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Pulm Final > lung cancer 2 > Flashcards

lung cancer 2 Flashcards

1
Q

what are the paraneopladtic syndromes associated with small cell lung cancer?

A

SIADH, Cushings, Labert-Eaton, cerebellar degeneration, peripheral neuropathy?

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2
Q

What are the driver mutations for NSCLC?

A

KRAS, EML4-ALK, EGFR

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3
Q

How does adenocarcinoma present radiographically?

A

peripherally. usually begins at the bronchioles or the alveolar walls

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4
Q

You have a female, non-smoker patient with clubbed digits, and frothy sputum. Which diagnostic tool should you use? Are negative results reliable?

A

transthoracic needle biopsies are excellent for peripheral lesions. This patient has peripheral lesions because she has adenocarcinoma. Negative results are not reliable (unless it’s benign).

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5
Q

hypertrophic osteoarthritis.. what is it and what cancer does it present with?

A
  • clubbing of digits
    periostitis of long bones
    arthritis

presents with adenocarcinoma usually, as well as other NSCLC

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6
Q

adenocarcinoma is most common in which patients?

A

women, non-smokers

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7
Q

What do squamous cell carcinoma cells secrete?

A

PTH like compound leading to hypercalcemia, causing weakness, dehydration, mental changes

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8
Q

Where is squamous cell carcinoma located in the lung?

A

centrally, so it can cause some obstruction of the airway with distal atelectesis

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9
Q

Which cancerous tumor exhibits cavitation?

A

squamous cell carcinoma

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10
Q

Which cancerous tumor exhibits desmosomes and keratin pearls

A

squamous cell carcinoma

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11
Q

What are the driver mutations for NSCLC?

A

KRAS, EML4-ALK, EGFR

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12
Q

How does adenocarcinoma present radiographically?

A

peripherally. usually begins at the bronchioles or the alveolar walls

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13
Q

If a child comes in with a solitary cartilaginous nodule in her lung, what would be the most likely diagnosis?

A

Hamartoma, a benign lung neoplasm. you would see cartilage in disarray under a microscope

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14
Q

hypertrophic osteoarthritis.. what is it and what cancer does it present with?

A
  • clubbing of digits- periostitis of long bones-arthritispresents with NSCLC
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15
Q

adenocarcinoma is most common in which patients?

A

women, non-smokers

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16
Q

What do squamous cell carcinoma cells secrete?

A

PTH like compound leading to hypercalcemia, causing weakness, dehydration, mental changes

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17
Q

Where is squamous cell carcinoma located in the lung?

A

centrally, so it can cause some obstruction of the airway with distal atelectesis

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18
Q

Which cancerous tumor exhibits cavitation?

A

squamous cell carcinoma

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19
Q

Which cancerous tumor exhibits desmosomes and keratin pearls

A

squamous cell carcinoma

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20
Q

What are the paraneoplastic syndromes assoc with NSCLC?

A

hypercalcemia, HPO and clubbing

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21
Q

You have a patient with obstructed airway, and the CXR shows cavitated lesions. What would be the best way to diagnose him?

A

Bronchoscopy is great from central lesions, which this patient has. He has Squamous cell carcinoma, which is evident with the cavitation.

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22
Q

You have a female, non-smoker patient with clubbed digits, and frothy sputum. Which diagnostic tool should you use? Are negative results reliable?

A

transthoracic needle biopsies are excellent for peripheral lesions. This patient has peripheral lesions because she has adenocarcinoma. Negative results are not reliable.

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23
Q

If a patient has a pleural effusion, which diagnostic modality should be used?

A

Thoracentesis

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24
Q

Which staging system is used for NSCLC?

A

T (size and location of tumor)

N (spread to lymph nodes)

M (distant metastases)

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25
Q

Treatment for early stage NSCLC?

A

surgery

surgery + chemo for stage II

26
Q

treatment for locally advanced stage III NSCLC

A

chemo and radiation, sometimes chemo and surgery

27
Q

Treatment for advanced stage IV NSCLC?

A

chemo, radiation for brain and bone mets, and targeted therapy for driver mutations

28
Q

What cancer is characterized by a bulky central tumor with extensive mediastinal and hilar lymph node involvement?

A

small cell lung cancer

29
Q

how is small cell lung cancer staged?

A

limited (encompassed in a radiation port)

extensive (beyond a radiation port, including malignant pleural effusion)

30
Q

What screening modality do we have for lung cancer?

A

low dose spiral CT, which is very sensitive. Adults 55-80 with a 30 pack year history should do this

grade B recommendation

31
Q

If a child comes in with a solitary cartilaginous nodule in her lung, what would be the most likely diagnosis?

A

Hamartoma, a benign lung neoplasm. you would see cartilage in disarray under a microscope

32
Q

What two stains are most useful for mesothelioma?

A

keratin and calretinin

33
Q

first degree lung neoplasms are usually ______, whereas first degree pleural neoplasms are usually _______

A

carcinomas and mesotheliomas

34
Q

what are the driver mutations for NSCLC?

A

KRAS, EML4-ALK, EGFR

EGFR more common in women, asians and never-smokers

35
Q

How does adenocarcinoma present radiographically?

A

peripherally. usually begins at the bronchioles or the alveolar walls

36
Q

Does adenocarcinoma present with glands or mucin?

A

with or without glands. with or with our mucin

37
Q

hypertrophic osteoarthritis.. what is it and what cancer does it present with?

A
  • clubbing of digits

periostitis of long bones

arthritis

presents with NSCLC

38
Q

adenocarcinoma is most common in which patients?

A

women, non-smokers

39
Q

What do squamous cell carcinoma cells secrete?

A

PTH like compound leading to hypercalcemia, causing weakness, dehydration, mental changes

40
Q

Where is squamous cell carcinoma located in the lung?

A

centrally, so it can cause some obstruction of the airway with distal atelectesis

41
Q

Which cancerous tumor exhibits cavitation?

A

squamous cell carcinoma

42
Q

Which cancerous tumor exhibits desmosomes and keratin pearls

A

squamous cell carcinoma

43
Q

what is one of the main carcinogens in cigarettes?

A

polycyclic hydrocarbons

44
Q

outdoor pollution mainly increases the risk for which lung cancer?

A

adenocarcinoma

also women are more likely than men to develop this cancer

45
Q

you see a cancer that has arisen from an area of previous scarring, which cancer might this be?

A

adenocarcinoma

46
Q

Which cancer has low contrast uptake on PET and why?

A

adenocarcinoma because it’s slow growing

47
Q

in which cancer is normal architecture preserved, but Type I cells are replaced by neoplastic mutinous cells?

A

Adenocarcinoma in situ

can be mutlifocal and bilateral

48
Q

if you see a <0.5cm invasive component, with multiple architectural patterns, which cancer would it be

A

minimally invasive adenocarcinoma

49
Q

> 0.3cm BAC or >0.5cm invasive carcinoma

A

invasive adenocarcinoma

50
Q

If someone comes in with mental status changes due to hypercalcemia, what lung cancer might stye have?

A

squamous cell carcinoma, due to secretion of PTH like compound

51
Q

squamous cell cancers under a microscope characteristically have dark pink _________ and __________

A

keratin pearls and desmosomal intercellular bridges

52
Q

if someone had NSCLC, what things would definitely and possibly help with prognostics?

A

definitely- stage and performance status

possibly- gender, ploidy, specific mutations

53
Q

If someone comes in with mental status changes due to low sodium, what lung cancer might stye have?

A

small cell lung cancer

54
Q

treatment for small cell lung cancer?

A

combined chemo and radiation. radiation just to thorax for limited. If extensive, radiate the brain and bones for mets as well

55
Q

if a patient with lung cancer presents with nonspecific symptoms (weight loss, anorexia, fatigue) what might you worry about?

A

metastasis

56
Q

if a patient present with muscle weakness of the limbs due to antibodies directed against presynaptic Ca channels, which lung cancer might you worry about?

A

Small cell lung cancer. This patient has the Lambert-Eaton paraneoplastic syndrome

57
Q

If someone is infected with HPV, which benign lung neoplasm are they at risk for?

A

Squamous papillomatosis

58
Q

a salivary gland neoplasm is characteristic of which benign lung neoplasm?

A

pleomorphic adenoma

59
Q

a naval shipyard worker has a pleural effusion, and a deeply invasive cancerous growth pattern on the pleura. What does he have? Use which two stains to ensure the right diagnosis?

A

mesothelioma from asbestos exposure

calretinin and keratin

60
Q

if a patient has melanoma in their lungs, where did it likely originate?

A

outside of the lungs. extra-pulmonary primary melanoma is much more common than pulmonary primary

61
Q

where do primary lung cancers most commonly occur? (which compartment of the lungs)

A

upper lobe

62
Q

mediastinal mass ddx

A

4 T’s: thymoma, thyroid cancer, teratoma, terrible lymphoma

primary lung cancer (esp small cell)

Pulm Final (5 decks)

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