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Medicine, Year 3, Cardiovascular and Respiratory Medicine > Lung Cancer > Flashcards

Lung Cancer Flashcards

1
Q

What are the two main groupings of Lung Cancer? What are the proportions of each in the UK? Can they be subdivided into further sub-types?

A 
Small Cell Lung Cancer (SCLC) - 15%
Non-Small Cell Lung Cancer (NSCLC) - 85%
1. Adenocarcinoma
2. Squamous cell
3. Large cell 
4. Carcinoid tumours
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2
Q

Which of the five types of cancers are peripherally, centrally located or found thoughout?

A

Centrally located: Small cell lung cancer, squamous cell lung cancer

Peripherally located: Adenocarcinoma

Thoughout: Carcinoid tumours, large cell carcinoma

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3
Q

What are common sites of metastasis in lung cancers?

A 
Mediastinum
Hilar lymph nodes
Lung pleura
Heart
Breasts
Liver
Brain
Adrenal Glands
Bone
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4
Q

What are some risk factors of Lung Cancer?

A
  • Smoking (dose dependent)
  • Radon exposure
  • Asbestos
  • Air pollution
  • Ionising radiation i.e. X-Ray, CTs
  • Genetics
  • Age
  • Natural background incidence
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5
Q

How many mutations are required to generate a malignant clone in lung cancer?

A

5

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6
Q

Give examples of genes commonly mutated in Lung Cancer

A 
KRAS
EGFR
ALK
BRAF
PIK3CA
HER2
ROS1
RET
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7
Q

What is the most common Non-small cell carcinoma?

A

Adenocarcinoma

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8
Q

Which type of lung cancer has gynaecomastia as a symptom?

A

Adenocarcinoma

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9
Q

What is the most common type of cancer in non smokers?

A

Adenocarcinoma

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10
Q

Which two cancers has the strongest associated with smoking?

A

Small cell
Squamous cell

(Both centrally located)

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11
Q

What is the best investigation for lung cancer when deciding upon treatment?

A

PET

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12
Q

How many times does smoking alone raise the chances of lung cancer?

A

10 fold

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13
Q

Small cell lung cancer develops from what cell type?

A

Immature endocrine cells

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14
Q

What 3 substances can Small Cell Lung Cancers typically produce to cause what symptoms / syndromes?

A
  • ACTH, causing a rise in Cortisol and thus Cushing’s syndrome. This leads to hyperglycaemia and HTN
  • ADH, causing a rise in water reabsorption. This leads to oedema, HTN and dark urine
  • Antibodies, causing Lambert Eaton syndrome. This leads to neuronal destruction
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15
Q

Centrally located tumours typically cause compression of what?

A

Superior Vena Cava (SVC) Obstruction

- Symptoms of facial swelling, headaches, upper limb oedema, venous distention in the neck

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16
Q

What cancers can cause SVC obstruction?

A

Small cell lung cancer

Squamous cell lung cancer

17
Q

Which cancer is involved in thyroid / parathyroid hormone release?

A

Squamous cell lung cancer

18
Q

Which cancer is involved in serotonin release?

A

Carcinoid tumours

19
Q

Which two cancers can cause Pancoast tumours? Where are they located? What are their effects?

A

Adenocarcinomas
Squamous cell lung cancer

Located in the apex of the lung. Can compress the thoracic inlet, brachial plexus and central sympathetic nerves (Horner’s Syndrome)

20
Q

Horner’s Syndrome is a triad of what three symptoms?

A

Miosis (pupil constriction)
Ptosis (eyelid drooping)
Anhidrosis (excessive sweating)

21
Q

What is the most common type of lung cancer?

A

Adenocarcinoma

22
Q

Describe Trosseau’s syndrome of malignancy (Paraneoplastic syndrome)

A

Palpable nodule caused by migratory thrombophlebitis

23
Q

Why are calcium levels raised in Squamous cell carcinoma?

A

Due to Parathyroid hormone-like hormone release (Paraneoplastic syndrome)

24
Q

What is the first imaging investigation performed in suspected lung cancer patients?

A

CXR

25
Q

What is the limitation to using CXR as first-line to diagnose lung cancer?

A

Can only detect lung cancers greater than 1 cm in size

26
Q

Why might a pneumonectomy instead of a lobectomy be performed in lung cancer patients?

A

When the cancer crosses the oblique fissure

27
Q

What is the classification system for NSCLC and SCLC?

A

NSCLC - TNM staging

SCLC - Limited vs Extensive

28
Q

What is the prognosis / treatment options for SCLC?

A

Almost always incurable by presentation

Hence surgical resection is not an option, however does respond to chemotherapy +/- radiotherapy

29
Q

What genetic mutation is associated with Mesothelioma? What proportion of patients with mesothelioma have it?

A

Chromosome 22 monosomy (40%)

30
Q

Aside from radiotherapy and chemotherapy, what other treatment options are there for SVC obstruction?

A

Stent placement

31
Q

What are the CXR and CT scan findings of a patient with mesothelioma?

A
  • Decreased chest cavity
  • Pleural thickening
  • Pleural effusion
32
Q

What are the Pleural fluid findings of a patient with mesothelioma?

A
  • High protein and normal LDH content

- WBC, RBC and malignant cells present

33
Q

What is the prognosis of mesothelioma?

A

Poor prognosis, 11 months survival

34
Q

Cannonball lung lesions are indicative of…

A

Lung metastasis

Most commonly caused by renal cell cancer, choriocarcinoma and prostate cancer

Medicine, Year 3, Cardiovascular and Respiratory Medicine (19 decks)

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