Pathology, principles, resp, cardio, GI. Flashcards
What are local effects of lung cancer?
Airway obstruction - pneumonia.
Chest wall invasion - pain.
Ulceration - haemoptysis.
What does PTH suggest in regards to lung cancer?
Squamous cell lung cancer.
What does ACHT suggest in regards to lung cancer?
Small cell lung cancer.
What are the 4 common smoking-associated types of lung tumour?
- Adenocarcinoma.
- Squamous cell carcinoma.
- Small cell carcinoma.
- Large cell carcinoma.
How may histological diagnosis of lung cancer be made?
Bronchoscopy and biopsy of tumour.
Biopsy or needle aspiration of metastases.
Feature of squamous cell lung carcinoma?
Keratinising.
Feature of lung adenocarcinoma?
Gland forming, mucin production
Which type of lung cancer has the worst prognosis?
Small cell, almost all diagnosed are dead at one year.
Main treatment for small cell lung cancer?
Chemotherapy, but has shown rapidly emerging resistance.
What is the treatment of choice in non-small cell lung cancers?
Surgery.
Which oncogene do small cell and non-small cell lung cancer share?
myc.
what are typical bronchial (large airway tumours)?
Squamous cell carcinoma. Often dysplastic, or carcinoma in situ, eventually displaying invasive malignancy.
Describe peripheral adenocarcinomas.
Display atypical adenomatous hyperplasia, and spread of neoplastic cells along alveolar walls. They are true invasive adenocarcinomas, becoming more common.
What are prognostic indicators in lung cancer?
Tumour staging and histological subtype.
What are carcinoid lung neoplasms?
Neuroendocrine neoplasms of low-grade malignancy.
Define neoplasm.
New and abnormal growth. commonly referred to as a tumour.
What is a lung abscess?
A localized collection of pus, tumour-like. Causes chronic malaise and fever. May result from aspiration.
Pathogenesis of ARDS?
Injury (e.g. by bacterial endotoxin), causing infiltration of inflammatory cells, cytokines, oxygen free radicals and injury to cell membranes.
This results in a fibrinous exudate lining alveolar walls (hyaline membrane), cellular regeneration and inflammation.
Define embolus.
Embolus is a mass (typically thrombus, but may be fat, foreign bodies, gas, tumour clumps), carried by the blood to a site in the body, distant of its origin.
Virchow’s triad.
- Endothelial injury
- Hypercoagulability (cancer, post MI)
- Stasis of blood flow
Pathology of pulmonary hypertension.
Hypoxia, increased flow through pulmonary circulation (congenital heart disease), blockage or loss of pulmonary vascular bed, back pressure from left-sided heart failure.
Morphology of pulmonary hypertension.
Medial hypertrophy of arteries, intimal thickening (fibrosis), atheroma, RV hypertrophy, extreme cases (congenital heart disease, primary pulmonary hypertension).
Purulent effusion.
Effusion filled with acute inflammatory cells, aka empyema. It may become chronic.
Define pneumothorax.
Air in the pleural space, may occur due to trauma or rupture of bulla.
Primary pleural neoplasia.
Most likely malignant mesothelioma, rarely benign.
Secondary pleural neoplasia.
Common, e.g. adenocarcinomas of the lung.
Mesothelioma.
Related to asbestos exposure, results in mixed epithelial/mesenchymal differentiation. Dismal prognosis.
Acute anaphylaxis.
Type 1 hypersensitivity (IgE) reaction. Causes flushing, pruritis, urticarial, angioneurotic oedema, abdo. pain, vomiting, hypotension, shock, stridor, wheeze, respiratory failure.
