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respiratory > tumours > Flashcards

tumours Flashcards

1
Q

what is main cause of lung cancer

A

smoking

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2
Q

other causes of lung cancer

A
  • radon exposure
  • asbestos
  • ionising radiation
  • arsenic
  • chromium
  • nickel
  • pulmonary fibrosis
  • HIV
  • genetics
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3
Q

what are the 2 types

A
  • small cell

- non-small cell

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4
Q

examples of non-small cell

A
  • adenocarcinoma
  • squamous cell
  • large cell
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5
Q

what is a mutation

A

in the epidermal growth factor (EGFR)

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6
Q

what do squamous cell carcinoma arise from

A

epithelial cells associated with production of keratin

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7
Q

what is most common type in non-smokers

A

adenocarcinoma

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8
Q

where do small cell arise from

A

neuroendocrine cells (APUD cells)

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9
Q

what do small cell often secrete

A

polypeptide hormones

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10
Q

where are small cell most common

A

centrally

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11
Q

symptoms

A
  • cough
  • chest pain
  • haemoptysis
  • chest infection
  • malaise
  • breathlessness
  • wheeze
  • recurrent infection
  • invasion of phrenic nerve
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12
Q

what is most common symptom

A

cough

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13
Q

why do patients get breathless

A

tumour occludes large airways can cause lung collapse

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14
Q

what is a co-existing disease

A

COPD

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15
Q

why does patient get hoarse voice

A

compression of left recurrent laryngeal

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16
Q

where can it metastases

A
  • liver
  • bone
  • adrenal gland
  • brain
  • malignant pleural effusion
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17
Q

extra pulmonary manifestations

A
  • anaemia
  • finger clubbing
  • hypertrophic pulmonary osteoarthropathy
  • weight loss
  • anorexia
  • gynaecomastia

lots more

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18
Q

aims of investigations

A
  • stage
  • differentiate
  • assess fitness to undergo treatment
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19
Q

what investigations are done

A
  • chest x-ray
  • CT
  • ultrasound
  • biopsy
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20
Q

what does CT indicate

A

extent of disease

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21
Q

what is used for staging

A

TNM

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22
Q

what does T stand for in TNM

A

tumour size

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23
Q

what does N stand for in TNM

A

nodal involvement

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24
Q

what does M stand for in TNM

A

metastases

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25
Q

TX means

A
  • primary tumour cannot be assessed

- or tumour present in sputum but cannot be found

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26
Q

T0 means

A

no evidence of primary tumour

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27
Q

Tis means

A

carcinoma in situ

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28
Q

T1 means

A

tumour <3cm

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29
Q

T2 means

A

tumour >3cm but less than 7cm

  • involves main bronchus
  • invades visceral pleura
30
Q

T3 means

A

tumour >7cm

  • directly invades chest wall, diaphragm, phrenic nerve, pleura
31
Q

T4 means

A

tumour of any size that invades any of the following: mediastinum, heart, great vessels, trachea, recurrent laryngeal nerve, oesophagus, carina

32
Q

NX means

A

regional lymph nodes cannot assessed

33
Q

N0 means

A

no regional lymph node metastases

34
Q

N1 means

A

metastasis in ipsilateral peribronchial hilar lymph nodes

35
Q

N2 means

A

metastasis in ipsilateral mediastinal and/or subcranial lymph nodes

36
Q

N3 means

A

metastasis in contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene nodes

37
Q

M0 means

A

no distant metastasis

38
Q

M1 means

A

distant metastasis

39
Q

when are lymph nodes classed as being enlarged

A

> 1cm

40
Q

what is test for assessing extent of lymph node involvement

A

PET

41
Q

is MRI useful

A

no

42
Q

when is MRI useful

A

pancoast tumour

43
Q

what is bronchoscopy used for

A

biopsy

44
Q

when is tumour inoperable

A

if carcinoma involved first 2cm of either main bronchus

45
Q

what is most common complication of biopsy

A

pneumothorax

46
Q

are most patients curable or incurable

A

incurable

47
Q

when is surgery done

A

non small cell

48
Q

what is treatment of choice when surgery not available

A

radiation therapy

49
Q

what is given at end of chemotherapy

A

radiotherapy

to consolidate treatment in small cell lung cancer

50
Q

what is used in palliation

A

laser therapy

51
Q

who are all involved in treatment

A

MDT

52
Q

how do metastases of lung present

A

as round shadows

53
Q

where do secondary lung tumours come from

A
  • kidney
  • prostrate
  • breast
  • bone
  • GI tract
54
Q

differential diagnosis

A
  • primary bronchial carcinoma
  • tuberculoma
  • benign tumour of lung
  • hydatid cyst
55
Q

BENIGN TUMOURS

A

BENIGN TUMOURS

56
Q

what is most common benign tumour

A

pulmonary hamartoma

57
Q

how is pulmonary hamartoma detected on CXR

A

well-defined round lesion 1-2cm

58
Q

what do bronchial carcinoids produce

A

adrenocorticotrophic hormone (ACTH)

59
Q

what does small cell release

A

ACTH

60
Q

what does ACTH cause

A

cushing syndrome

61
Q

what does squamous cell carcinoma release

A

PTH

62
Q

what does PTH cause

A

hypercalaemia

63
Q

what are the signs of cushing syndrome

A
  • central obesity
  • ‘buffalo hump’
  • striae
  • proximal muscle weakness
64
Q

what is most common in non-smokers

A

adenocarcinoma

65
Q

metastases from primary lung cancer

A

BLAB

  • brain
  • liver
  • adrenal
  • bone
66
Q

where is pancoast tumour

A

apex of lung

67
Q

where do pancoast tumour invade

A

the brachial plexus

68
Q

what is pancoast tumour associated with when it compresses the sympathetic chain

A

Horner syndrome

69
Q

features of Horner syndrome

A
  • miosis
  • ptosis
  • anhidrosis
70
Q

what can pancoast tumour compress

A

sympathetic chain

71
Q

what do squamous cell carcinoma produce

A

keratin

respiratory (20 decks)

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