Neoplastic (heads up these kinda suck)

Question 1

What are 4 examples of pulmonary nodules?

Answer 1

1. granulomatous infections
2. inflammation
3. mediastinal tumors
4. tumors in general

Question 2

What types of things are granulomatous?

Answer 2

TB, histoplasmosis, coccidiomycosis

Question 3

What diseases cause inflammatory nodules of the lungs?

Answer 3

RA, sarcoidosis, Wegener’s granulomatosis

Question 4

What would cause a mediastinal tumor?

Answer 4

thymoma

(aren’t you glad we learned all this? nahhht)

Question 5

What are characteristics of a benign nodule?

Answer 5

round, smooth, < 3cm

slow growth

calcifications present

cavitary present

Question 6

What are characteristics of a malignant tumor?

Answer 6

irregular, spiculated

rapid growth (may double in 4 mos)

cavitary with thick walls

Question 7

What is a bronchogenic carcinoma?

Answer 7

a benign or malignant neoplasm

Question 8

In whom do you find malignant bronchogenic carcinomas?

What causes them?

Answer 8

50-60y MC

cigarette smokers or 2ndhand exposure MC cause (asbestosis 2nd MC)

Question 9

Where is the greatest tendency for bronchogenic carcinoma to METS?

Answer 9

brain, bone, liver, lymph nodes, adrenals

Question 10

What are examples of non small cell carcinoma (NSCLC)?

Answer 10

adenocarcinoma

squamous cell carc

large cell (anaplastic) carc

bronchoalveolar carc

Question 11

Who gets adenocarcinoma and where is it in the lungs?

Answer 11

MC in both smokers and non, women

peripheral

Question 12

Where is squamous cell carcinoma found?

What is it assoc with on dx tests?

Answer 12

Found centrally

common in smokers

assoc with cavitary lesions, hypercalcemia, and Pancoast syndrome

Question 13

Where is large cell (anaplastic) carcinoma found?

What is this type of cancer like?

Answer 13

found peripherally

very aggressive

Question 14

How common is bronchoalveolar carcinoma?

How do patients respond to tx?

Answer 14

Rare.

Very good prognosis!!!

Question 15

What is the treatment for all these non small cell carcinomas?

Answer 15

usually local spread, so surgery is 1st line

Question 16

What are the characteristics of small cell (oat cell) carcinoma (SCLC)?

Answer 16

metastasizes early, so METS usually found

assoc. with smoking

central and aggressive

Question 17

What are treatment options for small cell carcinoma?

Answer 17

not surgery, because of METS

chemo w/ or w/o radiotherapy

Question 18

What are clinical manifestations of bronchogenic carcinoma?

Answer 18

asymptomatic

cough, hemoptysis, dyspnea, anorexia, wt loss

Trousseau’s syndrome (inc blood clotting d/o)

Other syndromes that will show up on the next cards: SVC, Cushing’s, Pancoast

Question 19

What is SVC syndrome?

Answer 19

dilated neck veins, facial plethora, prominent chest veins

assoc. with bronchogenic carc

Question 20

What is Cushing’s syndrome?

Answer 20

ectopic ACTH production, Eaton-Lambert syndrome (neuromuscular d/o)

assoc. with bronchogenic carc

Question 21

What is Pancoast syndrome?

Answer 21

esp with NSCLC

causes shoulder pain and Horner’s syndrome (miosis, ptosis, anhydrosis)

atrophy of hand/arm muscles

assoc. with bronchogenic carc

Question 22

What will your ABG labs show you with bronchogenic carcinoma?

Answer 22

Hypercalcemia

SIADH/hyponatremia

Question 23

Which findings are more common in small cell carcinoma?

Answer 23

SIADH/hyponatremia

Eaton-lambert syndrome

SVC syndrome

Question 24

Which finding is more common with squamous cell carcinoma?

Answer 24

Pancoast syndrome

Question 25

What are bronchial carcinoid tumors?

Answer 25

rare neuro-endocrine tumors characterized by slow growth and low METS

Question 26

What can bronchial carcinoid tumors secrete?

Answer 26

serotonin, ACTH, ADH, and MSH

Question 27

What are the clinical manifestations of a bronchial carcinoid tumor?

Answer 27

many asymptomatic, but show Cushing’s syndrome, obstruction, and hemoptysis

if not asymptomatic, will show “carcinoid syndrome”

Question 28

What is carcinoid syndrome?

Answer 28

diarrhea due to high serotonin, flushing, tachycardia, bronchoconstriction, hemodynamic instability

Question 29

How do you dx bronchial carcinoid tumors?

Answer 29

“pink to purple well-vascularized central tumor”

Question 30

How do you treat a bronchial carcinoid tumor?

Answer 30

tumor excision (surgery)

Question 31

Aaaand what do we need to know about metastatic tumors?

Answer 31

Like really.. just that it’s cancer from another part of the body that metastasized to the lung?

Sounds good to me