Lung Cancer Flashcards
Which cancer causes hypertrophic pulmonary osteoarthropathy?
Adenocarcionoma where there is primo steal reaction of bones cauasing clubbing and arthritis primary affecting wrists and akles
What is the criteria for 2 week referral?
Aged 40+ with unexplained haemoptysis
Chest X-ray findings suspicious for lung cancer
When should urgent CXR be performed?
Patient over 40 that has smoked and has either of the symptoms:
Cough
Fatigue
Shortness of breath
Chest pain
Weight loss
Anorexia
When should urgent CXR be considered for patient over 40+?
Persistent/recurrent chest infection
Finger clubbing
Supraclavicular or persistent cervical lymphadenopathy
Thrombocytosis
Chest signs consistent with lung cancer (e.g. reduced breath sounds, dullness to percussion)
Which cancers cause lobar collapse?
Squamous cell carcinoma because they are located centrally and can also cause bulky hilum.
Which cancers are located centrally?
Squamous cell and small cell lung carcinoma
-> require bronchoscopy for analysis
Which cancers are located peripherally?
Adenocarcioma and large cell
-> require Percutaneous biopsy for analysis
What is first line for small cell lung cancer?
Chemotherapy with palliative intent to prolong life
Lobectomy
-> small cell is more aggressive and ends to be more advanced at a later stage
When is immunotherapy typically sued?
Advanced non small cell lung cancer
-> includes medications such as pembrolizumab or atezolizumab
How can small tumours be removed?
Wedge resection
What is a requirement for all patients undergoing surgery?
Sampling of mediastinal adn hilar lymph nodes
How does adrenal gland metastasis present?
Flank pain
Adrenal insufficiency
Why does Persistent lower respiratory tract infection occur?
Due to obstructing tumour
Why does brachial plexus injury occur?
Tumour invasion from pancoast tumour
What does the rescue pack for COPD contain?
Amoxicillin antibiotic
Oral corticosteroids
What is the management of SVC syndrome?
Urgent administration of dexamethasone to reduce oedema and improve airway potency
What investigation is used if history indicates metastases?
Radionuclide bone scan
What is first line investigation if lesion is found on CXR?
CT scan to identify and localise the lesion
Which investigation is performed after CT scan?
Fibre-optic bronchoscopy which allows for samples to be taken to visualise the bronchial tree
What is endobrahcial ultrasound guided aspiration?
Ultrasound is inserted into the lungs and allows lymph node evaluation; less available than fibre optic bronchoscopy
What is the cause of leg and arm weakness between with exertion? l
Lambert Eaton myasthenia syndrome, which bilateral ptosis and double vision it is caused by voltage gated Ca2+ channel antibodies
What is lambert-Eaton associated with? s
Small cell lung cancer
