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Respiratory System > Lung Cancer > Flashcards

Lung Cancer Flashcards

1
Q

What is the most common cause of lung cancer

A

smoking

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2
Q

What are the most important contents of cigarettes

A

-tar
-nicotine
-CO

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3
Q

What is the histological type of lung cancer that is exclusively caused by smoking

A

-SCC

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4
Q

What are the risk factors that lead lung cancer

A

-passive smoker
-air pollution (urban>rural)
-pulmonary fibrosis (tb and fibrosing alveolitis)

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5
Q

What is the clinical manifestation occurs in 5% of patient

A

-asymptomatic
-thus the patient needs routine CXR

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6
Q

What is the clinical manifestation occurs in 95% of patient

A

-respiratory
-distant metastases
-paraneoplastic

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7
Q

What is the early manifestations of hilar tumour

A

-productive cough (cupful of frothy sputum)
-hemoptysis
-pleuritic chest pain

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8
Q

What is the late manifestations of hilar tumour

A

(note: late means the hilar tumor is large thus causing compression)
-obstuction that leads to:
-collapse (full)
-pneumonia, lung abscess, bronchioectasis (partial)

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9
Q

In case of lung abscess, why bronchioscopy is done

A

-to exclude lung cancer

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10
Q

In peripheral tumors, what is commonly known

A

adenocarcinoma

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11
Q

What is the manifestations of peripheral tumours

A

-massive hemorrhagic pleural effusion

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12
Q

Why the plural effusion in peripheral tumours don’t shift to the opposite side

A

-due to the underlying collapse

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13
Q

What structures infiltrated in pancoast syndrome

A

-sympathetic trunk
(Horner’s syndrome)
-bronchial plexus
(Shoulder pain, muscle atropy)
-posterior ribs
(Ribs erosions and dull kronig’s isthmus)

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14
Q

What is the cause of superior mediastinum syndrome

A

-venous engorgement
-compression to the venous return

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15
Q

What is the fate of superior mediastinum syndrome

A

-facial, conjunctival, laryngeal edema (hoarsness due SVC)
-headache
-nonpulsating external jugular vein

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16
Q

What are the sites of metastasis in lung cancer

A

-hilar lymph nodes
-liver
-brain
-bone

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17
Q

What is the most common metastatic manifestations of lymph nodes

A

-lymphagitis carcinomatosis

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18
Q

What is the characteristic of lymphagitis carcinomatosis in case of:
-diffuse or localized
-most common condition
-clinical
-radiological

A

-diffuse
-adenocarcinoma
-diffuse interstitial pulmonary syndrome
-septal nodular

19
Q

What is the most common metastatic manifestations of liver

A

-irregular enlargement
-increase ALP with absent alpha-protein

20
Q

What is the most common metastatic site of bone metastases

A

-ribs

21
Q

What is the most common paraneoplastic syndrome

A

-clubbing
-pulmonary osteoathropathy

22
Q

What is the cause of metabolic syndrome

A

-due to the secretion of antimetabolite polypeptide

23
Q

What is the example of metabolic syndrome

A

-loss of weight
-anorexia
-cachexia

24
Q

What is the example of endocrine symptoms with cause

A

-cushing (<K, small cell carcinoma)
-SIADH (<Na, small cell carcinoma)
-hypercalcemia (constipation, polyuria, stones, squamous cell carcinoma)
-carcinoid (>serotonin, bronchial carcinoid)
-gynecomastia
-polycythemia

25
Q

What is the example of neuromyopathy syndrome and characters

A

-encephalopathy; (dementia, secondary to ADH, cushing)
-subacute cerebellar degeneration; (bilateral, severe dysarthria but no nystagmus)
-myelopathy
-neuropathy (triads; ganglioreticulitis, peripheral neuropathy, GB)
-myopathy

26
Q

What is the characteristic of ganglioreticulitis

A

-distal sensory loss

27
Q

What are the examples of myopathy and its characteristics based on
-cause
-affected area

A

-polymyositis (adenocarcinoma; proximal)
-dermatomyositis (adenocarcinoma; proximal with violet rash)
-myasthenia syndrome (small cell carcinoma; proximal; dryness of the mouth and PP)

28
Q

What is the most important vascular syndrome and its cause

A

-DVT
-adenocarcinoma

(notes; venous gangrene, thrombotic endocarditis)

29
Q

What is the most important cutaneous syndrome and its cause

A

-erythema multiform
-adenocarcinoma

30
Q

What are the noninvasive modalities done in lung cancer

A

-chest x ray
-sputum cytology
-CT
-MRI
-PET
-Bone scan

31
Q

What is the characteristic of ssc in x-ray

A

-cavitation
-central (lobar and segmenta collapse)

32
Q

What is the characteristic of adenocarcinoma in x-ray

A

-peripheral
-leads to hilar and mediastinum affection

33
Q

What is the characteristic of adenocarcinoma in CT

A

-ground glass (slow; doubling >1)
-solid mass (rapid; doubling <1)

34
Q

What is the characteristic of bronchioalveolar carcinoma in x-ray

A

-single mass (the most common)
-diffuse multicentric
-localized consolidation

35
Q

What is the characteristic of bronchioalveolar carcinoma in CT

A

-bubble like areas in low attenuation

36
Q

What is the characteristic of small cell cancer in x-ray

A

-bulky hilar and mediastinal lymph node

37
Q

What is the location carcinoid tumor

A

-central

38
Q

What are the differences between typical and atypical carcinoid tumours based on;
-character
-mitoses
-necrosis

A

-character:endobronchial growth and obstucted pneumonia ; large size (>2.5)
-mitoses:<2; 2-10
-necrosis: 0, may presence

39
Q

Repeat radiograph should be performed at

A

2-6 weeks

40
Q

What are the characters of benign tumors

A

-age <35
-no history of smoking or metastasis
-calcification pattern and fat
-no growth compared to old film in 2 years

41
Q

What is the main invasive modality used in lung cancer

A

-bronchoscopy
-used to take sample for biopsy

42
Q

What is the best modalities for staging

A

-cervical mediastinoscopy

43
Q

What is the function of extended cervical mediastinoscopy

A

-left upper lobe cancer investigation

Respiratory System (15 decks)

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