lung cancer

Question 1

NSCLC

Answer 1

adenocarcinoma,
squamous cell carcinoma,
large-cell carcinoma

Question 2

SCLC: neurosecretory granules

Answer 2

release neuroendocrine hormones - paraneoplastic syndromes

Question 3

signs + symptoms

Answer 3

SOB,
cough,
haemoptysis,
 finger clubbing, 
recurrent pneumonia, 
weight loss, 
lymphadenopathy

Question 4

CXR findings indicative of lung Ca

Answer 4

hilar enlargement,
peripheral opacity (visible lesion),
pleural effusion (usually unilateral in Ca)
collapse

Question 5

lung Ca investigations

Answer 5

CXR, CT, PET-CT, bronchscopy w EBUS, histological diagnosis

Question 6

Mx: NSCLC

Answer 6

surgery if disease isolated to single area, radiotherapy, chemotherapy

Question 7

Mx: SCLC

Answer 7

chemortherapy and radiotherapy

Question 8

prognosis NSCLC vs SCLC

Answer 8

SCLC worse than NSCLC

Question 9

first line surgical manage,ent

Answer 9

lobectomy

Question 10

endobronchial treatment

Answer 10

with stents or debulking can be used palliatvely to relieve bronchial obstruction

Question 11

recurrent laryngeal nerve palsy

Answer 11

hoarse voiced - caused by ca pressing on/affecting recurrent laryngeal nerve as it passes through mediastinum

Question 12

phrenic nerve palsy

Answer 12

nerve compression causes diaphragm weakness –> SOB

Question 13

SVC obstruction

Answer 13

direct compression of Ca on SVC –> facial swelling, difficulty breathing, distended veins

Question 14

Horner’s syndrome

Answer 14

ptosis, anhidrosis and miosis –> caused by a pancoasts tumour pressing on sympathetic ganglion

Question 15

syndrome of innapropriate ADH

Answer 15

caused by ectopic ADH secretion by SCLC –> presents w hyponatramia

Question 16

cushing’s syndrome

Answer 16

ectopic ACTH secretion by SCLC

Question 17

hypercalcaemia

Answer 17

caused by ectopic PTH from squamous cell carcinoma

Question 18

limbic encephalitis

Answer 18

SCLC cancer immune system to make antibodies to tissues in brain (esp limbic system) causing inflammation in these areas –> short term memory impairment, hallucinations, confusion, seizures

Question 19

Lambert-Eaton myasthenic syndrome

Answer 19

result of antibodies produced by immune system against SCLC. Antibodies also target and damage voltage-gated calcium channels of motor neurones

Question 20

Lambert-Eaton myasthenic syndrome symptoms

Answer 20

muscle weakness,
 diplopia, 
ptosis, 
slurred speech, 
dysphagia,
dry mouth,
impotence, 
dizziness

Question 21

Lambert-Eaton myasthenic syndrome sugns

Answer 21

reduced tendon reflerxes,

post tetanic potentiation

Question 22

mesothelioma

Answer 22

lung malignancy affecting mesothelial cells of pleura - linked to asbestos inhalation

Question 23

aetiology/risk factors

Answer 23

smoking, 
asbestos, 
environmental radon, 
air pollution, 
pulmonary fibrosis

Question 24

adenocarcinoma lung location

Answer 24

lung periphery

Question 25

squamous cell carcinoma lung location

Answer 25

central lung airways

Question 26

paraneoplastic symptoms: Adenocarcinoma

Answer 26

gynaecomastia

hypertrophic pulmonary osteoarthropathy