Pulmonary Flashcards
what’s the MC cause of lung cancer?
smoking
where are METS MC in lung cancer?
brain, bone, liver, LNs, & adrenals
what are the 2 types of lung cancer?
Non-Small Cell Carcinoma (NSCC) & Small Cell Carcinoma (SCC)
who is adenocarcinoma lung cancer MC in?
smokers, women, & nonsmokers
where does adenocarcinoma lung cancer occur in the lungs?
peripherally
where does SCC lung cancer occur in the lungs?
centrally
what is squamous cell lung cancer a/w?
cavitary lesions (central necrosis), hypercalcemia, & pancoast syndrome
what are the types of NSCC lung cancer?
- Adenocarcinoma
- Squamous Cell
- Large Cell (Anaplastic) Carcinoma
what’s the s/s of lung cancer?
cough, hemoptysis, dyspnea
SVC syndrome
Hypercalcemia (esp. with Squamous Cell)
SIADH/Hyponatremia (MC w/ small cell)
Cushing’s syndrome (ectopic ACTH - MC w/ small cell)
Pancoast Syndrome (shoulder pain, Horner’s syndrome, atrophy of hand/arm muscles)
what’s the dx of lung cancer?
- CXR & CT scan (often seen on CXR but not used for screening; CT used for staging)
- Sputum cytology (good for central lesions)
- Bronchoscopy - for central lesions
what’s the tx of NSCC lung cancer?
surgical resection = TOC
what’s the tx of small cell lung cancer?
chemotherapy = TOC
what’s transudative pleural effusion?
d/t either incr. hydrostatic &/or decr. oncotic pressure
what’s the MC cause of transudative pleural effusion? other causes?
CHF = MC cause
nephrotic syndrome, cirrhosis = other causes
what is exudative pleural effusion? causes?
increase vascular permeability
causes: infection/inflammation
what are the s/s of pleural effusion?
MC asx
if symptomatic -> dyspnea, “pleuritic” chest pain, cough
what’s the PE like for pleural effusion?
decr. tactile fremitus, decr. breath sounds, dullness to percussion
what’s the dx test of choice for pleural effusion?
thoracentesis (dx and therapeutic)
how do you dx pleural effusion?
CXR: PA/lateral -> blunting of costophrenic angles
Thoracentesis (test of choice, dx and therapeutic)
CT scan (to confirm empyema)
what’s the light’s criteria?
criteria exclusive to exudates -> presence of ANY of the 3 = exudative pleural effusion:
- pleural fluid protein: serum protein >0.5
- pleural fluid LDG: serum LDH >0.6
- pleural fluid LDH > 2/3 ULN LDH
what’s the tx for pleural effusion?
- Treat the underlying condition
- Thoracentesis: GOLD STANDARD
- Chest tube pleural fluid drainage: if empyema (pleural fluid pH <7.2, glucose <40, pos. gram stain of pleura fluid)
- Pleurodesis (if malignant effusions or chronic - use talc (MC), doxycycline)
what’s the criteria for empyema pleural effusion?
pleural fluid pH <7.2, glucose <40, pos. gram stain of pleura fluid
what’s the GOLD STANDARD tx for pleural effusion?
Thoracentesis
who is primary spontaneous pneumothorax MC in?
NO underlying lung disease
Mainly affects tall, thin men 20-40 y/o, smokers, + family h/o pneumothorax
