Lung Cancer Flashcards

1
Q

What is the difference between a primary and secondary pleural malignancy?

A

Mesothelioma

Metastases

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2
Q

What is mesothelioma?

A

Cancer of pleural lining due to asbestos exposure gradually developing over 30-40 years

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3
Q

How do you diagnose mesothelioma?

A

Thoracoscopy (biopsy) —> Histology - BLOODY PLEURAL FLUID

CXR/CT - PLEURAL THICKENING

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4
Q

What are the common signs of mesothelioma?

A
Sweating
SOB
Reccurent pleural effusions
Chest pain
Weight loss
Fever
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5
Q

Treatment options for mesothelioma…

A

Palliative care, chemo, and rarely radiotherapy/surgery

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6
Q

The prevalence of lung cancer is low. True/False?

A

True Incidence is high, but patients do not live for very long

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7
Q

List some risk factors for lung cancer…

A
Smoking
Atmospheric pollution
Nickel
Asbestos
Genetics
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8
Q

List some signs for lung cancer…

A

Pneumonia, chest pain, haemoptysis, weight loss

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9
Q

What does ectopic production of PTH suggest?

A

Squamous cell cancer

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10
Q

What does ectopic production of ACTH suggest?

A

Small cell cancer

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11
Q

What symptom arises due to damage of the recurrent laryngeal nerve?

A

Hoarse voice

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12
Q

Pancoast tumours typically affect which part(s) of the lung? What does it manifest as?

A

Apex
Invasion of cervical sympathetic chain —>
Horners syndrome - unilateral ptosis, small pupil, anhydrosis

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13
Q

Name the 4 types of lung tumour classifications in order of severity and give their main effect

A

Small cell carcinoma : —> ADH (HYPONATRAEMIA)
Large cell carcinoma : —> GYNAECOMASTIA
Squamous cell carcinoma —> HYPERCALCAEMIA (increased PT gland)
Adenocarcinoma —> BLUE MUCIN, HYPERTROPHIC PULMONARY OSTEOARTHROPATHY/ FINGER CLUBBING

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14
Q

Are adenocarcinomas most assocated with smoking or non-smoking?

A

Non-smoking - smokers typically have squamous carcinomas

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15
Q

Common sites of lung cancer metastases (5)

A

Liver Brain Bone Adrenals Skin

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16
Q

Which LFT is particularly abnormal in liver metastasis?

A

Alkaline Phosphatase (ALP)

17
Q

How can hypercalcaemia arise? Signs?

A

Tumour produces a substance which mimics the effects of parathyroid hormone

Confusion (GROANS), constipation (MOANS), BONES, STONES, thirst

18
Q

Lung diseases causing clubbing (ABCDEF)

A
Abscess 
Bronchiectasis 
Cystic Fibrosis 
Don’t say COPD 
Empyema 
Fibrosis
19
Q

TTF-1 is expressed only in adenocarcinoma. True/False?

A

False Also in small cell carcinoma

20
Q

P63 is expressed in squamous cell carcinoma. True/False?

A

True

21
Q

Which type of lung cancer is responsive to chemotherapy?

A

Small cell carcinoma

22
Q

What is the treatment of choice for non-small cell carcinoma?

A

Surgery

23
Q

K-ras and EGFR mutations occur in which type of lung tumour?

A

Non-small cell cancer

24
Q

What characteristic of small cell carcinoma makes it susceptible to chemotherapy?

A

Rapid growth

25
Q

Surgery is only indicated if the disease is localised. True/False?

A

True

26
Q

What cells give rise to small cell carcinoma?

A

Neuroendocrine cells

27
Q

Which is the most common type of lung cancer?

A

Squamous cell carcinoma

28
Q

Who gets radical radiotherapy?

A

Early NSLC patients with adequate lung function but where surgery is not possible

29
Q

Describe the basic clinical picture for bronchial carcinoma…

A

Smoker
Haemoptysis
Abnormal CXR

30
Q

List some symptoms of bronchial carcinoma…(8)

A
Dyspnoea
Haemoptysis
Weight loss
Non productive cough (>3 wks)
Chest pain
Recurent/prolonged pneumonia
Lethargy
Inspiratory stridor
31
Q

List some signs of bronchial carcinoma…

A
Cachexia
Clubbing
Lymphadenopathy
Consolidation/ collapse/ pleural effusion
Hepatomegaly
32
Q

What are the diagnostic techniques for bronchial carcinoma?

A

CXR, CT, biopsy, FBC, coag screen, medical thoracoscopy

33
Q

What are the staging techniques for bronchial carcinoma?

A

Bronchoscopy, mediastinoscopy, CT brain, CT thorax, PET scan

34
Q

What are the two types of surgery for lung cancer?

A

Pneumonectomy - remove whole lung

Lobectomy - remove lobe

35
Q

Give methods of endobronchial therapy…

A

Tracheal stenting
Laser
Brachytherapy

36
Q

Give preventative methods for lung cancer…

A

Stop smoking

Prevent occupational exposure to carcinogens