Pathology - Lung tumours Flashcards
pulmonary hamartoma and chondroma are examples of which type of tumour?
a. primary benign lung
b. primary malignant lung
c. metastases to lung
a.primary benign lung
bronchogenic carcinoma, malagnant mesothelioma,malignant lymphoma and certain types of mesenchymal sarcoma are classified as
a. primary benign lung
b. primary malignant lung
c. metastases to lung
b.primary malignant lung
what type of spread gives large impressive cannonball tumours ?
a. lymphatic
b. haemotogenous
b.haemotogenous
what type of spread gives a diffuse pattern of tumours ?
a. lymphatic
b. haemotogenous
a.lymphatic
renal cell carcinoma, melanomas, sarcomas and malignant testicular germ cell tumours form metastases to the lungs in the form of large canonnball tumours via which spread?
a. lymphatic
b. haemotogenous
b.haemotogenous
what type of spread occurs by metastases penertrating spaces in the body?
a. lymphatic
b. haemotogenous spread
c. transcolemic
c.transcolemic
multiple variably sized tan round masses in all lung fields are characteristic of which type of cancer?
a. sarcoma
b. metastaic carcinoma
c. pulmonary hamartoma
d. metastatic melanoma
b.metastaic carcinoma
the x ray of a colonic adenocarcinoma in the lung has what appearance?
a. nodular pattern
b. stripes
c. large cannonball tumours
a.nodular pattern
what is the name of a benign tumour of the cartilage?
a. hamartoma
b. chondroma
c. carcinoma
b.chondroma
what is the name of a benign proliferation of mature cartilage, and smooth muscle with entrapped resp epithelium lined clefts?
a. hamartoma
b. chondroma
c. carcinoma
a.hamartoma
which of these benign tumours is more common in females than males?
a. chondroma
b. hamartoma
b.hamartoma
which of these tumours may be ossified?
a. chondroma
b. hamartoma
a. chondroma
which of these tumours tend to be more central
a. chondroma
b. hamartoma
b.hamartoma
which of these tumours tend to be more peripheral
a. chondroma
b. hamartoma
a.chondroma
gastric gastrointestinal stromal tumor, pulmonary chondroma, and extra-adrenal paraganglioma
make up …
a. carneys triad
b. virchows triad
a.carneys triad
which of these tumour types is associated with carneys triad?
a. chondroma
b. hamartoma
a.chondroma
which of these tumours are solitary?
a. chondroma
b. hamartoma
b.hamartoma
which tumour is made up mostly of chondrocytes in a cartilaginous matrix?
a. hamartoma
b. chondroma
b.chondroma
what are primary lung carcinoma classified on the basis of?
a. size
b. spread
c. histology
c.histology
what is the most common form of carcinoma?
a. squamous
b. adeno
c. large cell
d. small cell
b.adeno
what is the most significant cause of metaplasia
a. smoking and bronchiectasis
c. pneumonia
d. asthma
e. occupational hazards
a.smoking and bronchiectasis
injury to epithelium
a permanent change from respiratory cilliated bronchial epithelium to abnormal squamous is known as..
a. dysplasia
b. carcinoma
c. metaplasia
c.metaplasia
a permanent change from normal cell type to abnormal version of that cell.
a. dysplasia
b. carcinoma
c. metaplasia
a.dysplasia
what change supervenes with progression to carcinoma in situ
a. metaplasia
b. dysplasia
b.dysplasia
where is lung carcinoma normally situated
a. close to fissures
b. centre of lung close to hilum
c. periphery of lungs
d. external to the lungs
b.centre of lung close to hilum
where do adenocarcinomas develop?
a. close to fissures
b. centre of lung close to hilum
c. periphery of lungs
d. external to the lungs
c. periphery of lungs
associated with areas of fibrous scarring
what is the precursos legion for an adenocarcinoma?
a. metaplasia in bronchial
b. atypical adenotamous hyperplasia
c. typical adenotmaous hyperplasia
b.atypical adenotamous hyperplasia
what runs above the pulmonary sleeve on the medial right lung?
a. SVC
b. rib 1
c. aortic arch
d. azygous arch
e. left ventrivcle
d.azygous arch
what runs superior and medial on the medial right lung?
a. SVC
b. rib 1
c. aortic arch
d. azygous arch
e. left ventrivcle
a.SVC
what runs medial on the medial right lung?
a. SVC
b. right atrium
c. aortic arch
d. azygous arch
e. left ventrivcle
b.right atrium
what runs medial on the medial left lung?
a. SVC
b. right atrium
c. aortic arch
d. azygous arch
e. left ventrivcle
e.left ventrivcle
what runs superior to the hila on the medial left lung?
a. SVC
b. right atrium
c. aortic arch
d. azygous arch
e. left ventrivcle
c.aortic arch
collapse of the lung distal to a tumour leads to?
a. stroke
b. metasteses
c. infection
c.infection
ulceration of which structure as a result of tumour presence causes haemoptysis?
a. pulmonary artery /veins
b. superior vena cava
c. recurrent larangeal nerve
d. phrenic nerve
e. pleura
a.pulmonary artery /veins
invasion of which structure as a result of tumour presence causes fixed elevated JVP?
a. pulmonary artery /veins
b. superior vena cava
c. recurrent larangeal nerve
d. phrenic nerve
e. pleura
b. superior vena cava
invasion of which structure as a result of tumour presence causes hoarseness?
a. pulmonary artery /veins
b. superior vena cava
c. recurrent larangeal nerve
d. phrenic nerve
e. pleura
c. recurrent larangeal nerve
invasion of which structure as a result of tumour presence causes elevation of a hemidiaphragm?
a. pulmonary artery /veins
b. superior vena cava
c. recurrent larangeal nerve
d. phrenic nerve
e. pleura
d.phrenic nerve
invasion of which structure as a result of tumour presence causes malignant pericardial effusion, atrial fibrilation and arrhythmias?
a. pericardium
b. carina, oesophagus and vertebra
c. recurrent larangeal nerve
d. phrenic nerve
e. pleura
a.pericardium
invasion of which structure as a result of tumour presence causes malignant pleural effusion?
a. pericardium
b. carina, oesophagus and vertebra
c. recurrent larangeal nerve
d. phrenic nerve
e. pleura
e.pleura
what 3 symptoms make up Horners syndrome?
miosis, ptosis and anhidrosis
compression of which structure by a tumour leads to horners syndrome?
a. superior vena cava
b. recurrent larangeal nerve
c. pleura
d. pericardium
e. sympathetic/stellate ganglion
e.sympathetic/stellate ganglion
which tumour is found often at the apex of lungs compressing the superior vena cava?
a. carcinoma
b. adenocarcinoma
c. pancoast
c.pancoast
A 65 year old male smoker presents with shortness of breath,
cough and facial swelling. Chest Xray and CT show a right hilar mass
in keeping with a tumour. A fixed elevated JVP is likely to be
caused by invasion of which anatomical structure by carcinoma.
A Aortic arch
B Pericardium
C Pulmonary vein
D Recurrent laryngeal nerve
E.superior vena cava
E.superior vena cava
a tumour in both lungs/spread to other body parts/tumour in fluid or lining of lungs and heart is known as?
a. metastaic lung adenocarcinoma
b. metastatic lung carcinoma
c. hamartoma
d. chondroma
b.metastatic lung carcinoma
what is metastaticlung carcinoma also known as?
a. stage V disease
b. stage II disease
c. stage IV disease
c.stage IV disease
which of these factors does not affect lung cancer staging?
a. tumour size
b. lymph nodes
c. metastases
d. tumour shape
d. tumour shape
staging of tumours is informed by clinical examinations ,pathological examination and what other investigation?
a. Xray
b. radiography
c. blood tests
b.radiography
what is the largest tumour size
a. 1
b. 2
c. 3
d. 4
d.4
What does N refer to in tumour classification?
a. tumour size
b. degree of lymph node involvement
c. extent of distant metastases
b.degree of lymph node involvement
when all lymph nodes are involved in metasteses what is the N grade of the tumour?
a. 1
b. 2
c. 3
b.2
when no lymph nodes are involved in metastases what number is it given for N?
a. 0
b. 1
c. 2
a.0
tumour size values run from..
a. 1-4
b. 0-2
a.1-4
lymph node and metastases values run from..
a. 1-4
b. 0-2
b.0-2
when a tumour has metastasised to the lung only it is given the m number..
a. 1
b. 0
c. 2
a.1
when a tumour has metastasised to the lung and which other organ it is given the m number 2
a. spleen
b. kidney
c. liver
c.liver
which of these is the name for an adenocarcinoma in situ/
a. Tis (AIS)
b. T1mi
c. Tis (SCIS)
d. T1b
e. T1a
a.Tis (AIS)
which of these is the name for a minimally invasise adenocarcinoma
a. Tis (AIS)
b. T1mi
c. Tis (SCIS)
d. T1b
e. T1a
b.T1mi
which of these is the name for a squamous cell carcinoma in situ
a. Tis (AIS)
b. T1mi
c. Tis (SCIS)
d. T1b
e. T1a
c.Tis (SCIS)
which of these is the name for a tumour less than 10mm
a. Tis (AIS)
b. T1mi
c. Tis (SCIS)
d. T1b
e. T1a
e.T1a
which of these is the name for a tumour less than 20mm more than 10mm
a. Tis (AIS)
b. T1mi
c. Tis (SCIS)
d. T1b
e. T1a
d.T1b
which of these is not a feature along with being 30-50mm that makes a tumour T2
a. invades visceral pleura
b. invades main bronchus
c. associated with alectasis/pneumonitis that extends into the hilar region
d. invades the pericardium
d.invades the pericardium
which metastases leads to epilepsy
a. cerebral
b. bone
c. bronchial
a.cerebral
which metastases leads to pain and fracture
a. cerebral
b. bone
c. bronchial
b.bone
a malignant lung tumour has what effect on the hands
a. peripheral cyanosis
b. thenar wasting
c. finger clubbing
c. finger clubbing
true or false paraneoplastic syndromes are not explained by local effect or metastases or hormones indigenous to the tissue from which the tumour arose
a. true
b. false
a.true
paraneoplastic syndromes arise from immune cross reactivity between malignant and normal tissues and tumour secretion of hormones , peptides and which other substance?
a. cytokines
b. prostagaldins
c. lipids
d. neurotransmitters
a.cytokines
which cancer is most commonly associated with paraneoplastic syndromes?
a. breast cancer
b. gynacological tumours
c. haemotological malignancies
d. small cell lung cancer
d. small cell lung cancer
which of these syndromes is a neurologic paraneoplastic syndrome?
a. eaton lambert
b. cushings
c. hypertrophic osteoarthropathy
d. SIADH
a.eaton lambert
which of these syndromes is a hormonal paraneoplastic syndrome?
a. eaton lambert
b. cushings
c. hypertrophic osteoarthropathy
d. SIADH
b.cushings
which of these syndromes is a musculoskeletal paraneoplastic syndrome?
a. eaton lambert
b. cushings
c. hypertrophic osteoarthropathy
d. SIADH
c. hypertrophic osteoarthropathy
which of these paraneoplastic syndromes is an immune mediated , myasthenia like syndrome - weakness affecting the limbs and sparing eye and head muscles?
a. eaton lambert
b. cushings
c. hypertrophic osteoarthropathy
d. SIADH
a.eaton lambert
true or flase eaton lambert is immune mediated
a. true
b. false
a.true
eaton lambert syndrome..
a. preceeds cancer
b. occurs with cancer
c. develops after cancer
d. all three
d.all three
who does eaton lambert occur most commonly in?
a. women
b. men
c. elderly
d. young
b.men
most men with eaton lambert syndrome have what type of tumour?
a. small cell lung carcinoma
b. metastic adenocarcinoma
c. metastatic carcinoma
a.small cell lung carcinoma
fatigability, weakness, pain in proximal limb muscles, peripheral parathesis,dry mouth,erectile dysfunction and ptosis are symptoms of which paraneoplastic syndrome?
a. eaton lambert
b. cushings
c. hypertrophic osteoarthropathy
d. SIADH
a.eaton lambert
which cancers are responsible for cushings by paraneoplastic syndrome?
a. small cell and bronchial carcinoids
b. adenocarcinoma
c. squamous carcinoma
d. large cell
a.small cell and bronchial carcinoids
when do cushings syndrome symptoms normally present?
a. preceeds cancer
b. occurs with cancer
c. develops after cancer
d. all three
a.preceeds cancer
painful swelling of joints and finger clubbing is associated with which paraneoplastic syndrome?
a. eaton lambert
b. cushings
c. hypertrophic osteoarthropathy
d. SIADH
c. hypertrophic osteoarthropathy
hypo-osmotic euvolaemic hyponatraemia happens as a result of which paraneoplastic syndrome?
a. eaton lambert
b. cushings
c. hypertrophic osteoarthropathy
d. SIADH
d.SIADH
syndrome of inappropriate antidiuretic hormone secretion
SIADH is associated with small cell cancer. It arises from tumour cell production of ADH and which other substance?
a. cytokines
b. prostaglandins
c. atrial natrieuretic peptide
d. brain natriuretic peptide
c.atrial natrieuretic peptide
which type of lung cancer is associated with asbestos?
a. malignant mesothelioma
b. small cell carcinoma
d. squamous carcinoma
e. adenocarcinoma
a.malignant mesothelioma
calcified pleural plaques on a chest x ray/CT indicate which cancer caused by asbestos exposure?
a. malignant mesothelioma
b. small cell carcinoma
d. squamous carcinoma
e. adenocarcinoma
a.malignant mesothelioma
A 75 year old female smoker develops hirsutism and a rounded face. Cushing’s syndrome is
suspected. CT shows numerous abnormal enlarged mediastinal and cervical lymph nodes.
Core biopsy of one of the cervical lymph nodes is most likely to show:
A Hodgkins’ Lymphoma
B Metastatic adenocarcinoma
C Metastatic malignant mesothelioma
D Metastatic small cell carcinoma
E Metastatic squamous cell carcinoma
D Metastatic small cell carcinoma
A 70 year old retired shipyard worker presents with shortness of
breath. Chest X ray and CT confirm a pleural effusion and show
pleural plaques. No hilar lesion but abnormal thickening of pleura
on CT . A pleural tap drains 750mls of blood stained fluid. On
examination in the laboratory , the pleural fluid is most likely to
contain malignant cells from:
A Adenocarcinoma of the lung.
B Malignant mesothelioma
C Small cell carcinoma of lung
D Squamous cell carcinoma of lung
E Renal cell carcinoma
B Malignant mesothelioma
true or false small cell carcinoma is treated with surgery
a. true
b. false
b.false
because of high rates of metastasis
if the lung cancer has unfound drivers, high mutation load or high PD-L1 expression how is it treated?
a. targeted with specific inhibitors
b. immunotherapy
b.immunotherapy
what is the main driver mutation for adenocarcinoma?\
a. EGFR
b. KRas
c. Alk
d. HER2
a.EGFR
A 40 year old female non-smoker presents with shortness of breath and weight loss. CT
shows a peripheral left lower lobe mass. Core biopsy of an enlarged neck node shows
metastatic adenocarcinoma with features in keeping with a lung primary. Which
molecular biomarker is most likely to influence subsequent treatment?
A BRAF mutation
B EGFR mutation
C HER2 amplification
D Microsatellite instability
E PDL1 Expression
B EGFR mutation
