Repiratory Pathology Flashcards

1
Q

Which gene does smoking damage?

A

p53 gene

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

Clinical features of lung cancer

What do to after this?

A

Haemoptysis (coughing up blood)
Persistent (>3 weeks) of cough, chest pain, finger clubbing
Chest Xray then CT scan, exercise+ pulmonary function tests

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

TNM classfication

A
T= tumour (size, infiltrating major organ)
N= nodes (location)
M= metastasis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Types of lung cancer

A

Small cell lung cancer: highly malignant form, with shorter doubling time and earlier metastases

Non small cell lung cancer: subdivided to adenocarcinomas, squamous cell cancer or large cell cancer

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

FDG-PET-CT

A

Radioactively labelled glucose injected
Cells that use glucose a lot (cancer) detected
Additional specimen collection required

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

Trans-thoracic CT biopsy
Advantages?
Disadvantages?

A

Real-time
High sensitivity
Quick
Easy

Risk of pneumothorax
No immediate intrabronchial treatment possible if bleeding occurs

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

Reason for MRI on brain instead of PET scan on body

A

PET scan looks at glucose metabolism but brain always shows high levels

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

Reason why lung cancer= difficult to have a high survival rate

A

Adenocarcinoma diagnosis done very late+ tumours can spread before you see them

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

Lung cancer causes

A

Smoking

In non-smokers:
Asbestos exposure
Radiation
Genetic predispostion

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

Development of Carcinoma
Leads to?
Features?

A
Multistep accumulation of mutations
Disordered growth
Loss of cell adhesion
Invasion of tissue by tumour
Metastasis

REVERSIBLE= stimulation of new vessel formation around tumours

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

Benign vs Malignant

Most common malignant?

A

Benign= don’t metastasise, local complications (e.g. airway obstruction)
Malignant most common= carcinomas (epithelium)

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

Types of malignant epithelial tumours

Treatment?

A

Small cell carcinoma
Undifferentiated, aggressive, central near bronchi, often outgrow blood supply
Chemoradiotherapy= fast response but fast relapse

Non-small cell carcinoma (subtypes)
Less chemosensitive because detected too late

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

Non-small cell carcinoma types

A

Squamous cell carcinoma- cilitated epithelium= irritated by triggers= changes under metaplasia to squamous which is more resistant to smoke chemicals but no cilia= inhaled carcinogens sit in airway= dysplasia= potential to metastasise

Adenocarcinoma- tumour of glandular epithelium, develops around lung periphery.
Precursor stage= small lesions with atypical cells growing along alveolar wall, sometimes stop growing+ turn into fibrous scar, sometimes expand+ progress to cancer.
Smokers usually have K ras mutation, non-smoker= EGFr mutation, mutations= MUTUALLY EXCLUSIVE (won’t have both)

Large cell carcinoma- poorly differentiated tumours composed of large cells

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

Targets of treatment

Membrane receptor?

A
  1. EGFR gene
    Tyrosine kinase- regulates angiogenesis, proliferation apoptosis, migration, continually switched on= unregulated growth
    Tyrosine kinase inhibitors
  2. Immunemodulatory Therapy
    Tumour cells express PDL1: inhibits Cytotoxic T cells from targetting tumour cells so PDL1 inhibitor= used
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Types of biopsy

A

Normal done through bronchoscopy

Surgical= tumour exposed+ biopsy done, if benign then excised+ patient closed up. If tumour= malignant, surgery proceeds

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

Local effects of lung cancer

A

Bronchial obstruction
Collapse of distal lung= shortness of breath
Impaired drainage of bronchus= chest infection
Invasion of local vessels= haemoptysis
Invasion of large vessels= venous congestion= head+ arm oedema
Oesophagus= dysphagia (swallowing problems)
Chest wall= pain
Inflammation of pleura/ pericardium= breathlessness+ cardiac compromise