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401 - Content > Lung Cancer > Flashcards

Lung Cancer Flashcards

1
Q

Causes

A

• smoking
• air pollution
• family hx
• genetics
• precious respiratory condition
• exposure to randon gasses
• radiation
• low immunity

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2
Q

What 2 strategies are used to help for smoking cessation

A

• NHS stop smoking program
• stoptober

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3
Q

What is included in the NHS program

A

• NRT - patches, gums, inhalers
• bupropion (caution in depression)

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4
Q

Signs and symptoms of lung cancer

A

• SOB
• weight loss
• heamoptysis
• cough - painful, coloured phlegm

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5
Q

Signs and symptoms of metastasis

A

• clubbing of fingers
• decrease appetite
• on going chest infections
• back and chest pain

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6
Q

What is paranoplastic syndrome

A

This is when the lung cancer produces hormones, which are released into the blood stream and cause symptoms which are not related to the lung cancer itself

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7
Q

Paranoplastic syndrome - S/S

A

• pins and needles in fingers or toes
• breast swelling
• confusion
• dizziness
• blood clots

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8
Q

What the the 2 types of cancer

A

Small cell carcinoma

&

Non small cell lung cancer:
• squamous cell carcinoma
• adrenocarcinoma
• large cell carcinoma

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9
Q

How many stages are there

A

4

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10
Q

What is the staging system?

A

T - size of tumour
M - metastasis
N - spread to lymph nodes

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11
Q

Screening program - NHS lung health check

What is the patient eligibility criteria

A

• age 55-74
• registered with GP
• live in an area where this is offered
• previous or current smoker

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12
Q

What happens during consultation

A

• clinical assessment
• medical hx
• family hx
• lifestyle and health

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13
Q

After the consultation if there is no risk to the patient what happens

A

No further action

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14
Q

After the consultation it is established that patients is experiencing lung problems or breathing problems, what to do?

A

Refer to GP

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15
Q

After the consultation it is established that patients it at higher risk, what to do?

A

CT scan of lungs

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16
Q

Investigations/test

A

• chest x ray
• broncoscopy
• biopsy
• FBC
• LFT
• sputum test

17
Q

What are the methods for lung screening

A

• CT
• low dose CT
• CXR

18
Q

No national screening because

A

• expensive
• need specialised excipient
• high radiation exposure
• hard to locate high risk areas

19
Q

Treatment options for NSCLC

A

Surgery - early stage disease (bronchoangioplastic)
• 30% of these people have operable tumours

PD-1 inhibitor or tyrosine kinase inhibitor

20
Q

Which treatment option would be suitable for those with advanced NSCLC and EGFR mutation

A

TKIs - tyrosine kinase inhibitors

21
Q

Which treatment option would be suitable for those with advanced NSCLC and without EGFR mutation

A

PD-1 inhibitor

22
Q

PD-1 inhibitor moa

A

• PD-1 is found in macrophages
• their ligands are found on cytotoxic T cells
• PD-1 bind to PD-L1 and suppress cytotoxic T cells
• PD-L1 are overally expressed on cancer cells to evade immune system

This PD-1 inhibited block this and reactive chronic T cells

23
Q

TKI moa

A

Tyrosine kinase cause cancer cells to grow and divide TKI stop this

24
Q

Example of a PD-1

A

Pembrolizumab -IV

25
Q

Examples of TKI

A

Erlotinib or Gefitinib

26
Q

A common side effect of TKI?

A

Skin reactions

Manage:
• alcohol free emollient
• avoid skin exposure to sun (sun screen)
• bathe in look warm water and pat skin dry
• use soaps, lotions without alcohol or fragrance

27
Q

Gefitinib - counselling advise?

A

• 1 tablet each day at the same time
• take whole don’t chew
• store in cool dry place
• inhibitors/inducers of cyp450 enzymes can interact with us so avoid grapefruit, ketokonszole

28
Q

Which drugs are used to treat SCLC

A

Cisplatin + Etoposide

29
Q

Cisplatin moa

A

Binds to FNA, damages it and causes apoptosis

30
Q

Common ADRs

A

Nephrotic
Diarrhoea
Nausea

31
Q

Etoposide Mia

A

Inhibits DNA synthesis by forming complex with topoisomerase II

32
Q

Most common type of lung cancer amongst non smokers

A

Adenocarcinoma

401 - Content (17 decks)

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