Lung cancer Flashcards

1
Q

What percentage of lung tumours are carcinoid?

A

1%

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2
Q

What were carcinoid lung tumours previously known as?

A

Brionchial adenoma

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3
Q

Where in the lung do carcinoid tumours arise from?

A

Amine precursor uptake
and decarboxylation (APUD)

**i.e. same place as small cell tumours

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4
Q

Typical age of presentation with carcinoid lung tumour

A

40-50 years

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5
Q

Smoking is a risk factor for carcinoid tumours. TRUE/FALSE

A

FALSE

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6
Q

How do carcinoid tumours usually present?

A

slow growing
=> long history of cough
recurrent haemoptysis

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7
Q

Do carcinoid tumours present centrally or peripherally in the lung?

A

Centrally
=> often not seen on CXR

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8
Q

Sign on bronchoscopy

A

‘cherry red ball’

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9
Q

What metastases are common if a patient has developed carcinoid syndrome?

A

Liver

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10
Q

Management of carcinoid tumour

A

surgical resection

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11
Q

5 year prognosis in carcinoid tumour

A

if no metastases then 90% survival at 5 years

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12
Q

Investigations for lung cancer

A

CXR
CT
Bronchoscopy
PET
Bloods

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13
Q

Management options for non-small cell lung cancer

A
  • surgery (only 20% are suitable)
  • Radiotherapy curative/palliative
  • chemotherapy (poor response)
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14
Q

Give examples of some contraindications to surgery to manage non-small cell lung cancer

A

Stage IIIb or IV (i.e. metastases)
FEV1 < 1.5L
Malignant pleural effusion
Tumour near hilum
Vocal cord paralysis
SVC obstruction

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15
Q

Paraneoplastic syndromes associated with small cell lung ca

A

ADH (hyponatraemia)
ACTH (Cushing’s syndrome)
Lambert-Eaton Myasthenic Syndrome

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16
Q

Paraneoplastic syndromes associated with squamous cell lung ca

A

Parathyroid hormone-related protein (PTH-rp) secretion
=> hypercalcaemia

Hypertrophic pulmonary osteoarthropathy (HPOA)

Ectopic TSH => Hyperthyroidism

17
Q

Paraneoplastic syndromes associated with adenocarcinoma of the lung

A

gynaecomastia

hypertrophic pulmonary osteoarthropathy (HPOA)

18
Q

What is Hypertrophic pulmonary osteoarthropathy?

A
  • proliferative periostisis
  • typically involves the long bones
  • painful.
19
Q

What symptoms would prompt you to refer a patient >40years for urgent suspicion of lung cancer?

A
  • unexplained haemaoptysis
  • recurrent chest infection
  • finger clubbing
  • supraclavicular lymphadenopathy
  • thrombocytosis
20
Q

by how much does smoking increase the risk of lung cancer?

A

By a factor of 10

21
Q

Risk factors for lung cancer (excluding smoking)

A

asbestos
arsenic
radon
nickel
chromate
aromatic hydrocarbon
cryptogenic fibrosing alveolitis

22
Q

Smoking and asbestos exposure are synergistic in terms of lung cancer risk. What does this mean?

A

Smoking = 10 fold risk
Asbestos = 5 fold risk

i.e. a smoker with asbestos exposure has a 10 * 5 = 50 times increased risk

23
Q

Are small cell lung cancers usually central or peripheral?

A

Central

24
Q

What cells do small cell lung cancers arise from?

A

Amine precursor uptake and decarboxylation (APUD)

25
Q

Management of small cell lung cancer

A
  • early stage disease (T1-2a, N0, M0) are now considered for surgery
  • Most patients get chemotherapy and radiotherapy
  • palliative chemotherapy for extensive disease
26
Q

Small cell lung cancer is usually metastatic disease by time of diagnosis. TRUE/FALSE

A

TRUE

27
Q
A