Lung Malignancy

Question 1

Common presentation of lung cancer

Answer 1

haemoptysis, wt loss, recurrent pneumonia, stridor

Question 2

Common presentation of lung cancer

Answer 2

haemoptysis, wt loss, recurrent pneumonia, stridor

Question 3

Tumour can’t be resected if _____

Answer 3

less than 2cm from carina

Question 4

Hoarseness is due to invasion of the ______

Answer 4

left recurrent laryngeal nerve

Question 5

Pancoast tumours can invade

Answer 5

brachial plexus -> wasting of the hand

Question 6

Squamous cell carcinomas secrete

Answer 6

PTHrp -> hypercalcaemia

Question 7

Squamous cell carcinomas secrete

Answer 7

PTH -> hypercalcaemia

Question 8

Small cell carcinoma para-neoplastic syndromes

Answer 8

SI(syndrome of inappropriate) ADH -> hyponatraemia
ACTH -> hypernatraemia, hypokalaemia, hyperbicarbonate
Eaton Lambert -muscle weakness better on exercise

Question 9

4 types of lung cancer ass with smoking (commonest to least common)

Answer 9

adenocarcinoma, squamous cell, small cell, large cell

Question 10

Lung cancer that produces keratin pearls

Answer 10

Squamous cell carcinoma

Question 11

Lung cancer that is sensitive to chemo but developing resistance

Answer 11

small cell lung cancer

Question 12

NSCLC treatment

Answer 12

most commonly surgeyr

Question 13

Central tumours =

Answer 13

squamous cell carcinoma and small cell carcinoma

Question 14

Hoarseness is due to invasion of the ______

Answer 14

left recurrent laryngeal nerve

Question 15

Pancoast tumours can invade

Answer 15

brachial plexus -> wasting of the hand

Question 16

Paraneoplastic syndromes associated with lung cancer

Answer 16

HPOA (hypertrophic pulmonary osteoarthropathy
thrombophlebitis
Eaton-Lambert
hypercalcaemia
hyponatraemia

Question 17

Squamous cell carcinomas secrete

Answer 17

PTH -> hypercalcaemia

Question 18

Small cell carcinoma para-neoplastic syndromes

Answer 18

SI(syndrome of inappropriate) ADH -> hyponatraemia
ACTH -> hypernatraemia, hypokalaemia, hyperbicarbonate
Eaton Lambert -muscle weakness better on exercise

Question 19

4 types of lung cancer ass with smoking (commonest to least common)

Answer 19

adenocarcinoma, squamous cell, small cell, large cell

Question 20

Lung cancer that produces keratin pearls

Answer 20

Squamous cell carcinoma

Question 21

Lung cancer that is sensitive to chemo but developing resistance

Answer 21

small cell lung cancer

Question 22

NSCLC treatment

Answer 22

most commonly surgery

Question 23

Central tumours =

Answer 23

squamous cell carcinoma and small cell carcinoma

Question 24

Peripheral lung tumours =

Answer 24

Large cell and adenocarcinoma

Question 25

Prognosis - worst to best lung cancer

Answer 25

small cell > large cell > adenocarcinoma > squamous

Question 26

lung cancer not associated with smoking

Answer 26

adenocarcinoma

Question 27

Cancers in bronchial epithelium =

Answer 27

squamous and small cell

Question 28

cancers in bronchioles/alveoli

Answer 28

adenocarcinomas

Question 29

pleural neoplasia =

Answer 29

mesothelioma

Question 30

neuroendocrine neoplasm of low grade malignancy =

Answer 30

carcinoid

Question 31

bronchial gland neoplasms =

Answer 31

adenoid cystic ca or mucoepidermoid ca

Question 32

CXR of malignancy

Answer 32

multiple nodules
enlarged lymph nodes
focal bone destruction
may have lobar collapse or discrete mass

Question 33

NSCLC treated by

Answer 33

surgery or radical radiotherapy

Question 34

Investigations before operate for lung cancer

Answer 34

CXR, bronchoscopy, EBUS (check lymph nodes), CT brain (met.s) PET (met.s)

Question 35

Pneumonectomy/lobectomy is performed by which methods

Answer 35

thoracotomy (long incision around rib 6)

VATS - video assisted thoracic surgery

Question 36

Investigations performed prior to starting chemo

Answer 36

bronchoscopy, CT

give ECOG score - measures patients fitness to proceed