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Y1 Respiratory > Lung Cancer > Flashcards

Lung Cancer Flashcards

1
Q

Types of lung carcinoma

A

Non small cell lung carcinoma

Small cell lung carcinoma

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2
Q

What is carcinoma

A

malignancy that starts at layer surrounding internal organs

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3
Q

Types of non small cell lung carcinoma

A

Adenocarcinoma
Squamous cell
Large cell

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4
Q

What is the most common type of lung cancer

A

Adenocarcinoma

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5
Q

Why is the prognosis of small cell lung cancer often poor

A

When discovered, already at late stage, may have metastasized already
More aggressive

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6
Q

Symptoms

A 
Haemoptysis 
Hoarseness 
Unintentional weight loss 
Cough > 3 weeks 
Dyspnea 
chest pain
malaise
chest infection that doesn't go away
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7
Q

Where is adenocarcinoma often found

A

outer region of lungs

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8
Q

What is adenocarcinoma

A

Cancer of mucus secreting cells

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9
Q

What is squamous cell carcinoma

A

Cancer of squamous cell

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10
Q

Why may there be recurrent chest infections

A

Tumour blocking the airways may prevent clearance of mucus

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11
Q

Why may there be hoarseness of voice

A

Tumuor pressing against recurrent laryngeal nerve

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12
Q

Why may there by haemoptysis

A

Tumour needs good blood supply so angiogenesis occurs. Angiogenesis produces blood vessels with weak walls so can easily rupture

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13
Q

What other things can cause haemoptysis except from cancer

A

pneumonia / TB (cavitating granulomata) / coughing too hard

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14
Q

What is stridor

A

Wheeze on inspiration due to obstruction of airway

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14
Q

Why may there be stridor

A

Tumour blocking the airway

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15
Q

Clinical features / signs of local invasion

A 
Stridor 
lymphadenopathy 
pleural effusion
AF / pericardial effusion 
finger clubbing 
superior vena cava obstruction
dysphagia
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16
Q

Cancer spreading to lymph nodes causes

A

lymphadenopathy

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17
Q

Cancer spreading to pleural cavity causes

A

pleural effusion

18
Q

Cancer spreading to pericardium causes

A

AF / pericardial effusion

19
Q

Cancer spreading to oesophagus causes

A

dysphagia

20
Q

Signs of superior vena cava obstruction

A

Enlarged vessels at neck and face

21
Q

TNM staging - T

A

T0 - tumour not visible but found in sputum culture / bronchial fluids
T1 - 3cm or less
T2 - 3 < x

22
Q

TNM staging - N

A

N0 - no lymph node metastases
N1 - ipsilateral hilar lymph node
N2 - ipsilateral mediastinal or subcarinal lymph nodes
N3 - contralateral mediastinal or hilar lymph nodes

23
Q

TNM staging - M

A

M0 - no distant metastases

M1 - distant metastases

24
Q

Paraneoplastic syndromes

A 
Hypertrophic pulmonary osteopathy 
SIADH (hyponatraemia) 
Hypercalcaemia 
Cushing's Syndrome 
Eaton Lambert's Syndrome
25
Q

What is HPOA

A

periostitis - inflammation in periosteum layer of bone

26
Q

most common paraneoplastic syndromes of squamous cell carcinoma

A

HPOA

Hypercalcaemia

27
Q

What does HPOA cause

A

finger clubbing

pain during movement

28
Q

What causes hypercalcaemia

A

Due to bony metastases and secretion of PTHrP

29
Q

What does hypercalcaemia cause

A

Stones - renal / biliary calculi
Bones - bone pain
Groans - abdominal pain
Thornes - polyuria (excess urination)

30
Q

Most common paraneoplastic syndromes of SCLC

A

SIADH
Cushing’s
Eaton Lambert’s

31
Q

What is SIADH

A

Excess secretion of ADH

32
Q

What does SIADH cause

A

Too much retention of water in kidneys, causing dilutional hyponatraemia
Also decreases excretion of Na+ in urine = hyponatraemia

33
Q

What is Cushing’s Syndrome

A

Excessive release of ACTH hormone so makes too much glucocorticoids

34
Q

What does Cushing’s Syndrome cause

A 
Glucocorticoids are responsible for regulating blood sugar and blood pressure so 
Hyperglycaemia 
Hypertension
Hypokalaemia 
Alkalosis
35
Q

What tests to do for suspected lung cancer

A

Blood tests
LFTs
Scans
Biopsies

36
Q

What should blood tests for lung cancer measure

A

U&Es (urea and electrolytes)

FBC

37
Q

What scans are used

A

CXR - first thing to do
CT scan - usually definitive
PET scan - identifies metastases

38
Q

How does PET scan work

A

Tumour will be bright and light up in PET scan because it has high metabolic rate

39
Q

What to do to confirm diagnosis

A

Biopsies

40
Q

How to take biopsies

A 
Bronchoscopy 
Endobronchial ultrasound
Medical thoracoscopy 
Aspiration of pleural fluid
Aspiration of lymph nodes
41
Q

What does medical thoracoscopy do

A

Make an incision at 5/6/7th intercostal space to view the pleura for lesions and take biopsies

42
Q

Surgery

A

Curative intention

Not suitable for patients with metastases

Y1 Respiratory (4 decks)

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