Oncology

Question 1

What is a pleural effusion

Answer 1

When fluid accumulates within the potential cavity between the 2 layers of pleura
This creates an inward pressure reducing the lung volume

Question 2

Histological types of lung cancer

Answer 2

Small cell (20%)
Non small cell (80%)

Non small cell can be further divided:
- adenocarcinoma (40%)
- SCC (20%)
- large cell carcinoma

Question 3

Why are small cell lung cancers associated with paraneoplastic syndrome

Answer 3

Contain neurosecretory granules that can release neuroendocrine hormones

Question 4

What is mesothelioma

Answer 4

Malignancy of the mesothelial cells lining the pleura
Latent period following asbestosis exposure of up to 45 years
Poor prognosis

Question 5

Extrapulmonary manifestations of lung cancer

Answer 5

Recurrent laryngeal nerve palsy
Phrenic nerve palsy
SVC compression (facial swelling, difficulty breathing, distended veins in neck and upper chest - Pemberton sign)
Horners syndrome - pancoast tumour

Syndrome of inappropriate ADH - ectopic ADH from small cell cancer (hyponatremia)
Cushing’s syndrome (ACTH)
Hypercalcemia - ectopic PTH from squamous cell carcinoma
Limbic encephalitis (small cell lung cancer)
Lambert Eaton myasthenic syndrome - small cell

Question 6

What does ACTH secretion do in small cell lung cancer

Answer 6

Can cause bilateral adrenal hyperplasia
Can result in hypokalaemic alkalosis