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Respiratory System > Lung Cancer > Flashcards

Lung Cancer Flashcards

1
Q

Symptoms of Lung Cancer

A
  • Prolonged cough & haemoptysis.
  • Dyspnoea (SOB)
  • Recurrent Chest infections/pneumonia.
  • Weight loss.
  • Chest/Shoulder pain.
  • Fatigue.
  • Hoarseness.
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2
Q

Bronchial Carcinoma: Local Invasion

A

Recurrent laryngeal nerve, pericardium, oesophagus, brachial plexus, pleural cavity, superior vena cava.

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3
Q

Symptom associated with local invasion of recurrent laryngeal nerve

A

Hoarse voice

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4
Q

Symptoms associated with local invasion of pericardium

A

Dyspnoea, Atrial fibrillation & pericardial effusion.

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5
Q

Symptom associated with local invasion of oesophagus

A

Dysphagia

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6
Q

Symptom associated with local invasion of brachial plexus

A

Pancoast tumour.

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7
Q

Common sites for metastases

A

Liver, Brain, Bone, Adrenal, Skin, Lung

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8
Q

Symptoms of Cerebral metastases

A

Visual disturbances, weakness, headaches (worse in morning, not photophobic), fit.s.

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9
Q

Symptoms of Paraneoplastic syndrome

A
  • Finger clubbing
  • Weight loss
  • Weakness
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10
Q

Symptoms of Hypercalcaemia

A
  • Renal/Biliaru Calculi.
  • Bone pain.
  • Abdominal pain.
  • Constipation.
  • N&V.
  • Polyuria.
  • Depression, anxiety, reduced GCS, Coma.
  • Cardiac arrhythmias.
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11
Q

Treatment of Hypercalcaemia

A
  1. Rehydration.
  2. IV biphosphonate.

Treat underlying cancer.

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12
Q

Paraneoplastic Syndrome: associated conditions

A
  • Hypertrophic Pulmonary Osteroarthopathy (HPOA)
  • Thrombophlebitis.
  • Hypercalcaemia.
  • Hypernatraemia (SIADH).
  • Eaton Lambert Syndrome.
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13
Q

Symptoms of (SIADH)

A
  • Nausea/vomiting
  • Myoclonus
  • Lethargy/confusion
  • Seizures/coma
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14
Q

Treatment of SIADH

A
  1. Fluid restriction - 1.5L/day.
  2. Demeclocycline.

Treat underlying cause.

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15
Q

Signs of Lung Cancer

A
  • Finger Clubbing
  • Bloated Face
  • Lymphadenopathy
  • Tracheal deviation
  • Dull percussion
  • Stridor
  • Enlarged liver
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16
Q

Investigations for Lung Cancer

A

FBC, Coag screen, Na/K/Ca/Alk Phos,
Spirometry, CXR (abnormal), CT Thorax, PET, Bronchoscopy, EBUS, aspiration of pleural fluid, Thoracoscopy, Lymph node aspirate (Metastases).

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17
Q

Differential diagnoses

A

TB, Vasculitis, PE, Lymphoma, Bronchiectasis.

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18
Q

Types of Lung Neoplasms

A
  • Primary: Benign or malignant.

- Metastatic.

19
Q

Risk Factors

A
  • Smoker.
  • Asbestos exposure.
  • Nickel.
  • Chromates.
  • Radiation.
  • Atmospheric pollution.
  • Genetics.
20
Q

What causes haemoptysis?

A

Ulceration

21
Q

What causes chest pain?

A

Invasion of chest wall

22
Q

What causes pneumonia?

A

Obstruction of airway.

23
Q

Lung tumours: Types

A

Smoking associated:

  • Adenocarcinoma
  • Squamous carcinoma
  • Small cell carcinoma
  • Large cell carcinoma

Bronchial gland tumours & neuroendocrine tumours.

24
Q

Small Cell Lung Cancer

A
  • Worst prognosis.
  • Rapidly progressive.
  • Early metastases.
25
Q

Treatment of Small Cell Lung Cancer

A
  • More chemosensitive.

- Rarely suitable for surgery.

26
Q

Adenocarcinoma

A
  • Expresses TTF1
27
Q

Squamous Carcinoma

A
  • Expresses nuclear antigen p63 & height mwt. Cytokeratins.
28
Q

Peripheral adenocarcinomas

A

Atypical adenomatous hyperplasia.

  • Spread of neoplastic cells along alveolar walls (bronchioloalveolar carcinoma)
  • Invasive carcinoma.
29
Q

TNM Staging

A

Tumour, Nodes, Metastases.

  • Bronchoscopy: type (SCLC/NSCLC).
  • Mediastinoscopy/ EBUS.
  • CT (Brain&Thorax): Tumour size, local invasion, nodes, metastases.
  • PET scan.
30
Q

What are Carcinoids?

A

Neuroendocrine neoplasms of low grade malignancy.

31
Q

What are Bronchial gland neoplasms?

A
  • Adenoid cystic carcinoma.

- Mucoepidermoid carcinoma.

32
Q

Pleural Neoplasia

A

Primary malignant neoplasm => mesothelioma.

Common site of invasion of lung carcinomas and metastatic cancers.

33
Q

Treatment of non-small cell cancers

A
  • Surgery or radical radiotherapy.

- Palliative chemotherapy & new targeted treatment.

34
Q

Surgery

A

Pneumonectomy or lobectomy

  • Thoracotomy.
  • Minimal access VATS.

Curative objective.

35
Q

Cytotoxic Chemotherapy

A
  • Rarely curative but prolonged survival.
  • Better response in SCLC.
  • Major side effects.
  • Whole body treatment targeting rapidly dividing cells, blood brain barrier.
36
Q

Side effects of chemotherapy

A

Nausea, vomiting, tiredness, bone marrow suppression (opportunistic infection & anaemia), hair loss, pulmonary fibrosis.

37
Q

New Targets

A

Genetic mutations: EGFR, ALK1.

Immune Therapy: PD-L1.

38
Q

Radiotherapy

A
  • Ionising radiation (usually XR), external beam.
  • Radical: Curative intent.
  • Palliative: Delaying tactic, useful for metastases.
  • Well tolerated.
39
Q

Disadvantages of Radiotherapy

A
  • Max cumulative dose
  • Collateral damage: Spinal cord, oesophagus adjacent lung tissue.
  • Only goes where beam pointed.
40
Q

SABR

A

Many more, less powerful beams => total dose delivered to tumour higher and more effective but less collateral damage.

41
Q

Endobronchial therapy

A
  • Stent insertion for stridor.
  • Photodynamic therapy.
  • Other laser therapy.
42
Q

Co-morbidiities

A

Smoking related diseases:

  • COPD
  • Ischaemic heart disease.
43
Q

Palliative Care

A

Treating:

  • Pain
  • Dyspnoea
  • Cough
  • Anxiety
  • Poor mobilitu
44
Q

Causes of Lung Cancer

A

Tobacco Smoking, Asbestos, Radon

Respiratory System (35 decks)

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