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3rd Year Semester 1 > Lung Cancer > Flashcards

Lung Cancer Flashcards

1
Q

Screening programe for lung cancer

A

no national screening programe

test screening in CT. However its not quick and uses a large dose

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2
Q

Site Specific signs and symptoms

A

hoarseness due to the recurrent larygneal nerve (innervation of larynx) goes down the chest and comes back up

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3
Q

Sign and symptoms

A

svco
pancoast tumour which can cause horners syndrome

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4
Q

pancoast tumour

A

tumour at apex of lung

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5
Q

horners syndrome

A

invasion of the preganglionic neurons exiting the ventral spinal roots.

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6
Q

Some Signs/Symptoms of Horner Syndrome

A

MIOSIS:
PTOSIS / NARROWING PALPEBRAL FISSURE:
ANHIDROSIS:

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7
Q

miosis

A

difference in size of pupils , accentuated in dim light as the effected pupil does not dilate

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8
Q

PTOSIS / NARROWING PALPEBRAL FISSURE

A

lip drops due to paralysis of levator palpebrae.

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9
Q

ANHIDROSIS:

A

lack of sweating on ipsilateral side

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10
Q

Paraneoplastic Syndrome:
triggered by

A

abnormal immune system response to a cancerous tumour

Not directly related to invasion by the primary tumour or its metastases

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11
Q

likely investigations for lung cancer?

A

sputum cytology = asked to cough up something

bronchoscipy w/ biopsy = camera down trachea into bronchi

CT or PET/CT

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12
Q

staging NCCP Guidelines

A

• Contrast enhanced CT scanning of the chest and upper abdomen

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13
Q

staging NCCP Guidelines:
PET/CT recommened

A

–patients with NSCLC w bone metastasis
-patients clinically limited satged SCLC, to exclude occult metastases

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14
Q

staging NCCP guidelines:
brain metastases

A

contrast enchanced CT followed by contrast enhanced MRI

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15
Q

LUNG CANCER PATHWAY : 1

A

presented at GP or A&E

urgent CXR

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16
Q

LUNG CANCER PATHWAY : 2

A

Rapid access clincal assessment

clincal assess. = pulmonary fucntion tests PFT, performance status PS, bronchoscopy and CT thorax

17
Q

LUNG CANCER PATHWAY : 3

A

multi-disciplinary conference

tissue diagnosis , staging, PS ,weight loss, PFT

18
Q

LUNG CANCER PATHWAY : 4

A

primary treatment

surgery, combined chemo/RT , palliative care , chemo

19
Q

TNM Staging
types of staging assessments

A

clinical (c)- before tx
pathologic (p) -after resection
restaging (y) - after part or all tx given
reocurrence (r) - stage at time reoccurence
autopsy(a)-

20
Q

T1 : tumours less than 3cm in diameter

A

T1a(mi). - miniumly invasive adenocarcinoma
T1a(ss) superficial spreading tumour in central airways
T1a- less than 1cm
T1b-1cm - 2cm
T1c-2cm -3cm

21
Q

T2:

A

T2= 3cm - 5cm OR involved with visceral pluera or main bronchus

T2a=3cm -4
T2b=4cm - 5cm

22
Q

likely investigations for lung cancer:
CLINICAL

A

Hx and physical exam (Co-morbidities)
performance score
PFT
ECG
FBC

22
Q

likely investigations for lung cancer:
Radiological

A

-CXR
-CT chest and abdomen
- +/-PET Scan
– +/- MRI Brain

23
Q

likely investigations for lung cancer:
histology

A

-sputum cytology
-bronchoscopy w biopsy
-Bronchial brushings and washings
-EBUS (ENDOSCOPIC ULTRASOUND)

24
Q

histology : How is the diagnosis confirmed?

A

-imaged-guided biopsy
-EBUS
-bronchial washings
-fine needle aspiration(takes sample of lymph node)
-plueral fluid aspiration (remove pleural fluid for investigation)

25
Q

Small Cell Lung Cancer

A

12-15% of lung cancers
-small cell carcinoma
-Mixed small cell/large cell carcinoma.
-Combined small cell carcinoma (SCLC combined with neoplastic squamous)

26
Q

Non-Small Cell Lung Cancer

A

85-88% of lung cancers
– Squamous cell carcinoma
– Adenocarcinoma
– Large cell carcinoma

27
Q

Mesothelioma

A

plueral based lesions

28
Q

Staging of SCLC

A

limited stage
extensive stage

29
Q

limited stage

A

tumour confined to the hemi-thorax of origin

30
Q

extensive stage

A

tumour that is too widespread

31
Q

Histology Mesothelioma (plueral based tumours)

A

–Relatively rare
– 80% related to asbestos exposure
– Treated by chemotherapy
– palliative RT generally

32
Q

Patterns of Spread

A

local- intrathoracic

Regional - Lymphatic (eg mediastinal ,hilar ,lobar)

Distant - Haematogenous. ( most common lung,liver,brain,bone)

33
Q

Patterns of Spread
Related to cell histology:
SCLC
adenocarcinomas

A

-higher incidence of brain mets than NSCLC (15% of ptx at presentation ,further 50% go on to develop them)

-highest potential of brain mets in NSCLC

3rd Year Semester 1 (55 decks)

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