Lung Flashcards
Which cancers peripheral and which central?
Adeno and large peripheral
Squamous and small central
Which cancer does hypercalacemia?
squamous
Which cancer does LEMS?
Small cell
Which cancer does cerebellar ataxia?
Small cell
Anti Hu, Yo, P/Q ab
Which cancer does limbic encephalitis?
Small cell
Anti Hu, CRMP5, ANNA5
Which cancer does cushing from ACTH?
Small cell
Which cancer does HPOA?
squamous
clubbing with periostitis of small hand joints, joint swelling
Clubbing Which cancer does?
Non small cell
Who gets prophylactic CI?
limited and extensive stage small cell
What do you need the FEV1 and DLCO to be at before resect?
At 80% of predicted
Is carcinoid of the lung associated with smoking?
No
And very rarely get carcinoid syndrome
Lung cancer type presentation with PAIN that is dull and unrelenting,,,,?
Mesothelioma.
Pleura is painful
Verbal outline of small cell treatment?
Limited stage - chemo-radio concurrent with platinum based radio
+PCI
Extensive stage give chemo
+PCI
+ if good response but residual disease in thorax- radiotherapy
What is counted as extensive stage?
Tumour beyond the boundaries of limited disease including distant metastases, malignant pericardial, or pleural effusions, and contralateral supraclavicular and contralateral hilar involvement.
Outline treatment of non small cell?
1A resect
1B, II - resect and adjuvant chemo
If positive resection margins then do some RT
Stage III or IV
-Driver mutation- do that
-No driver mutation - cytotoxic chemo + bevacizumab if non-squamous
-once progress try non cross resistant agents
or anti-PD1
strongest smoking association
small cell
which makes ectopic TSH–>hyperthyroidism?
squamous
If SIADH not getting better with fluid restriction, check
ANP- ectopic can do this
carcinoid tumour and smoking
NO association
endobronchial lesion
non squamous and chemo; can also give
Bevacizumab
PD1 in lung cancer?
Non small cell and no driver mutation
most common organ involved in scleroderma
oesophagus
then lung
Most common lung cancer is
adenoca
what does the trial about lung cancer screening show
age 55 to 74 and smoked 30 PY and still smoking or stopped in last 15 years- low dose annual CT
What does micro of lung cancer with thyroid transcription factor staining tell you?
Adeno
TTF)
What does lack of staining for cytokeratin 7 and 20 tell you
squamous cell (others may be positive for CK7)
things that can cause PET negative
DM
lesion under 8mm
concurrent infection
Why no Bev in squamous cell?
bleeding risk
What PFT stuff to make sure safe to resect
pneumonectomy FEV1 must be over 80% predicted
lobectomy FEV1 must be over 1.5 L
must have DLCO over 40%
VO2Max under 15ml/kg predicts higher complication rate
asbestos increases what kinds lung cancer
NSCLC
NO association with small cell
