Pulmonary Neoplasms

Question 1

what are 3 characteristics of a pulmonary nodule?

Answer 1

< 3 cm
isolated
round

Question 2

what is the first step in evaluating malignancy for a pulmonary nodule?

Answer 2

review old imagining to estimate doubling time

Question 3

what doubling time of a pulmonary nodule suggests infection?

Answer 3

<30 days

Question 4

what doubling time of a pulmonary nodule suggests long-term stability and benign status?

Answer 4

> 465 days

Question 5

what is the 2nd step in evaluating malignancy for a pulmonary nodule?

Answer 5

evaluate nodule in current imaging

Question 6

what pulmonary nodule size has an 80% risk in malignancy?

Answer 6

21-45 mm

Question 7

what diagnostic should be done on all patients with a pulmonary nodule?

Answer 7

chest CT

Question 8

what is the treatment/evaluation for a nodule that has <5% probability of malignancy?

Answer 8

regular imaging studies to monitor

Question 9

what size nodule without risk factors for malignancy does not require follow up?

Answer 9

< 6mm

Question 10

what are 3 diagnostics that can be done for a nodule that has 5-60% probability of malignany?

Answer 10

biopsy via transthoracic needle aspiration
sputum cytology
PET scan

Question 11

what kind of lesions is a sputum cytology used for?

Answer 11

central lesions

Question 12

what does a PET scan detect in pulmonary nodules?

Answer 12

increased metabolism in malignant lesions

Question 13

what does a positive PET scan require?

Answer 13

removal

Question 14

what does a video-assisted thoracoscopic surgery do for a pulmonary nodule?

Answer 14

removes nodule and evaluates it in OR with frozen section for malignancy and staging

Question 15

what is the treatment/evaluation for a nodule that has >60% probability of malignancy?

Answer 15

immediate resection and tumor staging

Question 16

tumor found in the central bronchi of the lungs

Answer 16

carcinoid tumor

Question 17

what is carcinoid syndrome?

Answer 17

Cramping/diarrhea
Asthmatic wheezing
Right-sided hypotension
Cutaneous flushing

Question 18

a patient presents with cough, focal wheezing, and recurrent lung infections. what are they suspicious for?

Answer 18

carcinoid tumor

Question 19

what are complications of a carcinoid tumor?

Answer 19

local bleeding
airway obstruction

Question 20

what is the management for a carcinoid tumor?

Answer 20

only removed if clinically symptomatic

Question 21

what is characteristic of a carcinoid tumor?

Answer 21

grow slowly
rarely metastasize

Question 22

lung cancer that arises from bronchial epithelium and often present as an intraluminal mass

Answer 22

squamous cell carcinoma

Question 23

lung cancer that arises from mucous glands within or distal to the terminal bronchioles and affects lung parenchyma

Answer 23

adenocarcinoma

Question 24

lung cancer that spreads along preexisting alveolar structures without evidence of invasion into parenchyma

Answer 24

adenocarcinoma in situ

Question 25

lung cancer of bronchial origin that typically begin centrally and infiltrate submucosa to cause narrowing of the bronchus

Answer 25

small cell carcinoma

Question 26

lung cancer that is typically aggressive and have rapid doubling times, and present as central or peripheral masses

Answer 26

large cell carcinoma

Question 27

what is the most common type of lung cancer?

Answer 27

adenocarcinoma

Question 28

what are the top 5 symptoms of lung cancer?

Answer 28

cough anorexia pain hemoptysis pleural effusion

Question 29

what diagnostic is best for central airway lesions?

Answer 29

sputum cytology

Question 30

what diagnostic is best for malignant pleural effusions?

Answer 30

thoracentesis

Question 31

what diagnostic is best for metastatic lymph nodes?

Answer 31

fine-needle aspiration

Question 32

what diagnostic can be used to help visualize the major airways and help assist in the other diagnostics like biopsy and FNA?

Answer 32

bronchoscopy

Question 33

what does TNM stand for?

Answer 33

T - tumor size and location N- nodal metastases M - distant metastases

Question 34

what is the treatment for all non-small cell lung carcinomas?

Answer 34

resection +/- chemotherapy

Question 35

a patient with lung cancer presents with ipsilateral findings of ptosis, miosis, and anhidrosis. what are they experiencing?

Answer 35

horner sydrome

Question 36

what 3 places can distant metastasis occur?

Answer 36

bone brain liver

Question 37

what kind of organ dysfunction can occur in small cell carcinoma?

Answer 37

syndrome of inappropriate antidiuretic hormone (SIADH)

Question 38

what kind of organ dysfunction can occur in squamous cell carcinoma?

Answer 38

hypercalcemia