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Respiratory > Lung Cancer > Flashcards

Lung Cancer Flashcards

1
Q

What is the most common type of lung cancer?

A

Bronchial Carcinoma 90%

Adenocarcinoma
Squamous cell
Small cell
Large cell

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2
Q

What are features of adenocarcinoma?

A 
Central 
Frothy pink sputum 
Peripheral lesions 
Most common in non-smokers 
Often presents with Pleural effusion
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3
Q

What are features of Small cell carcinoma?

A

Presents late, high aggressive
Associated with smoking
Arises from endocrine cells - ECTOPIC ACTH production

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4
Q

What are features of squamous cell carcinoma?

A

Local spread common, mets late
Central or peripheral mass that can be cavitating
Production of PTH - hypercalcaemia

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5
Q

What are common sites of local spread of Lung Ca?

A

Axillary lymph nodes and Supraclavicular LN

Chest wall - BP damage

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6
Q

What are non-metastatic manifestations of bronchial carcinoma?

A

Inappropriate ADH secretion - Hyponatremia
Ectopic ACTH - Cushings
Hypercalcaima - Ectopic PTH

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7
Q

What is paraneoplastic syndrome?

A

Presentation resulting from tumour secretion of hormones, peptides or cytokines.

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8
Q

What are neurological presentations of paraneoplastic syndrome?

A

Lambert Eaton - autoimmune distruction of Neuromuscular junction. Improves with use

Polyneuropathy

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9
Q

What is the presentation of lung cancer?

A 
Cough - particularly change in character of smokers cough 
Weightloss 
Haemoptysis 
Malaise 
Chest pain 
Clubbing
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10
Q

What is the 2WW cancer referral criteria?

A

> 40 with unexplained Haemoptysis OR CXR with findings suggestive of Ca

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11
Q

What is the 2WW referral criteria for urgent CXR?

A

> 40 with 1 (if Hx smoking) or 2 (no smoking Hx) of WL, Fatigue, Chest pain, SOB or cough

> 40 with chest signs, persistent chest infection or thrombocytosis

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12
Q

What CXR findings would be suggestive of Lung Ca?

A 
Symptomatic tumours tend to be visible on CXR 
Hilar enlargement 
Lung collapse 
Pleural effusion 
Consolidation
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13
Q

Other than CXR what Ix would you want to do?

A

FBC - Anaemia? Infection?
U&E - Na+?
Bone profile - ? Ca2+

CT - Staging
Bronchoscopy with Fine needle aspiration OR percutaneous biopsy

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14
Q

What is the management of a non-small cell carcinoma?

A

Lobectomy and radiotherapy for stages 1,2,3,

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15
Q

What is the management of small cell carcinoma?

A

For patients with limited disease = Chemotherapy. 90% response. Palliative as presents late and often mets at presentation

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16
Q

What are common sites of metastasis?

A

Liver
Bone
Adrenal gland
Brain

17
Q

What cancers commonly met TO lung?

A 
Breast 
GI 
Prostate 
Kidney 
Melanoma
18
Q

Which form of lung cancer is most common in non-smokers?

A

Adenocarcinoma

19
Q

What is mesothelioma?

A

Aggressive Tumour of mesothelial cells of the lung pleura. Related to asbestos exposure

20
Q

What are typical CXR findings for mesothelioma?

A

Pleural effusion
Lobulated or nodular pleural thickening
Pleural mass

21
Q

What is the management of mesothelioma?

A

Symptomatic - cure only possible with very localised mesothelioma.

Poor prognosis around 1 year

22
Q

What is the presentation of local invasion of the sympathetic ganglion and which type of tumour is associated with this presentation?

A 
Pancoast Tumours - apex 
Horners syndrome - E MAP
Enopthalmous
Miosis 
Anhydrosis 
Ptosis
23
Q

Why may Lung Ca present with voice hoarseness?

A

Invasion of the recurrent laryngeal nerve

24
Q

Which subtype is most commonly associated with lambert eaton syndrome?

A

Small cell lung cancer

25
Q

Within the lung where are adenocarcinomas located and where do they most commonly metastasis too?

A

Peripheral

Bone

26
Q

Where do squamous cell carcinomas metastasis too and where are they located within the lung?

A

Centrally located

Locally invasive

27
Q

What is superior vena cava outlet obstruction and how does it present?

A

Acute onset
Dyspnoea
Neck and face plethora
Neck vein distension

28
Q

What sign would be positive in superior vena cava outlet obstruction?

A

Pemberton Sign - raising hands above your head produces facial congestion, cyanosis and transient respiratory distress

29
Q

What are surgery CI>

A

Disseminated disease
SVCO
FEV1 <1.5L
Vocal cord paralysis

Respiratory (7 decks)

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