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RESPIRATORY > Lung Cancer > Flashcards

Lung Cancer Flashcards

1
Q

what is lung cancer

A

malignant growth, uncontrolled replication, pleural neoplasm

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2
Q

what is mesothelioma

A

primary malignant neoplasm

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3
Q

what are the 4 main types of lung cancer (smoking associated)

A

adenocarcinoma
squamous carcinoma (kertiinisign)
small cell
large cell

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4
Q

what is the most common type of lung cancer in non-smokers and overall most common

A

adenocarcinoma

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5
Q

what is adenocarcinoma lung cancer

A

cancer of mucus-secreting glands

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6
Q

what is a peripheral adenocarcinoma

A
  • Atypical adenomatous hyperplasia
  • Neoplastic cell spread along alveolar walls (bronchioloalveolar carcinoma)
  • True invasive
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7
Q

in adenocarcinoma is metastases common

A

yes

to lymph nodes, pleura, brain, bones, adrenals

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8
Q

what is squamous carcinoma

A
  • From epithelial cells associated with keratin production

- causes obrsuting lesion s of bronchus with post-obstructive infection

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9
Q

how does metastases differ in adenocarcinoma to squamous carcinoma

A

in adenocarcinoma metastases common in squamous carcinoma spread is local then metastases occurs late on

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10
Q

cavities with central necrosis is an example of

A

squamous carcinoma

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11
Q

what is small cell lung cancer

A

from neuroendocrine cells (APUD)

- often secrete polypeptide hormones

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12
Q

a central tumour that has early metastases is likely to be what type of cancer

A

small cell

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13
Q

a poorly differentiated lung cancer that metastases early is likely to be

A

large cell

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14
Q

what is a neuroendocrine tumour with low grade malignancy

A

carcinoid

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15
Q

what is the tumour in salivary glands

A

bronchial gland tumour

eg. adenoid cystic carcinoma, mucoepidermoid carcinoma

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16
Q

2 types of large cell lung cancer

A

large cell neuroendocrine

large cell carcinoma

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17
Q

what percentage of smokers die of lung cancer

A

20%

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18
Q

what people are at highest risk of lung cancer

A

smokers/ex-smokers
- chronic bronchitis
passive smokers

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19
Q

TB is a risk factor of lung cancer - True or False

A

FALSE

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20
Q

what are the risk factors of lung cancer

A

asbestos, nickel, chromates, radiation, pollution, genetics, HIV, (interstitial) pulmonary fibrosis, bronchioalveolar adenoma, lipoid pneumonia, previous lung cancer

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21
Q

what is synchronous lung cancer

A

tumours occurring at same time

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22
Q

what is metachonous lung cancer

A

one tumour after another

23
Q

how does a pancoast tumour present

A

apex of lung
invades brachial plexus
C8/T1 palsy
nerve compression

24
Q

in severe cases what can a pan coast tumour cause

A

Horner’s syndrome

25
Q

what is horners syndrome and what are the features

A

compression of sympathetic chain

miosis, ptosis, anhidrosis

26
Q

muscle wasting in hand, weakness and pain down the arm can be a sign of

A

pan coast tumour

27
Q

what local invasion can occur as a result of lung cancer

A 
recurrent laryngeal nerve
pericardium
brachial plexus
oesophagus
pleural cavity
28
Q

what do patients with local invasion of the pericardium present with

A 
malignant dysrhythmia
breathlessness 
atrial fibrillation
pericardial effusion
phrenic nerce damage
29
Q

what does invasion of recurrent laryngeal nerve cause

A

coarse voice as vocal cords paralysed

30
Q

what is the presentation of tracheal tumours

A

progressive dyspnea
stridor
flow volume curve: dramatic reduction in inspiratory flow

31
Q

a patent presents with wasting hand muscles and T1 root infiltration where has he tumour invaded

A

brachial plexus

32
Q

a patient presents with dysphagia, cannot swallow meat/bread and is losing weight were might have the tumour invaded

A

oesophagus

33
Q

what is the result of a tumour invading the pleural cavity

A

pleural effusion

breathlessness (obstruction) by central tumours occulting large airways

34
Q

a patient presents with puffy eyelids, distention of superficial veins over neck and chest and normal pulsation loss what has the primary tumour invaded

A

superior vena cava, obstructive drainage of blood from head and neck

35
Q

if a primary tumour obstructs the airways what disease can arise

A

pneumonia

36
Q

a patient presents with sharp pleuritic pain where has the tumour invaded

A

peripheral tumours invade wall or pleura which are well innervated

37
Q

what is the sign of large volume mediastinal node disease

A

dull central chest ache

38
Q

what does tumour invasion of the phrenic nerve cause

A

paralysis of ipsilateral hemidigphragm

39
Q

where can secondary lung cancer metastasise to

A

mediastinal, cerical, axillary, intra-abdominal nodes
blood
serous cavities

40
Q

what does primary lung cancer in the liver present as

A

obstructive jaundice
weigh loss
nausea
right upper quadrant pain radiating across abdomen (liver capsular pain)

41
Q

how do cerebral metastases present

A

insidious onset

  • weakness (like stoke)
  • visual disturbance
  • headache (worse in morning, generalised, not photophobic, rinsed intracranial pressure)
  • seizures
  • cranial nerve defects
  • meningitis (uncommon)
42
Q

where does lung cancer commonly metastasise to

A

adrenals
asymptomatic
must be scanned

43
Q

how does cancer present in bone

A

localised pain, worse at night
pathological fracture
spine compressed (URGENT)

44
Q

what are the symptoms of lung cancer

A 
haemoptysis
stridor 
recurrent pneumonia in same part of lung
long standing chest infection
weight loss 
chest/shoulder pain
fatigue
horse voice
>3 week cough
breathlessness
finger clubbing
45
Q

what is stridor

A

wheeze on inspiration (partial obstruction of airways by tumour)
difficulty breathing in

46
Q

why do some lung cancer patients have a horse voice

A

mediastinal nodal/direct tumour invasion of mediastinum

compression of left recurrent laryngeal nerve

47
Q

what do smokers with lung cancer present with

A

no longer coughing up clear sputum
distortion of normal bronchial mucosa by tumour
cannot bring up sputum anymore

48
Q

what are the non-metastatic extra pulmonary manifestations of lung cancer

A

normocytic anaemia
paraneoplastic features
tumour cells that mimic effects of naturally occurring hormones

49
Q

what type of cancer do patients have if they present with hypercalcaemia (high calcium)

A

squamous cells cancer

tumour produces proteins miminicing effects of parathyroid hormone so parathyroid hormone switched on to produce calcium

50
Q

what do patients with hyercalcaemia present with

A 
headache, thirst, constipation
stones 
bones 
gorans
thrones 
psychiatric overtones
cardiac arrhythmias
51
Q

what ectopic hormone production occurs in cancer

A

PTH - squamous cell
ACTH - small cell
paraneoplastic syndromes
caused by small cell tumours

52
Q

what is HPOA

A

hypertrophic pulmonary osteoarthropathy

  • bone abnormality
  • periosteum lifts off and enlarges
  • pain down legs and shins
53
Q

what is hyponatraemic - SIADH

A 
production of a substance mimicking ADH (anti diuretic hormone)
causes water retention
low sodium concentration (<120)
nausea
myclonus
lethargy
seizures

RESPIRATORY (12 decks)

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