Paraneoplastic Syndromes

Question 1

All of the following are paraneoplastic syndromes and are all associated with small cell lung cancer. However, which ONE of this associated with squamous cell carcinoma?

1 - Syndrome of inappropriate antidiuretic hormone ADH release (SIADH)
2 - Pancost tumour
3 - Cushing’s syndrome
4 - Lambert-Eaton myasthenic syndrome
5 - Hypercalcaemia
6 - Limbic encephalitis

Answer 1

5 - Hypercalcaemia

Question 2

Syndrome of inappropriate antidiuretic hormone ADH release (SIADH) results in the kidneys retaining fluid. Which of the following lung cancers is this most commonly associated with?

1 - small cell lung cancer
2 - adenocarcinoma
3 - pancoast tumour
4 - squamous cell carcinoma

Answer 2

1 - small cell lung cancer

Typically ADH retains fluid and causes vasoconstriction

This helps maintain BP

Question 3

Syndrome of inappropriate antidiuretic hormone ADH release (SIADH) results in the kidneys retaining fluid and is most commonly ectopic release of ADH in small cell lung cancer. What is often the most common symptom this presents with?

1 - hypercalcaemia
2 - hyperkalaemia
3 - hyponatraemia
4 - hypernatraemia

Answer 3

3 - hyponatraemia

Excess ADH results in retention of fluid
Na+ is diluted in the circulation

Question 4

A pancoast tumour is a rare tumour that develops in the top of our lungs. This can lead to all of the following symptoms, EXCEPT which one?

1 - mitosis
2 - miosis
3 - anhidrosis
4 - ptosis

Answer 4

1 - mitosis

Mitosis = cells dividing
Miosis = dilated pupil
Anhidrosis = lack of sweating
Ptosis = drooping of the eye lid

Question 5

Cushing’s syndrome is caused by excess of which hormone?

1 - adrenaline
2 - T4
3 - aldosterone
4 - cortisol

can be caused by ectopic ACTH secretion by a small-cell lung cancer.

Answer 5

4 - cortisol

Question 6

Cushing’s syndrome is caused by excessive cortisol. Which of the following lung tumours is this most commonly associated with?

1 - small cell lung cancer
2 - adenocarcinoma
3 - pancoast tumour
4 - squamous cell carcinoma

Answer 6

1 - small cell lung cancer

Question 7

Cushing’s syndrome is caused by excessive cortisol and is associated with small cell lung cancers due to ectopic release of Adrenocorticotropic hormone (ACTH). Which of the following is NOT a symptom common in Cushing syndrome?

1 - weight loss
2 - thin arms and legs and weak muscles
3 - a round face
4 - increased fat in neck and back hump
5 - wide purple stretch marks

Answer 7

1 - weight loss

Causes weight gain

Question 8

Hypercalcaemia can be caused by ectopic parathyroid hormone, most commonly secreted by which lung cancer?

1 - small cell lung cancer
2 - squamous cell carcinoma
3 - adenocarcinoma
4 - pancoast tumour

Answer 8

2 - squamous cell carcinoma

Question 9

Lambert-Eaton myasthenic syndrome is a rare autoimmune disease that attacks the peripheral nervous system, causing muscle weakness, and actually improves temporarily after repeated use of the muscle. Which lung cancer do antibodies typically target in this syndrome?

1 - small cell lung cancer
2 - squamous cell carcinoma
3 - adenocarcinoma
4 - pancoast tumour

Answer 9

1 - small cell lung cancer

Question 10

Lambert-Eaton myasthenic syndrome is a rare autoimmune disease that attacks the peripheral nervous system, causing muscle weakness, and actually improves temporarily after repeated use of the muscle and is associated with small cell lung cancers. All of the following muscle groups are affected, but which is most commonly affected?

1 - intraocular muscles, causing diplopia (double vision)
2 - levator muscles in the eyelid (ptosis)
3 - proximal muscles (upper limbs)
4 - pharyngeal muscles (slurred speech and dysphagia (difficulty swallowing)

Answer 10

3 - proximal muscles (upper limbs)

Question 11

Limbic encephalitis is a paraneoplastic syndrome where antibodies are produced that target the brain (encephalic tissue). Which of the following lung cancers is this most common in?

1 - small cell lung cancer
2 - squamous cell carcinoma
3 - adenocarcinoma
4 - pancoast tumour

where small-cell lung cancer causes the immune system to make antibodies to tissues in the brain, specifically the limbic system, causing inflammation in these areas. This causes symptoms such as short-term memory impairment, hallucinations, confusion and seizures. It is associated with anti-Hu antibodies.

Answer 11

1 - small cell lung cancer

Question 12

Limbic encephalitis is a paraneoplastic syndrome where antibodies are produced that target the brain (encephalic tissue). This is most commonly associated with small cell lung cancer. Which of the following is NOT a clinical presentation of this?

1 - short-term memory impairment
2 - hallucinations
3 - confusion and seizures
4 - vision loss

Answer 12

4 - vision loss

Commonly associated with anti-Hu antibodies