L04: Respiratory Malignancies Flashcards
What is the angle of Louis
Point which is:
Bifurcation of trachea
Start of aortic arch
Azygous vein enters SVC
What lines the lungs
Parietal and visceral pleura
At which rib does the pleura meet
2nd rib
Between which rib does the heart lie
3-6 ribs on right of sternum
How many lobes are there on the left lobe
2
What are the lobes of the left lobe called
Upper
Lower
How many lobes does the right lobe have
3
What are the lobes of the right lobe called
Upper
Middle
Lower
What are the clinical features of lung cancer
Smoker Haemoptysis Weight loss Dyspnoea Cough Chest pain Hoarse voice
What is haemoptysis
Coughing up blood
What is dyspnoea
Breathlessness
What are the common causes of lung cancer
Smoking
Asbestos
Radiation
Which job is more likely to involve asbestos
Plumbing
Construction etc
What is the mechanism of asbestos causing lung cancer
1) asbestos binds to epithelial growth factor receptor
2) this sets up a cascade reaction for proliferation of cells
Or
1) asbestos leads to proteases for the break down of cells
Or
1) asbestos leads to DNA damage that is transcribed
If we suspect lung cancer what diagnosis method should take place
Chest x-ray
To confirm likely lung cancer what diagnostic method is undertaken
CT chest scan
If a patient is confirmed to have lung cancer what diagnostic method is used to used to find the type of cancer
Bronchoscopy
Biopsy
Which diagnostic method is used to diagnose the stage of cancer
PET
Neck USS
To see where the tumour is what method is used
CT scan
What are the types of lung cancer
Non small cell lung cancer
Small cell
Carcinoid
Within non small cell lung cancer what are the other subgroups of cancer
Squamous
Adenocarcinoma
Undifferentiated or mixed
What is the division of the left and right bronchi called
Carina
What is a complication of bronchoscopy
Bleeding from the tumour
Infection
What are the types of samples we can take with bronchoscopy
Brushing
Washing
Biopsy
What are the other wats to get tissue
EBUS
Cervical mediastinoscopy
Where is small cell lung cancer derived from
Neuro endocrine tissue
How do differentiate between different cell lung cancers
We use specific tumour markers
Why do we use tumour markers
Cells express tumours which we can target for it to show positive on a film
What does a PET scan enable us to see
If the tumour has spread elsewhere
What nodes do we have along the trachea
Lymph nodes
How do we stage non small cell lung cancer
We use TNM classification which is:
Tumour
Node
Metastases
How do we treat non small cell lung cancer
Surgery
Radiotherapy
Chemotherapy
What is the treatment for small cell lung cancer
Chemotherapy
How does metastases spread
Via lymphatic or blood
What is common place of metastases
Pleura
Brain
Bone
What do we use to treat brain metastases
Radiotherapy
What are the local complications of lung cancer
Superior vena cava obstruction
Horners syndrome
Recurrent laryngeal nerve palsy
Pleural effusion
What are the features of superior vena cava obstruction
Fixed and raised jugular venous pressure
Lips cyanosis
Collaterals
What are the features of horners syndrome
Partial ptosis
Enopthalmus
Meiosis
What is partial ptosis
Half drooping eye lid
What is enopthalmus
Sinking of the eye
What is meiosis
Shrinkage of pupil
What is pleural effusion
Fluid in the pleural space
What are the clinical features of a pleural effusion
Dyspnoea Pain Reduced expansion Dull percussion Reduced vocal resonance
What are the 3 main mechanism of pleural effusion
Leave into the pleural space
Or
Produced by pathology in the pleural space
Or
Pleural fluid is not been removed due to the lymphatics not working
What are the 2 classes of pleural effusion
Transudates
Exudates
What are the causes of exudate pleural effusion
MR BALDY SPIT M- mesothelioma/asbestos R- rheumatoid arthritis B- bronchial cancer A- abscess L- lymphoma D-dressers syndrome Y- yellow nail syndrome S- SLE P- pneumonia I- infarction T- TB
How do you manage pleural effusions
Tap fluid
Aspirate
Drain
What is mesothelioma
Cancer of pleura
What is the cause of mesothelioma
Asbestos
What is the treatment for mesothelioma
Chemotherapy
Radiotherapy
Surgery
Immunotherapy