Lung neoplasms - 1 Flashcards

1
Q

Rhonchi

A

Smoke inhalation

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2
Q

Lymph nodes to obtain FNA for lung cancer dx

A

Supraclavicular or cervical

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3
Q

TOC for bronchial carcinoid

A

Surgerical excision

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4
Q

Bibasilar crackles

A

Hypersensitivity Pneumonitis

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5
Q

Lung cancer CT and MRI helpful in

A

Diagnosis and staging (and PET for staging)

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6
Q

Lung cancer definitive dx

A

Tissue or cytology - Sputum, pleaural fluid, FNA aspirate of palpable lymph node, direct bx via bronchoscopy

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7
Q

Widening mediastinal

A

Squamous cell carcinoma

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8
Q

Lung cancer screening high risk patients

A

Yearly 55-80 with 30ppy hx - dc if not smoked for 15 years

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9
Q

TXT of mesothelioma

A

Chemotherapy

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10
Q

Mediastional adenopathy

A

Histoplasmosis, coccidioiomycosis,

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11
Q

MC vascular route of metastasis

A

Pulmonary artery

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12
Q

CXR for mesothelioma shows

A

Pleural effusion or pleural thickening

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13
Q

Mesothelioma is

A

primary tumor of surfacing lining of pleura (MC) or peritoneum

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14
Q

Anterior mediastinal masses (5)

A

Lymphoma, Mesenchymal tumors Teratoma Thymoma Thyroid lesion

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15
Q

Characteristics of Adenocarcinoma

A

Peripheral nodules & masses, Arises from mucus glands

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16
Q

Metastatic lung cancer CXR findings

A

Spherical with sharp margins <5cm bilateral MC in lower lung fields

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17
Q

Most important risk factor of lung cancer

A

Smoking

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18
Q

Can you treat SCLC with resection

A

NO

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19
Q

Characteristics of Squamous cell carcinoma

A

Most likely to present with hemoptysis, Intraluminal sessile or polypoid masses, arises from bronchial epithelium (MC) - 2nd/3rd bronchus

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20
Q

4 types of NSCLC

A

Adenocarcinoma
Squamous cell carcinoma
Large cell carcinoma
Bronchioalveolar cell carcinoma

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21
Q

Inspiratory Crackles

A

Asbestosis

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22
Q

Velcro rales

A

Idiopathic pulmonary fibrosis

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23
Q

TOC for SCLC

A

Chemo and radiation (palliative rather than curative)

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24
Q

Clubbing

A

Idiopathic pulmonary fibrosis Abestosis

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25
Q

Solitary pulmonary nodule benign features

A

<30yo, smooth, well defined borders, dense or diffuse calcification, small size on RPT imaging

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26
Q

MC NSCLC (primary)

A

Adenocarcinoma

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27
Q

Crackles at bases

A

Acute Gastric acid aspiration

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28
Q

Another name for Bronchioalveolar cell carcinoma

A

adenocarcinoma in situ

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29
Q

Bibasilar inspiratory crackles

A

Idiopathic pulmonary fibrosis

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30
Q

Pancoast syndrome misdx

A

Cervical OA or bursitis

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31
Q

Another name for solitary pulmonary nodule

A

Coin lesion

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32
Q

Large cell carcinoma characteristics

A

Aggressive, rapid doubling, group of undifferentiated cells, central or peripheral (MC) mass

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33
Q

Bronchial carcinoid S/S

A

Hemoptysis, cough, wheezing, recurrent pneumonia

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34
Q

Solitary pulmonary nodule imagine features of malig

A

Eccentric calcification, thick wall cavitation, spiculated, corona radiata margins

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35
Q

Solitary Pulm nodule def

A

<3cm isolated rounded opacity outlined by normal lung tissue

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36
Q

Wheezing

A

Smoke inhalation Acute Gastric acid aspiration PE

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37
Q

Pancoast syndrome

A

Lung tumor of the superior sulcus at extreme apex of lung

38
Q

MC SCLC paraneoplastic syndrome

A

SIADH

39
Q

Recurrent laryngeal Nerve palsy is

A

Tumor destruction of recurrent laryngeal nerve and New onset hoarseness

40
Q

SCLC pathogenesis

A

Begins centrallty and infilitrates submucosally which narrows/obstructs bronchus with out a luminal MASS

41
Q

Reducing lung cancer burden lung term

A

Preventive is better than screening

42
Q

Abrupt Severe hyponatremia

A

Cerebral edema, irritability, confusion, sezuires, coma

43
Q

MC NSCLC paraneoplastic syndrome

A

Hypercalcemia

44
Q

SIADH MOA

A

Too much ADH causes water retention and causes hyponatremia - <120 and concentrated urine >300 mol

45
Q

Superior vena cava obstruction MOA

A

Tumor causes venous obstruction of head, neck, UE

46
Q

S/S of SVC obstruction

A

Dyspnea, facial swelling, congestion, cough, arm swelling, chest pain

47
Q

NSCLC over all charcteristics

A

Slow spread, can resection early DZ, responds to chemo poorly

48
Q

Who does adenocarcinoma effect most

A

Women and non-smokers

49
Q

SCLC CXR

A

MC hilar mass with bulky mediastinal adenopathy

50
Q

TXT for NSCLC stage III and IV

A

Chemo and radiation

51
Q

Another name for SCLC

A

Oat cell

52
Q

Who does bronchial carcinoid effect

A

<60 yo

53
Q

Before lung surgery what test is required?

A

PFT’s for baseline and determining post-op lung fx

54
Q

MC cancer worldwide & leading cause of cancer deaths

A

Lung cancer

55
Q

Does mesothelioma have a smoking correlation

A

No

56
Q

Horner syndrome - triad

A

Ipsilateral miosis, ptosis anhidrosis

57
Q

Horner syndrome MOA

A

paravertebral sympatheric chain involvement

58
Q

Staging SCLC

A

Always metastatic at time of ID- either limited (one side of lung and regional nodes) or Extensive (MC) both lungs with distant spread

59
Q

Plain Crackles

A

PE, ARDS,

60
Q

Other tumor complications (2)

A

Recurrent laryngeal Nerve palsy and Phrenic nerve palsy

61
Q

Middle mediastinal masses (4)

A

Aortic Aneurysm Pulm artery enlargment LAP Cyst

62
Q

Staging NSCLC

A

TNM system - Tumor, Nodal involvement, Metastases

63
Q

Phrenic nerve palsy is

A

Tumor destruction of phrenic nerve causing hemidiaphragm paralysis (elevation)

64
Q

SCLC charcteristics

A

Early hematogenous spread, Cant resection, Very aggressive

65
Q

Anhidrosis

A

Diminished sweating

66
Q

Unilateral adenopathy

A

Coccidioidomycosis

67
Q

DX mesothelioma

A

Pleural aspirate or tissue bx

68
Q

TXT of low probability SPN

A

Observation and serial chest CT’s

69
Q

Bilateral Hilar adenopathy

A

Squamous cell carcinoma, Sarcoidosis, acute pulmonary histoplasmosis

70
Q

Routes of metastatic lung cancer

A

Direct extenstion Vascular Lymphatics

71
Q

TOC for early NSCLC stage I or II

A

Surgery

72
Q

TXT of intermiediate probability PSN

A

PET scan or VATS - Video assisted thoraoscopic surgery

73
Q

Distant spread of lung cancer may cause

A

HA, N/V, seizures, ALMS

74
Q

Solitary pulmonary nodule MC malignant etiology

A

Adenocarcinoma

75
Q

SVC syndrome DZ processes

A

Pancoast syndrome - tumor on right side

76
Q

Carcinoid syndrome -triad

A

Flushing, wheezing, HOTN

77
Q

Which lung cancer is prone to early hematogenous spread

A

SCLC

78
Q

Posterior mediastinal masses (5)

A

Hiatal hernia, neurogenic tumor, meningocele, esophageal tumor, thoracic spine Dz

79
Q

Solitary pulmonary nodule malig features

A

> 30yo, smoker, hx of malig, size at discovery is larger

80
Q

MC primary tumors of metastasis

A

Malignant melanoma Cervix Colorectal Breast Kidney Also head and neck cancers

81
Q

Local spread of Lung cancer can cause

A

Obstruction, atelectasis, pneomnia, pleural effusion, SVC syndrome, Horner syndrome

82
Q

Bronchial carcinoid charcteristics

A

Slow growing (pedunculated or sessile growth)- causes bleeding and airway obstruction, carcinoid synd

83
Q

TXT of high probability SPN

A

Resection following staging

84
Q

SOC for solitary pulm nodule

A

Chest CT

85
Q

Late inspiratory crackles

A

Interstital lung disease

86
Q

Paraneoplastic syndrome

A

non-lung syndromes produced by lung tumors

87
Q

Bronchial carcinoid def

A

Malig neuroendocrine neoplasm arising from bronchial mucosa

88
Q

Solitary pulmonary nodule MC benign etiology

A

Infectious granuloma (fungi or mycobacteria)

89
Q

Incidental DZs found

A

Solitary pulmonary nodule, mediastinal masses, past histoplasmosis infection,

90
Q

Cavitation DZ processes

A

Squamous Cell Carcinoma, Solitary Pulmonary nodule, Pulmonary vasculitis (GPA)

91
Q

MC symptom of pancoast syndrome

A

Shoulder pain - severe pain, invades brachial plexus, ribs, vertebrae, follows ulnar distribution C8 and T1

92
Q

Who gets mesothelioma

A

Men 3x more w/ after 20-40yr of asbestos expsoure