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Cardioresp > Lung Cancer > Flashcards

Lung Cancer Flashcards

1
Q

Types of lung cancer?

A

Small cell

Non-small cell - squamous, adeno, large cell

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2
Q

What is the most common type of lung cancer?

A

Squamous currently, but adeno increasing

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3
Q

Squamous cell carcinoma?

A

Epithelial cells associated with keratin production
Occasionally cavitate with central necrosis
Obstructing lesions with post-obstructive infection
Local spread, rarely metastasise

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4
Q

Adenocarcinoma?

A

Originates from mucus secreting glandular cells
Most common type in non-smokers
Peripheral lesions
Mets common

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5
Q

Large cell carcinoma?

A

Poorly differentiated

Mets early

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6
Q

Small cell carcinoma?

A

Arises from neuroendocrine cells
Secretes hormones
Arises centrally
Metastasise early

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7
Q

Presenting symptoms?

A 
Cough
Breathlessness
Haemoptysis
Wheeze + stridor
Weight loss
Fever
Clubbing
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8
Q

What is a pancoast tumour?

A

Apical lung tumour - often non-small cell

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9
Q

How do pancoast tumours present?

A

Hoarseness
Horner’s syndrome
Thoracic outlet syndrome
Bovine cough

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10
Q

What is Horner’s syndrome?

A

Damage to sympathetic trunk - mitosis, partial ptosis, anhydrosis and enophthalmos on ipsilateral side

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11
Q

Mitosis? Why?

A

Constricted pupil

Loss of sympathetic drive of iris dilator muscle

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12
Q

Ptosis? Why?

A

Weak, droopy eyelid

Loss of sympathetic control of Muller muscle that elevated eyelid

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13
Q

Anhydrosis? Why?

A

Decreased sweating

Impingement of sweat gland fibres from cervical sympathetic ganglion

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14
Q

Enophthalmos?

A

Inset eyeball

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15
Q

Thoracic outlet syndrome?

A

Compression of brachial plexus - pain and weakness of muscles of the arm and hand

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16
Q

Superior vena cava syndrome?

A 
Small-cell lung cancer
Obstruction of SVC by tumour
Facial + upper limb oedema
Headache
Dyspnoea
Stridor
Swollen collaterals on chest wall
Pemberton's sign
17
Q

What is pemberton’s sign?

A

Demonstrate presence of latent pressure in thoracic inlet - elevate both arms to side of face - +ve sign is marked by the presence of facial congestion and cyanosis

18
Q

Other symptoms of lung cancer?

A

Pericardial effusion
Pleural effusion
Dysphagia

19
Q

Para-neoplastic syndromes?

A

Ectopic Cushing’s
SIADH
Hypercalcemia
Hypertrophic osteoarthropathy

20
Q

Ectopic Cushing’s?

A 
ACTH secretion
Weight gain
Hypertension
Hypokalemia
Muscle weakness
Small cell lung cancer
21
Q

SIADH?

A

ADH secretion
Euvolmic hyponatremia
Headache, weakness, altered mental state, seizures, respiratory depression
Small cell lung cancer

22
Q

Why hypercalcemia in some lung cancers?

A

Increased PTHrP - increased bone resorption and renal calcium absorption - hypercalcemia
Squamous cell carcinoma

23
Q

Symptoms of hypercalcemia?

A 
Abdominal pain
Bone pain
Confusion
Depression
Weakness
Kidney stones
Abnormal heart rhythm
24
Q

Hypertrophic osteoarthropathy?

A

Periosteal proliferation of tubular bones
Painful symmetrical arthritis of ankles, knees, wrists and elbows
Clubbing
Adenocarcinoma

25
Q

What is Lambert-Eaton myasthenic syndrome?

A

Autoantibodies against the presynaptic voltage-gated calcium channels
Muscle weakness of limbs
Small-cell lung cancer

26
Q

Investigations for suspected lung cancer?

A 
Bloods
CXR
Contrast CT
PET scan
Bronchoscopy
Neck ultrasound
LFTs
Cytology
27
Q

NSCLC treatment?

A

Surgery (I, II)
Radiotherapy (I - III)
Chemotherapy (III, IV)

28
Q

SCLC treatment?

A

Chemotherapy

29
Q

TNM staging NSCLC?

A

T1 <3cm
T2 <7cm
T3 >7cm with invasion
T4 invasion of mediastinum, vessels, trachea

N1 - ipsilateral hilar nodes
N2 - ipsilateral mediastinal/subcarinal nodes
N3 - contralateral nodes

M1 - metastases

30
Q

Paraneoplastic features of small cell?

A

ADH
ACTH
Lambert-Eaton syndrome

31
Q

Paraneoplastic features squamous cell?

A

Parathyroid related protein
Hyperthyroidism
Hypertrophic pulmonary osteoarthropathy

32
Q

Paraneoplastic features of adenocarcinoma?

A

Gynaecomastia

Hypertrophic pulmonary osteoarthropathy

33
Q

What is Lambert-Eaton syndrome?

A

Weakness in the muscles of proximal arms and legs
Legs are worse
Improves with muscle use

Cardioresp (8 decks)

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