Lung cancer Flashcards

1
Q

How might a patient with lung cancer present?

A
Chest pain
Haemoptysis
Chronic chest infection
Weight loss
Fatigue
Breathlessness
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2
Q

What is the most common type of lung cancer?

A

Adenocarcinoma

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3
Q

Where might a tumour spread to?

A
Pericardium
Pleura
Brachial plexus
Recurrent laryngeal nerve
Oesophagus
Superior vena cava
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4
Q

What might invasion of the recurrent laryngeal nerve cause?

A

Hoarse voice

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5
Q

What is a pancoast tumour?

A

A tumour of the apex

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6
Q

What nerves might a pancoast tumour invade and how might a patient with the resulting pathology present?

A

Brachial plexus

Arm paralysis

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7
Q

What are some common sites for lung tumour metastases?

A

Liver
Brain
Bone

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8
Q

What biochemical abnormalities may indicate a lung cancer?

A

Hypercalcaemia

Hyponatraemia

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9
Q

What is Lambert-Eaton syndrome?

A

Muscle weakness in the limbs, most commonly caused by underlying malignancy - in lung cancer this is usually small cell

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10
Q

What changes in the hands could indicate underlying malignancy?

A

Finger clubbing

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11
Q

What investigations must be done if a diagnosis of lung cancer is suspected?

A
FBC
Ca, Na, K, Alk phos
Spirometry
Coagulation screen
CXR
Bronchoscopy 
CT scan & CT guided biopsy
Lymph node aspirate
Aspiration of pleural effusion
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12
Q

Why is small cell carcinoma rarely suitable for surgery?

A

Metastasises early

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13
Q

Which cancer shows the best initial reaction to chemotherapy?

A

Small cell lung cancer

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14
Q

Which cancer is the most rapidly progressive?

A

Small cell

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15
Q

Which area does small cell lung cancer typically affect?

A

Hilum, may compress bronchial lumen externally

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16
Q

Which area do squamous cell carcinomas typically affect?

A

They are central, usually affecting main or segmental bronchi

17
Q

Which area do adenocarcinomas typically affect?

A

Peripheries

18
Q

Where do central adenocarcinomas arise from?

A

Bronchial mucous glands

19
Q

Which other anatomical structures might adenocarcinomas rapidly invade?

A

Lymphatics
Blood vessels
Pleura

20
Q

How might you distinguish a lung primary adenocarcinoma from a secondary carcinoma e.g. of lung or pancreas?

A

Primary adenocarcinoma express thyroid transcription factor