Test 2 study guide Flashcards
What are the two major categories of lung cancers?
Small cell (SCLC) and Non-small cell lung cancers (NSCLC)
What percent of lung cancers fall into SCLC and NSCLC?
90%
T or F: Non-small cell lung cancers behave similarly, so are treated similarly.
True
Which category is worse, SCLC or NSCLC?
SCLC
Which responds better to chemotherapy, SCLC or NSCLC?
SCLC
T of F: NSCLC tends to grow faster than SCLC.
False, SCLC tends to grow the fastest.
What are the three types of NSCLC?
Adenocarcinoma
Squamous cell carcinoma
Large cell undifferentiated carcinoma
Which type carries a greater risk of metastasis, SCLC or NSCLC?
SCLC
SCLC is often called:
Oat cell carcinoma
The (older/younger) a person is when they start smoking, the (greater/lesser) their risk of getting lung cancer.
Younger/greater
Malignant neoplasm that arises in the lung tissue:
Bronchogenic carcinoma
T or F: Quitting smoking for 10 years reduces the risk of cancer to that of a non-smoker.
False, risk is reduced, but not to non-smoker status.
Paraneoplastic syndromes are common with ________ (NSCLC or SCLC)
SCLC
Histologically, SCLC shows (small/large) (light/dark) staining epithelial cells with (scant/copious) cytoplasm.
small/dark/scant
The first sign of SCLC might be:
paraneoplastic syndrome
Weight loss occurs in what % of lung cancer?
40%
Dyspnea occurs in what % of lung cancer?
20%
The most common symptom in lung cancer? %?
Cough; 75%
Most common clinical presentation of lung cancer?
50s, symptoms of several months duration
Adenocarcinoma is typically found:
In the periphery
SCLC is typically found:
Centrally, near the hilum, but may be found anywhere.
Large cell undifferentiated carcinomas are typically found:
anywhere in the lung
Squamous cell carcinomas are typically found:
centrally
Adenocarcinoma can be described with the 3 P’s:
Peripheral
Pigmented
Puckered
Adenocarcinoma is a __________ epithelial tumor that produces _______ .
Glandular
Mucin
Adenocarcinoma is ofter first found:
On a routine CXR, & often having already spread.
Adenocarcinoma accounts for ____ of lung cancer.
33%
Most frequently diagnosed type of cancer:
Adenocarcinoma
How is Squamous cell carcinoma characterized?
Keratinization in the form of pearls, or
individual cells with eosinophillic dense cytoplasm.
Squamous cell carcinoma arises from:
The main, lobar, or segmented bronchi.
Squamous cell carcinoma is thought to be related to:
Chronic inflammation
Injury of bronchial ciliated columnar epithelium
Large cell carcinoma is an epithelial tumor with (small/large) nuclei and (small/moderate/large) amounts of cytoplasm.
large/moderate
T of F: LCC and large cell undifferentiated carcinoma are the same thing.
True
Most common primary lung neoplasm in children:
Bronchial carcinoid tumors
T of F: Bronchial carcinoid tumors are considered a separate type of lung neoplasm.
True
Bronchial carcinoid tumors may present with:
Diarrhea
Facial flushing
Wheezing
(Usually with liver metastasis)
Most pancoast tumors are SCLC or NSCLC?
NSCLC
S/Sx of Pancoast tumors:
general CA
Horner’s syndrome
SVC syndrome
Neurogenic thoracic outlet syndrome
SVC syndrome is characterized by:
Obstruction of venous drainage
Dilation of neck veins
Neck/facial edema
Redness
Horner’s syndrome is characterized by:
Miosis (pupil constriction)
Anhidrosis (inability to sweat)
Ptosis (drooping eyelids)
Enopthalmos (posterior eye displacement)
What are the potential complications of Otitis Media?
Spread to mastoid Tympanic membrane perforation Hearing loss Speech delay in babies Cholesteatoma
Meniere’s disease S/Sx:
Overproduction of endolymph
Tinnitus
Vertigo
Sensorineural hearing loss
Benign tumor of the Schwann cells of CN XIII:
Acoustic neuroma
S/Sx of acoustic neuroma:
Progressive unilateral hearing loss (hallmark) Tinnitus Dizziness Otalgia Trigeminal neuralgia Hemiparesis
A cholesteatoma is:
an epidermoid cyst located in the middle ear, TM, or mastoid; filled with amorphous debris, sometimes cholesterol.
Progressive enlargement of a cholesteatoma causes:
erosion of the soft tissues and bones (ossicles, labyrinth, adjacent skull bone)
Cholesteatomas are lined with what type of epithelium?
Keratinized squamous or columnar (mucus producing)
Cholesteatoma sequelae:
Grow into ossicles Deafness Facial paralysis Infection Intercranial abcess
What is the typical pathogen in Malignant Otitis Externa?
Psuedomonas aeruginosa
S/Sx of malignant otitis externa:
Foul smell
Purulent otorrhea
Severe otalgia
Granulation tissue is apparent in external canal
Scleritis:
Inflammation of the white of the eye, connective tissue layer covering the choroid, deep to bulbar conjunctiva.
Conjunctivitis:
Inflammation of the surface tissue of the globe and inner surface of the eyelid.
Causes of conjunctivitis:
Allergic
Infectious
Granulomatous
T of F: Conjunctivitis is more dangerous than Scleritis.
False. Scleritis is much more dangerous;
May result from systemic dz like RA;
May point to inflammation of the uvea.
How can scleritis be differentiated from conjunctivitis?
In scleritis, deep vessels do not constrict with phenylephrine, and are non-displaceable, vs. the surface vessels of the conjunctiva.
Glaucoma:
collection of conditions the lead to changes in the visual field, accompanied by elevated intraocular pressure; lack of drainage in anterior chamber.
Most common form of glaucoma:
Primary open-angle
Two types of glaucoma:
Open-angle, and angle-closure. (refers to anterior angle btw constrictor muscle and cornea; in open-angle, iris is ‘back’ nearer lens)
Describe the microcirculatory changes seen in DM.
Thickened basement membranes of retinal vessels.
Frequent microaneurysms.
Exudates.
Micro occlusions of the small vessels leads to macular edema; cause of vision loss, risk of retinal detachment.
Neovascular membrane of new blood vessels forms.
How is blood volume restored after acute blood loss?
Shift of water from the interstitial fluid compartment.
Immediately after acute hemorrhage, what is the HCT? Later?
Immediately normal - volume of RBCs to plasma still the same. After influx of interstitial fluid into vasculature HCT goes down (hemodilution).
What triggers production of erythropoietin (EPO)?
Decreased oxygenation of tissues.
Bone marrow can increase capacity of RBC production by how much?
7-8 fold above baseline.
Dogs bled out 30%, died when transfused with ________ and lived when transfused with ______________.
Whole blood
Saline
(Whole blood transfusion made them hyperosmotic)
Hemolytic anemia leads to:
Gallstones Pulmonary HTN Jaundice SOB Fatigue
Direct Coomb’s Test:
Warm AIHA
IgG antibody
Chronic disease: SLE, RA
Indirect Coomb’s Test:
Cold AIHA
IgM antibody
Acute, self-limiting disease: mycoplasma, mono, virus
Intravascular hemolysis leads to:
mechanical trauma: heart valves, physical trauma
antibody fixation: mismatch blood transfusion
toxic injury to RBCs: malaria, septic shock
Extravascular hemolysis leads to:
structural changes: less deformable (sickle cell, hereditary spherocytosis)
