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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
Horner`s syndrome
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
distance metastases of lung cancer
metastases to the liver adrenals, bone , skin , extrathoracic lymph nodes
26
secondary to local effects of lung cancer
neural and vascular
27
skeletal effects of lung cancer
clubbing HPOA ( hypertrophic pulmonary osteoarthopathy )
28
effects of lung cancer on the endocrine system
PTH ADH ACTH gynaecomastia carcinoid syndrome
29
neurological
polyneuropathy encephalopathy cerebellar degeneration myasthenia (Eaton-Lambert)
30
haematologic
granulocytosis eosinophilia DIC
31
renal
nephrotic syndrome
32
manifestation of hypertrophic pulmonary osteoarthropathy
pain and tenderness on the wrists and ankles there is also distal periosteal inflammation
33
hormones affected by small cell carcinoma
ACTH (adreno -corticoprotic hormone ) ADH (anti-diuretic hormone) fluid retention
34
hormones affected by the squamous cell carcinoma
parathyroid hormone
35
investigations for lung cancer
chest x-rays sputum cytology bronchoscopy trans-thoracic fine needle aspiration trans-thoracic core biopsy pleural effusion cytology and biopsy
36
advanced imaging techniques for lung cancer
CT scanning MRI , PET scanning
37
therapy biomarkers for adenocarcinoma
adenocarcinoma -EGRF, KRAS , BRAF, MET , HER 2 mutations ALK , ROS1 ,RET , NTRK fusion genes
38
squamous cell biomarker therapy
little to no molecular targeted therapy
39
immunotherapy treatment
non small cell lung cancer
40
cancer immune response
some cancers are not immunogenic traht means there is no immune response
41
Immune checkpoint in non small cell lung cancer
The PD1/PD-L1 axis immune checkpoint in NSCLC​ A therapeutic target​ An important biomarker​
42
Signs of lung cancer
Coughing up blood Unexplained weight loss Nail clubbing Chest infections Chest and bone pain Nail clubbing Wheezing sound (cows bovine voice)
43
Clinical signs of lung cancer
Chest signs Clubbing Hornet’s syndrome Swelling of the lymph nodes Hepatomegaly Skin nodules metastasis
44
Tests to be conducted to test on the tissue of the lung tumour
Bronchoscopy Liver biopsy Lung biopsy Bone biopsy Surgical excision biopsy Mediastinoscopy.
45
Types of lung cancer by histology
Small cell carcinoma Adenocarcinoma Squamous cell carcinoma Large cell carcinoma
46
Upstaging of metastases in other regions of the body
PET -ct scan
47
Factors to consider before giving out the treatments
Performance status Histologicql type and the stage of the disease Aims of the treatment
48
What is meant by performance status
Level of activity will determine the kind of treatment that T the patient gets could lead to further deterioration
49
Communication with cancer patients
Pre and post cancer suggestions are given to the patient
50
Treatment of cancer
Surgical ,radiotherapy, chemotherapy
51
Surgical treatment of cancer
Lobectomy Wedge resection which is only taking off the cancer although not recommended
52
Radiotherapy treatment
Radical treatment Palliative treatment Stereotactic
53
Chemotherapy targets
Tyrosine kinase inhibitor Monoclonal antibodies erlotinib , gefitinib ,crizotinib
54
Palliative management of Lung cancer
Mostly symptom control Chemotherapy is given to manage the symptoms a
55

MBCHB 1 (62 decks)

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