Lung Cancer Flashcards
Define hypertrophic osteoarthropathy
Combines clubbing and periostitis of the small hand joints - can occur secondary to lung cancer
Myasthenia gravis can be associated with what type of malignancy?
Thymus tumour
What is the most common malignancy to be associated with Lambert-Eaton syndrome?
Small cell lung cancer
What is Lambert-Eaton syndrome?
Rare autoimmune condition characterised by muscle weakness of the the limbs as a result of impaired [re-synpatic release fo ACh. Also known as LEMS - Lambert-Eaton myasthenic syndrome
Small cell lung cancer is classically associated with what type of hormone condition?
SIADH
What does SPIKES stand for in the context of breaking bad news?
S - Situation
P - Patient perception
I - Invitation to continue with the explanation
K - Knowledge in small chunks
E -Empathy for the shock/ other emotions
S -Strategy, what you and the patient are going to do
What are the 4 most common forms of cancer seen in the UK population?
- Breast
- Lung
- Colorectal
- Prostate
Suggest 5 potential causes of bronchial carcinoma
- Smoking
- Ionising radiation
- Asbestos
- Fibrosing alveolitis
- Industrial chemicals
What is the most common form of primary lung cancer?
Small cell lung cancer
Give 2 clinical signs associated with SVC obstruction
- Facial/ hand swelling that is worse in the morning
2. Headache
What is the treatment of choice for small cell lung cancer?
Chemotherapy
Suggest 5 potential differential diagnoses for bronchial carcinoma
- TB
- Pneumonia
- Lung metastases from another primary malignancy
- Benign lung tumour
- Wegener’s granulomatosis
Define Wegener’s granulomatosis
Rare inflammatory disease that affects a variety of tissue types including the blood vessels, lungs and kidneys
What are the 3 subcategories of TNM staging
T - Grade of primary tumour
N - Regional lymph nodes
M - Distant metastases
Give 5 indications that would make a bronchial carcinoma inoperable
- Distant metastases
- Mediastinal spread
- Poor pulmonary function
- Frequent angina/ heart failure
- Psychological failure
What is the mainstay treatment for non-small cell lung cancer
Surgery and radiotherapy
Name the chemotherapy agent that can be used in the treatment of EGFR mutation positive cells
Gefitinib
Name the 2 most common nerves to be affect by the mass affect of a bronchial carcinoma
- Recurrent laryngeal nerve - leading to Horner’s syndrome
2. Phrenic nerve
Briefly outline the action of parathyroid hormone on the kidney
Upregulates the reabsorption of calcium from the kidney tubules
PTrP is most commonly associated with which 4 cancer types?
- Breast
- Squamous cell lung cancer
- Cholangiocarcinoma
- Multiple myeloma
Name the procedure used to collect a sample of fluid in the assessment of a pleural effusion
Thoracentesis
A bloody pleural effusion sample may indicate one of which 4 conditions?
- Malignancy
- Asbestosis
- Pulmonary infarction
- Postcardiac injury syndrome
A white coloured pleural effusion sample may indicate what underlying pathology? (2)
- Chylothorax
2. Cholesterol effusion
A black pleural effusion sample may indicate what underlying pathology?
Aspergillus
Yellow-green pleural effusion sample may indicate what underlying pathology?
Rheumatoid pleurisy
Dark green pleural effusion sample may indicate what underlying pathology?
Bilothorax
‘Anchovy paste like’ pleural effusion sample is indicative of which underlying pathology?
Amebic liver abscess
Pus in the pleural effusion sample is indicative of which underlying pathology?
Empyema
What are the 3 main causes of a transudate pleural effusion?
- Chronic heart failure
- Cirrhosis
- Nephrosis
Recall the 3 components of Light’s criteria
- Pleural fluid protein/ serum protein >0.5
- Pleural fluid LDH/ serum LDH >0.6
- Pleural fluid LDH > 2/3 upper limit of normal serum LDH
If a pleural effusion has protein >7-8g/dL which 2 differential diagnoses should be considered?
- Waldenstrom’s macroglobulinemia
2. Mutiple myeloma
When analysing a pleural effusion sample, and LDH > 1000 points towards which 3 differentials?
- Empyema
- Rheumatoid pleurisy
- Malignancy
Pleural fluid glucose <60 mg/dL points towards which 5 differential diagnoses?
- Rheumatoid pleurisy
- Parapneumonic effusion or empyema
- Malignant effusion
- Lupus pleuritis
- Oesophageal rupture