Lung Cancer

Question 1

What are the RFs of Lung cancer?

Answer 1

Genetic (KRAS)

Smoking mc
Radon 2nd mc

Occupational Nickle and asbestosis
Pollution
COPD

Question 2

Unilateral lesion

Answer 2

Stage 1

Question 3

Unilateral lesion with affection of peribronchial LN

Answer 3

Stage w

Question 4

Unilateral lesion with affection of hilar LN on the same side

Answer 4

3a

Question 5

Unilateral lesion with affection of hilar LN on the other side

Answer 5

3b

Question 6

Bilateral lesion with affection of hilar LN on the both sides

Answer 6

Grade 4

Question 7

Histopathological types of lung cancer

Answer 7

Small oat cell

Non small
-Large
-Adenocarninoma
-Squamous Carcinoma

Lymphoma sarcoma carcinoid

Question 8

Mc type of cancer

And a very important note

Answer 8

Adeno

Even in non smoker females

Question 9

Site of adenocarcinoma and conclusion

Answer 9

Peripheral

Confirmation through thoracotomy

Leads to
• chest pain
• plural effusion
• Massive hemorrhage non responding
• pulling of mediastinum
• presence of seeds

Question 10

Site of squamous and conclusions

Answer 10

Usually central

Confirmation through bronchoscopy
Mediastinal syndrome (dyspnea, dysphagia and hoarseness)

Question 11

Causes of solitary lung nodules

Answer 11

TB
Abcess
Hemartoma
Primary lung cancer
Single metasis
Hydatid cyst
Rhoid nodule

Question 12

Bilateral lung nodule

Answer 12

Wegner granulomatosis
Bronchopneumonia
Hillary TB
ILD
Pulmonary edema

Question 13

What is very characteristic to Squamous carcinoma other than mediastinal syndrome ?

Answer 13

Hypercalcemia 2ndry to ptrp

Question 14

Other than peripheral and central what is the last site ?

Answer 14

Apical or pancoast

Question 15

Describe the C/P of pancoast tumor

Answer 15

Usually old age

Thoracic inlet syndrome
-unilateral paresthia
-unilateral limb ischemia
-Horner syndrome (ptosis miosis anhydrosis)?

Question 16

Describe small cell carcinoma

Answer 16

Rapidly dividing
Early metasis
Ccc by paramalignant syndrome (siadh and Cushing)
Sensitive to chemotherapy

Question 17

Describe paraneplastic syndrome of lung cancer

Answer 17

Specific:
Ca
Cushing siadh

Non specific

Acanthosis Nigricans
Lambert eaton sydrome
Clubbing
Hypertrophic pulmonary osteoarthopathy

Question 18

What is general C/P of lung cancer

Answer 18

Specific to each cancer
TOP male old smoker
General:

Metastasis: other lung, brain, bone and liver
Persistent cough plus or minus hemoptisis

Question 19

Mc benign solitary nodule

Answer 19

TB

Question 20

Describe the TTT of bronchogenic carcinoma

Answer 20

1. CXR if larger than 1 cm
2. CT for TNM (diagnostic)
3. Biopsy (confirmatory)
4. PETCT for metasis

Question 21

How do we benefit from neoadjuvant

Answer 21

Decrease size
Decrease metastasis

Question 22

What is an adjuvant ?

Answer 22

Chemotherapy to eliminate remains and becomes main in stage 3 and 4

Question 23

What are the treatments of stages and 1 and 2

Answer 23

1. Resection
2. Segmentectomy, lobectomy or pneumoectomy

Question 24

What are the treatment of stages 3 and 4?

Answer 24

3. Surgery, radiation and chemo
4. Surgery, chemo,targeted and immunotherapy

Question 25

Treatment of small cell carcinoma

Answer 25

4. Surgery, chemo,targeted and immunotherapy