lung cancer

Question 1

non-small cell lung cancer - types

Answer 1

squamous cell cancer
adenocarcinoma
large cell carcinoma

Question 2

squamous cell lung cancer - features

Answer 2

sCCCuamous:
Clubbing
Central tumour
Calcaemia (PTH-rP secretion)

hypertrophic pulmonary osteoarthropathy (HPOA)

Question 3

which is the commonest type of lung cancer in non-smokers?

Answer 3

adenocarcinoma - adeno why i have lung ca when i never smoked!!

Question 4

Adenocarcinoma of the lung - where is the lesion? who does it affect?

Answer 4

typically peripheral
commonest type of lung ca in non-smokers, tho most who develop it are smokers

A = periphery of alphabet = peripheral

Question 5

Large cell lung carcinoma

Answer 5

typically peripheral
anaplastic, poorly differentiated, poor prognosis
may secrete β-hCG

large = bad = poor prognosis

Question 6

management of hiccups in palliative care

Answer 6

chlorpromazine or haloperidol

Question 7

what is lambert-eaton syndrome? when seen? features?

Answer 7

paraneoplastic syndrome, common in scLC : antibodies formed against Ca channels in NMJ

weakness of proximal limb muscles that’s relieved by exertion (ie opposite of MG)

Question 8

small cell lung cancer - features? assoc paraneoplastic syndromes?

Answer 8

usually central
ectopic ADH + ACTH secretion
ADH → hyponatraemia
ACTH → cushing’s + bilateral adrenal hyperplasia

high cortisol → hypokalaemic alkalosis
lambert-eaton syndrome

Question 9

small-cell lung cancer - management

Answer 9

usually mets at dx
v early - surgery
most - chemo + radio
extensive - palliative chemo

Question 10

what does it mean when high dose dex doesn’t suppress cortisol?

Answer 10

ectopic source of ACTH

in cushing’s disease (pituitary tumour), cortisol should be suppressed by hi dose dex

Question 11

how does ectopic ACTH secretion present in scLC?

Answer 11

HTN + hypokalaemia
oedema + muscle weakness
cushings