Lung Cancer

Question 1

what is the most common type of lung cancer?

Answer 1

non-small cell carcinoma

i.e. adenocarcinoma and squamous cell

Question 2

what do adenocarcinomas arise from?

Answer 2

mucus cells within bronchial epithelium

Question 3

what do small cell carcinomas arise from?

Answer 3

endocrine cells that contain neurosecretory granules that release poly-peptides

Question 4

risk factors of lung cancer

Answer 4

smoking (tobacco and cannabis)
passive smoking 
occupational exposures 
HIV 
organ transplantation
radiation exposure 
beta-carotene supplements

Question 5

clinical features of lung cancer

Answer 5

dyspnoea (with wheeze/stridor)
persistent cough (productive and/without haemoptysis)
chest pain 
weight loss 
nausea and vomiting

Question 6

signs of lung cancer

Answer 6

cachexia
finger clubbing
anaemia
enlargement of supraclavicular and axillary lymph nodes
decreased vocal resonance and breath sounds (pleural effusion)

Question 7

features of squamous cell carcinoma

Answer 7

hypercalcaemia
clubbing
hypertrophic pulmonary oesteoarthropathy
caviates and presents as obstructive bronchial lesions

Question 8

features of adenocarcinomas

Answer 8

invade mediastinal lymph nodes and pleura
metastases to brain and bones
does NOT caviate
more common in non-smokers, women and far eastern patients
causes pleural effusion

Question 9

features of small cell carcinoma

Answer 9

secretion of polypeptides such as ACTH to causes presentation of Addison’s or Cushing’s
spread easily and often inoperable
do NOT respond to chemotherapy

Question 10

investigations of lung cancer

Answer 10

CXR (within 2wks of referral)
sputum cytology
bronchoscopy/EBUS to obtain histology sample
bloods (FBC, U+E, LFTs, Ca and clotting)
pulmonary function tests