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Clinical Medicine II > Neoplastic Disorders > Flashcards

Neoplastic Disorders Flashcards

1
Q

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

A

Bronchial carcinoid tumors

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2
Q

Serotonin, ACTH, ADH, MSH

A

Substances secreted by bronchial carcinoid tumors

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3
Q

Bronchial carcinoid tumors are usually ___ ___

A

Well differentiated

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4
Q

How many patients with a bronchial carcinoid tumor are asymptomatic?

A

25-39%

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5
Q

What are the two clinical manifestations of bronchial carcinoid tumors?

A
  1. asymptomatic

2. Carcinoid syndrome

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6
Q

Diarrhea due to increase in serotonin

A

Carcinoid syndrome

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7
Q

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

A

Bradykinin and histamine

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8
Q

How do you diagnose bronchial carcinoid tumors?

A

“Pink to purple well-vascularized central tumor”

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9
Q

How do you manage bronchial carcinoid tumors?

A

Excision

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10
Q

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

A

Malignant bronchogenic carcinoma

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11
Q

What is the most common cause of bronchogenic carcinoma?

A

Cigarette smoking (including 2nd hand)

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12
Q

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

A

85

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13
Q

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

A 
Brain
Bone
Liver
Lymph nodes
Adrenals
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14
Q

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

A

Surgery

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15
Q

NSCLC is usually ______ spread

A

Locally

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16
Q

Which Bronchogenic carcinoma accounts for 85% of cases?

A

NSCLC

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17
Q

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

A

Adenocarcinoma

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18
Q

Adenocarcinoma is typically _______ located

A

Peripheral

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19
Q

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

A

Squamous cell carcinoma

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20
Q

Squamous cell carcinoma is typically _______ located

A

centrally

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21
Q

Usually peripheral and very aggressive

A

Large cell (anaplastic) carcinoma

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22
Q

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

A

Bronchoalveolar NSCLC

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23
Q

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

A

Small cell (oat cell) carcinoma SCLC

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24
Q

Why is Small cell carcinoma usually central and aggressive?

A

Bc there is mets at presentation

25
Q

Is surgery usually a treatment of choice for SCLC?

A

No

26
Q

Small cell carcinoma is eerily associated with?

A

Paraneoplastic syndromes

27
Q

What ist he management for small cell carcinoma?

A

Chemotherapy with or without radiation

28
Q

Dilated neck veins, facial plethora, prominent chest veins

A

SVC syndrome

29
Q

What is SVC syndrome most commonly associated with?

A

Small cell carcinoma

30
Q

what are the clinical manifestations of bronchogenic carcinoma?

A 
Trousseaus syndrome
SVC syndrome 
Hypercalcemia/Hyponatremia
Cushing's syndrome
Eaton-lambert syndrome
Pancoast syndrome
31
Q

Hypercalcemia is a clinical manifestation most often associated with?

A

Squamous cell carcinoma

32
Q

Hypernatremia is a clinical manifestation most often associated with?

A

Small cell carcinoma

33
Q

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

A

Small cell carcinoma

34
Q

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

A

Pancoast syndrome

35
Q

Pancoast syndrome is a clinical manifestation most often associated with?

A

NSCLC esp. squamous cell

36
Q

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

A

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

37
Q

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

A

3cm

38
Q

Pulmonary nodules are also known as __ __

A

Coin lesions

39
Q

What are solitary nodules usually a result of?

A

Old or active TB
Fungal infection
Foreign body reaction

40
Q

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

A

inflammation

41
Q

What is the most common anterior mediastinal tumor?

A

Thymoma

42
Q

Rounds and smooth (

A

Benign pulmonary nodule

43
Q

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

A

Malignant pulmonary nodule

44
Q

When are pulmonary nodules usually found?

A

Unexpectedly at radiography; most are asymptomatic

45
Q

What will give an accurate assessment of a pulmonary nodule?

A

CT

46
Q

How do you definitively diagnose a pulmonary nodule?

A

Biopsy

47
Q

What is another name for a solitary pulmonary nodule?

A

Coin lesion

48
Q

What surrounds a coin lesion?

A

Usually normal lung tissue

49
Q

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

A

Infectious

50
Q

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

A

2

51
Q

Malignant lesions are usually greater than ___cm in diameter

A

2

52
Q

Malignant lesions typically have _____ margins

A

indistinct

53
Q

Malignant lesions usually ____ progress

A

rapidly

54
Q

Malignant lesions are _______ calcified

A

rarely

55
Q

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

A

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

56
Q

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

A

Resect ASAP

57
Q

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

A

Biopsy

58
Q

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

A

CT

Clinical Medicine II (10 decks)

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