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Z Year3 Resp Conditions > Lung Cancer > Flashcards

Lung Cancer Flashcards

1
Q

What are two different types of lung cancer?

A
  1. Small cell lung cancer (SCLC) 15%

2. Non-small cell lung cancer (NSCLC) 85%

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2
Q

What is the presentation and epid like for SCLC?

A
  1. 2/3 patients have distant metastasis at presentation
  2. Develops older adult smokers 65-70
  3. Male
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3
Q

What are RF for SCLC?

A
  1. Cig smoking
  2. Exposure second hand tobacco smoke
  3. Radon gas
  4. Age
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4
Q

What is the presentation of NSCLC like?

A

small tumour in lung often asymptomatic so majority have locally advance or metastatic disease at diagnosis

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5
Q

What are RF for NSCLC?

A
  1. Cig smoking
  2. Exposure to tobacco smoke
  3. Radon gas
  4. Asbestos (esp Sqcc)
  5. COPD
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6
Q

What is lung cancer?

A

group of malignant epithelial tumour arising from cells lining lower resp tract

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7
Q

Which type of lung cancer is more common?

A

NSCLC (80%)

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8
Q

What are the 3 main types of NSCLC?

A
  1. adenocarcinoma
  2. squamous cell carcinoma
  3. large cell carcinoma
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9
Q

What are signs of symptoms of lung cancer?

A
  1. Cough
  2. Chest pain
  3. Haemoptysis
  4. Dyspnoea
  5. Weight loss
  6. Clubbing
  7. Cachexia
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10
Q

What are DDx for lung cancer?

A
  1. SC/NSC lung cancer
  2. Pneumonia/bronchitis
  3. Carcinoid tumour
  4. Metastatic cancer from a non-thoracic primary site
  5. Infectious granuloma
  6. Sarcoidosis
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11
Q

What should happen for a sus lung mass?

A

biopsied during bronchoscopy or using CT guidance

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12
Q

What would CXR show in SCLC?

A

central mass, hilar lymphadenopathy, pleural effusion

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13
Q

What would sputum culture show in SCLC?

A

malignant cells

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14
Q

What would CXR show in NSCLC?

A

can detect single or multiple pulmonary nodules, mass, pleural effusion, lung collapse or mediastinal or hilar fullness

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15
Q

What other imaging should be done for lung cancer?

A
  1. Contrast enhance CT of lower neck, throax and upper abdomen
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16
Q

What is management of SCLC?

A

Chemotherapy + radiotherapy + prophylactic irradiation

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17
Q

When is surgery offered in SCLC?

A

patients with clinical T1N0 or T2N0 disease after mediastinoscopy

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18
Q

What is treatment for NSCLC?

A
  1. Chemotherapy and radiotherapy

2. Surgery and molecular targeted therapy for specific genotypes and immunotherapy

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19
Q

What are some complications for lung cancer?

A
  1. Post-obstructive pneumonia/hypoxia
  2. Chemotherapy-induced haematological toxicity
  3. Superior vena cava syndrome
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20
Q

What is survival for SCLC like?

A

5 year survival: 12-24% for limited stage and 1 to 5% for extensive stage

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21
Q

What is definition of LC?

A

malignant neoplasm of lung

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22
Q

What is definition of primary lung cancer?

A

originated from lung

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23
Q

What is definition of secondary LC?

A

metastasised from another organ (breast, colorectal)

24
Q

Where is SCLC derived from?

A

endocrine cells: Kulchitsky endocrine cells and have paraneoplastic syndromes

25
What is SCLC assoicated with?
1. SIADH 2. Ectopic ACTH 3. Lambert Eaton syndrome
26
What type of cell is adenocarcinoma dervied from?
goblet cell
27
What part of lung is associted with adenocarcinoma?
peripheral lung
28
What cell is squamous cell carcinoma associated with?
squamous epithelial cells
29
What is squamous cell carcinoma associted with?
PTH related peptide and central lung
30
What is large cell carcinoma associated with?
from less differentiated cells and peripheral + central lung associated
31
What is definition of mesothelioma?
malignant neoplasm of mesothelial cells of pleura (rare condition)
32
What is RF for mesothelioma?
asbestos exposure: 20-50 years latency
33
What are symptoms and signs of mesothelioma?
- Symptoms: 1. Cough 2. FLAWS - Signs: 1. Auscultation: pleural friction rub: fresh snow
34
What may you see on CXR for mesothelioma?
1. Pleural thickening 2. Pleural plaques due to asbestos 3. Pleural effusions
35
What invasive testing may be used for mesothelioma?
1. Pleural fluid cytology (via thoracentesis aka pleural tap) 2. Pleural lining biopsy (via thoracoscopy + histology)
36
What are primary tumour symptoms?
1. Cough (dry or productive) 2. Haemopytsis 3. SOB 4. FLAWS
37
What are symptoms of metastases?
1. Bone: bone pain, fracture 2. Brain (headaches, blurry vision) 3. Liver (hepatomegaly) 4. Lymphadenopathy
38
What are inspection signs of LC?
1. Clubbing 2. Tar staining of fingernails 3. Lymphadenopathy 4. Cachexia
39
What are percussion signs of LC?
1. Dull percussion | 2. Stony dull (if associated pleural effusion)
40
What are auscultation signs of LC?
1. Crepitations | 2. Increased vocal resonance
41
Where does lung cancer usually metastase to?
bone, brain and liver
42
What are signs of pancoast apical tumour?
- Horner's syndrome | - Structures that are compressed
43
What are horner syndrome signs?
miosis, partial ptosis and anhidrosis
44
What are signs if tumour compresses brachial plexus?
shoulder/arm pain and paratheasia
45
What are signs if tumour compresses recurrent laryngeal nerve?
hoarse voice /bovine cough
46
What is superior vena cava syndrome?
tumour in right lung apex = SVC obstruction
47
What sign is positive and what does it lead to in superior vena cava syndrome?
(+ve Pemberton sign) – pooling of blood and oedema so facial flushing
48
What do all these different compression by tumour lead to?
pancoast syndrome
49
What basic obvs are done for lung cancer?
HR, RR, BP, O2 sats, temp
50
What bedside test is done for lung cancer?
sputum cytology
51
What blood are done in lung cacner?
1. FBC 2. Calcium (bone mets or PTHrp) 3. ALP (bone mets) 4. LFTS (liver mets)
52
Why do you do CT chest, abdo, pelvis + PET scan?
Staging
53
How do you do a biopsy for TNM staging?
- Via bronchoscopy | - Via transthoracic needle
54
What would primary lung cancer CXR show?
1. Consolidation: usually hertrogenous 2. Bi hilar lymphadenopathy 3. Pleural effusion 4. Cavitating lesions usually SqCC
55
What would secondary lung cancer show on CXR?
1. Coin shaped lesions (cannonball mets)

Z Year3 Resp Conditions (20 decks)

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