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cardio and pulm > LA pulm-cancers/nodules > Flashcards

LA pulm-cancers/nodules Flashcards

1
Q

5 year survival rate for bronchogenic cancer

A

15%

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2
Q

SCLC

occurance rate, location, mets, tx

A
  • Oat cell 25-35% cases
  • AGGRESSIVE, prone to early mets, spreads early
  • originate in CENTRAL bronchi and mets to regional lymphnodes
  • chemo. rarely amenable to sx.
    • Kulchitsky cells(dk blue cells)
      **can secrete ADH and ACTH
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3
Q

5 year survival rate for NSCLC

A

35-40%, grows slowly and amenable to surgery

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4
Q

squamous cell

occurance rate, location, dx

A

25-35% of cases.
bronchial in origin, it is a centrally located mass
hemoptysis so do a sputum cytology.
**hypercalcemia; keratin pearls

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5
Q

** Kulchitsky cells(dk blue cells)

A

SCLC

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6
Q

**hypercalcemia; keratin pearls

A

squamous cell

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7
Q

adenocarcinoma

occurance rate, location, dx

A

overall most common. 40%
arise from mucous glands, usually appears on PERIPHERAL
cannot do a sputum cytology
**NON SMOKERS, clubbing

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8
Q

bronchoalveolar subtype

A

from adenocarcinoma. low grade.

CXR has hazy infiltrates. Good prognosis.

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9
Q

large cell carcinoma

characteristics, location, dx

A

10%
rapid doubling time; mets early; poor prognosis
central or peripheral mass
do cytology
do surgery. less responsive to chemo
**polymorphic giant cells, secrete b HCG(gynocomastia)

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10
Q

**polymorphic giant cells, secrete b HCG(gynocomastia)

A

large cell carcinoma

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11
Q

which cancers are central

A

squamous and small cell

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12
Q

lung cancer mets locations

A

LABB: liver, adrenal, brain, bone

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13
Q

bronchial carcinoid tumor

prognosis, mets, sx

A

good prognosis and mets rare.
carcinoid syndrome
** nests of neuroendocrine cells

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14
Q

** nests of neuroendocrine cells

A

bronchial carcinoid tumor

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15
Q

carcinoid syndrome

A

flushing, diarrhea, tachycardia, bronchoconstriction, hypoTN

think bronchia carcinoid tumor

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16
Q

S/S of lung cancer

A

symptoms: new or changing cough, hemoptysis, pain, anorexia, wt loss, athenia, night sweats, resistant pneumonia
signs: lymphadenopathy, hepatomegaly, clubbing
* paraneoplastic syndromes 10-20%

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17
Q

tests to order for lung cancer dx

A

CXR, CT, cytologic exam of sputum,
bronchoscopy and central biopsy, exam of pleural fluid
*FNA if peripheral

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18
Q

horner’s syndrome

A

apical pancoast tumor compresses sympathetic trunk, ptosis, miosis, facial anhidrosis

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19
Q

lung ca FEV1 and ratio

A

both low

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20
Q

solitary nodule in non smoker screening

A

CT every 6 months for 2 years

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21
Q

low dose CT scan annual screening for who

A

ages 55-74, 30 pack/yr, quit smoking in the last 15 years

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22
Q

stages TMN

A

tumor size, mets, node

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23
Q

stage 1 tx

A

only lung: resection and radiation (75% survival)

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24
Q

stage 2 tx

A

lung and hilar nodes: resection and chemoradiation (50% survival)

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25
Q

stage 3 tx

A

lung and mediastinal nodes: chemoradiation

26
Q

stage 4 tx

A

lung and distant mets: chemotherapy only

27
Q

what causes an increased risk of malignancy in a solitary pulm nodule

A

spiculated nodule, upper lobe, over 40 y/o

28
Q

what is the most common mediastinal tumor

A

thymoma

29
Q

etio most common with a solitary pulm nodule

A

infectiour granulomas

30
Q

imaging of choice for solitary pulm nodule

A

CT chest, get CXR first

31
Q

bronchoscopy shows pink to purple well vascularized centrall located tumor

A

bronchial carcinoid tumor

32
Q

what tumor is resistant to radiation and chemotherapy

A

bronchial carcinoid tumor

33
Q

1st and 2nd most common locations for carcinoid tumor

A
  1. GI tract
  2. lung
34
Q

may secrete serotonin, ADH, ACTH, melanocyte stimulating hormone

A

bronchial carcinoid tumor

35
Q

octreotide

A

reduces symptoms in bronchial carcinoid tumor. decreases secretion of active hormones.

36
Q

second most common cancer dx in US (after prostate and breast)

A

lung

37
Q

what is synergistic with smoking and lung cancer

A

asbestosis

38
Q

lung ca screening with low dose CT in what ages

A

55-80 who have no symptoms plus a 30 PPY current smoking hx or quit within15 years

39
Q

most common primary lung cancer in smokers and non smokers; what is second

A
  1. adenocarcinoma
  2. squamous cell lung carcinoma
40
Q

lung cancer for pts with exposure to silica, asbestos, radon, heavy metals

A

adenocarcinoma

41
Q

peripheral on CXR; lepidic (non invasive growth along intact alveolar septae)-voluminous sputum and interstitial lung pattern

A

adenocarcinoma

42
Q

histology: gland formation and mucin production

A

adenocarcinoma

43
Q

bronchial in origin. arises from proximal portions of tracheobronchial epithelium.

A

squamous cell lung carcinoma

44
Q

bx: keratinization and/or intracellular desmosomes (bridges)

A

squamous cell lung carcinoma

45
Q

CCCP characteristics of squamous cell lung carcinoma

A

centrally located, cavitary lesions, hypercalcemia, Pancoast syndrome

46
Q

s/s of hypercalcemia

A

confusion, lethargy, nausea, abd pain, tachycardic, short QT interval

think squamous cell lung carcinoma

47
Q

confusion, lethargy, nausea, abd pain, tachycardic, short QT interval

A

hypercalcemia

squamous cell lung carcinoma

48
Q

what comprises 15% of all lung cancers, aggressive and associated with early mets

A

small cell(oat cell)

49
Q

paraneoplastic syndromes in which lung cancer

A

small cell(oat cell)

50
Q

SVC syndrome, SIADH(hyponatremia), cushing syndrome, lambert eaton syndrome

A

paraneoplastic syndromes

small cell(oat cell)

51
Q

histology: sheets of small dark blue cells with rosette formation

A

small cell(oat cell)

52
Q

small cell(oat cell) located where and tx

A

central.
chemotherapy with or w/out radiation

53
Q

what is lambert eaton syndrome

A

antibodies against presynaptic voltage gated calcium channels prevent acethycholine release, leading to muscle weakness

54
Q

antibodies against presynaptic voltage gated calcium channels prevent acethycholine release, leading to muscle weakness

A

lambert eaton syndrome

paraneoplastic syndrome/small cell ca

55
Q

proximal muscle weakness that IMPROVES with repeated use; hyporeflexia

A

lambert eaton syndrome

56
Q

pancoast tumor, what cancer is most common

A

non small cell, squamous

57
Q

Pancoast tumor compression of ____ brachial plexus, ___ nerve, and central ____ nerve chain

A

lower brachial plexus
ulnar nerve
central sympathetic nerve chain

58
Q

most common initial symptoms of pancoast tumor

A

shoulder and arm pain

59
Q

3 tests pancoast tumor

A
  1. CXR initial test
  2. MRI better to assess extent of infiltration of adjacent tissues
  3. needle bx definitive dx
60
Q

80% of chronic asbestos exposure can lead to what

A

mesothelioma

61
Q

CXR: unilateral pleural thickening

A

mesothelioma

62
Q
A

cardio and pulm (22 decks)

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