Respiratory Tumours Flashcards

1
Q

Where should a chest drain be placed?

A

5th intercostal space in the mid-axillary line

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2
Q

Does lung cancer cause a transudate or an exudate

A

Exudate = pleurql effusions caused by changes to the local factors that influence the formation and absorption of pleural fluid

eg Malignancy,
infection etc

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3
Q

What is the difference between a transudate and an exudate

A

Transudate =
Pprotein <30 g/L

Exudate= protein >30 g/L

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4
Q

What nerve might be affected in a lung cancer causing hoarseness?

A

Recurrent laryngeal nerve

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5
Q

Invasion of which nerve in lung cancer can cause dysphagia?

A

Phrenic nerve

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6
Q

What hormone does small cell carcinoma produce?

A

ACTH

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7
Q

What lung cancer is common in non-smokers?

A

Adenocarcinoma

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8
Q

Which type of lung cancer is chemotherapy more effective against?

A

Small cell lung cancer

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9
Q

If a lung cancer is located centrally on a CT scan, what is the best way to obtain tissue for histology?

A

Bronchoscopy

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10
Q

If a lung cancer is located peripherally on a CT scan, what is the best way to obtain tissue for histology?

A

Percutaneous FNA/biopsy

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11
Q

When should sputum cytology be used as a test for lung cancer?

A

In patients with large central lesions where bronchoscopy and other tests are unsafe

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12
Q

Using the TNM system for non-small cell lung cancer staging, what is the most advanced tumour that can still be resected?

A

T3N1M0

(T3 occasionally may be resectable but T4 invades vital structures. N1 is ipsilateral hilar tumour spread and can still be resected)

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13
Q

Where are the common sites for lung mets?

A

Liver, adrenal glands, bone and brain

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14
Q

What investigation is performed in patients with symptoms suggestive of metastatic bone disease?

A

Bone scan

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15
Q

Patients with Stage I or Stage II NSCLC and Stage I SCLC should be considered for curative surgery. True or false?

A

True

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16
Q

Patients of which performance status are fit for surgery?

A

0, 1 & 2

17
Q

What makes a lung cancer patient inoperable?

A
  • 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
18
Q

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
A

Stage II non-small cell lung cancer

Stage I & II NSCLC can be resected, as can stage I SCLC

19
Q

Chemotherapy is generally not recommended in patients with what performance status?

A

3 or 4

20
Q

Radiotherapy is never curative in lung cancer. True or false?

A

Radiotherapy may be curative in some cases (mainly NCCLC)

21
Q

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?

A

Horner’s syndrome

22
Q

What is a pancoast tumour?

A

Cancers that begin at the apex of the lung which can invade the brachial plexus

23
Q

What symptoms apart from Horner’s syndrome can a pancoast tumour cause (aka pancoast syndrome)

A

Ipsilateral shoulder and arm pain, paresthesias, paresis and atrophy of the thenar muscles of the hand

24
Q

Small cell lung cancer does not use the TNM staging system. Instead it is either classified as what or what disease?

A

Limited or extensive

25
Q

What hand sign is associated with lung cancer?

A

Finger clubbing?

26
Q

Pain and tenderness in which bones is a symptoms of the paraneoplastic syndrome hypertrophic pulmonary osteoarthropathy (HPOA)

A

Long bones near the adjacent joints

27
Q

A painful red line running up the leg is a paraneoplastic syndrome associated with many types of cancer?

A

Thrombophlebitis

28
Q

Hyponatraemia in lung cancer is associated with which condition?

A

SIADH (increases water retention)

29
Q

Pleural fluid in malignancy will classically look what?

A

Bloody

30
Q

Which is more rapidly progressive with early mets, NSCLC or SCLC?

A

SCLC

31
Q

What is more common, NSCLC or SCLC?

A

NSCLC

32
Q

Which is more likely to be operable, NSCLC or SCLC?

A

NSCLC