Respiratory

Question 1

what is the third most common cancer in the UK

Answer 1

lung cancer

Question 2

what is the leading cause of cancer death

Answer 2

lung cancer

Question 3

what was some other causes of lung cancer recognised in old times (1900s)

Answer 3

air pollution, asphalted roads, road traffic, gas exposure in ww1, influenza pandemic in 1918, working with petroleum

Question 4

what is the distribution of lung cancer amongst people, epidemiologically (age sex eat)

Answer 4

peak at 75-90, males more than females, lower socioeconomic backgrounds ( lower health, have other resp. conditions, less access to healthcare) , smoking history

Question 5

what is the smoking rate in uk now

Answer 5

going down

Question 6

what is the worldly distribution of smoking

Answer 6

as poorer parts get richer, their smoking rates go up

Question 7

where is the smoking rates the highest

Answer 7

??

Question 8

what is the percentage of patients with lung cancer who never smoked and what can be other causes for this

Answer 8

10-15%, asbestos exposure, radon and uranium, indoor cooking fumes, chronic lung diseases (COPD< fibrosis), immunodeficiency (HIV), familial/genetic

Question 9

what is the 4 types (could be narrowed to 2) of lung cancer

Answer 9

adenocarcinoma 40%
squamous cell carcinoma 30%
large cell lung cancer15%
(all these non-small cell carcinoma)
small cell lung cancer 15%

Question 10

where does squamous cell carcinoma originate from

Answer 10

bronchial epithelium; centrally located

Question 11

why did adenocarcinoma became more common than squamous cell carcinoma

Answer 11

low tar cigarettes, inhaled more deeply and retained more longer

Question 12

where does adenocarcinoma originate from

Answer 12

mucus-producing glandular tissue; more peripherally-locate

Question 13

what is the stages in the model of lung cancer development

Answer 13

normal epithelium > hyperplasia > squamous metaplasia > dysplasia > carcinoma in situ > invasive carcinoma

Question 14

what are the cellular early stages of cancer development

Answer 14

normal epithelium > hyperplasia > squamous metaplasia

Question 15

what is the intermediate cellular level of lung cancer development

Answer 15

dysplasia

Question 16

what are the late cellular levels of cancer development

Answer 16

carcinoma in situ, invasive carcinoma

Question 17

at what point of the cellular model of lung cancer development does things become irreversible, and what causes this

Answer 17

at the end of early stage, genetic mutations occur and you get proliferation and disordered growth of cells

Question 18

what is metaplasia

Answer 18

reversible change in which one adult cell type replaced by another adult cell type

Question 19

what is dysplasia

Answer 19

abnormal pattern of growth in which some of the cellular and architectural features of malignancy are present; pre-invasive stage with intact basement membrane

Question 20

what is a genetic mutation responsible for 15-30% of adenocarcinomas

Answer 20

EGFR (epidermal growth factor) tyrosine kinase

Question 21

what is a genetic mutation responsible for 2-7% of non small cell lung cancer

Answer 21

anaplastic lymphoma kinase (ALK) tyrosine kinase

Question 22

what is a genetic mutation responsible for 1-2% of non-small cell lung cancer

Answer 22

c-ROS oncogene 1 (ROS1) receptor tyrosine kinase

Question 23

what is a genetic mutation responsible for 1-3% of non-small cell lung cancer

Answer 23

BRAF (downstream cell-cycle signalling mediator)

Question 24

what are the key symptoms of lung cancer

Answer 24

cough, weight loss, breathlessness, fatigue, chest pain, ////