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STEP 2 Pulmonary > Pulm. Cancer > Flashcards

Pulm. Cancer Flashcards

1
Q
A
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2
Q

Screening. what 2 criteria?

A

recommended for patients that fullfill 2 criteria:
1. >20 pack years smoking history

  1. Currently smoking or quit smoking within the past 15 years. (if stopped >= 15 years, do not needed to be screened)
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3
Q

Screening. what recommended test?

A

low dose CT scan of the chest

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4
Q

Screening. Recommended interval?

A

Yearly

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5
Q

Screening. age?

A

50-80 years

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6
Q

Screening. termination of screening? 2

A

Patient successfully quit smoking for >= 15 years
OR
Patient has medical conditions that significantly limit life expectancy

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7
Q

Adenocarcinoma. Incidence?

A

40-50 proc.

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8
Q

Adenocarcinoma. location?
treatment?

A

peripheral (involves pleura)

Stage
Chemoradiation
Resection

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9
Q

Adenocarcinoma. clinical associations? 2

A

Clubbing
Hyperthrophic osteoarthropathy

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10
Q

Squamous cell carcinoma. incidence?

A

20-25 proc.

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11
Q

Squamous cell carcinoma. location?
treatment?

A

Central
Necrosis and cavitation

Stage
Chemoradiation
Resection

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12
Q

Squamous cell carcinoma. clinical assoc?

A

Hypercalcemia (PTH-rp)

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13
Q

Small cell carcinoma. incidence?

A

10-15 proc.

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14
Q

Small cell carcinoma. location?
Treatment?

A

Central
Chemoradiation

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15
Q

Small cell carcinoma. clinical assoc?

A

Cushing syndrome (ACTH)
SIADH (ADH)
Lambert-Eaton syndrome

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16
Q

Large cell carcinoma. incidence?

A

5-10 proc.

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17
Q

Large cell carcinoma. location?

A

Peripheral

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18
Q

Large cell carcinoma. clinical assoc?

A

Gynecomastia
Galactorrhea

Secretes b-hcg

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19
Q

Solitary pulmonary nodule. definition?

A

It is defined by the features of round opacity, up to 3 cm in diameter, and surrounded by
pulmonary parenchyma
+ no assoc LN enlargement

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20
Q

Solitary pulmonary nodule.
by convention is must not be assoc. with what?

A

pleural effusion, adenopathy, or atelectasis

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21
Q

Solitary pulmonary nodule.
Most nodules are benign (eg, infectious granuloma, hamartoma)

A

.

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22
Q

Solitary pulmonary nodule. causes.
Primary lung cancer?

A

Squamous cell, adenocarcinoma , small cell, large cell & carcinoid [can be first in lung then go to intestine]

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23
Q

Solitary pulmonary nodule. causes. metastatic?

A

Melanoma , breast, head & neck, renal cell, colon, germ cell & sarcoma

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24
Q

Solitary pulmonary nodule. causes. benign infectious granulomas?

A

Tuberculosis , histoplasmosis , atypical mycobacteria , granulomas coccidioidomycosis , Cryptococcus & blastomycosis

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25
Q

Solitary pulmonary nodule. causes. benign neoplasmas?

A

Lipoma , hamartoma & fibroma

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26
Q

Solitary pulmonary nodule. causes. vascular?

A

Arteriovenous malformations

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27
Q

Solitary pulmonary nodule. findings that favour carcinoma? CT findings

A

CT scan findings
i. Large nodule size > 3
ii. Low density
iii. Spiculated borders
iv. Eccentric calcifications

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28
Q

Solitary pulmonary nodule. findings that favour carcinoma? clinical findings

A

Clinical findings:
i. Age >40
ii. History of smoking
iii. Weight loss
iv. Previous malignancy

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29
Q

Solitary pulmonary nodule. Management based on CT.
Bening features –>?

A

Serial CT scans for 2-3 years

30
Q

Solitary pulmonary nodule. Management based on CT.
Ground glass appearance –>?

A

Yearly assessment (even with stable appearance and size)

31
Q

Solitary pulmonary nodule. Management based on CT.
Intermediate features –>?

A

Further investigation with biopsy or PET

32
Q

Solitary pulmonary nodule. Management based on CT.
Highly malignant features–>?

A

Surgical excision

33
Q

Solitary pulmonary nodule. yra algoritmas faile, is esmes kortose parasyta ka daryti pagal CT findings

A

.

34
Q

Assessment of malignancy risk for solitary pulmonary nodule. Low risk. size?

A

<0,8 cm

35
Q

Assessment of malignancy risk for solitary pulmonary nodule. immediate risk. size?

A

0,8 - 2 cm

36
Q

Assessment of malignancy risk for solitary pulmonary nodule. high risk. size?

A

> = 2 cm

37
Q

Assessment of malignancy risk for solitary pulmonary nodule. Low risk. age?

A

< 40

38
Q

Assessment of malignancy risk for solitary pulmonary nodule. intermediate risk. age?

A

40-60

39
Q

Assessment of malignancy risk for solitary pulmonary nodule. high risk. age?

A

> 60

40
Q

Assessment of malignancy risk for solitary pulmonary nodule. Low risk. smoking status?

A

Never smoked

41
Q

Assessment of malignancy risk for solitary pulmonary nodule. Intermediate risk. smoking status?

A

current

42
Q

Assessment of malignancy risk for solitary pulmonary nodule. High risk. smoking status?

A

current

43
Q

Assessment of malignancy risk for solitary pulmonary nodule. Low risk. smoking cessation?

A

> 15 years

44
Q

Assessment of malignancy risk for solitary pulmonary nodule. Intermediate risk. smoking cessation?

A

5-15 years

45
Q

Assessment of malignancy risk for solitary pulmonary nodule. High risk. smoking cessation?

A

<5 years

46
Q

Assessment of malignancy risk for solitary pulmonary nodule. Low risk. Nodule margin characteristics?

A

Smooth

47
Q

Assessment of malignancy risk for solitary pulmonary nodule. Intermediate risk. Nodule margin characteristics?

A

Scalloped

48
Q

Assessment of malignancy risk for solitary pulmonary nodule. High risk. Nodule margin characteristics?

A

Corona radiate or spiculated

49
Q

Cancer. clinical presentation?

A

● Fever.
● Weight loss.
● Hemoptysis.

50
Q

Cancer. diagnosis. Xray. Nothing ->

A

Check for paraneoplastic syndrome.
Positive –> cancer
Negative –> no cancer

51
Q

Cancer. diagnosis. Xray. Effusion –>?

A

Do troracenthesis
Malignant cells –> cancer (stage 4 - metastatic disease)
No malignant cells –> no cancer

52
Q

Cancer. diagnosis. Xray. Cancer (gali tipo tiesiog matytis). –> Do CT

A

.

53
Q

Cancer. diagnosis. CT scan.
Find in the large airway –>?

A

bronchoscopy and biopsy.

54
Q

Cancer. diagnosis. CT scan.
Found outside the lung –>?

A

Endobronchial US

55
Q

Cancer. diagnosis. CT scan.
Periphery ->?

A

CT guided percutaneous biopsy

55
Q

Cancer. diagnosis. CT scan.
Middle –>?

A

Video assisted thoracoscopic surgery

56
Q

Cancer. diagnosis. CT scan.
Thoracenthesis with effusion –>?

A

–> positive malignant cells –> stage 4 lung cancer.

57
Q

Cancer. diagnosis. what for staging?

A

PET CT for staging

58
Q

Cancer. diagnosis. What test to do if candidate of surgery?

A

PFT

59
Q

Cancer. diagnosis. treatment?

A

Treatment either chemotherapy, radiation, or surgery.
▪ Lobectomy if FEV1>1.5L and DLCO>60%.

60
Q

Cancer: Primary prevention?

A

Quit smoking and secondhand smoking.

61
Q

Infectious granulomas are the MCC of benign pulmonary nodules; multiple
rather than single, and associated with active disease (fever, cough, weight
loss).

A

.

62
Q

Solitary pulmonary nodules. Factors increasing malignant probability?

A

Large size (> 2 cm), agvanced age, female, active or previous smoking, family/personal history of cancer, upper lobe location, spiculated radiograph appearance

63
Q

Solitary pulmonary nodule. Algo.
High risk malignancy –>?

A

Surgical excision

64
Q

Solitary pulmonary nodule. Algo.
Low-intermediate risk malignancy –>?

A

Evaluate nodule size

65
Q

Solitary pulmonary nodule. Algo.
Low-intermediate risk malignancy –> size >= 8 mm –> what tests to do?

A

FDG-PET or biopsy

66
Q

Solitary pulmonary nodule. Algo.
Low-intermediate risk malignancy –> size >= 8 mm –>FDG-PET or biopsy –> suspicious for malignancy –>?

A

Surgical excision

67
Q

Solitary pulmonary nodule. Algo.
Low-intermediate risk malignancy –> size >= 8 mm –>FDG-PET or biopsy –> NO suspicious for malignancy –>?

A

Serial CT scans

68
Q

Solitary pulmonary nodule. Algo.
Low-intermediate risk malignancy –> size < 8 mm –> if nodule 5-7 mm?–>?

A

Serial CT scans

69
Q

Solitary pulmonary nodule. Algo.
Low-intermediate risk malignancy –> size < 8 mm –> if nodule =< 4?–>?

A

Evaluate malignancy risk:
If low –> no follow up
If intermediate –> Serial CT scans

70
Q

Bronchoalveolar carcinoma.
Peripheral location (pneumonia-alike on xray)
Treatment: stage, chemoradiation, resection

A

.

STEP 2 Pulmonary (30 decks)

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