Respiratory Tumours Flashcards
Where should a chest drain be placed?
5th intercostal space in the mid-axillary line
Does lung cancer cause a transudate or an exudate
Exudate = pleurql effusions caused by changes to the local factors that influence the formation and absorption of pleural fluid
eg Malignancy,
infection etc
What is the difference between a transudate and an exudate
Transudate =
Pprotein <30 g/L
Exudate= protein >30 g/L
What nerve might be affected in a lung cancer causing hoarseness?
Recurrent laryngeal nerve
Invasion of which nerve in lung cancer can cause dysphagia?
Phrenic nerve
What hormone does small cell carcinoma produce?
ACTH
What lung cancer is common in non-smokers?
Adenocarcinoma
Which type of lung cancer is chemotherapy more effective against?
Small cell lung cancer
If a lung cancer is located centrally on a CT scan, what is the best way to obtain tissue for histology?
Bronchoscopy
If a lung cancer is located peripherally on a CT scan, what is the best way to obtain tissue for histology?
Percutaneous FNA/biopsy
When should sputum cytology be used as a test for lung cancer?
In patients with large central lesions where bronchoscopy and other tests are unsafe
Using the TNM system for non-small cell lung cancer staging, what is the most advanced tumour that can still be resected?
T3N1M0
(T3 occasionally may be resectable but T4 invades vital structures. N1 is ipsilateral hilar tumour spread and can still be resected)
Where are the common sites for lung mets?
Liver, adrenal glands, bone and brain
What investigation is performed in patients with symptoms suggestive of metastatic bone disease?
Bone scan
Patients with Stage I or Stage II NSCLC and Stage I SCLC should be considered for curative surgery. True or false?
True
Patients of which performance status are fit for surgery?
0, 1 & 2
What makes a lung cancer patient inoperable?
- Stage III or stage IV lung cancer
- Poor respiratory reserve, i.e. poor FEV1
- Multiple co-morbidities making them a high risk surgical candidate
- WHO performance status 3 or 4
Which of the following is chemotherapy not the first line treatment option for?
- Most cases of small cell lung cancer
- Stage II non-small cell lung cancer
- Stage IIIB non-small cell lung cancer
- Stage IV non-small cell lung cancer
Stage II non-small cell lung cancer
Stage I & II NSCLC can be resected, as can stage I SCLC
Chemotherapy is generally not recommended in patients with what performance status?
3 or 4
Radiotherapy is never curative in lung cancer. True or false?
Radiotherapy may be curative in some cases (mainly NCCLC)
A patient with a pancoast tumour presents with unilateral miosis (constriction of the pupil), ptosis (drooping of the upper eyelid), and anhidrosis (absence of sweating of the face). What condition do they have?
Horner’s syndrome
What is a pancoast tumour?
Cancers that begin at the apex of the lung which can invade the brachial plexus
What symptoms apart from Horner’s syndrome can a pancoast tumour cause (aka pancoast syndrome)
Ipsilateral shoulder and arm pain, paresthesias, paresis and atrophy of the thenar muscles of the hand
Small cell lung cancer does not use the TNM staging system. Instead it is either classified as what or what disease?
Limited or extensive
What hand sign is associated with lung cancer?
Finger clubbing?
Pain and tenderness in which bones is a symptoms of the paraneoplastic syndrome hypertrophic pulmonary osteoarthropathy (HPOA)
Long bones near the adjacent joints
A painful red line running up the leg is a paraneoplastic syndrome associated with many types of cancer?
Thrombophlebitis
Hyponatraemia in lung cancer is associated with which condition?
SIADH (increases water retention)
Pleural fluid in malignancy will classically look what?
Bloody
Which is more rapidly progressive with early mets, NSCLC or SCLC?
SCLC
What is more common, NSCLC or SCLC?
NSCLC
Which is more likely to be operable, NSCLC or SCLC?
NSCLC
