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Clin Med II-Pulmonary > Lung Cancer > Flashcards

Lung Cancer Flashcards

1
Q

most common cancer worldwide

A

bronchogenic carcinoma

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2
Q

bronchogenic carcinoma

A

malignancies that originate in airways or pulmonary parenchyma

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3
Q

Solitary Pulmonary Nodule (SPN)

A

coin lesion, <3cm, isolated, rounded opacity not a/w infiltrate, atelectasis or adenopathy , mostly benign

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4
Q

benign SPN

A

smooth, well-defined edeges, dense central calcification

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5
Q

watchful waiting for SPN

A

only if low risk, otherwise biopsy

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6
Q

> 3cm SPN

A

mass, usually malignant , CA until proven otherwise (mass or nodules)

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7
Q

Benign SPN

A

infectious granulomas (TB, cocci), hamartoma, pulm abscess, vasculitic lesion, pulm dirofilariasis

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8
Q

Malignant SPN

A

bronchogenic CA, bronchoalveolar CA, carcinoid tumor, Mets

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9
Q

PE findings of SPN

A

wt loss, lymphadenopathy (supraclavicular/scalene nodes), fixed/localized wheeze, joint tenderness

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10
Q

fixed or localized wheeze a/w

A

endobronchial tumor

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11
Q

Lab findings of SPN

A

no specific findings

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12
Q

abnl labs w/

A

paraneoplastic syndrome

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13
Q

why review of old films

A

malignant nodules double in 20-400 days -minimal growth= benign

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14
Q

no calcification=

A

elevated risk of CA

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15
Q

poorly defined irregular spiculated shape=

A

elevated risk of CA

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16
Q

the larger the lesion=

A

greater risk of malignancy >5cm

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17
Q

indication for referral SPN

A
  1. lesion is unstable, noncalcified, not rounded, >3cm 2. new or enlarging 3. indeterminate lesion with at risk pt
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18
Q

lung malignancy cell types

A
  1. small cell carcinoma 2. non-small cell types : a.adenocarcinoma b.squamous cell carcinoma c. large cell carcinoma
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19
Q

most common type of lung malignancy

A

adenocarcinoma

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20
Q

occurs centrally - bronchial origin

A

small cell carcinoma

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21
Q

small cell carcinoma

A

narrows bronchi by extrinsic compression, metastasizes aggressively, not amenable to surgery, micrometastases are present at time of dx

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22
Q

most prevalent lucg CA in both sexes

A

adenocarcinoma

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23
Q

adenocarcinoma arises from

A

mucous glands

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24
Q

occurs in lung periphery

A

adenocarcinoma

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25
Q

present as nodules or masses and metas. to distant organs

A

adenocarcinoma

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26
Q

occurs centrally

A

squamous cell carcinoma

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27
Q

squamous cell carcinoma arises from

A

bronchial epithelium

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28
Q

seen as an intraluminal growth in the bronchi

A

squamous cell carcinoma

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29
Q

may be able to detect by sputum cytology

A

squamous cell carcinoma

30
Q

more likely to cause hemoptysis

A

squamous cell carcinoma

31
Q

likely to metastasize to regional lymph nodes

A

squamous cell carcinoma

32
Q

can cavitate

A

squamous cell carcinoma

33
Q

large cell carcinoma occurs in

A

lung periphery and metas. to distant organs

34
Q

lung CA symptoms result from

A
  1. primary lesion 2. intrathoracic spread : a.pleural effusion, pericardial effusion, hoarseness b. SVC syndrome c. pancoast syndrome 3. paraneoplastic syndromes 4. mets w/no lung complaints
35
Q

most common symptom

A

cough

36
Q

primary lesion symptoms

A

cough, sputum, dyspnea, hemoptysis, chest pain, unilateral localized wheezing, wt loss

37
Q

most common cause of hemoptysis

A

bronchitis

38
Q

unilateral localized wheezing a/w

A

suspect bronchogenic CA causing obstruction of major airway

39
Q

pleural effusion due to

A
  1. direct pleural extension 2. mediastinal node involvement & lymphatic obstruction
40
Q

pericardial effusion due to

A

direct extension of tumor into pericardium

41
Q

hoarseness due to

A

compression of recurrent layngeal nerve

42
Q

hoarseness more common with

A

Left side tumors

43
Q

SVC (superior vena cava) syndrome due to

A

compression or direct invasion

44
Q

SVC syndrome most commonly a/w

A

small cell carcinoma

45
Q

SVC syndrome symptoms

A

ha, dyspnea, facial/ UE edema, plethora, dilated neck veins, prominent venous pattern on chest

46
Q

pancoast syndrome

A

tumor involving superior sulcus of lung compresses brachial plexus and cervical sympathetic nerves

47
Q

Horner’s syndrome

A

part of pancoast -injury to sns of face, signs of ipsilateral side of tumor

48
Q

symptoms of Horner’s syndrome

A

miosis, anhidrosis, ptosis, sinking of eyeball

49
Q

symptoms of pancoast syndrome

A

ipsilateral: rib destruction, atrophy of hand muscles, pain C8,T1,T2 nerve roots

50
Q

paraneoplastic syndrome

A

disorders arises from tumor secretions (hormones, peptides, cytokines)

51
Q

constellation of paraneoplastic syndrome

A

anorexia, st loss, cachexia, fever, suppressed immunity

52
Q

hematologic symptoms of paraneoplastic syndrome

A
  1. carcinogenic thrombophlebitis (trousseau’s syndrome) 2. malignancies often a/w hypercoaguability
53
Q

carcinogenic thrombophlebitis (trousseau’s syndrome) is most commonly a/w

A

adenocarcinoma

54
Q

endocrine symptoms of paraneoplastic syndrome

A

PTH like substance, Xs HCG production, SIADH, Cushing’s (ectopic ACTH)

55
Q

PTH like substance is a/w

A

NSCLC squamous

56
Q

Xs HCG is a/w

A

large cell

57
Q

SIADH is a/w

A

Small cell

58
Q

Cushings a/w

A

small cell

59
Q

neurologic symptoms of paraneoplastic syndrome

A

eaton-lambert syndrome, peripheral neuropathy

60
Q

eaton-lambert a/w

A

small cell

61
Q

most common sites of distant met.

A

liver, bone, brain, adrenal gland

62
Q

primary site for majority of cancers that present as symptomatic brain mets

A

lung

63
Q

lung CA tissue dx

A
  1. sputum culture 2. bronchoscopy w/biopsies 3. thoracentesis 4. fine needle aspiration/CT guided needle biopsy 5. transbronchial aspiration (VATS)
64
Q

best tissue dx for central lesions

A

sputum culture

65
Q

stages of SCLC

A
  1. limited dz 2. extensive dz (80%)
66
Q

SCLC extensive dz

A

beyond hemithorax, includes pleural effusions

67
Q

tx of non small cell lung CA

A

surgical resection in localized dz

68
Q

tx of small cell lung CA

A

regardless of stage : chemo, prophylactic WBRT (brain)

69
Q

management of malignant effusions

A

thoracentesis, pleurodesis, pleurx catheters

70
Q

screening for lung CA

A

not recommended

71
Q

zyban

A

for smoking cessation- SE: seizure

Clin Med II-Pulmonary (7 decks)

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