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1Fall24 PoA II > Oncology pt3 > Flashcards

Oncology pt3 Flashcards

1
Q

What is the major cause of lung cancer?

A

Tobacco smoke (90%)

3 decade lag time in cancer occurrence

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2
Q

What substances commonly cause lung cancer other than tobacco? (2)

A
  • Asbestos
  • Radon gas
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3
Q

What are the types of lung cancer? (4) Which is most prevalent?

A
  • Small cell
  • Non-small cell (75-80%)
  • Carcinoid
  • Mesothelioma
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4
Q

What are the subtypes of non-small-cell lung cancer? (3)

A

NSCLC Lung cancer:

  • Squamous
  • Adenocarcinoma
  • Large cell
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5
Q

What type of lung cancer makes up 75-80% of cases?

A

Non-small cell

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6
Q

What is the typical origin of small cell lung cancer?

A

Neuroendocrine

Thus the cancer is typically metastatic on presentation

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7
Q

What lung cancer always recurs and is resistant to further treatment?

A

Small cell lung cancer

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8
Q

What are possible large side effects of small cell lung cancer? (3)

A
  • ↓ Na⁺ [SIADH]
  • Hypercortisolism [Cushings]
  • Lambert-Eaton Syndrome
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9
Q

What is the name for the disease called hypercortisolism?

A

Cushing’s Disease

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10
Q

Lambert-Eaton syndrome involves weakness/fatiguability symptoms that ________ as the day goes on and with exercise.

A

improves with exercise

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11
Q

Myasthenia Gravis involves weakness/fatiguability symptoms that ________ as the day goes on.

A

worsen with exercise and throughout the day

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12
Q

Lack of improvement with acetylcholinesterase inhibitors and extreme sensitivity to non-depolarizing neuromuscular blockers are characteristics of what disease?

A

Lambert-Eaton Syndrome (LEMS)

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13
Q

What tumor type is mostly benign and has great (>90%) 5 year survival rates?

A

carcinoid tumors

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14
Q

Carcinoid syndrome usually results from tumor originating from where?

A

GI tract

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15
Q

What are characteristics of Carcinoid Syndrome? (3)

A
  • Tumor secretion of serotonin, histamine, PG’s, tachykinins, kallikrein
  • Hemodynamic collapse unresponsive to pressors
  • Coronary artery spasm
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16
Q

How is carcinoid syndrome treated? What do these drugs do?

A

Octreotide & Somatostatin

These inhibit tumor growth, angiogenesis, and the hormones secreted from the tumor.

17
Q

What type of lung cancer has a 5-year survival rate that greatly improves with surgery?

A

Non-small cell lung cancer (NSCLC)

  • 10% w/o surgery
  • 40% w/ surgery
18
Q

Squamous cell lung cancers grow to a large size but _______ late.

A

metastasize late

19
Q

What are possible consequences of squamous cancer’s large growth (mass effect)? (3)

A

Mass Effect:

  • Hemoptysis
  • Obstructive PNA
  • Superior Vena Cava syndrome
20
Q

What is the most common subtype of non-small cell lung cancers?

A

Adenocarcinomas

21
Q

Adenocarcinomas will typically metastasize ______.

A

metastasize early

22
Q

What two hormones are often secreted by adenocarcinomas? (2)

A
  • Growth Hormone
  • ACTH

⇶ cushings symptoms

23
Q

What is the least common non-small cell lung cancer subtype?
What should be known about its metastatic characteristics?

A
  • Large cell
  • Metastasizes rapidly
24
Q

NSAIDs can induce acute respiratory failure when combined with what chemotherapeutic?

A

Cisplatin

25
Q

What factors can help predict one lung desaturation? (3)

A
  • High % of Ventilation or perfusion to operative lung on the preoperative V/Q scan.
  • Poor PaO₂ during two lung ventilation
  • Right sided thoracotomy
26
Q

What is the formula for predicted post-operative FEV₁ ?

A

PreopFEV1 x (1-(%resection/100))

If 70% FEV1 preop and resecting RLL

  • RLL = 12/42 = 29% resection
  • 70 x (1-(29/100))
  • ppoFEV1=49.7%
27
Q

A patient has had a right upper and right middle lobectomy done. The patients preoperative FEV₁ was 60%. What is the predicted post-operative FEV₁ ?

A

ppoFEV₁ = 60 x (1 - 23.8/100)

ppoFEV₁ = 45.72%

28
Q

How many dermatomes are typically covered via a paravertebral block?

A

4-6 dermatomes

29
Q

What are contraindications for paravertebral blocks? (4)

A
  • Site infection
  • Empyema
  • Paravertebral tumor
  • Kyphoscoliosis
30
Q

A paravertebral block at ___ is necessary for a sternotomy.

A

T4

31
Q

A paravertebral block at ___ is necessary for a thoracotomy.

A

T6

32
Q

A paravertebral block at ___ is necessary for abdominal procedures.

A

T10

33
Q

What is required for intercostal nerve block?

A

Blockade 2 dermatomes above and 2 dermatomes below incision.

34
Q

What are indications for intercostal nerve block? (3)

A
  • Thorax surgery
  • Upper abdomen surgery
  • Mastectomy
35
Q

What are disadvantages associated with intercostal nerve block? (2)

A
  • Pneumothorax risk
  • LA toxicity (especially if multiple levels are blocked).
36
Q

Flip for intercostal nerve block pictures.

A
37
Q

What is the leading cause of cancer deaths in both genders?

A

Lung cancer

38
Q

What are 3 subtypes of non-small cell lung cancer?

A
  • squamous cell
  • adenocarcinoma
  • large-cell
39
Q

What are the 4 M’s of assessment for patients with lung cancer?

A
  • Mass effect
  • Metabolic abnormalities
  • Metastases
  • Medications

1Fall24 PoA II (34 decks)

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