Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RC-Respiratory illnesses > Radiology of Lung Cancer and Staging > Flashcards

Radiology of Lung Cancer and Staging Flashcards

1
Q

What percentage of patients with lung cancer present with advanced disease?

A

66%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What do you need to check when looking at a chest X-ray?

A

Name/marker/rotation/penetration

Lines/metal work

Heart

Mediastinum

Lung (zones - upper, middle, lower)

Bones

Diaphragm

Soft tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the first 4 things you should look at in a chest X-ray?

A

Name

Marker

Rotation

Penetration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the zones of the lungs in a chest X-ray?

A

Upper

Middle

Lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is A?

A

Mediastinum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are you looking for in the mediastinum?

A

Hilar vascular structures crisply defined

No widening of mediastinum

Trachea should be central

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are you looking for in the lungs?

A

Compare upper, middle and lower zones

Look between ribs for lung detail

Remember to look ‘behind’ the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is this?

A

Peripheral lung carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is this?

A

Central lung carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How should we identify lung cancers on X-rays?

A

Compare with previous films

Always look at review areas

Remember lesions are often more subtle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the review areas of a chest X-ray?

A

Hila

Lung apices

Behind the heart

Behind the diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is this?

A

Left hilar mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is this?

A

Right hilar mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is this?

A

Mass behind the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is this?

A

Mass left costophrenic angle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is this?

A

Right apex tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What could the clinical history for lung cancer include?

A

Increasing shortness of breath in smoker

History of pulmonary fibrosis

Recent haemoptysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What follows taking a history and examining the patient?

A

CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What should be evaluated using a CT scan?

A

Size

Shape

Atelectasis

Border

Density

Solid or non-solid

Dynamic contrast enhancement >25HU

Growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is atelectasis?

A

Collapse of lung resulting in reduced gas exchange

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the collapse of the lung resulting in reduced gas exchange called?

A

Atelectasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is a pulmonary mass?

A

Opacity in the lung over 3cm with no medistinal adenopathy or atelectasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is an opacity in the lung over 3cm with no mediastinal adenopathy or atelectasis called?

A

Pulmonary mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is a pulmonary nodule?

A

Opacity in the lung up to 3cm with no mediastinal adenopathy or atelectasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is an opacity in the lung up to 3cm with no mediastinal adenopathy or atelectasis called?

A

Pulmonary nodule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the difference between a pulmonary nodule and a pulmonary mass?

A

Pulmonary mass is over 3cm and pulmonary nodule is up to 3cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What could a solitary pulmonary nodule or mass be?

A

Lung cancer

Metastasis

Benign lung neoplasm

Infection

Vascular haemotoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What could suggest a solitary pulmonary nodule or mass is a metastasis?

A

Previous history of breast. renal, seminoma or sarcoma cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are examples of benign lung neoplasms?

A

Carcinoid

Hamartoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What does the staging of lung cancer take into account?

A

Clinical history/examination

Performance status

Pulmonary function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What system does the staging of lung cancer use?

A

TNM international system for staging lung cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What does the TNM international staging of lung cancer consider?

A

Size and position of tumour (T)

Whether cancer cells have spread into the lymph nodes (N)

Whether the tumour has spread anywhere else in the body, metastasis (M)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is T?

A

Size and position of tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is N?

A

Whether tumour has spread to lymph nodes

35
Q

What is M?

A

Whether the tumour has spread into other parts of the body, metastasis

36
Q

What investigations can be done to determine T?

A

CT

PET-CT

Bronchoscopy

37
Q

What investigations can be done to determine N?

A

PET-CT

Mediastinoscopy

CT

EBUS/EUS (endobronchial ultrasound)

38
Q

What does EBUS stand up for?

A

Endobronchial ultrasound

39
Q

What investigations can be done to determine M?

A

PET-CT

CT

Bone scan

40
Q

What is the most common tracer used?

A

FDG (flourodeoxyglucose)

41
Q

What does FDG stand for?

A

Flourodeoxyglucose

42
Q

What is often used for the staging of lung cancer?

A

Flourodeoxyglucose PET

43
Q

What can be said about the availability and cost of FDG PET?

A

Expensive

Limited availability in the UK

44
Q

What is the labelled glucose analogue used in FDG-PET?

A

18F-FDG

45
Q

What is the half body time of 18F-FDG?

A

60 minutes

46
Q

What does TX mean?

A

Primary tumour cannot be assessed

47
Q

What does T0 mean?

A

No evidence of primary tumour

48
Q

What does Tis mean?

A

Carcinoma in situ (has not spread to surrounding tissue, group of abnormal cells in the place where they formed)

49
Q

What is carcinoma in situ?

A

Group of abnormal cells which are still where they were formed, have not spread to nearby tissue

50
Q

What is T1?

A

Less than or equal to 3cm in diameter

Surrounded by lung or visceral pleura

Without bronchoscopic evidence of involvement of the main bronchus

51
Q

What is T1a?

A

Less than or equal to 1cm

52
Q

What is T1b?

A

Less than or equal to 2cm

53
Q

What is T1c?

A

Less than or equal to 3cm

54
Q

What are the sub classes of T1?

A

T1a

T1b

T1c

55
Q

What is T2?

A

More than 3cm but less than 5cm

56
Q

What are the different classes of T2?

A

T2a

T2b

57
Q

What is T2a?

A

More than 3cm but less than 4cm

58
Q

What is T2b?

A

More than 4cm but less than 5cm

59
Q

When are tumours classified as T2a although they are less than 3cm?

A

Invades main bronchus

Invades visceral pleura

Associated with atelectasis or obstructive pneumonitis that extends to the hilar region involving part or all of the lung

60
Q

What is T3?

A

More than 5cm but less than 7cm

61
Q

When are tumours classified as T3 althouh they are less than 5cm?

A

Invades any of:

Chest wall

Phrenic nerve

Parietal pericardium

or has seperate tumour nodules in the same lobe as primary

62
Q

What is T4?

A

More than 7cm

63
Q

When is a tumour T4 although it is less than 7cm?

A

Invades any of:

Diaphragm

Mediastinum

Heart

Great vessels

Trachea

Recurrent laryngeal nerve

Oesophagus

Vertebral body

Carina

or seperate tumour nodules in a different ipsilateral lobe

64
Q

What does N staging range from?

A

N0 to N3

65
Q

What is N0?

A

No regional lymph node involvement

66
Q

What is N1?

A

Ipsilateral peribronchial, hilar or intrapulmonary nodes including by direct extension

67
Q

What is N2?

A

Ipsilateral mediastinal, subcarinal

68
Q

What is N3?

A

Contralateral mediastinal, contralateral hilar, scalene or supraclavicular

69
Q

How does the number of lymph nodes change with size?

A

There are many small lymph nodes and few large ones

70
Q

How does the prevalence of metastasis change with the size of lymph nodes?

A

Large lymph nodes are more likely to have metastasis

71
Q

What percentage of patients present with metastasis?

A

33%

72
Q

What are common metastasis?

A

Cerebral

Skeletal

Adrenal

Liver

73
Q

What does M staging range from?

A

M0 to M1

74
Q

What is M0?

A

No distant metastasis

75
Q

What is M1?

A

Distant metastasis

76
Q

What are the different classes of M1?

A

M1a

M1b

M1c

77
Q

What is M1a?

A

Seperate tumour nodes in a contralateral lobe, tumour with pleural or pericardial nodules or malignant pleural or pericardial effusion

78
Q

What is M1b?

A

Single distant metastasis

79
Q

What is M1c?

A

Multiple distant metastasis

80
Q

What are some of the advantages of PET/CT scanning in staging?

A

Performs whole body staging in single study excluding cerebral disease

Discloses metastasis and other pathology no detected by other means

Excludes metastasis where structural imaging abnormal

Non invasive

81
Q

What are some limitations of CT/PET?

A

All tests have false positives and false negatives

Cost

82
Q

How does 5 year survival change with staging?

A

As staging increases survival decreases

83
Q

What are some examples of tissue diagnosis methods?

A

Bronchoscopy with endobronchial ultrasound

Percutaneous image guided biopsy, flouroscopy/CT/US guided

Mediastinoscopy (sample mediastinal nodes)

Mediastinotomy (anterior mediastinal nodes)

Video assisted thoracoscopic surgery (VATS)

Explorative thoracotomy

RC-Respiratory illnesses (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions