Lung Cancer & Sleep Apnoea Flashcards
On an x-ray, if there is a visible mass, where would you assume the mass is located?
Peripherally
What is the biggest cause of lung cancer?
Smoking
Name 6 other causes of lung cancer
- Radon gas
- Chemicals within workplace
- Wood stoves
- Genetics
- Radiation therapy
- People with COPD and pulmonary fibrosis
What are the two main groups of lung tumours?
- Small cell tumours
- Non-small cell tumours
which group of lung tumours is more common?
Non-small cell tumours
what are the three most common non-small cell tumours that arise in the lungs?
- Squamous cell carcinoma
- Large cell carcinoma
- Adenocarcinoma
What are the 4 main signs and symptoms of lung tumours?
- Cough
- Haemoptysis (blood stained sputum)
- Pneumonia
- Metastasis
Name the 3 less common, but still significant symptoms/signs of lung tumours
- Dysphagia (swallowing difficulties)
- Superior vena cava obstruction
- Recurrent laryngeal nerve palsy
How does superior vena cava obstruction occur?
Because of compression from a tumour in the mediastinum which will prevent blood from returning to the right side of he heart. This leads to distension of the veins and swelling in the head and neck region
What characterises recurrent laryngeal nerve palsy?
Unexplained hoarseness
Describe a stage 1 lung tumour
Solitary lesion
describe a stage 2 lung tumour
Multiple lesions but only on one side of the thorax
describe a stage 3 lung tumour
Lesions on both sides of thorax
describe a stage 4 lung tumour
Metastatic lesions throughout the lung and also symptoms of oedema, fluid or pneumonia.
what stage will most patients with lung cancer be diagnosed?
Stage 3 or 4
what is the standard treatment for non-small cell lung tumour?
Chemo-radiotherapy
What type of analysis allows physicians to classify patients by their probable disease risk, prognosis and/or response to treatment?
Biomarkers
What is sleep apnoea?
Airway obstruction whilst asleep, lasting 10 seconds or more
What happens to the airway muscle during sleep apnoea and what is the consequence?
Airway muscle tone drops and this allows the tongue to fall back and block the airway by occluding it against the back of the pharynx
Hypoxia is caused by sleep apnoea, what risks increase due to hypoxia?
Risk of acute cardiac event such as MI
what are the two ways to measure if someone has sleep apnoea?
- Epworth sleepiness scale
- Apnoea hypopnea index
What does the apnoea hypopnea index measure?
How many events of airway obstruction occur per hour
What are the two mechanical treatments for obstructive sleep apnoea?
- Mandibular advancement appliance
- CPAP (continuous positive airway pressure)
How does the mandibular advancement appliance function?
It pulls the lower jaw forward, so the tongue moves with it to open up the airway
Why do some patients find the mandibular advancement appliance intolerable?
Because it puts considerable pressure onto the gingivae in the upper anterior and lower lingual regions, so some patients find this very uncomfortable
What are mandibular advancement appliances?
Essentially two vacuum formed splints
How does CPAP function to improve sleep apnoea?
Patient wears a mask, which keeps a certain amount of pressure within the airways at all times. This pressure blows apart the tongue and pharynx, keeping the airway patent and allowing the patient to breathe
What sleeping position encourages sleep apnoea?
Sleeping on your back
