Lung cancer

Question 1

2 broad categories of LC?

Answer 1

Small cell lung cancer (15%)

non-small cell lung cancer (85%)

Question 2

sub-categories of NSCLC?

Answer 2

adenocarcinoma (40%)
squmous cell (25-30%)
large cell (10-15%)
carcinoid (rare)
bronchoalveolar cell

Question 3

which type of LC is common in non-smokers?

Answer 3

adenocarcinoma

Question 4

paraneoplastic syndromes associated with SCLC?

Answer 4

1. SIADH –> hyponatraemia
2. ectopic ACTH secretion –> hyperglycaemia, HTN, hypokalaemic alkalosis, muscle weakness, bilateral adrenal hyperplasia, bushings syndrome
3. Lambert- eaton myasthenic syndrome
4. Limbic encephalitis

Question 5

paraneoplastic syndrome associated with adenocarcinoma?

Answer 5

1. hypertrophic pulmonary osteoarthropathy (HPOA), clubbing

2. gynaecomastia

Question 6

paraneoplastic syndrome associated with squamous cell?

Answer 6

1. HPOA
2. PTHrP –> hypercalcaemia
3. clubbing

Question 7

paraneoplastic syndrome associated with large cell?

Answer 7

1. HPOA

2. ectopic B-HCG secretion

Question 8

symptoms of LC?

Answer 8

persistent cough 
haemoptysis 
SOB
pleuritic chest pain 
fever, weight loss, night sweats, lethargy

Question 9

signs on exam of LC?

Answer 9

reduced breath sounds
?wheeze
stony dull percussion –> malignant pleural effusion
clubbing
hoarseness
supraclavicular or persistent cervical lymphadenopathy

Question 10

extrapulmonary manifesations?

Answer 10

Recurrent laryngeal nerve palsy
Phrenic nerve palsy
SVCO
Horner’s syndrome