*Lung Cancer

Question 1

How can tissue biopsies be taken to diagnose lung cancer? (4)

Answer 1

Bronchoscopy
CT guided biopsy
Lymph node biopsy
Aspiration of pleural fluid

Question 2

What is used to assess a patients fitness for chemotherapy?

Answer 2

ECOG score

Question 3

How can a tissue sample be taken during bronchoscopy?

Answer 3

Biopsy

Brush cytology

Question 4

What is endobronchial ultrasound used to visualise?

Answer 4

Hilar and mediastinal structures

Question 5

What are the 5 main types of lung cancer?

Answer 5

Small cell
Non--small cell:
Squamous cell
Adenocarcinoma
Large cell
Bronchoalveolar cell

Question 6

What ectopic hormone can small cell lung cancer secrete?

Answer 6

ACTH

Question 7

What is the most common type of lung cancer?

Answer 7

Adenocarcinoma (followed by scam cell, then small cell, then large cell, then bronchoalveolar cell)

Question 8

What is the most common type of lung cancer in non-smokers?

Answer 8

Adenocarcinoma

Question 9

What type of cancer hardly ever occurs in non-smokers?

Answer 9

Small cell

Question 10

Treatment of small cell lung cancer?

Answer 10

Chemosensitive (usually becomes rapidly resistant) backed up with radiation
Usually disseminated on diagnosis therefore no surgery

Question 11

What lung cancer has the worst survival stats?

Answer 11

Small cell lung cancer

Question 12

Is small cell normally central or peripheral?

Answer 12

Central

Question 13

How are non-small cell lung cancers normally treated?

Answer 13

Surgery (can be backed up with radiotherapy) is normally the curative treatment of choice
If it is more than stage T1 however surgery is not usually performed - there are chemo/radiotherapy regimens been developed but not very sucessful

Question 14

What type of lung cancer can histologically look like lymphocytes and therefore mimic lymphoma?

Answer 14

Small cell

Question 15

Is squamous cell normally central or peripheral?

Answer 15

Central

Question 16

What type of ectopic hormone does squamous cell carcinoma secrete?

Answer 16

PTH (if high levels, can cause Ca to leave bone for blood)

Question 17

What can express p63 and high molecular weight cytokeratins?

Answer 17

Squamous cell

Question 18

What type of lung cancer has the highest survival rates?

Answer 18

Adenocarcinoma

Question 19

Are adenocarcinoma tumours normally central or peripheral?

Answer 19

Periperhal

Question 20

What type of cancer normally has mutations in EFGR?

Answer 20

Adenocarcinoma (respond to tyrosine kinase inhibitors e.g. erlotinib)

Question 21

What type of tumour can express TTF1?

Answer 21

Adenocarcinoma

Question 22

What is mucin producing tumour?

Answer 22

Adenocarcinoma

Question 23

What are the types endobronchial therapy?

Answer 23

Stent for stridor
Photo-dynamic therapy
Other laser therapy
Radio-active pellets