L5: Lung Cancer Flashcards
1
Q
Types of Lung Cancer
A
2
Q
…… is the most common site for metastasis from other body tumors.
A
Lung
3
Q
Etiology of Bronchogenic Carcinoma
A
4
Q
Etiology of Bronchogenic Carcinoma
- Smoking
A
5
Q
Etiology of Bronchogenic Carcinoma
- Air Pollution
A
6
Q
Etiology of Bronchogenic Carcinoma
- Lung Diseases
A
as
- post TB
- Interstitial lung fibrosis
- COPD
- Asbestosis
- Silicosis
7
Q
Etiology of Bronchogenic Carcinoma
- Dietary Factors
A
8
Q
Etiology of Bronchogenic Carcinoma
- Gender & Radial Differences
A
9
Q
Etiology of Bronchogenic Carcinoma
- Inheritance
A
10
Q
Pathology of Bronchogenic Carcinoma
A
11
Q
Pathology of Bronchogenic Carcinoma
- Microscopy
A
12
Q
Pathology of Bronchogenic Carcinoma
- Site
A
13
Q
Pathology of Bronchogenic Carcinoma
- Spread
A
14
Q
Presentation of bronchial carcinoma
A
15
Q
Symptoms of Bronchial carcinoma
A
16
Q
Symptoms of Bronchial carcinoma
- Symptoms due to irritation and/ or obstruction of the bronchus with the tumor itself
A
17
Q
Symptoms of Bronchial carcinoma
- Symptoms due to intra thoracic extrapulmonary extension due to compression and or infilliation of the chest wall, pleura, diaphragm, mediastinum with the tumor or its draining lymph nodes
A
18
Q
Symptoms of Bronchial carcinoma
- Symptoms due to metastasis
A
19
Q
Symptoms of Bronchial carcinoma
- Systemic non- metastatic paraneoplastic symptoms
A
20
Q
Signs of Bronchial Carcinoma
A
21
Q
General Examination in Bronchial Carcinoma
- Breathlessness
A
- due to bronchial carcinoma or the associated disease as COPD and / or ischemic heart disease
22
Q
Signs of Bronchial Carcinoma
- None
A
….
22
Q
Signs of Bronchial Carcinoma
- General Examination
A
23
Q
General Examination in Bronchial Carcinoma
- Stridor
A
due to tracheal obstruction.
24
General Examination in **Bronchial Carcinoma**
- Clubbing
hypertrophic pulmonary osteoarthropathy (HPOA).
25
General Examination in **Bronchial Carcinoma**
- Tachycardia
due to vagal nerve infiltration.
26
Signs of **Bronchial Carcinoma**
- Local Examination
27
Local Examination in **Bronchial Carcinoma**
- localized Wheezes
- due to fixed partial bronchial obstruction with tumor mass or its lymph nodes, the wheezes do not disappear after coughing.
28
Local Examination in **Bronchial Carcinoma**
- Signs of Pleural Effuasion
due to spread or metastasis to the pleura:
- Stony dullness
- decreased tactile vocal fremitus
- decreased or absent breath sounds
29
Local Examination in **Bronchial Carcinoma**
- Diaphragmatic Paralysis Signs
- basal dullness with reversed tidal percussion.
30
Local Examination in **Bronchial Carcinoma**
- Signs of Lobe or lung collapse
- impaired note
- decreased tactile vocal fremitus
- decreased or absent breath sounds
31
Local Examination in **Bronchial Carcinoma**
- Positive Despine Sign
due to mediastinal lymphadenopathy.
32
Local Examination in **Bronchial Carcinoma**
- Pancoast Tumor
(apical bronchial carcinoma): dull Kronig' s isthmus.
33
Def of Pancoast's tumor
34
The Pancoast's tumor invades .......
35
Mediastinal syndrome is a sign of .....
inoperability
36
Causes of Mediastinal syndrome
is caused BY compression or direct invasion by tumor to:
- Superior vena cava, Subclavian artery, Trachea, Esophagous,
- left recurrent laryngial nerve and phernic nerve.
37
CP of **Mediastinal syndrome**
38
CP of **Paraneoplastic Syndrome**
39
CP of **Paraneoplastic Syndrome**
- Endocrine
* Cushing's syndrome.
* Gynecomastia
* Hypercalcaemia.
* Acromegally.
* Water intoxication.
* Carcinoid syndrome
40
INvx for **Bronchial Carcinoma**
- Chest X-Ray
41
INvx for **Bronchial Carcinoma**
42
INvx for **Bronchial Carcinoma**
- CT
- For accurate localization and evaluation of hilar and mediastinal lymph nodes and for staging.
43
INvx for **Bronchial Carcinoma**
- Sputum Cytology
44
INvx for **Bronchial Carcinoma**
- Bronchoscopy
45
INvx for **Bronchial Carcinoma**
- Biopsy
46
Assessment of operability of lung cancer
47
Assessment of operability of lung cancer
- Clinical
Clinical signs of inoperabity
- (poor pulmonary or heart function), mediastinal syndrome
48
Assessment of operability of lung cancer
- rads
Radiological signs of inoperability
- large tumors with or without local or distant spread;
- stages Illb and VI.
49
Assessment of operability of lung cancer
- Bronchoscopy
Bronchoscopic signs of inoperability
- tumors affecting the trachea or the main airway adjacent to the carina
50
Staging of Bronchial Carcinoma
- NSCLC
50
Assessment of operability of lung cancer
- Assesment of Mets
51
Staging of Bronchial Carcinoma
- SLCC
52
Staging of Bronchial Carcinoma
53
DDx of **Bronchial Carcinoma**
54
TTT of **Bronchial Carcinoma**
55
TTT of **Bronchial Carcinoma**
- Aim
to cure sometimes, to relieve often and to comfort always
56
TTT of **Bronchial Carcinoma**
- Surgery
57
TTT of **Bronchial Carcinoma**
- Palliative
58
Palliative TTT in **Bronchial Carcinoma**
- Chemotherapy
59
Palliative TTT in **Bronchial Carcinoma**
- radiotherapy
60
Palliative TTT in **Bronchial Carcinoma**
- endobronchial therapy
It is done to control hemoptysis and obstructed central airways: eg laser
61
Palliative TTT in **Bronchial Carcinoma**
- Supportive TTT
1. Psychotherapy for anxiety, depression and insomnia.
2. Analgesics for pain (morphia).
3. Nutritional support.
4. Treatment of concomitant diseases
62
Def of **Bronchial Adenoma (Carcinoid Tumor)**
- It is a locally malignant tumor, usually affecting the middle aged females and originates from neuroendocrine cells (APUD).
63
Incidence of **Bronchial Adenoma (Carcinoid Tumor)**
usually affecting the middle aged females
64
Prognosis of **Bronchial Adenoma (Carcinoid Tumor)**
Good
65
CP of **Bronchial Adenoma (Carcinoid Tumor)**
66
CP of **Bronchial Adenoma (Carcinoid Tumor)**
- Hemoptysis
frank and recurrent
67
CP of **Bronchial Adenoma (Carcinoid Tumor)**
- Lobe Collapse
which is usually acute, and followed with
- aeration (fleeting shadows),
- localized area of dullness and decreased intensity of breath sounds.
68
CP of **Bronchial Adenoma (Carcinoid Tumor)**
- Partial Obstruction
Partial obstruction of the bronchi:
- localized emphysema, localized area of hyperresonance.
69
CP of **Bronchial Adenoma (Carcinoid Tumor)**
- Others
70
DDx of **Bronchial Adenoma (Carcinoid Tumor)**
71
INVx for **Bronchial Adenoma (Carcinoid Tumor)**
72
INVx for **Bronchial Adenoma (Carcinoid Tumor)**
- X-Ray
- Normal.
- Coin shadow.
- Area of atelectasis.
73
INVx for **Bronchial Adenoma (Carcinoid Tumor)**
- CT
For accurate localization and evaluation of
- hilar and mediastinal lymph nodes.
74
INVx for **Bronchial Adenoma (Carcinoid Tumor)**
- Bronchoscopy
bleeds easily so, this must be considered in biopsy taking
75
TTT of **Bronchial Adenoma (Carcinoid Tumor)**
76
TTT of **Bronchial Adenoma (Carcinoid Tumor)**
- Surgery
* Pneumonectomy, lobectomy, segmentectomy or
* sleeve resection according to the site of the tumor.
