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Respiratory Diseases > Lung Cancer > Flashcards

Lung Cancer Flashcards

1
Q

Symptoms of lung cancer

A 
chronic cough
Breathless
Wheeze
Stridor
Haemoptysis (50%)
Dysphagia
Hoarse voice
Chest pain
Bone pain
Neurology
Anorexia
Weight loss
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2
Q

Signs of lung cancer

A

Anorexia / weight loss
Clubbing
Tachypnoea
Signs of collapse / consolidation / effusion (fluid on lungs, outpouring of fluid)
Lymphadenopathy (inflammation of lymph nodes)
SVC obstruction
Horner’s syndrome (constricted pupil, drooping eyelid)
Signs from metastatic spread eg Neurological / bone pain etc

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3
Q

What tissue is affected?

A

all lung tissue, particularly bronchi

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4
Q

What are the two types of lung cancer?

A

Small cell

Non-small cell (NSCLC)

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5
Q

Which group most commonly has lung cancer?

A

Men > 65

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6
Q

What is Horner’s syndrome?

A 
interruption of sympathetic nerve supply
Miosis (constricted pupil)
Partial Ptosis (drooping)
Anhidrosis (loss of hemifacial sweating)
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7
Q

Why does lung cancer cause Horner’s syndrome?

A

Tumours at the top of the lung (Pancoast tumours) press on brachial nerve plexus, sympathetic supply to the eye (like Burke in Gray’s except he doesn’t have Horner’s syndrome)

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8
Q

What is clubbing?

A

tissue at base of male is thickened
no angle between nail bed and fold
no space between nails

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9
Q

What is Lambert-Eaton myastheniac syndrome and why is it caused by lung cancer?

A

immune condition of muscle weakness of the limbs

caused by auto-antibodies fighting the cancer

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10
Q

What is hypercalcaemia and how does lung cancer cause it?

A

High blood calcium

cancer causes elevated parathyroid hormone, which causes bone to release calcium

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11
Q

What are Pancoast tumours?

A

Tumours at the top of the lung - can press on brachial plexus and cause Horner’s syndrome

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12
Q

What is syndrome of inappropriate antidiuretic hormone production (SIADH)?

A

Too much ADH in the blood, which leads to water retention, electrolyte imbalances and a low level of sodium in the blood

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13
Q

What investigations would be done for suspected lung cancer?

A 
CXR
CT/PET (positron emission tomography)
Bronchoscopy
Percutaneous fine needle aspiration/biopsy
Mediastinoscopy
Endobronchial ultrasound (EBUS)
Bone scan/head CT
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14
Q

What is a PET scan?

A

Similar to C - system detects gama rays emitted by a tracer (radioactive glucose) to indicate metabolic activity of tissue.
Cancer tissue is metabolically active so takes up glucose and shows up as active

also shows lymphatics

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15
Q

Where do most lung cancers arise?

A

Large bronchi

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16
Q

Can most tumours be seen/biopsied on a bronchoscopy?

A

yes

17
Q

What is the treatment for small cell cancer?

A

chemo

radiotherapy

18
Q

What is the treatment for non-small cell cancer

A

surgery (lobectomy, pneumonectomy)
radiotherapy
chemo maybe

19
Q

What is EGFR-TK mutation testing?

A

tests for epidermal growth factor receptor in those with advanced/metastatic non-small cell lung cancer

genetic mutations are known to play roles in the progression to metastatic disease, and can affect the response of tumours to chemo

20
Q

Why does lung cancer have low survival outcome?

A

2/3 of patients diagnosed at late stage

21
Q

Other than smoking, what can cause lung cancer?

A 
asbestos exposure
radioactive minerals
radon gas
arsenic, nickel, pyrene
family history
22
Q

What does aetiology mean?

A

causes

23
Q

What are paraneoplastic syndromes?

A

rare disorders that are triggered by an altered immune system response to cancer/a growth

24
Q

Name some common sites of lung cancer metastasis?

A 
brain
bone
adrenal glands
other lung
liver
pericardium
kidney
25
Q

What is a pleural effusion?

A

Liquid in the pleural cavity

26
Q

What is the difference between transudate and exudate pleural effusion?

A

Transudate is fluid pushed through the capillary due to high pressure within the capillary.

Exudate is fluid that leaks around the cells of the capillaries caused by inflammation

27
Q

What is exudate pleural effusion >30g/l a sign of?

A

Malignancy

infection

28
Q

What is transudate pleural effusion <30 g/l a sign of?

A

heart failure

nephrotic syndrome

29
Q

What is empyema?

A

Pus in pleural cavity

30
Q

Define hydropneumothorax

A

both air and fluid in pleural space

31
Q

Define haemothorax

A

Blood in pleural space

32
Q

Define chylothorax

A

lymph in pleural cavity

33
Q

Why is a dock worker likely to get a pleural effusion?

A

asbestos
–> mesothelioma (cancer the pleura)
and pleural plaques

34
Q

What % of people will be unaware of symptoms at diagnosis?

A

10%

Respiratory Diseases (10 decks)

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