Neoplastic Disorders

Question 1

Rare neuroendocrine (enterochromaffin cell) tumors characterized by slow growth and low METS

Answer 1

Bronchial carcinoid tumors

Question 2

Serotonin, ACTH, ADH, MSH

Answer 2

Substances secreted by bronchial carcinoid tumors

Question 3

Bronchial carcinoid tumors are usually ___ ___

Answer 3

Well differentiated

Question 4

How many patients with a bronchial carcinoid tumor are asymptomatic?

Answer 4

25-39%

Question 5

What are the two clinical manifestations of bronchial carcinoid tumors?

Answer 5

1. asymptomatic

2. Carcinoid syndrome

Question 6

Diarrhea due to increase in serotonin

Answer 6

Carcinoid syndrome

Question 7

What levels can be increased in bronchial carcinoid tumors that cause flushing, tachycardia, bronchoconstriction, hemodynamic instability, and acidosis?

Answer 7

Bradykinin and histamine

Question 8

How do you diagnose bronchial carcinoid tumors?

Answer 8

“Pink to purple well-vascularized central tumor”

Question 9

How do you manage bronchial carcinoid tumors?

Answer 9

Excision

Question 10

What is the most common cause of cancer deaths in men and women?

Answer 10

Malignant bronchogenic carcinoma

Question 11

What is the most common cause of bronchogenic carcinoma?

Answer 11

Cigarette smoking (including 2nd hand)

Question 12

Bronchogenic carcinoma accounts for ____% of lung cancer seen in smokers

Answer 12

85

Question 13

Where are METS most likely to spread to with bronchogenic carcinoma?

Answer 13

Brain
Bone
Liver
Lymph nodes
Adrenals

Question 14

What is the first line treatment for non small cell carcinoma?

Answer 14

Surgery

Question 15

NSCLC is usually ______ spread

Answer 15

Locally

Question 16

Which Bronchogenic carcinoma accounts for 85% of cases?

Answer 16

NSCLC

Question 17

What ist he most common type of bronchogenic carcinoma in smokers, non smokers, and women?

Answer 17

Adenocarcinoma

Question 18

Adenocarcinoma is typically _______ located

Answer 18

Peripheral

Question 19

Associated with smoking and cavitary lesions, hypercalcemia, and pan coast syndrome

Answer 19

Squamous cell carcinoma

Question 20

Squamous cell carcinoma is typically _______ located

Answer 20

centrally

Question 21

Usually peripheral and very aggressive

Answer 21

Large cell (anaplastic) carcinoma

Question 22

Rare, interstitial lung pattern associated with voluminous sputum; Associated with the best prognosis

Answer 22

Bronchoalveolar NSCLC

Question 23

Metastasizes early* METs usually found on presentation. Increased association with smoking.

Answer 23

Small cell (oat cell) carcinoma SCLC

Question 24

Why is Small cell carcinoma usually central and aggressive?

Answer 24

Bc there is mets at presentation

Question 25

Is surgery usually a treatment of choice for SCLC?

Answer 25

No

Question 26

Small cell carcinoma is eerily associated with?

Answer 26

Paraneoplastic syndromes

Question 27

What ist he management for small cell carcinoma?

Answer 27

Chemotherapy with or without radiation

Question 28

Dilated neck veins, facial plethora, prominent chest veins

Answer 28

SVC syndrome

Question 29

What is SVC syndrome most commonly associated with?

Answer 29

Small cell carcinoma

Question 30

what are the clinical manifestations of bronchogenic carcinoma?

Answer 30

``` Trousseaus syndrome SVC syndrome Hypercalcemia/Hyponatremia Cushing's syndrome Eaton-lambert syndrome Pancoast syndrome ```

Question 31

Hypercalcemia is a clinical manifestation most often associated with?

Answer 31

Squamous cell carcinoma

Question 32

Hypernatremia is a clinical manifestation most often associated with?

Answer 32

Small cell carcinoma

Question 33

Cushing's syndrome and eaton-lambert syndrome most often associated with?

Answer 33

Small cell carcinoma

Question 34

Shoulder pain, horner's syndrome (mitosis, ptosis, anhydrosis), and atrophy of hand/arm muscles are a triad called?

Answer 34

Pancoast syndrome

Question 35

Pancoast syndrome is a clinical manifestation most often associated with?

Answer 35

NSCLC esp. squamous cell

Question 36

Where would you find a pancoast tumor? How does it explain pancoast syndrome?

Answer 36

In the apical region under the clavicle, it presses on cervical CNs

Question 37

How big does a lesion have to be for it to be considered a mass?

Answer 37

3cm

Question 38

Pulmonary nodules are also known as __ __

Answer 38

Coin lesions

Question 39

What are solitary nodules usually a result of?

Answer 39

Old or active TB Fungal infection Foreign body reaction

Question 40

Wegener's granulomatosis, sarcoidosis, and RA are all pulmonary nodules that result from ___

Answer 40

inflammation

Question 41

What is the most common anterior mediastinal tumor?

Answer 41

Thymoma

Question 42

Rounds and smooth (

Answer 42

Benign pulmonary nodule

Question 43

Irregular, speculated Rapid (may double in 4 months) Cavitary with thickened walls

Answer 43

Malignant pulmonary nodule

Question 44

When are pulmonary nodules usually found?

Answer 44

Unexpectedly at radiography; most are asymptomatic

Question 45

What will give an accurate assessment of a pulmonary nodule?

Answer 45

CT

Question 46

How do you definitively diagnose a pulmonary nodule?

Answer 46

Biopsy

Question 47

What is another name for a solitary pulmonary nodule?

Answer 47

Coin lesion

Question 48

What surrounds a coin lesion?

Answer 48

Usually normal lung tissue

Question 49

Granulomas that result from TB, histoplasmosis, and coccidiomycosis are usually what type of pulmonary nodule?

Answer 49

Infectious

Question 50

A lesion that has not enlarged in ___ years suggests a benign cause

Answer 50

2

Question 51

Malignant lesions are usually greater than ___cm in diameter

Answer 51

2

Question 52

Malignant lesions typically have _____ margins

Answer 52

indistinct

Question 53

Malignant lesions usually ____ progress

Answer 53

rapidly

Question 54

Malignant lesions are _______ calcified

Answer 54

rarely

Question 55

How do you manage a pulmonary nodule that has a low probability of malignancy?

Answer 55

They should be watched with CTs every 3 months for a year, then reduced to every 6 months for 2 years

Question 56

How do you manage a pulmonary nodule that has a high probability of malignancy?

Answer 56

Resect ASAP

Question 57

How do you manage a pulmonary nodule that has an intermediate probability of malignancy?

Answer 57

Biopsy

Question 58

What will help delineate the mass and detect adenopathy or the presence of multiple nodules

Answer 58

CT