Lung tumours

Question 1

risk actors bronchial carcinoma

Answer 1

cigarette smoking, asbestos, chromium, arsenic, iron oxides, radiation

Question 2

what is another word for small cell cancer

Answer 2

oat cell

Question 3

which cancer is more aggressive SCLC or NSCLC

Answer 3

SCLC

Question 4

symptoms

Answer 4

cough, haemoptysis, dyspnoea, chest pain, pneumonia, lethargy, anorexia, weight loss

Question 5

signs

Answer 5

cachexia, anaemia, clubbing, HPOA, supraclav or axillary nodes. chest- none or consolidation, collapse, effusion. mets- bone tenderness, hepatomegaly, confusion, fits, focal CNS signs, cerebellar syndrome, proximal myopathy, peripheral neuropathy

Question 6

local complications

Answer 6

recurrent laryngeal nerve paly, phrenic nerve palsy, SVC obstruction, Horners (pancoast), rib erosion, pericarditis, AF

Question 7

other complications

Answer 7

met- brain, bone, liver, adrenals. endo- ectopic hormone secretion. non met neuro- confusion, fits, proximal myopathy, neuropathy, clubbing, dermatomyositis, acanthosis nigricans

Question 8

tests

Answer 8

cytology- sputum and pleural fluid, CXR- peripheral nodule, hilar enlagement, consolidation, lung collapse, effusion. fine needle aspiration or biopsy. CT. bronchoscopy. PET. radionuclide bone scan

Question 9

treatment NSCLC

Answer 9

excision, radio, chemo +- radio

Question 10

treatment SCLC

Answer 10

almost always disseminated at presentation. chemo. palliation- radiotheraoy. pleural drainage and pleurodesis for symptomatic effusions

Question 11

prognosis

Answer 11

non small cell 50% 2y without spread, 10% with spread. small cell- 3 m if untreated, 1-1.5y if treated