02b: Lung Flashcards
LDCT screening for lung cancer has high false (pos/neg) rate.
Pos
T/F: in study comparing CXR and LDCT for lung cancer screening, there was an immediate increase in lung cancer diagnosis with LDCT.
True
T/F: in study comparing CXR and LDCT for lung cancer screening, there was an immediate decrease in lung cancer deaths with LDCT.
False - not immediate (2y lag)
But CT screening reduces lung cancer mortality by 20%
Gene mutations in which two oncogenes play big role in adenocarcinomas of lung?
KRAS (35%) and EGFR (15%)
Patients with NSCLC (lung cancer) are treated based on:
The specific oncogenic mutations/drivers (KRAS, EGFR, ALK, ROS)
Most lung adenocarcinomas are located (centrally/peripherally) and follow (typical/atypical) (X) pattern.
Peripherally
Typical
X = acinar (with glandular differentiation)
NSCLC: histology shows large, irregular, peripheral nuclei and some highly eosinophilic cytoplasm, indicating (X). Which specific type of cancer?
X = keratinization
Squamous cell carcinoma
New p40 market is positive for (X) lung cancer with 100% sensitivity and 98% specificity
X = squamous cell carcinoma
Lung cancer (SCLC) usually present as (central/peripherally) tumors and most patients are (symptomatic/asymptomatic) at presentation.
Central
Symptomatic
SVC syndrome symptoms
- Neck/ arm swelling
- Distended brings over neck
- SOB, HA, hoarseness
Symptoms related to hepatic metastasis of lung cancer
Weight loss, weakness
Symptoms related to brain metastasis of lung cancer
HA, N/V, seizures, personality change, confusion
Symptoms related to bone metastasis of lung cancer
Bone pain
T/F: paraneoplastic syndromes are signs of metastasis
False - bio active substances secreted by or in response to tumor
Humeral hypercalcemia of Malignancy results due to secretin of (X) by which type of lung cancer?
X = PTHrP
Squamous cell carcinoma
Hypertrophic osteoarthropathy is paraneoplastic syndrome seen in which lung cancers? What are the symptoms?
Adenocarcinomas
Hand/leg pain, new bone formation, clubbing
List the paraneoplastic syndromes seen in SCLC
- SIADH
- Lambert-Eaton Syndrome
- Cushing (ectopic ACTH)
Stage I NSCLC treatment
Surg resection
Stage II NSCLC treatment
Surg resection + adjuvant chemo
Stage IIIA NSCLC treatment
Surg + adjuvant chemo or chemo radiation
Stage IIIB NSCLC treatment
Chemo and radiation
Stage IV NSCLC treatment
Palliative chemo and maybe radiation
All SCLC stages treated the same depending on:
Whether it’s a limited or extensive stage
SCLC “limited stage” criteria and treatment
Tumor confined to one area of the chest
Radiation and chemo simultaneously
