Lung cancer

Question 1

Risk factors

Answer 1

Smoking (associated with chronic tissue irritation, responsible for 85% of all lung cancer deaths)
Secondhand smoke
Occupation exposure asbestos, cold distillates, radiation, arsenic)
Increased radon

Question 2

SCLC small cell lung cancer (oat cell)

Answer 2

Rapidly growing
High rate of metastasis
Surgical resectability

Question 3

NSCLC non-small cell lung cancer includes

Answer 3

Squamous cell
Adenocarcinoma (gland)
Large cell

Question 4

NSCLC non-small cell lung cancer

Answer 4

Slower growing

Surgical respectability good for stage one or two

Question 5

Metastasis occurs by

Answer 5

Direct extension, via blood or lymph system

Question 6

Sites of metastasis

Answer 6

1. liver
2. lymph nodes
3. walls of esophagus
   4, pericardium
4. Brain
5. bone

Question 7

Clinical manifestations

Answer 7

75% have persistent cough
50% have hemoptysis 
Shortness of breath
Change in respiratory pattern
Hoarseness (laryngeal nerve invasion)
Chest, shoulder or arm pain
Recurrent respiratory infection
Unilateral wheezing
Weight loss
Clubbing

Question 8

Diagnostics

Answer 8

Cytologic exam of the early morning sputum may identify malignant cells
Pleural effusion fluid for cytology
CT scans
Fiberoptic bronchoscopy
Thoracoscopy 
Needle biopsy, MRI

Question 9

Surgery management

Answer 9

Only one third of tumors are resectable
Surgery not indicated if metastasis present
Treatment of choice for stage one and 2 NSCLC
Procedure: thoracotomy (removal of tumor), lobectomy (lobe), pneumonectomy (entire lung)

Question 10

Post operative care thoracotomy

Answer 10

Chest tube is inserted to drain air, blood, fluid from plural space
CT restores intrapleural pressure which allows reexpansion of lung