Lung cancer and friends

Question 1

Pulmonary hypertension

Answer 1

• Sustained pulm artery pressure of >25
• Sustained capillary wedge pressure of >15
  - Valued obtained by Swans ganz
• Causes RH failure
• Treat with prostacylin (Epoprotstenol, Trepostinil, Iloporst)

Question 2

Pulm embolism

Answer 2

• Forms in deep veins due to long sitting, or on catheters, or in SVC, or trauma
• Creates dead space (V/Q=infinity)
• Decreased surfactant
• Treat with heparin or warfarin prophylactically

Question 3

Edema

Answer 3

• Cardiogenic: l vent problem –> increased pulmonary vein pressure –> fluid leakage
• Non cardio: leaky capillaries, low albuminea
• Kerleys b lines
• V-q mismatch
• A-a gradients widens
• Rales
• Treat heart with inotropes to decrease after load

Question 4

Small cell

Answer 4

• Histo: Poorly differentiated
• Association: male smoker
• Location: central
• Comment: ADH (causing hyponatremia)/ACTH, Cushing’s (fatty hump on shoulders)
  - called oat cells.
• Treatment: Chemo
• Mutation: MYC

Question 5

Squamous

Answer 5

• Histo: keratin pearls, intercell bridges
• Association: male smoker
• Location: central
• Comment: PTHrP –>hypercalcemia, Pancost (shoulder pain radiating down arm), SVC sydrome (JVD)
• Treatment: resection

Question 6

Adenocarcinoma

Answer 6

• Histo: Glands and mucous filled acinar
• Association: nonsmoker, female smoker
• Location: peripheral
• Comment: Pleural related, preserves lung
• Mutation: EGFR,
• Acinar is most common form of adenocarcinoma

Question 7

Large cell

Answer 7

• Histo: no defining
• Association: smokin
• Location: cent/peri
• Comment: u gon die

Question 8

Bronchioalveolar (Lepidic Adeno)

Answer 8

• Histo: columnar cells in bronchioles that looks like a butterfly
• Association: no smoke
• Location: peripheral
• Comment: pneuomia consolidation

Question 9

Hamartoma

Answer 9

benign lesion of cartilage, bone and fat.

Question 10

Metastatic

Answer 10

comes from butts and boobs.

-Lung cancer goes to the adrenal, liver, bone, brain.