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Respiratory: Lung cancer > Lung Cancer > Flashcards

Lung Cancer Flashcards

1
Q

what are the symptoms of cancer?

A

cough - a long standing cough that gets worse

breathlessness - many patients with lung cancer also have COPD

haemoptysis

chest pain

wheeze

hoarseness

dysphagia

nerve compression

puffy eyelids and headache

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2
Q

what causes the breathlessness?

A

large tumours occluding airways

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3
Q

what causes chest pain?

A

peripheral tumours invading the chest wall

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4
Q

what causes hoarseness?

A

mediastinal, nodal or direct tumour invasion of the mediastinum results in compression of the recurrent laryngeal nerve

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5
Q

what causes dysphagia?

A

invasion of the phrenic nerve/ oesophagus

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6
Q

what 4 things may people present with ?

A

primary tumour

local invasion

metastases

non-metastatic
- paraneoplastic

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7
Q

what are the symptoms you get from primary tumour?

A

haemoptysis

recurrent pneumonia

stridor

breathlessness

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8
Q

what causes the recurrent pneumonia ?

A

tumour causing partial obstruction of an airway results in post-obstructive pneumonia

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9
Q

what symptoms may you get from local invasion

A

hoarseness

pericardium local invasion

  • breathlessness
  • atrial fibrillation
  • pericardial effusion

oesophagus
- dysphagia

brachial plexus

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10
Q

what may happen because of invasion to the brachial plexus ?

A

may get pancoast tumour in the apex of the lung which may invade the brachial plexus causing C8/T1 palsy with small muscle wasting in the hand and weakness as well as pain down the arm.

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11
Q

what may happen because of invasion of the pleural space?

A

pleural effusion

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12
Q

what may happen because of invasion of the superior vena cava ?

A
  • obstructs drainage of blood from the arms and head
  • leads to a distended external jugular vein
  • patients may present with puffy eyelids and a headache
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13
Q

what may happen as a result of SVC obstruction?

A

anastamoses to inferior vena cava - the blood flow is bypassing the obstructed SVC by opening up anastamoses with the IVC tributaries

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14
Q

where are the common sites of metastases for bronchial carcinomas?

A

mediastinal, cervical and even axillary or intra-abdominal nodes

liver

brain

bone

adrenal glands

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15
Q

what are the symptoms of liver metastases?

A

anorexia, nausea and weight loss

pain across abdomen

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16
Q

what are the symptoms of brain metastases?

A
  • presentation due to raised intra-cranial pressure
  • weakness - may mimic a stroke but develops slowly unlike stroke
  • visual disturbance
  • headaches
  • fits - if the metastases involved the cortex
17
Q

what are the symptoms of bone metastases?

A

localised pain which is worse at night

  • pathological fracture
18
Q

what are the characteristics of headaches from metastases?

A

worse in the morning

not photophobic

19
Q

what do you know if someone presents with a sore arm and you know it is cancer?

A

that it is not curable

20
Q

what are the non-metastatic features of lancer?

A

finger clubbing

  • hypertrophic pulmonary osteoarthropathy
  • weight loss
  • weight loss
  • thrombophlebitis
  • hypercalcaemia
  • hyponatraemia
  • weakness
  • Ectopic hormone production
21
Q

why do people get thrombophlebitis?

A

increased coagulability of cancer patients

22
Q

why do people get hypercalcaemia?

A

results from the tumour producing a substance which mimics the effects of a parathyroid hormone.

23
Q

what are features of hypercalcaemia?

A

Headaches, thirst and constipation

24
Q

why do people get hyponatraemia?

A

may result from the production of a substance which mimics ADH.

25
Q

which ectopic hormones are produced by squamous cancer?

A

PTH

26
Q

which ectopic hormones are produced by small cell lung cancer?

A

ACTH

27
Q

what history should be taken?

A

cough

haemoptysis

cigarette smoker

breathless

weight loss

chest wall pain

fatigue

recurrent infection

other smoking related disease

Investigate risk factors 
from tobacco smoke; polycyclic hydrocarbons, aromatic amines, phenols, nickel, cyanates 
asbestos 
nickel 
chromates 
radiation 
atmospheric pollution 
genetics
28
Q

what symptoms may indicate specifically small cell lung cancer?

A

the presence of vomiting and euvolaemic hyponatremia is indicative of ectopic antidiuretic hormone secretion, which is most commonly seen in the context of small cell lung cancer

29
Q

what would you examine for in lung cancer?

A

finger clubbing

  • breathlessness
  • cough
  • weight loss
  • bloated face
  • lymphadenopathy
  • tracheal deviation
  • dull percussion
  • stridor
  • enlarged liver
  • anastomosis of IVC
  • thrombophlebitis

Respiratory: Lung cancer (4 decks)

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