lung cancer Flashcards
what are smoking related lung diseases?
COPD
EMPHYSEMA
CHRONIC BRONCHITIS
what is the link between genetics and smoking in the development of lung disease?
In cigarette smoking, there are different genetic predispositions to respond to cigarette smoke. Some patients, may activate more quickly leading to more reactive oxygen species, while others may be slow at detoxification (at removing toxic metabolites). Otherwise might be in the middle, better for them.
That’s why not every smoker gets lung disease, also if they do not at the same age
what are factors effecting the development of cancer?
- male:female 5:1
- tobacco
- alcohol
- HPV
- hygiene
- repeated trauma
what are the biomarkers for cancer
p16 or HPV
why is there a delay in seeking medical advise in emphysema patients?
for symptoms to show, require 60% of lost lung tissue.
- before then, patients tend to adapt their lifestyle
what are the 5 main clinical features of chronic bronchitis?
- cough
- productive sputum
- oedema
- reversible or irreversible wheeze
what are 3 causes of chronic bronchitis?
- cigarette smoking
- industrial exposure and passive cigarette smoke
- e cigarettes and vaping
define interstitial lung disease
this is a pulmonary disorder that is characterised by:
- interstitial inflammatory infiltrates
- decreased lung volume
- decreased oxygen diffusing capacity on pulmonary function studies.
what are the main interstitial lung diseases?
- hypersensitivity
- sarcoidosis
- idiopathic pulmonary fibrosis
people who smoke, are more likely to use what when they stop?
people who stop smoking are more likely to take more caffeine to satisfy cravings, they can end up with caffeine toxicity and get the shakes.
emphysema?
loss of lung tissue and the area for gas exchange decreases
what are the 2 main types of emphysema?
panacinar emphysema = permanentant destruction to the airspace.
centrilobular emphysema = increase in size of respiratory bronchioles
what are the main feuures of idiopathic pulmonary fibrosis?
- scarring in lower lobes
- fibrosis is often patchy, with areas of dense scarring and honeycomb cystic change.
what are the 4 main features of hypersensitivity pneumonitis?
what are 2 common types of hypersensitive pneumonitis?
1) - inhaling antigen and getting hypersensitive reaction
- extrinsic because antigens come from outside
- acute or chronic interstitial inflammation of the lungs
- fibrosis or scarring.
2) - bird fancier (allergic to pigeons)
- farmers lung (allergic to the dust)
5 main features of sarcoidosis?
cell mediated
- granuloma and scattered in the interstitum of the lung
- the granulomatous phase of sarcoidosis can progress to a fibrotic phase
- hilar lymphadenopathy
- raised ACE
treatment for hypersensitive pneumonitis and sarcoidosis?
- hypersensitive pneumonitis = get away from allergen
sarcoidosis = steroids or immunosuppressants
what type of disease is idiopathic pulmonary fibrosis
systemic disease
What are the characteristics of a benign lung tumor which could help you distinguish it from a malignant tumour ?
What treatment would be required in such a situation?
1) lack of invasiveness
- clearly defined borders
- slow growth
2) - either leave it or surgical excision
where can a primary malignant tumour grow in the lung?
- Epithelium (most common)
- Vessels
- Muscle
- Cartilage
- Lymphoid
- Pleura
characteristic or invasive tumour?
- not well defined
- invasion pushing and invading lymph tissue.
Define metaplasia. How is it relevant in the lung ?
change in one differentiates somatic stem cell for another
- irritation due to smoking can cause glandular columnar epithelium to chnage into squamos epthelium (metaplasia)
define dysplasia?
how is it relevant in the lung?
an abnormality of development. It IS pre-malignant.
If metaplasia occurred due to cigarette smoking, and continue to expose epithelium it to carcinogens, squamous epithelium will become dysplasic. Either dysplasia superimposes original glandular (giving you adenocarcinoma) or superimposes squamous (giving you squamous carcinoma, which is likely to be central because airways larger so more likely to get direct trauma)
Identify the main tumours which cause secondary malignant tumours in the lung.
How does it reach the lungs ?
-Renal carcinoma: via lymph nodes, and along renal veins
-Osteosarcoma: by blood (not lymph nodes)
What are the main types of primary epithelial malignant tumours ?
- Squamous cell carcinoma (=NSCLC)
- Adenocarcinoma
- Small cell undifferentiated carcinoma
- Carcinoid tumours
