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Respiratory > Neoplasia 3 > Flashcards

Neoplasia 3 Flashcards

1
Q

What is the clinical presentation of a lung tumour?

A

cough, haemoptysis, wheeze, dyspnoea, pneumonia, Pancoast’s syndrome

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2
Q

What are some of the common clinical presentations of metastases?

A

lymphadenopathy, bone pain/hypercalcaemia, jaundice, seizures

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3
Q

What causes weight loss and anorexia in cancer?

A

TNF-alpha and IL-1

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4
Q

What are paraneoplastic effects?

A

Symptoms which aren’t related to the local presence of a tumour

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5
Q

What are some common paraneoplastic effects?

A

endocrine problems, immunological problems, clubbing, hypertrophic osteoarthropathy, venous thrombosis, endocarditis

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6
Q

What are some paraneoplastic endocrine effects of lung cancer?

A

hypercalcaemia, cushings, inappropriate ADH/ACTH

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7
Q

What are some other paraneoplastic endocrine disorders?

A

hypoglycaemia, polycythaemia

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8
Q

What blood tests might you order for a cancer patient?

A

blood picture, liver function test, tumour markers

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9
Q

What are tumour markers?

A

Proteins in the blood which are useful in follow up of a tumour such as prostate specific antigen in prostate cancer, carcinoembryonic antigen, alpha fetoprotein in colon cancer

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10
Q

Why is tissue sampling important?

A

To confirm malignancy and to determine features relevant to prognosis and management

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11
Q

What type of stains may be done on a tissue sample?

A

H&E, stains for melanin, stains for musin, immunohistochemistry to determine cell line

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12
Q

Why is cytology not as useful as a whole tissue sample?

A

Can’t see stroma and don’t see relationship of cells to each other

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13
Q

What do you need to know about the tumour?

A

specific tumour type and subtype, grade, stage, presence of lymphovascular invasion

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14
Q

What are the 4 main types of lung carcinomas?

A

squamous cell carcinoma, adenocarcinoma, large cell carcinoma, small cell carcinoma

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15
Q

What type of lung carcinoma is the most common?

A

adenocarcinoma

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16
Q

What type of lung carcinoma is the most likely if the patient is a non smoker?

A

adenocarcinoma

17
Q

What type of lung carcinoma is a result of squamous metaplasia?

A

squamous cell carcinoma

18
Q

What type of lung carcinoma is the most aggressive?

A

squamous cell carcinoma

19
Q

What are the macroscopic features of lung cancer?

A

Pale irregular mass often related to a bronchus that may be necrotic. Can lead to lung collapse or bronchiecstasis. Hilar lymph nodes often appear black.

20
Q

What type of lung carcinoma tends to be more peripheral?

A

adenocarcinomas

21
Q

What are the microscopic features of adenocarcinoma?

A

The cells show a glandular structure - they cell may try and form a lumen or there may just be an accumulation of mucous

22
Q

What are the microscopic features of squamous cell carcinoma?

A

There are rounded areas of keratin in the centre of the tumour and intracellular bridges

23
Q

What are the microscopic features of small cell carcinoma?

A

The cells are small and don’t show the typical features of malignancy

24
Q

What are the microscopic features of large cell carcinoma?

A

The cells are large and atypical and are undifferentiated

25
Q

How does immunohistochemistry work?

A

Labeled antibodies which are labeled either with fluorescence or an enzyme are used to detect the presence of particular proteins which indicate cell lineage

26
Q

What does the S100 protein indicate in immunohistochemistry?

A

That the cells are melanocytes

27
Q

What does the CAM5.2 protein indicate in immunohistochemistry?

A

That the cells are epithelium

28
Q

What does LCA protein indicate in immunohistochemistry?

A

That the cells are leukocytes

29
Q

What is the stage of a tumour?

A

Stage refers to how far advanced the tumour is - it incorporates size, how advances local spread is, if it has metastasised and if so where to

30
Q

What is the TNM system?

A

A system for staging - T is the level of the primary tumour, N is regional lymph node metastases and M is the absence or presence of distant metastases

31
Q

What is the action of traditional chemotherapy drugs?

A

Interfere with cell division

32
Q

What is the action of targeted therapies?

A

Block the growth of cancer by interfering with the function of specific molecules resulting from genetic alterations

33
Q

What specific mutation is targeted in non-small cell carcinomas?

A

EGFR tyrosine kinase

34
Q

What are the benefits of this targeted treatment?

A

superior response rate, prolonged progression-free survival, improved quality of life

35
Q

What causes death in cancer?

A

cachexia, secondary infection, damage to vital organ

Respiratory (31 decks)

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