaemia
rheumatoid disease
24
Q

what might be suggestive of lung Ca on CXR

A 
peripheral circular opacities
hilar enlargement
lung collapse
consolidation
pleural effusion
bony secondaries
25
Q

which derrangements might you see on blood tests in pts with lung Ca

A

hypercalcaemia from bone mets
hyponatraemia from Addisons
LFTs indicative of liver involvement
FBC - anaemia

26
Q

which types of lung cancer is TNM staging used for

A

NSCLC

sCLC aggressive so categorised into limited or extensive

27
Q

where might lung cancers spread directly

A 
pleura and ribs
sympathetic ganglion -> Horners
Lt recurrent laryngeal nerve palsy -> hoarseness
Spinal cord compression
oesophagus
SVC obstruction
28
Q

where do lung mets go to

A

bones
liver
brain
adrenal glands

29
Q

what is carcinoid syndrome

A

hepatomegaly, flushing and diarrhoea

30
Q

which type of lung cancer is surgery the main curative treatment for

A

NSCLC

31
Q

what is the first line chemo agent for adenocarcinoma or large cell cancer of the lung

A

EGFR +ve
gefitinib or erlotinib

EGFR -ve
pemetrexed
paclitaxel

32
Q

what is the first line chemo for squamous cell carcinoma of the lung

A

gemcitabine

33
Q

what is the first line chemo for SCLC

A

carboplatin/ciplatin and etoposide

34
Q

which two medical emergencies can lung Ca cause

A

spinal cord compression
SVCO
Hypercalcaemia

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