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(3) Cardio-Pulmo-Renal Rehabilitation > S1 L4.1: Lung Malignancies > Flashcards

S1 L4.1: Lung Malignancies Flashcards

1
Q

Statement 1: 1 in 6 people will develop cancer before the age of 75.
Statement 2: Globally, 1 out of 6 deaths is d/t cancer

a. TF
b. FT
c. TT
d. FF

A

c. FT

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2
Q

What are the top 2 spots of common cancer cases?

A

Breast Cancer (11.7%)
Lung Cancer (11.4%)

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3
Q

T/F: In terms of cause of death, breast cancer is on the top spot

A

False

Lung Cancer

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4
Q

Primary Cause of lung cancer

A

Tobacco consumption

It is also the most preventable cause of cancer death

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5
Q

Statement 1: More Americans die of lung cancer than of cocolorectal, breast, and prostate cancers combined
Statement 2: Lung cancer arising in a lifetime of never smoking is more common in men and East Asians.

a. TF
b. FT
c. TT
d. FF

A

a. TF

2: More common in women and East Asians.

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6
Q

Rank the Biggest Percentage of New Cancer Cases from greatest the least (incidence)

Breast, Colorectal, Lung, Prostate, Stomach

A
  1. Lung
  2. Breast
  3. Colorectal
  4. Prostate
  5. Stomach
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7
Q

Rank the Biggest Percentage of New Cancer Cases from greatest the least (mortality)

Breast, Colorectal, Liver, Lung, Stomach

A
  1. Lung
  2. Colorectal
  3. Stomach
  4. Liver
  5. Breast
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8
Q

T/F: In the 5-year survival rates, prostate cancer has the best prognosis, followed by breast then lung cancer

A

True

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9
Q

Prostate and breast are detected before they spread due to detectable symptoms:
Male (Prostate): [?]
Female (Breast): [?]

A

Male: Dysuria (diff in urinating)
Female: Lump in breast

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10
Q

Statement 1: 50% of cancer deaths are from lung cancer
Statement 2: 1⁄2 with cancers would die from lung cancer

a. TF
b. FT
c. TT
d. FF

A

d. FF

1: 25%; 2: 1/4

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11
Q

Statement 1: Squamous Cell Caricinoma has the worst prognosis
Statement 2: Adenocarcionoma is the most common type of lung cancer

a. TF
b. FT
c. TT
d. FF

A

b. FT

Small Cell Lung Cancer has the worst prognosis

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12
Q

What occurence is still within Stage 1 Cancer?

A

The cancer would just be confined to a certain spot in the lung and have a better prognosis.

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13
Q

The World Health Organization (WHO) defines lung cancer as [?]

A

Tumors arising from the respiratory epithelium

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14
Q

Arise from the bronchial epithelium and often present as an intraluminal mass.

A

Squamous Cell or Epidermoid Carcinoma

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15
Q

They are aggressive cancers that often involve regional or distant metastasis on presentation

A

Small Cell (also called oat cell) Carcinoma

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16
Q

Arise from mucous glands or from any epithelial cell within or distal to the terminal bronchioles.

A

Adenocarcinoma (including bronchioloalveolar)

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17
Q

Heterogeneous group of undifferentiated cancers that share large cells and do not fit into other categories

A

Large Cell Carcinoma

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18
Q

Histologic diagnosis is vital because?

A

We have to define the enemy before we employ the right intervention

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19
Q

Statement 1: Survival rate is best if the cancer is localized
Statement 2: As cancer starts to spread to different regions the prognosis worsens.

a. TF
b. FT
c. TT
d. FF

A

c. TT

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20
Q

Scant cytoplasm

a. Small Cell Lung CA
b. Non-small Cell Lung CA

A

a. Small Cell Lung CA

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21
Q

Abundant cytoplasm

a. Small Cell Lung CA
b. Non-small Cell Lung CA

A

b. Non-small Cell Lung CA

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22
Q

This kind of cancer is glandular or squamous in architecture

a. Small Cell Lung CA
b. Non-small Cell Lung CA

A

b. Non-small Cell Lung CA

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23
Q

Most ultimately relapse and become worse

a. Small Cell Lung CA
b. Non-small Cell Lung CA

A

a. Small Cell Lung CA

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24
Q

No neuroendocrine properties, does not present with other symptoms outside the pulmonary system, unless it has spread.

a. Small Cell Lung CA
b. Non-small Cell Lung CA

A

b. Non-small Cell Lung CA

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25
Q

Small hyperchromatic nuclei with fine chromatin pattern and indistinct nucleoli with diffuse sheets of cells

a. Small Cell Lung CA
b. Non-small Cell Lung CA

A

a. Small Cell Lung CA

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26
Q

Secretes endocrine hormones that give symptoms to a patient with this kind of cancer.

a. Small Cell Lung CA
b. Non-small Cell Lung CA

A

a. Small Cell Lung CA

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27
Q

Tumor shrinkage following radiotx in 30- 50% of cases

a. Small Cell Lung CA
b. Non-small Cell Lung CA

A

b. Non-small Cell Lung CA

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28
Q

Response to combination chemotherapy in 20–35% of cases

a. Small Cell Lung CA
b. Non-small Cell Lung CA

A

b. Non-small Cell Lung CA

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29
Q

At presentation, usually have already spread

a. Small Cell Lung CA
b. Non-small Cell Lung CA

A

a. Small Cell Lung CA

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30
Q

More gene mutations forming different abnormal cells.

a. Small Cell Lung CA
b. Non-small Cell Lung CA

A

a. Small Cell Lung CA

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31
Q

Pleomorphic nuclei with coarse chromatin pattern & prominent nucleoli

a. Small Cell Lung CA
b. Non-small Cell Lung CA

A

b. Non-small Cell Lung CA

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32
Q

Initially very responsive to:
1. Combination chemotherapy
2. Radiotherapy

a. Small Cell Lung CA
b. Non-small Cell Lung CA

A

a. Small Cell Lung CA

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33
Q

Easier to treat since the spread is not as spread & may be cured with either surgery or radiotherapy

a. Small Cell Lung CA
b. Non-small Cell Lung CA

A

b. Non-small Cell Lung CA

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34
Q

Most common form of lung cancer arising in lifetime non-smokers, women, and young patients

A

Adenocarcinoma

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35
Q

T/F: Smoking is not the only cause, there is also the environment, pollution, and even genetics.

36
Q

Risk increases by ___ in active smokers
Risk increases by ___ in passive smokers

37
Q

Statement 1: Death rate decreases with number of pack years
Statement 2: Risk increases with cessation, but may never return to normal

a. TF
b. FT
c. TT
d. FF

A

d. FF

1. Increases
2. Decreases

38
Q

Central or endobronchial growth of the primary tumor may cause:

A
  • Cough
  • Hemoptysis
  • Wheeze and stridor
  • Dyspnea
  • Postobstructive pneumonitis (fever and productive cough)
39
Q

T/F: Peripheral growth of the primary tumor may cause more symptoms unless widespread or big

A

False. Peripheral growth of the primary tumor may cause less symptoms unless widespread or big
- Less symptoms unless widespread or big
- Pain from pleural or chest wall involvement
- Dyspnea on a restrictive basis
- Symptoms of lung abscess resulting from tumor cavitation (lumps may develop abscess)

40
Q

T/F
Signs and symptoms caused by:

  1. local tumor growth and size
  2. invasion or obstruction of adjacent structures
  3. Growth in systemic nodes through lymphatic spread
  4. Growth in proximal metastatic sites after hematogenous dissemination
A
  1. T
  2. T
  3. F- Growth in regional nodes through lymphatic spread
  4. F- Growth in distant metastatic sites after hematogenous dissemination
41
Q

T/F: 1-5% asymptomatic on diagnosis

A

FALSE. 5-15% asymptomatic on diagnosis

42
Q

Regional spread of tumor in the thorax (by contiguous growth or by metastasis to regional lymph nodes) may cause:

A
  • Tracheal obstruction
  • Esophageal compression with dysphagia
  • Recurrent laryngeal nerve paralysis with hoarseness
  • Phrenic nerve paralysis with elevation of the hemidiaphragm and dyspnea
  • Sympathetic nerve paralysis with Horner’s syndrome
43
Q

T/F
Horner’s syndrome is characterized by:

  1. Enophthalmos
  2. Diplopia
  3. Miosis
  4. Contralateral loss of sweating
A
  1. TRUE
  2. FALSE
  3. TRUE
  4. FALSE

Sx are:
-Enophthalmos
-Ptosis
-Drooping eyelid
-Miosis
-Ipsilateral loss of sweating
-Similar with neurologic symptoms; part of the neuroendocrine or paraneoplastic syndrome

44
Q

MODIFIED T/F:

A. Malignant pleural effusion often leads to dyspnea
B. This is relieved by Thoracentesis - to drain the fluid completely.

45
Q

Local extension of a tumor growing in the apex of the lung with the involvement of the 8th cervical and 1st and 2nd thoracic nerves & shoulder pain that radiates to the ulnar distribution of the arm ARE SIGNS OF WHAT SYNDROME?

A

Pancoast’s (or superior sulcus tumor) syndrome

46
Q

MATCHING TYPE

  1. Often with radiologic destruction of the first and second ribs
  2. Obstruction of venous blood coming from the head, neck and upper arms. The tumor prevents the entry of blood to the heart.

A. Superior vena cava syndrome
B. Pancoast’s (or superior sulcus tumor) syndrome

47
Q
  1. Plethora
  2. Tamponade
  3. Distended neck veins
  4. Distended anterior chest veins
  5. Arrhythmia

A. Superior vena cava syndrome
B. Pericardial and cardiac extension

48
Q

violet-like shade on the face and neck

49
Q

Normal amount of fluid in the pericardial sac

50
Q

To remove pericardial fluid from the pericardial sac &
extract fluid using a needle and catheter, MD does:

A

Pericardiocentesis

51
Q

T/F: PT usually does not get to treat pts with superior vena cava syndrome anymore, except if there’s a need for prevention of atrophy etc. since the tumor is so big

52
Q
  • pleural effusion
  • causes edema
    -could be seen in hands or feet depending on cancer spread
  • accumulation of fluid in the pleural cavity

These are the symptoms of:

A

Lymphatic obstruction

53
Q

When Lymphangitic spread through the lungs, pt will die of?

A

hypoxemia: the patient will die not because of the cancer but the complications brought about by cancer

54
Q

T/F: Extrathoracic metastatic disease (at autopsy)
1. >50% of pts with squamous carcinoma
2. 70% of patients with adenocarcinoma and large cell carcinoma
3. > 95% of pts with small cell cancer
4. Liver cancer metastases may occur in virtually every organ system

A
  1. TRUE
  2. FALSE, 80% of patients with adenocarcinoma and large cell carcinoma
  3. > 95% of pts with small cell cancer
  4. FALSE, Lung cancer metastases may occur in virtually every organ system
55
Q

Symptoms of Brain Metastases:

A

headache
nausea
neurologic deficits

56
Q

T/F: Bone affectations produce the least pain

A

FALSE. Bone affectations produce the most pain, so most pts need strong narcotics

57
Q

Bone Metastases symptoms

A
  • Pain
  • Pathologic fracture
58
Q

Explain why bone matastases cause pathologic fracture

A

calcium should stay in the bone but d/t cancer, calcium lost and excreted to the blood = osteoperosis = weak = fx

59
Q

Leukemias, Cytopenias, leukoerythroblastosis are characteristics of?

A

Bone Marrow Invasion

60
Q
  • liver dysfunction
  • biliary obstruction
  • anorexia
  • Pain

are seen in pts with?

A

Liver Metastases

61
Q

In pts with liver metastases, they are given 5 to 10 mos to live usually

A

FALSE - pts are given 3 to 6 mos to live usually

62
Q

Usual sites of Lymph Node Metastases are?

A
  • supraclavicular region
  • occasionally in the axilla and groin
  • anywhere as long as its close and drains the lungs; efficient way of spreading cancer
63
Q

Matching type

  1. Epidural metastases
  2. rarely cause adrenal insufficiency
  3. Bone metastases
  4. Does not usually cause problems

A. Spinal cord compression syndromes:
B. Adrenal metastases

64
Q

Matching type

  1. Common in patients with lung cancer (small cell)
  2. in 12% of patients
  3. ectopic secretion of ACTH by small cell cancer
  4. May be the presenting finding or first sign of recurrence
  5. Cachexia

A. Paraneoplastic syndromes: Systemic symptoms
B. Endocrine syndromes

65
Q

It is secreted by pituitary gland; stimulate a lot of organs (endocrinologic). It is also an Adrenocorticotropic hormone

66
Q

True about Skeletal–connective tissue syndromes

  1. Clubbing in 20% of cases (usually in non-small cell carcinomas)
  2. Hypertrophic cardiac osteoarthropathy in 1-10% of cases (usually adenocarcinomas)
  3. With periostitis and clubbing causing pain, tenderness, and swelling over the affected bones and a positive bone scan
A
  1. FALSE- Clubbing in 30% of cases (usually in non-small cell carcinomas)
  2. FALSE - Hypertrophic pulmonary osteoarthropathy in 1-10% of cases (usually adenocarcinomas)
  3. TRUE
67
Q

Myasthenic Eaton-Lambert syndrome and retinal blindness with small cell cancer are classified under

A

Neurologic-myopathic syndromes

68
Q

Neurologic-myopathic syndromes are seen in only ___% of patients but are ________

A

Neurologic-myopathic syndromes are seen in only 1% of patients but are dramatic

69
Q

T/F: Peripheral neuropathies, subacute cerebellar degeneration, cortical degeneration, and polymyositis are seen with all lung cancer types

70
Q

Coagulation, thrombotic or other hematologic manifestations are seen in in 5-15% of patients

A

Coagulation, thrombotic or other hematologic manifestations are seen in 1-8% of patients

71
Q
  • Migratory clotting and inflammation of the veins
  • Can cause pulmonary embolism

Are sx of what syndrome?

A

Migratory venous thrombophlebitis (trousseau’s syndrome)

72
Q

not infectious, not bacteria

73
Q

inside of the heart, lining of the valves, get inflammed

A

endocarditis

74
Q

Modified T/F

A. If the blood clot develops in the left ventricle, it would go to the brain (embolic stroke) or other parts of the body (arms, legs) causing acute ischemia
B. The scenario above is not an emergency

A

TF

B. Emergency- need urgent care

75
Q

end stage of overwhelming infection

76
Q

Cutaneous manifestations are seen in ___% of pts

77
Q

MODIFIED T/F

A.Polymyositis- skin lesions
B. Dermatomyositis- muscle problem

A

FF

Polymyositis- muscle problem
Dermatomyositis- skin lesions

78
Q

IDENTIFICATION

  • Dermatologic sign
  • Not necessarily considered cancer immediately
  • Common in smoker- sign of lung cancer
A

acanthosis nigricans (black sabbath)

79
Q

IDENTIFICATION

losing a lot of protein in their urine

A

nephrotic syndrome

80
Q

IDENTIFICATION

inflammation of the kidneys

A

Glomerulonephritis

81
Q

Imaging modalities of dx

  1. for cancer spread
  2. more delineation of tumor
  3. high-tech scan

A. Radionuclide Scan
B. PET Scan
C. CT scan

82
Q

The much needed step in diagnosis of lung cancer is to establish __________

A

The much needed step in diagnosis of lung cancer is to establish histopathological diagnosis

83
Q

This test is done for tissue Diagnosis

84
Q

Treatments for lung malignancies

A
  • Chemotherapy
  • Radiotherapy
  • Surgical resection
  • Palliative care
85
Q

Treatment for advanced cases where we cannot do anything. The goal here is to make their life comfortable.

A

Palliative care

(3) Cardio-Pulmo-Renal Rehabilitation (34 decks)

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