Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RESP (Respiratory Medicine) > Lung Cancer > Flashcards

Lung Cancer Flashcards

1
Q

Epidemiology of Lung Cancer.

A

3rd commonest cancer in UK (after Breast and Prostate).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Risk Factor of Lung Cancer.

A

Cigarette Smoking (major).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Main Types of Lung Cancer (2).

A
  1. Non-Small Cell (80%).

2. Small Cell (20%).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Types of NSC Lung Cancers (4).

A
  1. Adenocarcinoma (40%) - often in non-smokers : peripheral.
  2. Squamous Cell Carcinoma (20%) : central.
  3. Large Cell Carcinoma (10%) : peripheral and may secrete b-hCG.
  4. Other Types (10%).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a Mesothelioma?

A

Lung malignancy affecting the mesothelial cells of the pleura - poor prognosis (chemotherapy = palliative).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Risk Factor of Mesothelioma.

A

Asbestos Inhalation (huge latency period - up to 45 years).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are SC Lung Cancers associated with?

A

Paraneoplastic Syndromes - SC lung cancer cells contain neurosecretory granules that can release neuroendocrine hormones.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pathophysiology of SC Lung Cancers.

A

Central tumours arising from APUD Kulchitsky (high content of Amine, Precursor Uptake, Decarboxylase) cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pathophysiology of SCC Lung Cancer.

A

Metaplasia - Dysplasia - Carcinoma Sequence : Columnar Epithelium becomes Squamous Epithelium by smoking.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Clinical Features of Lung Cancer (6).

A
  1. SOB & Fixed Monophonic Wheeze.
  2. Persistent Cough & Haemoptysis.
  3. Finger Clubbing.
  4. Recurrent Pneumonia.
  5. Constitutional Symptoms.
  6. Lymphadenopathy (Supraclavicular).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Extrapulmonary Manifestations of Lung Cancer (4).

A
  1. Recurrent Laryngeal Nerve Palsy : Hoarse Voice (Compression of Recurrent Laryngeal Nerve).
  2. Phrenic Nerve Palsy : SOB (Compression of Phrenic Nerve).
  3. SVC Obstruction : Facial Swelling, Difficulty Breathing, Distended Veins in Neck + Chest (Right-Sided Compression of SVC).
  4. Horner’s Syndrome : Triad of Partial Ptosis, Anhidrosis, Miosis OR Pancoast’s Syndrome (Shoulder pain radiating down ulnar arm) -(Pancoast’s Tumour (C8, T1, T2 Nerves) - Pulmonary Apex Tumour = Compression of Sympathetic Ganglion).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Paraneoplastic Syndromes of Lung Cancer (5).

A
  1. SIADH - Ectopic ADH Secretion : Hyponatraemia (SC).
  2. Cushing’s Syndrome - Ectopic ACTH Secretion (SC) = Bilateral Adrenal Cortical Hyperplasia.
  3. Hypercalcaemia - Ectopic PTHrp Secretion (SCC).
  4. Limbic Encephalitis (Anti-Hu autoantibodies against limbic system) : Short Term Memory Impairment, Hallucinations, Confusion and Seizures.
  5. Lambert-Eaton Myasthenia Syndrome (SC).
  6. Hypertrophic Pulmonary Osteoarthropathy (HPOA - NSC) - proliferative periostitis at the ends of the long bones, which have an ‘onion skin’ appearance.
  7. Hyperthyroidism - Ectopic TSH Secretion (SCC).
  8. Gynaecomastia (Adenocarcinoma).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Pathophysiology of Lambert-Eaton Myasthenia Syndrome.

A

Antibodies against SC cells but they also target and damage VGCCs on presynaptic terminals of motor neurones.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Clinical Features of Lambert-Eaton Myasthenia Syndrome.

A
  1. Proximal Muscle Weakness.
  2. Intraocular Muscle Weakness - Diplopia.
  3. Levator (Eyelid) Muscle Weakness - Ptosis.
  4. Pharyngeal Muscle Weakness : Slurred Speech and Dysphagia.
  5. Autonomic Dysfunction : Dry Mouth, Blurred Vision, Impotence, Dizziness.
  6. Post-Tetanic Potentiation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Post-Titanic Potentiation?

A

Reduced Tendon Reflexes but become normal briefly following strong muscle contraction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does Cushing’s syndrome present in SC Lung Cancer?

A

Thirst + Polyuria = Atypical : HTN, Hyperglycaemia, Hypokalaemia Alkalosis and Muscle Weakness (less buffalo hump).

17
Q

How does SIADH present in Lung Cancer?

A

Cerebral Oedema due to water intoxication e.g. clumsiness, tiredness (increasing drowsiness and confusion) : low serum Sodium and osmolality due to increased water resorption.

18
Q

Investigations of Lung Cancer (4).

A
  1. CXR - 1st line.
  2. CT TAP - Suspicion OR Staging (Contrast-Enhanced).
  3. PET-CT - Metastasis.
  4. Bronchoscopy with EBUS (Endotrachial US) - Biopsy.
19
Q

CXR Findings of Lung Cancer (4).

A
  1. Hilar Enlargement.
  2. Peripheral Opacity - Visible Lesion in Lung Field.
  3. Pleural Effusion (Unilateral).
  4. Collapse.
20
Q

How do PET-CT scans work? (3)

A
  1. Inject radioactive tracer (attached to glucose).
  2. Use CT and y-detector to visualise how metabolically active tissues are.
  3. More Metabolic Activity = ?Cancer?
21
Q

How do EBUS procedures work? (2)

A
  1. Endoscopy of the Bronchi with US at end of scope.

2. Detailed assessment of tumour and US-guided biopsy.

22
Q

Referral Criteria in Lung Cancer (2).

A
  1. 2WR : CXR Findings or 40+ and Unexplained Haemoptysis.

2. Offer URGENT CXR if 40+ and : 2+ unexplained symptoms or smoked and 1+ unexplained symptom.

23
Q

Blood Findings in Lung Cancer.

A

Thrombocytosis.

24
Q

Biopsies in Lung Cancer (2).

A
  1. Central Lesions - Bronchoscopy.

2. Peripheral Lesions - CT-Guided Sampling.

25
Q

Management of NSC Lung Cancer (4).

A
  1. MDT Meeting.
  2. Surgery - 1st Line (if disease is isolated to a single area) : Lobectomy (or Segmentectomy / Wedge Resection).
  3. Radiotherapy - curative if early.
  4. Chemotherapy - Adjuvant or Palliative.
26
Q

Management of SC Lung Cancer (2).

A
  1. Chemotherapy + Radiotherapy.

2. Palliative : Endobronchial Treatment with Stents/Debulking for Bronchial Obstruction.

27
Q

Surgery in NSC Lung Cancer.

A
  1. Mediastinoscopy prior to surgery because CT may not show mediastinal lymph node involvement.
  2. Contraindications : Stage IIIB, IV; FEV < 1.5L; Malignant Effusion, Hilar Tumour, Vocal Cord Paralysis, SVC Obstruction.
28
Q

Prognosis of Lung Cancer.

A

SC < NSC.

29
Q

What is a Paraneoplastic Syndrome?

A

Syndrome caused by substances produced by tumour cells that act remotely from the tumour or its metastases.

30
Q

Why is Lung Cancer associated with Recurrent Pneumonia?

A

Tumours may partially obstruct airways, leading to poor ventilation and increased susceptibility.

RESP (Respiratory Medicine) (35 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions