lung cancer

Question 1

haemoptysis

Answer 1

bright red blood in sputum

Question 2

adenocarcinoma of the lung

Answer 2

–not related to smoking
Presentation as pleural effusion
Diagnosis by image-guided biopsy
Surgery is appropriate for localised disease

Question 3

squamous cell carcunom

Answer 3

Arises in metaplastic epithelium
Smoking-related
Presentation by cough, ulceration and bleeding
Diagnosis by sputum cytology and biopsy
Management options determined by both tumour-related and patient-related factors.

Question 4

epidemiology of lung cancer

Answer 4

3rd most common cancer
Most common cause of death by cancer
More common in:
Male  
Age
Risk factors:
Smoking – greatest risk factor
Radon 
Asbestos

Question 5

common presentation of lung cancer

Answer 5

symptoms:
Cough
Haemoptysis
Shortness of breath
Recurrent chest infections
Pain 

signs:
Weight loss / cachexia
Clubbing
Effusion / collapse / consolidation
Monophonic wheeze

Question 6

other presentations of lung cancer:

Answer 6

Hoarseness
Horner’s syndrome (ptosis, enophthalmos, small pupil, lack of sweating on ipsilateral side of face)
Wasted muscles of the hand
Paraneoplastic syndromes:
SIADH (low sodium and plasma osmolality and high urine osmolality)
Ectopic ACTH (Cushing’s syndrome)
Hypercalcaemia (Parathormone related peptide)
Neurological syndromes (cerebellar degeneration, Lambert Eaton myasthenic syndromes)