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BMS 250 test 2 > Week 6 Lecture 1 > Flashcards

Week 6 Lecture 1 Flashcards

1
Q

What are the main types of primary lung cancer?

A

Non-small cell lung cancer, small cell lung cancer, carcinoid, mesothelioma

Mesothelioma specifically affects the pleura.

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2
Q

What is the most common cause of cancer death in both men and women?

A

Lung cancer

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3
Q

What age range has the peak incidence of lung cancer?

A

60 to 70 years

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4
Q

What percentage of lung cancers are classified as non-small cell lung cancer?

A

80%

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5
Q

List the three main subtypes of non-small cell lung cancer.

A
  • Adenocarcinoma
  • Squamous cell carcinoma
  • Large cell carcinoma
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6
Q

What are Pancoast tumors?

A

Primary lung cancers that develop in the apex of the lung, usually non-small cell cancers

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7
Q

What is the most common subtype of lung cancer in North America?

A

Adenocarcinoma

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8
Q

What is the prognosis for adenocarcinoma in terms of 5-year survival?

A

13%

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9
Q

Which type of lung cancer is most strongly associated with smoking?

A

Squamous cell carcinoma

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10
Q

What is the characteristic histological feature of squamous cell carcinoma?

A

Presence of keratin pearls

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11
Q

What is the prognosis for large cell carcinoma in terms of 5-year survival?

A

10%

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12
Q

What percentage of lung cancers does small cell lung cancer account for?

A

13.8%

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13
Q

What is the prognosis for small cell lung cancer in terms of 5-year survival?

A

5%

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14
Q

What staging system is used for lung carcinoma?

A

TNM scoring system

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15
Q

What does ‘T’ represent in the TNM staging system?

A

Tumor size and extent of local and/or regional spread

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16
Q

What does ‘N’ represent in the TNM staging system?

A

Spread of tumor to regional or distant lymph nodes

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17
Q

What does ‘M’ represent in the TNM staging system?

A

Presence of distant metastases

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18
Q

What is the most common presenting symptom of lung cancer?

A

Cough

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19
Q

What clinical feature is common due to central tumors in lung cancer?

A

Hemoptysis

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20
Q

What is Horner’s syndrome?

A

Drooping of the upper eyelid, constriction of the pupil, absence of sweating

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21
Q

What is the primary cause of paraneoplastic syndromes in lung cancer?

A

Production of physiologically active substances by cancer

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22
Q

What is the lifetime risk of developing lung cancer in smokers?

A

12-17%

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23
Q

What are the two most common causes of paraneoplastic syndromes?

A
  • Production of active substances by cancer
  • Altered immune response
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24
Q

What type of lung cancer is most commonly associated with hypercalcemia?

A

Squamous cell carcinoma

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25
Q

What are common mutations involved in the molecular pathogenesis of lung cancers?

A
  • K-ras mutations
  • EGFR mutations
  • EML4-ALK translocations
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26
Q

What is the most common occupational risk factor for lung cancer?

A

Exposure to asbestos

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27
Q

What are carcinoid tumors and where do they most often appear?

A

Tumors that develop in neuroendocrine cells, most often in the gastrointestinal tract

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28
Q

What percentage of lung cancers do carcinoid tumors account for?

A

2-3%

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29
Q

What are the two subtypes of lung carcinoid tumors?

A
  • Typical carcinoid
  • Atypical carcinoid
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30
Q

What are lung carcinoids and their prevalence in lung cancers?

A

Lung carcinoids are very rare, accounting for 2-3% of all lung cancers.

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31
Q

Where do lung carcinoids develop?

A

Lung carcinoids develop in neuroendocrine cells of the normal bronchial epithelium.

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32
Q

What are the two subtypes of lung carcinoids?

A

The two subtypes are typical carcinoid and atypical carcinoid.

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33
Q

Are lung carcinoids more common in men or women?

A

Lung carcinoids are equally common in men and women.

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34
Q

Are lung carcinoids related to smoking?

A

No, lung carcinoids are not related to smoking.

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35
Q

How do lung carcinoids compare in growth rate to other lung cancers?

A

Lung carcinoids tend to grow slower than other types of lung cancers.

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36
Q

Do most lung carcinoids cause endocrine paraneoplastic syndromes?

A

Most lung carcinoids do not cause endocrine paraneoplastic syndromes.

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37
Q

What is the 5-year survival rate after surgery for typical carcinoids?

A

The 5-year survival rate for typical carcinoids is 90% after surgery.

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38
Q

What is the 5-year survival rate after surgery for atypical carcinoids?

A

The 5-year survival rate for atypical carcinoids is 60% after surgery.

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39
Q

What is mesothelioma?

A

Mesothelioma is a cancer of the pleural lining.

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40
Q

What percentage of lung cancers does mesothelioma account for?

A

Mesothelioma accounts for about 5% of all lung cancers.

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41
Q

What is the primary cause of mesothelioma?

A

Mesothelioma is most often caused by asbestos exposure.

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42
Q

How long does it typically take for mesothelioma to develop after asbestos exposure?

A

It typically takes 30 to 50 years between exposure to asbestos and diagnosis.

43
Q

What are common initial symptoms of mesothelioma?

A

Common initial symptoms include pleural effusion, pleural mass, chest pain, weight loss, and malaise.

44
Q

How does pleural mesothelioma typically spread?

A

Pleural mesotheliomas tend to spread locally within the chest cavity, invading and compressing major structures.

45
Q

What is the prognosis for mesothelioma patients?

A

The prognosis is poor, with few patients surviving longer than 18 months after diagnosis.

46
Q

What is metastasized cancer?

A

Metastasized cancer refers to cancer that has spread to other parts of the body, including the lungs.

47
Q

How do cancers typically spread to the lungs?

A

Cancers can spread to the lungs via the lymphatic system or the bloodstream.

48
Q

Where do most metastatic cancers develop in the lungs?

A

Most metastatic cancers develop near the edges of the lungs and in the lower lobes.

49
Q

Can lung metastases cause symptoms initially?

A

Lung metastases may not cause any symptoms initially.

50
Q

List some cancers that commonly metastasize to the lungs.

A
  • Bladder cancer
  • Breast cancer
  • Colorectal cancer
  • Kidney cancer
  • Melanoma
  • Sarcomas
  • Testicular cancer
51
Q

Fill in the blank: Mesothelioma is primarily caused by _______.

A

asbestos exposure

52
Q

What is the most common cause of cancer death in both men and women?

A

Lung cancer

Lung cancer is a leading cause of cancer mortality.

53
Q

What age range has the peak incidence of lung cancer?

A

60 to 70 years

The risk of developing lung cancer increases with age.

54
Q

What percentage of all lung cancers is accounted for by Non-Small Cell Lung Cancer?

A

80%

This type is the most prevalent among lung cancer cases.

55
Q

Name the three main subtypes of Non-Small Cell Lung Cancer.

A
  • Adenocarcinoma
  • Squamous cell carcinoma
  • Large cell carcinoma

These subtypes are grouped due to historically similar treatment approaches.

56
Q

What are Pancoast tumors?

A

Primary lung cancers that develop in the apex of the lung

They are usually non-small cell cancers, most often squamous cell carcinomas.

57
Q

Which subtype of lung cancer is most common in North America?

A

Adenocarcinoma

It accounts for 36.4% of all lung cancers.

58
Q

What is the prognosis for adenocarcinoma?

A

13% 5-year survival

This indicates a relatively poor long-term outcome.

59
Q

What is the most common presenting symptom of lung cancer?

A

Cough

Cough often presents in advanced stages of lung cancer.

60
Q

True or False: Squamous Cell Carcinoma accounts for 20% of all lung cancers.

A

True

This type is most common in men and strongly associated with smoking.

61
Q

What is the prognosis for Large Cell Carcinoma?

A

10% 5-year survival

This subtype tends to grow and spread faster than other types.

62
Q

What is the most common location for Small Cell Lung Cancer?

A

Centrally or in the hilum

This type develops in the neuroendocrine cells of the lung.

63
Q

What is the single most important predictor of prognosis in lung cancer?

A

Tumor stage

The TNM scoring system is used to stage lung carcinoma.

64
Q

Fill in the blank: The TNM scoring system stands for Tumor size, ________, and Metastasis.

A

Node spread

This scoring system helps assess the extent of cancer.

65
Q

What percentage of patients have localized disease at the initial diagnosis of lung cancer?

A

20%

Most patients present with advanced disease.

66
Q

What are the most common sites of metastasis for lung cancer?

A
  • Regional lymph nodes
  • Brain
  • Bone
  • Liver
  • Adrenal glands

These sites are frequently involved in the progression of lung cancer.

67
Q

What is Horner’s syndrome?

A

Drooping of the upper eyelid, constriction of the pupil, absence of sweating

This syndrome can occur due to Pancoast tumors impacting the sympathetic nerve plexus.

68
Q

What are paraneoplastic syndromes?

A

Clinical syndromes involving nonmetastatic systemic effects that accompany a cancer

They can include symptoms from substances produced by the cancer.

69
Q

What is the most common cause of hypercalcemia in lung cancer patients?

A

Ectopic production of a parathyroid hormone related peptide

This is most commonly seen in patients with squamous cell carcinomas.

70
Q

What is the primary risk factor for developing lung cancer?

A

Tobacco smoke

85-90% of lung cancers occur in tobacco smokers.

71
Q

Fill in the blank: Exposure to _______ is associated with 10% of lung cancers.

A

Radon

Radon is a colorless, odorless gas that can accumulate in homes.

72
Q

What is the lifetime risk of developing lung cancer in smokers?

A

12-17%

This risk is significantly higher compared to non-smokers.

73
Q

What determines the development of lung cancer?

A

No single mutation determines the development of lung cancer

74
Q

Which family of oncogenes is most important in lung cancer?

A

ras family of oncogenes, particularly K-ras

75
Q

What is the role of ras mutations in lung cancer?

A

Involved with the molecular pathogenesis of Non-small cell lung cancers and contribute to tumor progression

76
Q

What percentage of adenocarcinomas have K-ras gene mutations?

77
Q

K-ras mutations are associated with which lifestyle factor?

A

Cigarette smoking

78
Q

What is currently available for targeted therapy of K-ras mutations in lung cancer?

A

No effective targeted molecular therapy available

79
Q

What gene has activating mutations in up to 25% of adenocarcinomas?

A

Epidermal Growth Factor Receptor (EGFR)

80
Q

In which populations are mutations in EGFR more common?

A
  • Nonsmokers
  • People of East Asian descent
  • Women
81
Q

What is the significance of EGFR mutations in lung cancer treatment?

A

These cancers respond very well to tyrosine kinase inhibitor drugs

82
Q

What percentage of adenocarcinomas show EML4-ALK translocations?

83
Q

What is a common occurrence in adenocarcinomas with EML4-ALK translocations?

A

Brain metastases present at diagnosis in 25% of cases

84
Q

EGFR and EML4-ALK mutations are ________.

A

mutually exclusive

85
Q

What type of genetic alteration involves ROS1 translocations?

A

Fusions between ROS1 and various partners occur in 2% of all lung cancers

86
Q

What percentage of small cell lung cancers show overexpression of MYC?

A

10 – 40%

87
Q

What is the mutation prevalence of TP53 in lung cancers?

A

Identified in more than 80% of small cell and 50% of non–small cell lung cancers

88
Q

What percentage of small cell and non-small cell cancers have RB mutations?

A
  • > 80% of small cell
  • 25% of non–small cell
89
Q

What genetic deletion is frequently found in all types of lung cancers?

A

Deletions in the short arm of chromosome 3 (3p)

90
Q

What does the BCL2 protooncogene encode?

A

Bcl-2, a protein that inhibits apoptosis

91
Q

What is the mutation prevalence of PTEN in non-small cell lung cancers?

A

Deficient in many non–small cell lung cancers

92
Q

Amplification of which receptor is found in 20% of squamous cell carcinomas?

A

FGFR1 (fibroblast growth factor receptor 1)

93
Q

What is a consequence of early and extensive mutations in lung cancers?

A

Pronounced intratumor heterogeneity

94
Q

What percentage of all lung cancers do carcinoid tumors account for?

95
Q

What are the two subtypes of carcinoid tumors?

A
  • Typical carcinoid
  • Atypical carcinoid
96
Q

What is the 5-year survival rate after surgery for typical carcinoids?

97
Q

What is the prognosis for atypical carcinoids after surgery?

A

60% 5-year survival

98
Q

What type of cancer is mesothelioma?

A

Cancer of the pleural lining

99
Q

What is the common cause of mesothelioma?

A

Asbestos exposure

100
Q

How long can it take for mesothelioma to develop after asbestos exposure?

A

30 to 50 years

101
Q

What is the prognosis for patients diagnosed with mesothelioma?

A

Poor, with few surviving longer than 18 months

102
Q

What is a common site of metastasis for other cancers?

103
Q

Which cancers are more common to metastasize to the lungs? List at least three.

A
  • Bladder cancer
  • Breast cancer
  • Colorectal cancer

BMS 250 test 2 (11 decks)

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