surgical complications of lung cancer

Question 1

clinical examination

Answer 1

history:
-pain especially bone pain
-Hematuria- blood In urine
-neurological symptoms
Examination:
-brachial plexus palsy
-larangeal palsy
-pleural effusion
-chest wall masses
-hepatomegaly

Question 2

Chest X-ray

Answer 2

• pleural effusion
• chest wall invasion
• collapsed lung
• phrenic nerve palsy

Question 3

CT

Answer 3

• size of tumour
• distance from mediastinal structures
• Diaphragmatic involvement
• pleural effusion
• metastases

Question 4

Blood tests

Answer 4

• anaemia
• liver function tests
• abnormal bone profile- e.g. xs calcium

Question 5

Other

Answer 5

MRI-good in determining neurological and vascular damage in the pancoast tumour
Bone scan
ECHO- pericardial effusion

Question 6

Surgical

Answer 6

Bronchoscopy

Mediastinoscopy- behind the breast

Question 7

Fitness for surgery;

-what to look out for

Answer 7

CVS:
-angina
-high blood pressure 
-heart murmurs
Respiratory:
-smoker
-asthmatic
-barrell chest
-exercise
-recent URTI
-obstructive disease
Psych:
-social background 
-mental health
other:
-Pulmonary hypertension
-rheumatoid arthritis

Question 8

Fitness for surgery:

-how to assess

Answer 8

respiratory:
-V/Q 
-spirometry
-diffusion studies: inhale small amounts of CO
CVS:
-ECHO
-ECG
-ETT
-CT-for pericardial effusion

Question 9

surgical complications

Answer 9

1-DEATH by
-pneumothorax
-MI
-ARDS
-Bronchopneumonia
-Intrathoracic bleeding 
2-Non fatal complications:
-empyema 
-wound infection 
-AF 
-MI
-Broncho-pleural fistula 
3- complications with staging 
-adrenal nodule
-presence of another small nodule 
-collapse of lung

Question 10

When there are signs if could be lung cancer but it is not

Answer 10

• infection
• benign tumour
• fibrosis
• granuloma