Lung cancer

Question 1

Primary lung cancer that has the most favourable prognosis

Answer 1

Carcinoid

Question 2

Factor that has the greatest impact on prognosis in non small cell lung cancer (NSCLC

Answer 2

Staging of cancer at presentation

Question 3

TOC for non resectable NSCLC

Answer 3

Chemotherapy -cisplatin and venorelbine +RT

Question 4

Which cancer types can be trialled on erlotinib

Answer 4

colorectal, head, neck and lung cancer

Question 5

MOA of erlotinib

Answer 5

EGFR Tyrosine kinase inhibitor

S/E : Can cause interstitial pneumonitis

Question 6

Factors conferring good response to erlotinib

Answer 6

1) EGFR mutation
2) Wild type K-ras
3) EGFR polysomy >4 copies

Patient characteritics for good response: Asian, female, never-smoker, adenocarcinoma

Question 7

Types of lung cancer is most associated with cavitating lesions

Answer 7

squamous cell cancer

Question 8

Paraneoplastic feature least commonly seen in patients with squamous cell lung cancer

Answer 8

Lambert Eaton Syndrome
Squamous cell: PTHrp, clubbing, HPOA,hyperthyroidism due to ectopic TSH
Small cell: ADH, ACTH, Lambert-Eaton syndrome
Adenocarcinoma: gynaecomastia

Question 9

Cancers responsive to erlotinib

Answer 9

Lung
Head and neck
Colorectal

Question 10

Contraindications for surgery in NSCLC

Answer 10

FEV1<1.5
Vocal cord paralysis
Tumour near hilum
SVC obstruction
Mailgnant pleural effusion

Question 11

Most common fungal infection post lung transplant

Answer 11

Candida

Question 12

Lung cancer most likely to cause elevated neuron specific enolase in blood

Answer 12

Small cell lung cancer -found in 75%