Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Medicine Respiratory > Lung Cancer > Flashcards

Lung Cancer Flashcards

1
Q

General features of cancer

A

Malignant growth, uncontrolled replication, local invasion, metastasis (lymphatic spread, blood stream, serous cavities), non-metastatic systemic effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Symptoms of lung cancer

A

Cough >3 weeks, breathlessness, chest infection that doesn’t clear, haemoptysis, unexplained weight loss, chest or shoulder pains, unexplained tiredness or lack of energy, a hoarse voice, enlarged liver, dysphagia, bloated face, stridor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What causes haemoptysis in lung cancer?

A

Haemorrhage due to the tumour ulcerating through the surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Local invasion of lung cancer

A

Recurrent pharyngeal nerve, pericardium, oesophagus, brachial plexus, pleural cavity, SVC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Symptoms arising from local invasion of lung cancer to pericardium

A

Breathlessness, atrial fibrillation, pericardial effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What causes muscle weakness in lung cancer?

A

Brachial plexus invasion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which symptom can occur when the lung cancer invades the pleural space?

A

Breathlessness due to pleural effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which symptoms can occur when the lung cancer invades the superior vena cava?

A

Distended veins on abdomen and thorax, distended external jugular vein, puffy eyelids and headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Common sites for metastases for lung cancer

A

Brain, liver, bone, adrenal, skin, lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Symptoms of cerebral metastases

A

Insidious onset: weakness, visual disturbances, headaches (worse in morning and not photophobic)
Fits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Common presentations of bone metastases

A

Localised pain that is worse at night or a pathological fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What type of imaging can show bone metastases?

A

Isotope bone scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Paraneoplastic symptoms in lung cancer

A

Finger clubbing, hypertrophic pulmonary osteoarthropathy, weight loss, thrombophlebitis, hypercalcaemia, hyponatraemia, weakness (Eaton Lambert syndrome)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What should you think of when you hear hypercalcaemia (Rhyme)

A

Stones (renal/biliary calculi)
Bones (bone pain)
Groans (abdominal pain, constipation, nausea and vomiting)
Thrones (polyuria)
Psychiatric overtones (depression, anxiety, reduced GCS, coma)
Cardiac arrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Treatment for hypercalcaemia

A

Initial treatment is rehydration
If calcium very high on admission >4 or does not correct with fluid then also use IV biphosphonate
Treat underlying cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which cancer is usually associated with hypercalcaemia?

A

Squamous cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Syndrome of inappropriate antidiuretic hormone:

  • Which cancer is it related to?
  • What does it result in?
  • Symptoms
A
  • Usually small cell lung cancer
  • Low sodium concentration
  • Nausea, vomiting, myoclonus, lethargy/confusion, seizures/coma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Treatment of syndrome of inappropriate antidiuretic hormone

A

Treat the underlying cause, fluid restriction (1.5L/day), sometimes need demeclocycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Signs of lung cancer

A

Finger clubbing, bloated face, lymphadenopathy, tracheal deviation, dull percussion, enlarged liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Investigations for lung cancer

A
  • FBC
  • Coagulation screen
  • Na, K, Ca, Alk phos
  • Spirometry, FEV1
  • CXR
  • CT scan of thorax
  • PET scan
  • Bronchoscopy
  • Endobronchial ultrasound
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

PET scan in lung cancer:

  • What does it assess?
  • What does it analyse?
A
  • Function rather than structure

- Analysis of tissue uptake of radio-labelled glucose - tissues with high metabolic activity light up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Investigations to make a tissue diagnosis in lung cancer

A
  • Bronchoscopy
  • CT guided biopsy
  • Lymph node aspirate
  • Aspiration of pleural fluid
  • Endobronchial ultrasound
  • Thoracoscopy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Bronchoscopy:

  • Under what type of anaesthetic?
  • Where is the bronchoscope passed?
  • What types of tumours are bronchoscopies useless in identifying
A
  • Local anaesthetic with intravenous sedation
  • Through the nose
  • Possible tumours out in the periphery of the lungs
24
Q

Endobronchial ultrasound:

  • What is used to do this?
  • What does it do?
A
  • A bronchoscope with ultrasound tip

- Enables visualisation of hilar and mediastinal lymph structures and targets and samples lymph nodes

25
Medical thoracoscopy: - Under what type of anaesthetic? - Where is the semi-rigid scope inserted? - What does it do?
- Local anaesthetic and under sedation - Between the rib spaces - The lung is deflated to allow visualisation of the pleural space and biopsies can be taken from the pleura
26
Differential diagnoses for the following clinical picture: | Haemoptysis, smoker, abnormal chest x-ray
Lung cancer, tuberculosis, vasculitis, pulmonary embolism, secondary cancer, lymphoma, bronchiectasis
27
Harmful carcinogens in tobacco smoke
Polycyclic hydrocarbons, aromatic amines, phenols, nickel, cyanates
28
Risk factors for lung cancer
- Smoking - main risk factor - Asbestos exposure - Nickel - Chromates - Radiation - Atmospheric pollution - Genetics play a very small part
29
4 common smoking associated types of lung cancer
Adenocarcinoma (35%), squamous carcinoma (30%), small cell carcinoma (25%), large cell carcinoma (10%)
30
Why is classification of lung cancer important?
To determine prognosis, treatment, pathogenesis and epidemiology
31
Which type of lung cancer has the worst prognosis?
Small cell lung cancer
32
What is the only way to differentiate between different non-small cell lung cancers?
Immunohistochemistry: - Adenocarcinoma expresses TTF1 - Squamous cell carcinoma expresses nuclear cell antigen p63 and high molecular weight cytokeratins
33
New targeted treatments for lung cancer: - What are they based on? - Give an example
- Pathologically identified abnormal DNA or other markers in tumour - Specific point mutations render the EGFR gene active in the absence of ligand binding and this mutation is most commonly seen in adenocarcinoma (non-smokers and asian population). These tumours respond to tyrosine kinase inhibitors
34
PD-L1: - What does it do? - How can it be treated?
- Binds to programmed death receptor on T lymphocytes inactivating the cytotoxic immune response - Targeted therapy can often inhibit this effect and enhance immune killing of the tumour
35
Bronchial tumours development
Squamous metaplasia → dysplasia → carcinoma in situ → invasive malignancy
36
Prognostic indicators in lung cancer
Tumour stage, tumour histological subtype
37
Giving the patient the diagnosis of lung cancer
- Prepare the ground - ask what they think the diagnosis could be - Bring a relative - Make sure they understand - Prepare for the obvious questions - Tell their GP - Arrange a follow-up
38
Treatment for small cell lung cancer
Rapidly spreads and has early metastases so rules out surgery. Has a good initial response to chemotherapy nit has rapidly emerging resistance. => cytotoxic chemotherapy often backed up by radiotherapy
39
Treatment of non-small cell lung cancer
Surgery or radical radiotherapy are curative options. Palliative chemotherapy can also be given
40
Treatment choices in lung cancer
Surgery, radiotherapy, chemotherapy, palliative care
41
Things to consider when surgery is a treatment option for lung cancer
Can we cut it out? Is the disease localised? Will the patient survive the operation? What will the residual lung function be?
42
Staging for surgery
- Bronchoscopy (vocal cord palsy, proximity to carina, cell type - EBUS (lymph nodes) - CT of brain (metastases) - CT of thorax (tumour size, lymph nodes, metastases, local invasion) - PET scan (metastases)
43
After lung removal, how much disease free bronchus must you have to close off the hole?
2cm
44
Surgical options for lung cancer
Pneumonectomy or lobectomy done through thoracotomy or video assisted thoracic surgery
45
Thoracotomy: - What is it? - How long does it take to recover?
- Major surgery involving a long incision around the length of the 6th rib to gain access to the lung - Weeks
46
Staging for chemotherapy
- Bronchoscopy or other tissue sampling (small cell vs non-small cell) - CT scan (tumour size, local invasion, nodes, metastases) - Performance on the ECOG score
47
What is the combination of drugs given in chemotherapy dependent on?
The cell type
48
Cytotoxic chemotherapy: - Curative or Palliative? - Which type of cancer has a better response? - How is it given? - What does it target?
- Rarely curative but longer survival - Better response in small cell cancer - IV infusions every 3-4 weeks in outpatient clinic - Targets rapidly dividing cells and can cross the blood-brain barrier
49
Side effects of cytotoxic chemotherapy
- Nausea and vomiting - Tiredness - Hair loss - Bone marrow suppression (opportunistic infection and anaemia) - Pulmonary fibrosis - Neutropenic sepsis
50
Radiotherapy: - What does it involve? - Curative or palliative?
- Involves radiation (usually X-rays in an external beam) | - Can be radical, with curative intent, or palliative which is useful for metastases)
51
Downsides to radiotherapy
- Maximum cumulative dose - Collateral damage (spinal cord, oesophagus, adjacent lung tissue) - Only goes where you point the beam
52
Common side effect of radiotherapy
Temporary oesophagitis
53
Positives of stereotactic ablative radiotherapy
Many more beams and each beam is less powerful so there is less collateral damage. The total dose delivered to the tumour is higher and so more effective
54
Examples of endobronchial therapy
Stent insertion for stridor, photodynamic therapy, other laser therapy
55
What is treatment of lung cancer determined by?
The cell type, the extent of the disease, co-morbidity and patient's wishes
56
Co-morbidities in lung cancer
Smoking related diseases (COPD, ischaemic heart disease)

Medicine Respiratory (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions