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Respiratory > Lung Cancer > Flashcards

Lung Cancer Flashcards

1
Q

Lung cancer normally occurs in what age group?

A

> 75 years

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2
Q

What is the biggest risk factor for the development of lung cancer?

A

Smoking

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3
Q

Lung cancer has a good prognosis. T/F?

A

False

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4
Q

What types of lung cancer is smoking particularly associated with?

A

Squamous and small cell lung cancer

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5
Q

Stopping smoking reduces the risk of lung lung cancer. T/F?

A

True - but this takes time

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6
Q

Other than smoking, what are the risk factors for lung cancer?

A 
Environmental tobacco smoke
Ionising radiation such as radon or uranium
Air pollution
Asbestos
Other fibrosing conditions of the lung
HPV
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7
Q

What are the signs and symptoms of lung cancer?

A 
Cough
Haemoptysis
Shortness of breath
Chest pain
Weight loss/anorexia
General malaise
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8
Q

What can result from thoracic duct involvement in lung cancer?

A

Chylothorax

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9
Q

What can result from pericardial involvement in lung cancer?

A

Pericarditis

Effusion

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10
Q

What can result from recurrent laryngeal nerve involvement in lung cancer?

A

Hoarseness

Vocal cord paralysis

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11
Q

What can result from eosophageal involvement in lung cancer?

A

Compression dysphagia
Pneumonia
Tracheoesopahgeal fistula

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12
Q

What can result from mediastinal involvement in lung cancer?

A

Superior vena cava obstruction - oedema of face and arms, raised JVP, plethoric face
Recurrent laryngeal nerve compression
Phrenic nerve compression resulting in hemidiaphragm paralysis

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13
Q

Where do lung cancer spread to via haematogenous spread?

A

Liver
Bone
Brain
Adrenal glands

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14
Q

What are the non-metastatic effects of lung cancer?

A 
Emotional disturbance
Enlarged sella turcica
Moon faces
Osteoporosis
Cardiac hypertrophy
Buffalo hump
Obesity
Adrenal tumour or hyperplasia
Thin, wrinkled skin
Abdominal striae
Muscle weakness
Purpura
Skin ulcers
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15
Q

Small cell cancers are usually advanced at diagnosis and respond to chemotherapy. T/F?

A

True

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16
Q

Non-small cell cancers may be localised at diagnosis and can be treated by surgery or radiotherapy. T/F?

A

True

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17
Q

What cancers are encompassed by non-small cell lung carcinoma?

A

Adenocarcinoma
Squamous cell. carcinoma
Large cell carcinoma
Other lung cancers

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18
Q

Other than small or non-small cell, what are the other lung cancers?

A 
Tumours of mesenchymal tissues
Salivary gland type tumours
Tumours of ectopic origin
Tumours of neuroendocrine cells
Tumours of lymphatic system
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19
Q

Why has there been a recent rise in adenocarcinoma and small cell carcinoma with a fall in squamous carcinoma?

A

Changes in smoking habits

Composition of cigarettes

20
Q

What type of cancers are central lung tumours usually?

A

Squamous or small cell carcinomas

21
Q

What type of tumours are peripheral lung tumours usually?

A

Adenocarcinomas

22
Q

What is the most aggressive form of lung cancer?

A

Small cell carcinoma

23
Q

What histological changes occur in small cell carcinoma?

A

Oval to spindle shaped cells
Inconscpicuous nucleoli
Scant cytoplasm
Show nuclear moulding

24
Q

What type of cancer commonly results from squamous metaplasia in the lungs?

A

Squamous cell carcinoma

25
Q

Squamous cell carcinoma is slow growing and often metastasise late. Therefore how can it be treated?

A

Surgically

26
Q

What is the histological appearance of squamous cell. carcinomas in the lung?

A

Malignant epithelial tumour showing keratinisation and/or intracellular bridges

27
Q

Adenocarcinomas of the lung are more common in which gender?

A

Women

28
Q

The majority of adenocarcinomas arise in the centre of the lung. T/F?

A

False- 2/3 of adenocarcinomas arise in the periphery of the lung

29
Q

Large cell carcinoma of the lung is a diagnosis of exclusion. T/F?

A

True

30
Q

What is a carcinoid tumour of the lungs?

A

A tumour of the neuroendocrine cells

31
Q

How can lung cancer patients with an ECFR receptor mutation be treated?

A

Tyrosine kinase inhibitor

32
Q

How can lung cancer patients with an EML4-ALK gene mutation be treated?

A

ALK-inhibitor

33
Q

How can lung cancer patients with PD-1 over expression be treated?

A

PD-1 inhibitors

34
Q

Metastases are the most common tumours found in the lung. T/F?

A

True

35
Q

Other than the pleura, where can a mesothelioma occur?

A

Peritoneum
Pericardium
Tunica vaginalis testis

36
Q

Mesothelioma is almost always caused by exposure to…?

A

Asbestos

37
Q

What are the two possible appearance of a mesothelioma histologically?

A

Epithelial
Sarcomatous
Combination

38
Q

What CXR changes might be seen in lung cancer?

A 
Mass lesion
Lobar or lung collpase
Mediatinal widening or hilar lymph node
pleural effusion
Slowly resolving consolidation
39
Q

What investigations might be conducted to assess a patient’s fitness to undergo surgical resection of a lung tumour?

A

Spirometry
ECG
Echocardiogram

40
Q

Give an example of an EGFR inhibitor used in the treatment of lung cancers with EGFR mutations?

A

Erlotinib

41
Q

Give an example of an ALK inhibitor used in the treatment of lung cancers with ALK mutations?

A

Crizotinib

42
Q

Give two examples of emergencies associated with lung cancer.

A

Superior vena cava obstruction

Spinal cord compression

43
Q

What are the symptoms of superior vena cava obstruction?

A

Breathlessness
Dysphagia
Stridor
Swollen oedematous face and right arm

44
Q

How is superior vena cava obstruction due to a lung cancer treated?

A

High dose steroids
Vascular stents
Anti-coagulation
Radiotherapy/chemotherapy

45
Q

What are the signs and symptoms of spinal cord compression (which may be a result of lung cancer)?

A

Leg weakness and numbness
Reduce bladder and bowel control
Upper motor neurone signs in legs

46
Q

How is spinal cord compression as a result of lung cancer treated?

A

High dose steroids

Urgent oncology input (radiotherapy) and/or neurosurgical input

Respiratory (10 decks)

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