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exam - M - Respiratory diseases (Megan) > Lung Cancer > Flashcards

Lung Cancer Flashcards

1
Q

How common is lung cancer?

A

3rd most common cancer in the UK after breast an prostate.

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2
Q

How much lung cancer is thought to be preventable?

A

80%

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3
Q

What are the two main types of lung cancer?

A

Small cell lung cancer - 20%

Non small cell lung cancer - 80%

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4
Q

Within non small cell lung cancer, what are the classifications?

A

Squamous cell carcinoma
Adenocarcinoma
Large cell carcinoma
Other types

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5
Q

What is the most common type of lung cancer?

A

Squamous cell carcinoma

Followed by adenocarcinoma

(Both non small cell lung cancers)

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6
Q

What are the risk factors of lung cancer?

A 
Smoking
Passive smoking
Asbestos 
HIV
organ transplant
Radiation exposure
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7
Q

What are the general symptoms of lung cancer?

A 
cough
haemoptysis
cachexia 
weight loss
dyspnoea
weight loss
nausea
vomiting
chest pain
anorexia
finger clubbing
anaemia
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8
Q

What are the lung signs?

A

Consolidation
Pleural effusion
Collapse

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9
Q

Which lymph nodes are most likely to be enlarged?

A

Supraclavicular (then axillary)

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10
Q

What sign does a pan coast tumour present with?

A

Horners syndrome - partial ptosis, myosis, anhidrosis.

Tumour presses on sympathetic ganglion.

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11
Q

Where is lung cancer most likely to spread to?

A

Brain
Breast
Bone
Adrenal gland

Via blood

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12
Q

What are the features of squamous cell carcinoma?

A

X-ray - can’t tell if its abscess or cancer
CT - shows jagged border proving its cancer
Local spread is common
Metastasis is late
Finger clubbing
Infections

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13
Q

What are the features of adenocarcinoma?

A 
Caused by mucous secreting cells 
Metastasises to brain and bone
Cause pleural effusion
Can happen in non smokers and women
Involves mediastinal lymph nodes
Does not cavitate
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14
Q

What are the features of small cell cancer?

A

Presents with paraneoplastic syndromes
Poor prognosis
Spreads early
Usually inoperable at presentation

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15
Q

In which type of cancer is finger clubbing more common?

A

Non small cell cancer

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16
Q

When hoarse voice is a symptom, where is the tumour?

A

Pressing on the recurrent laryngeal nerve.

17
Q

In diaphragm weakness, where is the tumour?

A

Causes dyspnoea.

Pressing on the phrenic nerve.

18
Q

What are the signs of superior vena cava obstruction?

A

Facial swelling
Difficulty breathing
Venous swelling on face and neck
Facial swelling and cyanosis when raised hand

Medical emergency

19
Q

What are common paraneoplastic syndromes?

A

Hyponatraemia - ectopic ADH
Cushing syndrome - ectopic ACTH
Addisons syndrome
Hypercalcaemia - ectopic parathyroid hormone

Most common in small cell cancers.

20
Q

What is the referral criteria for an urgent chest x-ray (within 2 weeks)?

A 
>40yrs
Clubbing
Supraclavicular lymphadenopathy
Recurrent chest infections
Raised platelets
Chest signs of lung cancer
21
Q

Which 2 key findings automatically mean an urgent referral for chest x-ray?

A

Finger clubbing

Supraclavicular lymphadenopathy

22
Q

What are the investigations?

A

Chest x-ray
Staging CT
PET CT
Bronchoscopy with endobronchial ultrasound

23
Q

What can be seen on chest x-ray?

A 
Hilar enlargement
Peripheral opacity
Visible obstruction in lung field
Pleural effusion (unilateral)
collapse of lung tissue
24
Q

How is a biopsy done?

A

Bronchoscopy

Percutaneous (through skin)

25
Q

What is the usual treatment for small cell cancer?

A

Palliative chemotherapy

+ Radiotherapy

26
Q

Which cancer has the worst prognosis?

A

Small cell cancer

27
Q

What is the usual treatment for non small cell cancer?

A

1st line - Surgery - if in one place
2nd line - curative chemotherapy + radiotherapy

Chemo for disease control - if it can’t be treated

28
Q

What are the types of surgery?

A

Segmentectomy
Lobectomy
Pneumonectomy

29
Q

In an open thoracotomy, where is the cut most likely to be?

A

Posterolateral.

exam - M - Respiratory diseases (Megan) (24 decks)

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