Neoplasia and Pleural Disease

Question 1

5 year survival rate of lung cancer in Scotland

Answer 1

around 10%

Question 2

Percentage of lung cancers attributable to tobacco

Answer 2

> 85%

Question 3

Percentage of smokers who will get lung cancer

Answer 3

around 10%

Question 4

4 main primary lung cancers (carcinomas)

Answer 4

Adenocarcinoma (41%)
Squamous cell carcinoma (40%)
Small cell carcinoma (15%)
Large cell carcinoma (4%)

Question 5

Worst prognosis of 4 main types of primary lung cancer

Answer 5

Small cell carcinoma usually worst

Question 6

2 types of lung cancer staging

Answer 6

TNM and performance staging (0-4)

Question 7

What does TNM staging stand for

Answer 7

T-primary tumour
N-nodes
M-distant metastasis
(study notes for more specific divisions of each)

Question 8

Explain performance status (0-4)

Answer 8

0=fully active
1= symptoms but relatively well/active
2='up and about' > 50% of the time
3='up and about' < 50% of the time
4= chair/bed bound

Question 9

Percentage of lung cancer patients fit for surgery

Answer 9

around 10%

Question 10

What progresses quicker: small cell or non-small cell lung cancer?

Answer 10

Small cell

Question 11

Pleural effusion definition

Answer 11

Collection of fluid in pleural space

Question 12

Difference between transudate and exudate

Answer 12

Transudate is non-inflammatory

Exudate is inflammatory

Question 13

Light’s criteria for defining effusion as exudate

Answer 13

Any of the following and effusion is exudative:
Protein: pleural fluid to serum fluid ratio >0.5
Lactate dehydrogenase (LDH): pleural fluid to serum fluid ratio >0.6
Pleural fluid LDH >2/3 of normal serum LDH

Question 14

Causes of transudates

Answer 14

LV failure
Liver cirrhosis
Peritoneal dialysis
Hypothyroidism

Question 15

Causes of exudates

Answer 15

Malignancy
Parapneumonic effusions, empyema
TB
Pulmonary embolism

Question 16

Categories of pneumothorax

Answer 16

Primary spontaneous
Secondary spontaneous
Traumatic
Iatrogenic
Tension

Question 17

Clinical presentation of pneumothorax

Answer 17

Fast breathing (tachypnoea)
Hypoxic
Tachycardic
Reduced chest movement and breathing sounds