Pulm Vascular Disorder: Lung CA Flashcards
Lung CA is a major cause of _____ and can be both ______ and _______
death
primary and secondary
The lungs are ______ and _________ and is a common place for _______
large and vascularized
metastases
Lung CA is ________ and _______.
aggressive and invasive
What are the 3 preferred sec sites lung CA mets to?
skeleton, brain, and liver
What are the 4 primary types of Lung CA? (%?)
- small cell carcinoma (~12%)
- large cell carcinoma (~12%)
- squamous cell carcinoma (~27%)
- adenocarcinoma (~30%)
Which types of Lung CA are Small Cell Lung CA (SCLC)? Which are Non-small Cell Lung CA (NSCLC)?
- small cell carcinoma
2. large cell carcinoma, squamous cell carcinoma, and adenocarcinoma
Which type of Lung CA have the highest prevalence?
adenocarcinoma
Etiology of Lung CA (3)
- > 85% is d/t smoking: contain carcinogens
- toxins (eg asbestos–> used in insulation in building but banned now)
- marijuana (increase smoking)
What are warning signs?
signs that are unexplained by other underlying cause
What are the 6 warning signs?
- chronic coughs
- dyspnea
- chest, arm, and shoulder pain: r/t to cardiac issue
- blood-tinged sputum: blood in sputum
- alternate respiratory pattern: r/t asthma, emphysema, or bronchitis
- hemoptysis:
What is hemoptysis?
coughing up blood
Where is the central malignancy located in a/w? Peripheral malignancy?
- larger a/w –> bronchus
2. smaller a/w –>alveoli and bronchioles
Patho: Small Cell Carcinoma (SCLC) (5)
- 99% smokers
- small oval (oat cells)–> non-resectable
- aggressive, invasive, early mets (esp brain)
- mets at diagnosis –> 70%
- paraneoplastic syndromes
Small Cell Carcinoma is the ________ type of Lung CA and most _________ and mets _______
worst
aggressive
early
Small Call Carcinoma: How are the cells described as? Why is tumor excision not an option for this type?
small oval malignant cells resembles grains of oat
They are non-resectable b/c the cells are diffused in terms of location –> no uniform mass to excise
Small Call Carcinoma: Is the prognosis good or poor? Where does it mets to especially?
POOOORRRR
BRAIINNNZZZ
Small Call Carcinoma: At dx, mets has spread ____%
70
Small Call Carcinoma:
What is paraneoplastic syndrome? Examples?
How does it contribute to this type?
What is this tumor called?
Disorders that relates to the abn secretion of ACTH.
Examples: syndrome of inappropriate ADH (SIADH) or Cushing’s
Tumor in the lungs may secrete hormone-like substance that have similar action to ACTH –> give Cushing- or SIADH-like symptoms
Ectopic tumors
Patho: Adenocarcinoma (NSCLC) (3)
- most common form
- in females and non-smokers
- origin in bronchioles and alveoli
What does adeno- refer to? What does it secrete?
granular epithelium –>secretes mucus
Adenocarcinoma: Central or Peripheral Origin? Explain.
Peripheral origin –> smaller origin eg alveoli and bronchioles
away from large a/w or mediastinum
Adenocarcinoma: If lung CA occur in ___-_____, it is likely this form.
non-smoker
Adenocarcinoma: Prevalence? Can men get this type?
higher prevalence in women and non-smoker but not exclusive
YESS
Can the tumor be excised? Why?
YES
the mass is uniform
Patho: Squamous Cell Carcinoma (NSCLC) (6)
- more common in males
- central origin (bronchi)
- intraluminal
- impacts mediastinum
- spread to hilar nodes
Squamous Cell Carcinoma: Which a/w is impacted? What can it impact?
large a/w towards bronchi and mediastinum –> may impact heart
Squamous Cell Carcinoma: What is the hilar nodes?
refers to the area of lung where vessels and bronchi enter
Squamous Cell Carcinoma: Most proximal nodes are ______ nodes and are immediately ______ as the tumor advances
lymph
affected
Patho: Larger Cell Carcinoma (NSCLC) (4)
- large, undifferentiated cells
- peripheral origin
- eary mets–> happens quickly
- poor prognosis
Larger Cell Carcinoma: What does large, undifferentiated cells mean?
cells in the early differentiation stage are large and cannot carry out their function b/c it is undifferentiated
Larger Cell Carcinoma: Which a/w is affected?
affects the smaller a/w but affect rest of lung as it advance
What are the mnfst if central in origin? (2)
- coughing, wheezing, and dyspnea
2. cardiac mnfst
Why does coughing, wheezing, and dyspnea occur in central origin?
centrally located tumor obstr large a/w —> ventilation is impaired–> mnfst occur
Why do cardiac mnfst occur? What is the first structure impacted?
first structure impacted is the pericardium
accum of fluids apply external pressure on the heart–> compromise filling/emptying of the heart
What are the 2 typical mnfst?
- hemoptysis: coughing up blood
2. pain
What is the pain associated with (2)?
- inflm
2. perivascular nerves around blood vessels
What does manifestations depends on? (4)
- site (type): central or peripheral
- stage of CA
- extent, mets
- paraneoplastic syndrome
Diagnosis of Lung CA (4)
- hx and px
- imaging
- bronchoscopy and biopsy
- cytology
What 3 imaging are used?
- CXR w/ cardiac mnfst
- U/S initally
- CT and MRI to identify location and size precisely
What is a bronchoscopy? ______ _________ is used to take sample of fluid percutaneously. What else is done
insert a scope to visualize the a/w eg alveoli
needle aspiration
biopsy
Cytology is a _____ / _____ ______. WHY?
sputum/bronchial wash –> analyzing expectorate to identify neoplastic malignant cells
Treatment of for SCLC? ____ is not used because it is not a uniform mass
chemo and radiation
sx
Treatment for NSCLC? What is done first to shrink tumor?
chemo and radiation is used first to shrink tumor and the surgically remove tumor
- chemo/radiation
- sx
Unless detected and intervened early, the prognosis is ____ and many go into _______ w/ lung CA
poor
remission
