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Jamie Respiration Pathology > Lung Cancer > Flashcards

Lung Cancer Flashcards

1
Q

What are the 3 main causes of lung cancer?

A

Tobacco
Asbestos
Environmental radon (from granite usually)

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2
Q

What are less common example of substances from occupational exposure that can cause lung cancer? (2)

A

Chromates
Hydrocarbons
Nickel

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3
Q

What are the 2 main types of carcinogenesis in the lung?

A

Adenocarcinoma

Squamous cell carcinoma

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4
Q

What area does adenocarcinoma affect and what effect does it have on that area?

A

Lung periphery

Transforms bronchioloalveolar epithelial stem cells

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5
Q

What area does squamous cell carcinoma affect and what effect does it have on that area?

A

Central lung airways

Transforms bronchial epithelial stem cells

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6
Q

What is the carcinoma sequence of peripheral lung adenocarcinogenesis? (3)

A

1: Atypical adenomatous hyperlasia
2: Adenocarcinoma in situ
3: Invasive adenocarcinoma

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7
Q

What are the 2 main key driver mutations in adenocarcinogenesis?

A

KRAS (smoking induced)

EGFR (not smoking related)

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8
Q

What are the 4 main carcinomas of the lung in order of commonness?

A

Adenocarcinoma
Squamous cell carcinoma
Small cell carcinoma
Large cell carcinoma

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9
Q

Are metastases to the lung common?

A

Yes

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10
Q

How common are tumours of the bronchial glands and give an example of one?

A

Very rare

Adenoid cystic carcinoma

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11
Q

What type of lung carcinoma is most likely to cavity?

A

Squamous

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12
Q

What are 5 examples of the local effects of lung cancer in terms of bronchial obstruction?

A 
Collapse
Infection
Abscess
Bronchiectasis
Endogenous lipoid pneumonia
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13
Q

What are 2 examples of the local effects of lung cancer has pleurally?

A

Inflammation

Malignancy

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14
Q

What are the 3 indicators of horner’s syndrome?

A

Dry on one side of the face
Droopy eyes
Different sizes of pupil

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15
Q

What type of lung cancer does could a hoarse bovine cough indicate?

A

Left recurrent laryngeal lung cancer

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16
Q

What 5 organs are most likely to be the sites of distant metastases of lung cancer?

A 
Liver
Bone
Brain
Skin
Adrenals
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17
Q

What does paraneoplastic effects of lung cancer mean?

A

A consequence of cancer not due to the local presence of cancer cells

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18
Q

Give an example of a non-metastatic paraneoplastic effect of lung cancer for each of the following:

  1. Skeletal
  2. Endocrine
  3. Neurological
  4. Cutaneous
  5. Haematological
  6. Cardiovascular
  7. Renal
A
  1. Clubbing
  2. Carcinoid syndrome
  3. Polyneuropathy
  4. Dermatomyositis
  5. Eosiniphilia
  6. Thrombophlebitis migrans
  7. Nephrotic syndrome
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19
Q

What are 3 non-imaging investigations that might be done when identifying lung cancer?

A

Bronchoscopy
Trans-thoracic fine needle aspiration
Trans-thoracic core biopsy

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20
Q

What is a pulmonary mass?

A

An opacity in lung that is over 3cm with no mediastinal adenopathy (lymph enlargement) or atelectasis (collapse or incomplete inflation of lung)

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21
Q

What is a pulmonary nodule?

A

An opacity in lung that is under 3cm with no mediastinal adenopathy (lymph enlargement) or atelectasis (collapse or incomplete inflation of lung)

22
Q

What is adenopathy?

A

Enlargement of lymph nodes

23
Q

what is atelectasis?

A

Partial collapse or incomplete inflation of the lung

24
Q

What does the T stand for in TNM staging of tumours?

A

Size and position of the tumour

25
Q

What does the N stand for in TNM staging of tumours?

A

Whether cancer cells have spread into the lymph nodes

26
Q

What does the M stand for in TNM staging of tumours?

A

Where the tumour has metastasised

27
Q

What is the best investigation for identifying the TNM of a tumour?

A

PET-CT

28
Q 
What do the following stand for in TNM staging
A: T0
B: T1
C. T2
D. T3
E. T4
A 
T0 - no evidence of tumour
T1 - tumour between 0-3cm
T2 - tumour between 3-5cm
T3 - tumour between 5-7cm
T4 - tumour between of larger than 7cm
29
Q

What do the following stand for in TNM staging
A: N0
B: N1-3

A

N0 - no lymph node metastases

N1-3 - lymph node metastases present

30
Q 
What do the following stand for in TNM staging
A: M0
B: M1
C. M1b
D. M1c
A

M0 - no distant metastasis
M1 - distant metastasis
M1b - single distant metastasis
M1c - multiple distant metastases

31
Q

What are 3 investigations that can be used for the tissue diagnosis of tumours?

A

Bronchoscopy
Endobronchial ultrasound (EBUS)
Percutaneous image guided biopsy

32
Q

What are the 4 main causes for solitary pulmonary nodules?

A

Primary lung cancers
Metastases
Infections
Pseudotumour

33
Q

What is a pseudotumour?

A

Gives the appearance of a mass that it isn’t (i.e. pleural fluid giving the appearance of a tumour)

34
Q

Name at least 4 symptoms of lung cancers?

A 
Cough
Fatigue
Weight loss
Dyspnoea
Haemoptysis
Chest pain
Chest infections
35
Q

What are 4 metastatic symptoms of lung cancer?

A

Bone pain
Spinal cord compression
Cerebral metastases
Thrombosis

36
Q

Name 3 paraneoplastic symptoms of lung cancer?

A

Anaemia
Hypercalcaemia
Dermatomyositis

37
Q

Name at least 3 signs of lung cancer you may find on investigation?

A 
Finger clubbing
Lymphadenopathy
Hepatomegally
Skin nodules
Pleural effusion
38
Q

What are the 3 main treatment options for lung cancer?

A

Surgery
Radiotherapy
Chemotherapy

39
Q

What is the main function of chemotherapy?

A

To downstage a tumour to make it operable

40
Q

What use does MRI have for lung cancer?

A

Determines degree of vascular and neurological involvement in Pancoast tumour

41
Q

What use does a Bone Scan have for lung cancer?

A

Indicates chest wall invasion and bony metastases

42
Q

What use does ECHO have for lung cancer?

A

Demonstrates presence or absence of pericardial effusion

43
Q

What are 4 consequences of lung cancer surgery that can lead to peri-operative death?

A

MI
Pulmonary thromboembolism
Pneumothorax
Intrathoracic bleeding

44
Q

What are 4 consequences of lung cancer surgery that don’t to peri-operative death?

A

Arterial fibrillation
Empyema
Wound infection
Constipation

45
Q 
What do the following mean in the ECOG performance status:
A:0
B:1
C:2
D:3
E:4
A

0 - asymptomatic; well
1 - symptomatic; able to do light work
2 - has to rest for less than half the day
3 - has to rest for more than half the day
4 - bedbound

46
Q

What does stage IV NSCLC mean?

A

Distant metastases

47
Q

What is clinically significant about stage IV NSCLC?

A

It is incurable and requires pallation

48
Q

What targeted drugs are used for adenocarcinoma with driver mutation:
A - EGFR
B - ALK

A

EGFR - erlotinib

ALK - certinib

49
Q

What is second line treatment for adenocarcinoma with progression?

A

Docetaxel + erlotinib

50
Q

What is the main treatment for SCLC (small cell)?

A

Chemotherapy

51
Q

What is the drug treatment for SCLC?

A

Cisplatin + etoposide

Jamie Respiration Pathology (15 decks)

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