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circulation and breathing > lung cancer > Flashcards

lung cancer Flashcards

1
Q

what is pack/packet year histroy

A
  • number of packets of cigarretted smoked each tday times rthe number of years the patient has smoked
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2
Q

what is haemoptysis

A
  • the coughing of blood origination from the respiratory tract below the level of the larynx- can be a indication of lunger cancer
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3
Q
  • what is afebrile
A
  • free from fever
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4
Q

when should you offer an urgent chest x ray to assess for lunger cancer for people aged 40 or over

A
  • if they have two or more of the following unexplained symptoms for non smokers and one unexplained symptom for smoker: cough, fatigue, shortness of breath, chest pain, weight loss, appetitie loss
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5
Q
  • how many lung cancer cases in the uk preventable
A
  • 79%
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6
Q
  • what percentage does smoking contribute to lung cancer cases in uk
A
  • 72%
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7
Q
  • what can smoking cause
A
  • lung cancer
    • pregnancy complications
    • dementia
    • osteoporosis
    • infant mortality
    • cardivascular disease
    • COPD
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8
Q
  • what are the two categories lung cancer can be divided in
A
  • small cell lung carcinoma
    • non small cell lung carcinoma
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9
Q
  • what can non small lung carcinoma be divide into
A
  • adenocarcinoma
    • squamous carcinoma
    • large cell carcinoma
    • adenocarcinoma most common of three
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10
Q
  • what are the features of small cell lung cancer
A
  • highly agressive maligancy, metastatic occurs early in the disease
    • 2/3 patients present with advanced disease
    • strong link to smoking relative to other cancers
    • fatal- low chance of recovery
    • either advanced or local- not divided into levels like other cancer
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11
Q
  • what is the percentage distriubtion of cancer in lungs
A
  • most likely to found in upper lobe (48%)
    • 26% in lower lobe
    • 4% middle lobe
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12
Q
  • how comes lung cancer can grow unoticed
A
  • can grow unnoticed if it grows in an area of lung which is not innervated by a nerve so lack of pain sensory innervation
    • however if near pleura there is pain sensory innervation so would be more likely to be noticed
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13
Q
  • what cancers develop to stage 4 cancer
A
  • pancreatis
    • lung
    • oral cavity
    • all due to lack fo pain sensory innervsation- so grow unoticed
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14
Q
  • for non small cell lung carcinoma can surgery br used at later stages
A
  • yes due to the fact it has less rapid metastaiss
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15
Q
  • for small cell carninoma of lung is surgery (tumour resection) possible
A
  • no- rapid metastais
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16
Q
  • what diagnostic investivations can use to diagnose someone which might have lunger cancer and order prioriry
A
  • chest x ray (1)
    • full blood count (any markers, is there infection) (2`)
    • chest ct (important but time consuming and expensive)
    • trial of antibiotics
17
Q
  • what is pleural effusion
A
  • reuslts when fluid collecrs between parietal and visceral pleura surfaces of the thorax
    • investigations of pleural fluid aspirate can underly causes
18
Q
  • what is mesothelioma cancer, where is it derived from
A
  • a highly agressive and deadly cancer that affects the mesothelium
    • mesothelium lines many surface cavities such as rhe pleura
    • mesothelioma 90% of times is derived from pleura
    • non curative treatment- 80% cases occur in males
    • pleura is directly exposed to inhaled abestos fibres (main cuase of mesothelioma)
    • inhaled abestos fibres lodge in pleura causing inflammation, gneetic mutations and thus cancer
19
Q
  • what is the histological composition of mesothilioma tumours
A
  • composed of spindle cells (sarcomatoid), epithelial elements or both (biphasic)
    • mesothelioma cancer orginates from epithelial cells so it is an epithelial cancer not mysenchymal however whern it comes under the cells under the microscope it can look like epithelial cells and/or mysenchymal cells
    • sarcamatoid mesothilioma cells have spindle shapes, epihtelial mesothilioma have epihtelial shape appearance or biphasic which is a mixture of both
20
Q
  • what is pancoast tumour
A
  • tumour of any form (NSCLC or SCLC, mesothelioma) arising in the apex of the lung
    • most likely to be non small cell carinoma
    • can be dangerous and is close to very important structures such as brachail plexus, ribs and vertebrae
21
Q
  • what is the symptoms of pancoast tumous lung cancer
A
  • shoulder pain secondary to brachial plexus invasion (C8 to T1)
    • arm or hand weakness
    • arm oedema secondary to compresson of blood vessels
    • unilateral recurrent laryngeal nerve palsy producing unilateral vocal cord paralysis (damage to recurrent laryngeal nerve on side causing paralsysis of larynx on one side- same side as damaged nerve)
    • horners syndrome (triage of symptoms)
22
Q
  • what is horners syndrome
A
  • ptosis (dropping eyelid)
    • meiosis (constriction of pupil)
    • anhydrosis (lack of sweating on one side of the face)
23
Q
  • why does horners syndrome occur
A
  • pancoast tumour found in apex of lung near brachial plexus
    • growth of this tumour affects the sympathetic fibres in the brachial plexus leading to lack of sympathetic stimulation to face ( theres a specific nerve supply which control pupil size, dropping eyelid and sweat on side of face)
    • theres 3 neurone involved in sympathetic nerve pathway- pancoast tumour can impact the 2nd or first oder neurone in the pathway- disrutpiton in pathway results into horners syndrome
    • fisrt neurone originates in hypothalamus goes down to spinal cord, 2nd neurone leaves spinal cord (pre ganglionic neurone) and goes to cerbicsl ganglia and 3rd neurone is the post ganglionic neurone and goes directly to the areas in face used to control pupil dilation, sweating etc- not these sympathtic fibres pass the brachial plexus along the way
24
Q
  • what is mediastinal lymphoma
A
  • lymphoma (cancer orginated from lympathic system) that affectd the mediastinum
    • lymphoma cells invade the lymph nodes in mediastinum
25
Q
  • what is symtpoms associated with mediastinal lymphoma
A
  • retrosternal chest pain
    • dysponea- shortness of breath
    • cough
    • superior vena cava compression with SVC syndrome
26
Q
  • what is SVC obstruction
A
  • facial swelling
    • difficulty breathing
    • flushed appearing
    • surgical managment
    • caused by compression or envasion by tumour of superior vena cava leading to obstruction- leads to venous congestion and swelling

circulation and breathing (26 decks)

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