Key points of lung cancer

Question 1

lung diseases causing clubbing (ABCDEF)

Answer 1

Abscess
Bronchiectasis 
Cystic Fibrosis 
Don't say COPD 
Empyema Fibrosis

Question 2

TTF-1 is only expressed in adenocarcinoma.

True/False

Answer 2

false

- also in small cell carcinoma

Question 3

P63 is expressed in squamous cell carcinoma.

Ture/false

Answer 3

true

Question 4

K-ras and EGFR mutations occur in which type of lung tumour?

Answer 4

non-small cell cancer

Question 5

what cells give rise to small cell carcinomas?

Answer 5

neuroendocrine cells

Question 6

which type of lung cancer is more common in non-smokers?

Answer 6

adenocarcinomas

Question 7

what is the most common type of lung cancer?

Answer 7

squamous cell carcinoma

Question 8

Who gets radical radiotherapy?

Answer 8

early non-small cell lung cancer patients with adequate lung function but where surgery is not possible

Question 9

describe the locations of possible local invasions of a primary tumour?

Answer 9

1) Recurrent laryngeal nerve
2) pericardium
3) oesophagus
4) brachial plexus
5) pleural cavity
6) superior vena cava

Question 10

what does invasion of recurrent laryngeal nerve lead to?

Answer 10

HOARSE voice

Question 11

what does invasion of the pericardium do?

Answer 11

• breathless
• atrial fibrillation
• pericardial effusion

Question 12

what does invasion of the oesophagus do?

Answer 12

• dysphagia

= difficulty swallowing solids

Question 13

when a primary tumour invades a brachial plexus, what can the tumour be Called?

Answer 13

a pan coast tumour

Question 14

which part of the lung is the pan coast tumour referring to?

Answer 14

the TOP of the lung

Question 15

what happens when the tumour invades the pleural cavity?

Answer 15

leads to a pleural effusion

Question 16

what happens when the tumour invades the superior vena cava (SVC)?

Answer 16

= obstructs drainage of blood from arms & head

• puffy eyelids & headache result
• distension of superficial veins
• normal pulsation is lost

Question 17

what are the 5 most common site for metastases?

Answer 17

1) brain
2) liver
3) bone
4) adrenal / lymph
5) skin

Question 18

which LFT is particularly abnormal in liver metastases?

Answer 18

Alkaline phosphate (ALP)

Question 19

what is HPOA?

Answer 19

hypertrophic pulmonary osteoarthropathy

Question 20

what is thrombophlebitis?

Answer 20

= inflammation of the wall of a vein with associate thrombosis

Question 21

how does hypercalcaemia arise?

Answer 21

• tumour produces a substance which mimics the effect of the PARATHYROID hormone.
• parathyroid hormone holds onto the calcium & increases its conc

Question 22

what are the 5 things related to hypercalcaemia?

Answer 22

1) stones
= renal/biliary calculi

2) bones
= bone pain

3) groans
= abdominal pain
= constipation
= nausea & vomitting

4) thrones
= polyuria

5) psychiactic overtones
= depression
= anxiety

Question 23

what are the symptoms of hypercalcaemia?

Answer 23

1) headache
2) confusion
3) extreme thirst
4) constipation

Question 24

how would you treat hypercalcaemia?

Answer 24

• rehydrration

- if this doesn’t work then use IV biphosphonate

Question 25

what is hyponataemia?

Answer 25

= results from production of substance which mimics anti-diuretic setting

Question 26

what is the syndrome called which relates to Hyponatramia and what does it lead to?

Answer 26

Syndrome of Inappropriate anti-diuretic hormone. (SIADH)

= low sodium concentration

Question 27

how would you treat SIADH?

Answer 27

1) fluid restriction = 1.5L/day

2) demeclocyclinnne