Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 6 Respiratory > Lung cancer > Flashcards

Lung cancer Flashcards

1
Q

What are the features of lung cancer?

A

persistent cough, haemoptysis, dyspnoea, chest pain, weight loss and anorexia, hoarseness, seen with Pancoast tumours pressing on the recurrent laryngeal nerve, superior vena cava syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What examination findings may be noted in lung cancer?

A

a fixed, monophonic wheeze may be noted, supraclavicular lymphadenopathy or persistent cervical lymphadenopathy, clubbing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the paraneoplastic features associated with small cell lung cancer?

A

ADH, ACTH - not typical, hypertension, hyperglycaemia, hypokalaemia, alkalosis and muscle weakness are more common than buffalo hump etc, Lambert-Eaton syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the paraneoplastic features associated with squamous cell lung cancer?

A

parathyroid hormone-related protein (PTH-rp) secretion causing hypercalcaemia, clubbing, hypertrophic pulmonary osteoarthropathy (HPOA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the paraneoplastic features associated with adenocarcinoma?

A

hyperthyroidism due to ectopic TSH, gynaecomastia, hypertrophic pulmonary osteoarthropathy (HPOA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What complications may arise from lung cancer?

A

hoarseness, stridor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What blood finding may be noted in lung cancer?

A

A thrombocytosis may be noted on bloods.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Lung cancer features

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is often the first investigation done in patients with suspected lung cancer?

A

Chest x-ray

In around 10% of patients subsequently diagnosed with lung cancer, the chest x-ray was reported as normal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the investigation of choice to investigate suspected lung cancer?

A

CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does bronchoscopy allow in the investigation of lung cancer?

A

It allows a biopsy to be taken to obtain a histological diagnosis, sometimes aided by endobronchial ultrasound.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is PET scanning typically done for in lung cancer?

A

It is typically done in non-small cell lung cancer to establish eligibility for curative treatment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What substance is used in PET scanning for lung cancer?

A

18-fluorodeoxygenase, which is preferentially taken up by neoplastic tissue.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What has PET scanning been shown to improve in non-small cell lung cancer?

A

It has been shown to improve diagnostic sensitivity of both local and distant metastasis spread.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What blood abnormality may be seen in lung cancer patients?

A

Raised platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
A

cancer left lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the three main subtypes of non-small cell lung cancer?

A

The three main subtypes are Squamous cell cancer, Adenocarcinoma, and Large cell lung carcinoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the characteristics of Squamous cell cancer?

A

Typically central, associated with PTHrP secretion leading to hypercalcaemia, strongly associated with finger clubbing, cavitating lesions are more common than other types, and may cause hypertrophic pulmonary osteoarthropathy (HPOA).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the characteristics of Adenocarcinoma?

A

Typically peripheral and the most common type of lung cancer in non-smokers, although the majority of patients who develop lung adenocarcinoma are smokers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the characteristics of Large cell lung carcinoma?

A

Typically peripheral, anaplastic, poorly differentiated tumours with a poor prognosis, and may secrete β-hCG.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What percentage of lung cancer patients are suitable for surgery?

A

Only 20% are suitable for surgery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Why is mediastinoscopy performed prior to surgery?

A

Mediastinoscopy is performed as CT does not always show mediastinal lymph node involvement.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What types of radiotherapy are available for lung cancer management?

A

Curative or palliative radiotherapy.

24
Q

What is the response of lung cancer to chemotherapy?

A

There is a poor response to chemotherapy.

25
Q

What factors contraindicate surgery for lung cancer?

A

Factors include assessing general health, stage IIIb or IV, FEV1 < 1.5 litres, malignant pleural effusion, tumour near hilum, vocal cord paralysis, and SVC obstruction.

26
Q

What is the general cut-off point for FEV1 in lung cancer surgery?

A

FEV1 < 1.5 litres is considered a general cut-off point.

27
Q

What should be considered if FEV1 is < 1.5 for lobectomy or < 2.0 for pneumonectomy?

A

Some authorities advocate further lung function tests as operations may still go ahead based on the results.

28
Q

What paraneoplastic feature is associated with small cell lung cancer?

A

ADH secretion and ACTH secretion leading to hypertension, hyperglycaemia, hypokalaemia, alkalosis, and muscle weakness.

Buffalo hump is less common.

29
Q

What syndrome is associated with small cell lung cancer?

A

Lambert-Eaton syndrome.

30
Q

What paraneoplastic feature is associated with squamous cell lung cancer?

A

Secretion of parathyroid hormone-related protein (PTH-rp) causing hypercalcaemia, clubbing, and hypertrophic pulmonary osteoarthropathy (HPOA).

Hyperthyroidism due to ectopic TSH is also noted.

31
Q

What paraneoplastic features are associated with adenocarcinoma?

A

Gynaecomastia and hypertrophic pulmonary osteoarthropathy (HPOA).

Some studies indicate adenocarcinoma is the most common cause of HPOA, contrary to traditional teaching.

32
Q
A

Hypertrophic pulmonary osteoarthropathy is a proliferative periostisis involving that typically involves the long bones. It is often painful.

33
Q

What are the referral criteria for lung cancer according to the 2015 NICE guidelines?

A

Refer people using a suspected cancer pathway referral (for an appointment within 2 weeks) for lung cancer if they have:
- chest x-ray findings that suggest lung cancer
- are aged 40 and over with unexplained haemoptysis

34
Q

What should be offered to people aged 40 and over with unexplained symptoms suggestive of lung cancer?

A

Offer an urgent chest x-ray (to be performed within 2 weeks) if they have 2 or more of the following unexplained symptoms, or if they have ever smoked and have 1 or more of the following unexplained symptoms:
- cough
- fatigue
- shortness of breath
- chest pain
- weight loss
- appetite loss

35
Q

What additional criteria warrant consideration for an urgent chest x-ray in people aged 40 and over?

A

Consider an urgent chest x-ray (to be performed within 2 weeks) for people aged 40 and over with any of the following:
- persistent or recurrent chest infection
- finger clubbing
- supraclavicular lymphadenopathy or persistent cervical lymphadenopathy
- chest signs consistent with lung cancer
- thrombocytosis

36
Q

What are the features of small cell lung cancer?

A

Usually central, arise from APUD cells, associated with ectopic ADH and ACTH secretion.

37
Q

What does ADH secretion lead to in small cell lung cancer?

A

Hyponatraemia.

38
Q

What does ACTH secretion lead to in small cell lung cancer?

A

Cushing’s syndrome.

39
Q

What can ACTH secretion cause?

A

Bilateral adrenal hyperplasia; high levels of cortisol can lead to hypokalaemic alkalosis.

40
Q

What is Lambert-Eaton syndrome?

A

Antibodies to voltage gated calcium channels causing myasthenic-like syndrome.

41
Q

What is the typical management for small cell lung cancer?

A

Usually metastatic disease by time of diagnosis.

42
Q

What is the management approach for very early stage small cell lung cancer?

A

Patients with T1-2a, N0, M0 are now considered for surgery as supported by NICE guidelines.

43
Q

What treatment do most patients with limited disease receive?

A

A combination of chemotherapy and radiotherapy.

44
Q

What is offered to patients with more extensive small cell lung cancer?

A

Palliative chemotherapy.

45
Q

What does APUD stand for?

A

Amine, Precursor Uptake, Decarboxylase.

46
Q
A

CT scan showing small cell lung cancer with multiple pulmonary nodules and extensive mediastinal nodal metastases.

47
Q

What are the two main types of lung cancer?

A

Lung cancer is classified as either small cell lung cancer (SCLC) or non-small cell lung cancer (NSCLC).

48
Q

What percentage of lung cancer cases does SCLC account for?

A

SCLC accounts for around 15% of lung cancer cases.

49
Q

What is the prognosis of SCLC compared to NSCLC?

A

SCLC generally carries a worse prognosis than NSCLC.

50
Q

What is the most common type of lung cancer?

A

Adenocarcinoma is now the most common type of lung cancer.

51
Q

What has contributed to the increase in adenocarcinoma cases?

A

The increased use of low-tar cigarettes is thought to have contributed to the rise in adenocarcinoma cases.

52
Q

What percentage of lung cancer cases caused by adenocarcinoma are seen in non-smokers?

A

Amongst ‘never’ smokers, adenocarcinoma accounts for 62% of cases.

53
Q

What type of lung cancer accounts for 18% of cases in non-smokers?

A

Squamous cell lung cancer accounts for 18% of cases in non-smokers.

54
Q

What are the other types of NSCLC mentioned?

A

Other types of NSCLC include large cell carcinoma, alveolar cell carcinoma, and bronchial adenoma (mostly carcinoid).

55
Q

Why is differentiating between NSCLC subtypes important?

A

Differentiating between NSCLC subtypes is important due to the different drugs available to treat them.

Year 6 Respiratory (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions