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MBCHB 1 > lung cancer > Flashcards

lung cancer Flashcards

1
Q

aetiology of lung cancer

A

tobacco
asbestos
air pollution
pulmonary fibrosis
other radiation

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1
Q

susceptibility of lung cancer

A

more common in women

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2
Q

how does tobacco smoke cause lung cancer

A

destruction or metaplasia of the epithelium
causes destruction of the genes ( multi hit theory of carcinogenesis)
there is activation of pro -carcinogens and metabolism of pro-carcinogens .

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3
Q

pathways for lung carcinogenesis

A

terminal respiratory unit epithelial transformation
bronchial epithelial transformation

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4
Q

adenocarcinogenesis

A

could be from smoking with complex mutations
could be non tobacco carcinogenesis with a simple genomic driver alteration.

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5
Q

gene mutations that are associated with smoking

A

KRAS
BRAF
MET

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6
Q

genes mutations that are not associated with smoking

A

EGFR , HER2

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7
Q

mutations that lead to adenocarcinomas

A

GFR mutation​

ALK rearrangement​

ROS1 rearrangement​

RET rearrangement​

NTRK rearrangement​

MET exon14 mutation​

BRAF V600E mutation​

KRAS G12C mutation​

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8
Q

targets for adenocarcinoma therapy

A

there are drugs that can target the mutated genes

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9
Q

targets for squamous cell carcinoma

A

very few suitable targets and very few additive oncogenes
there is complete alteration of tumor suppressor genes

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10
Q

lung carcinoma based on cell types

A

squamous cell
adenocarcinoma ( cancer of the alveolar cells )
small cell carcinoma
large cell carcinoma

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11
Q

lung carcinoma based on histology

A

small cell carcinoma
non small cell carcinoma

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12
Q

tumors of the lung

A

benign mass
carcinoid tumour
tumour of bronchial glands
lymphoma
sarcoma
metastases to lungs

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13
Q

primary lung cancer

A

mostly asymptomatic
presentation in the later stages
symptomatic lung cancer is fatal

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14
Q

characteristics of squamous cell carcinoma

A

cavitating on the lung surface

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15
Q

local effects of lung cancer

A

collapse of the bronchial
lipoid pneumonia
infection and abscess
bronchiectasis

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16
Q

local effects of lung cancer on the pleural cavity

A

inflammation
malignant
there could also be chest wall invasion
lymph node metastases

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17
Q

Local effects of lung cancer to the nerves

A

effects on the phrenic nerve is diaphragmatic paralysis

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18
Q

effects of the tumor on the recurrent laryngeal nerve

A

hoarse and bovine cough ( coughing like a cow)

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19
Q

local effect of lung cancer on the brachial plexus

A

T1 damage

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20
Q

effect of lung cancer on cervical sympathetic

A

Horner`s syndrome

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21
Q

local effects of lung cancer on the mediastinum

A

pericardium

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22
Q

local effects of lung cancer on the lymph nodes

A

metastases of the cancer

23
Q

SVC obstruction

A

accumulation of venous blood even on the upper body such as the face

24
Q

Horner`s syndrome

A

there is the loss of the sympathetic nervous system and this leads to drooping and there is also no dilatation of the pupils when there is exposure to light in dark regions

25
Q

distance metastases of lung cancer

A

metastases to the liver
adrenals, bone , skin , extrathoracic lymph nodes

26
Q

secondary to local effects of lung cancer

A

neural and vascular

27
Q

skeletal effects of lung cancer

A

clubbing
HPOA ( hypertrophic pulmonary osteoarthopathy )

28
Q

effects of lung cancer on the endocrine system

A

PTH
ADH
ACTH
gynaecomastia
carcinoid syndrome

29
Q

neurological

A

polyneuropathy
encephalopathy
cerebellar degeneration
myasthenia (Eaton-Lambert)

30
Q

haematologic

A

granulocytosis
eosinophilia
DIC

31
Q

renal

A

nephrotic syndrome

32
Q

manifestation of hypertrophic pulmonary osteoarthropathy

A

pain and tenderness on the wrists and ankles
there is also distal periosteal inflammation

33
Q

hormones affected by small cell carcinoma

A

ACTH (adreno -corticoprotic hormone )
ADH (anti-diuretic hormone) fluid retention

34
Q

hormones affected by the squamous cell carcinoma

A

parathyroid hormone

35
Q

investigations for lung cancer

A

chest x-rays
sputum cytology
bronchoscopy
trans-thoracic fine needle aspiration
trans-thoracic core biopsy
pleural effusion cytology and biopsy

36
Q

advanced imaging techniques for lung cancer

A

CT scanning
MRI , PET scanning

37
Q

therapy biomarkers for adenocarcinoma

A

adenocarcinoma
-EGRF, KRAS , BRAF, MET , HER 2 mutations
ALK , ROS1 ,RET , NTRK fusion genes

38
Q

squamous cell biomarker therapy

A

little to no molecular targeted therapy

39
Q

immunotherapy treatment

A

non small cell lung cancer

40
Q

cancer immune response

A

some cancers are not immunogenic traht means there is no immune response

41
Q

Immune checkpoint in non small cell lung cancer

A

The PD1/PD-L1 axis immune checkpoint in NSCLC​
A therapeutic target​
An important biomarker​

42
Q

Signs of lung cancer

A

Coughing up blood
Unexplained weight loss
Nail clubbing
Chest infections
Chest and bone pain
Nail clubbing
Wheezing sound (cows bovine voice)

43
Q

Clinical signs of lung cancer

A

Chest signs
Clubbing
Hornet’s syndrome
Swelling of the lymph nodes
Hepatomegaly
Skin nodules metastasis

44
Q

Tests to be conducted to test on the tissue of the lung tumour

A

Bronchoscopy
Liver biopsy
Lung biopsy
Bone biopsy
Surgical excision biopsy
Mediastinoscopy.

45
Q

Types of lung cancer by histology

A

Small cell carcinoma
Adenocarcinoma
Squamous cell carcinoma
Large cell carcinoma

46
Q

Upstaging of metastases in other regions of the body

A

PET -ct scan

47
Q

Factors to consider before giving out the treatments

A

Performance status
Histologicql type and the stage of the disease
Aims of the treatment

48
Q

What is meant by performance status

A

Level of activity will determine the kind of treatment that T the patient gets could lead to further deterioration

49
Q

Communication with cancer patients

A

Pre and post cancer suggestions are given to the patient

50
Q

Treatment of cancer

A

Surgical ,radiotherapy, chemotherapy

51
Q

Surgical treatment of cancer

A

Lobectomy
Wedge resection which is only taking off the cancer although not recommended

52
Q

Radiotherapy treatment

A

Radical treatment
Palliative treatment
Stereotactic

53
Q

Chemotherapy targets

A

Tyrosine kinase inhibitor
Monoclonal antibodies erlotinib , gefitinib ,crizotinib

54
Q

Palliative management of Lung cancer

A

Mostly symptom control
Chemotherapy is given to manage the symptoms a

55
Q
A

MBCHB 1 (27 decks)

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