Thoracic oncology Flashcards
You see a 76 year old male with a CT CAP showing a 3cm right upper lobe mass. Assuming this is lung cancer, what is the T stage?
A) T1a
B) T1b
C) T1c
D) T2a
E) T2b
T1c
T1 is 0 to 3cm including 3cm
T1a 0 to 1cm including 1cm
T1b >1 to 2cm including 2 cm
T1c >2cm to 3cm including 3 cm
What 4 features upstages a T1 lung tumour to T2?
Involvement of:
1) Main bronchus without carina
2) Invasion of visceral Pleura
3) atelectasis
4) post obstructive pneumonitis extending to hilum
What 4 features upstages a lung tumour to T3?
Involvement of:
1) Chest wall
2) Pericardium
3) Phrenic nerve
4) satellite nodule in the same lobe
Which 10 features upstage a lung tumour to T4?
Involvement of:
1) Mediastinum
2) Diaphragm
3) Heart
4) Great vessels
5) Recurrent laryngeal nerve
6) Carina
7) Trachea
8) Oesophagus
9) Spine
10) Separate tumour in different ipsilateral lung lobe
By volume which nodules with benign features can be discharge based on volume ?
A) <50mm3
B) <80mm3
C) <120mm3
D) <300mm3
E) <400mm3
<80mm3
Do not offer nodule follow-up for people with nodules <5 mm in maximum diameter or <80 mm3 volume. - BTS
A 70-year-old female smoker presents with cough and weight loss.
A CT scan of the chest shows a 5.5 cm primary mass in the right lower lobe and a smaller malignant-looking nodule in the right upper lobe. There are bilateral enlarged hilar lymph nodes.
What stage grouping is her lung cancer based on CT imaging?
A) 2A
B) 2B
C) 3A
D) 3B
E) 3C
E) 3C
T4 (by upstage) - 5.5 cm primary mass in the right lower lobe and a smaller malignant-looking nodule in the right upper lobe.
N3 - contralateral hilar lymphadenopathy
M0 - No mets
Which of the below is not part of the brock score?
A) Age
B) Gender
C) Family Hx of Lung Ca
D) Emphysema
E) Smoking History
E) Smoking History
Which of the below is not part of the Herder score?
A) Age
B) Gender
C) Family Hx of Lung Ca
D) Emphysema
E) Smoking history
F) Hx of Extrathoracic Ca
B) Gender
C) Family Hx of Lung Ca
D) Emphysema
You see a patient with a 9mm nodule. What brock score would necessitate CT follow up and what brock score would necessitate PET scan?
A) <10% needs CT follow up, ≥10% requires PET scan
B) <20% needs CT follow up, ≥20% requires PET scan
C) <30% needs CT follow up, ≥30% requires PET scan
D) <50% needs CT follow up, ≥50% requires PET scan
E) <70% needs CT follow up, ≥70% requires PET scan
A) <10% needs CT follow up, ≥10% requires PET scan
Where initial risk stratification assigns a nodule a chance of malignancy of <10%, assess growth rate using interval CT with capability for automated volumetric analysis.
Offer a PET-CT scan to patients with a pulmonary nodule with an initial risk of malignancy of >10% (Brock model)
where the nodule size is greater than the local PET-CT detection threshold.
A 5.5mm nodule goes through the virtual nodule clinic. The 1 year interval CT scan is reviewed.
When can you consider discharge based on Volume doubling time?
VDT >600 days
VDT > 600 days - consider discharge based on volumetry or ongoing CT surveillance depending on patient preference
VDT 600 - 400 days - consider biopsy or CT surveillance depending on
VDT < 400 days - further diagnostic investigations (biopsy, imagining, or resection)
A 8mm nodule is being reviewed in virtual nodule clinic. It has been 3 months since the initial scan and you are using volume doubling time (VDT) to decide what further management is needed.
The VDT is 360 days at 3 months scan.
What is the next appropriate management?
A) CT in 6 months from baseline
B) CT in 12 months from baseline
C) CT in 24 months from baseline
D) further diagnostic investigations (biopsy, imagining, or resection)
E) Discharge
D) further diagnostic investigations (biopsy, imagining, or resection)
Offer further diagnostic investigation (biopsy, imaging or resection) for patients with nodules showing clear growth or a VDT of <400 days (assessed after 3 months, and 1 year).
If at 3 months VDT is >400 proceed to 1 year scan from baseline
How long after a myocardial infarction should you wait till lung cancer surgery?
A) 7 days
B) 14 days
C) 21 days
D) 28 days
E) 30 days
E) 30 days
Avoid surgery within 30 days of myocardial infarction. [2011]
What is the 1 year survival and 5 year survival of Stage 1 lung cancer?
A) 1 year - 100% 5 years 90%
B) 1 year - 88% 5 years 56%
C) 1 year - 75% 5 years 50%
D) 1 year - 70% 5 years 50%
E) 1 year - 65% 5 years 50%
B) 1 year - 88% 5 years 56%
What is the 1 year survival and 5 year survival of Stage 2 lung cancer?
A) 1 year - 88% 5 years 56%
B) 1 year - 73% 5 years 34%
C) 1 year - 65% 5 years 30%
D) 1 year - 62% 5 years 25%
E) 1 year - 60% 5 years 24%
B) 1 year - 73% 5 years 34%
What is the 1 year survival and 5 year survival of Stage 3 lung cancer?
A) 1 year - 88% 5 years 56%
B) 1 year - 73% 5 years 34%
C) 1 year - 52% 5 years 13%
D) 1 year - 40% 5 years 10%
E) 1 year - 30% 5 years 5%
C) 1 year - 52% 5 years 13%
What is the 1 year survival and 5 year survival of Stage 4 lung cancer?
A) 1 year - 88% 5 years 56%
B) 1 year - 73% 5 years 34%
C) 1 year - 52% 5 years 13%
D) 1 year - 19% 5 years 3%
E) 1 year - 10% 5 years 1%
D) 1 year - 19% 5 years 3%
What term correlates to part ground glass nodule of <5mm
A) Atypical adenomatous hyperplasia (AAH)
B) Adenocarcinoma in situ (AIS)
C) Minimally invasive adenocarcinoma (MIA)
D) Invasive adenocarcinoma
E) Bronchoalveolar Carcinoma
A) Atypical adenomatous hyperplasia (AAH)
What term correlates to part ground glass nodule of 5mm to 30mm
A) Atypical adenomatous hyperplasia (AAH)
B) Adenocarcinoma in situ (AIS)
C) Minimally invasive adenocarcinoma (MIA)
D) Invasive adenocarcinoma
E) Bronchoalveolar Carcinoma
B) Adenocarcinoma in situ (AIS)
What term correlates to part solid nodule, with solid area of <5mm
A) Atypical adenomatous hyperplasia (AAH)
B) Adenocarcinoma in situ (AIS)
C) Minimally invasive adenocarcinoma (MIA)
D) Invasive adenocarcinoma
E) Bronchoalveolar Carcinoma
C) Minimally invasive adenocarcinoma (MIA)
What term correlates to part solid nodule, with solid area of >5mm
A) Atypical adenomatous hyperplasia (AAH)
B) Adenocarcinoma in situ (AIS)
C) Minimally invasive adenocarcinoma (MIA)
D) Invasive adenocarcinoma
E) Bronchoalveolar Carcinoma
D) Invasive adenocarcinoma
