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Respiratory (LECTURE NOTES) > Carcinoma of the Lung > Flashcards

Carcinoma of the Lung Flashcards

1
Q

How many people does lung cancer kill in the UK per year

A

34000

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2
Q

What are most lung cancers caused by

A

Smoking

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3
Q

Studies by who estabilished the causative link between smoking and lung cancer?

A

Doll and Hill

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4
Q

What are some other causes of carcinoma of the lung

A 
Passive smoking 
Genetic factors
Ionising radiation (radon gas) 
Asbestos exposure 
Diffuse lung fibrosis 
Lack of dietary fruit and vegetables
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5
Q

Family history of Lung cancer is a risk factor. True or false

A

True

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6
Q

What are the 2 main groups of lung cancer

A

Small cell and non small cell

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7
Q

What are 3 types of non small cell carcinomas

A

Squamous cell carcinoma
Adenocarcinoma
Large cell (undifferentiated) carcinoma

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8
Q

Where do small cell carcinoma usually arise from

A

Neuro-endocrine cells of the bronchial tree and its endocrine potential is sometime manifest clinically by ectopic hormone production

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9
Q

What is the most common type of lung cancer

A

Squamous cell carcinoma

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10
Q

What type of lung cancer has the greatest tendency to cavitate

A

Squamous cell

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11
Q

Define large - cell undifferentiated carcinomas

A

Lung cancers that do not show squamous or glandular differentiation

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12
Q

What do central lung cancers usually present with

A

chest symptoms (haemoptysis)

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13
Q

What do peripheral tumours present with

A

More often general symptoms or effects of metastases

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14
Q

Where do paraneoplastic syndromes arise

A

At sites distant from the tumour or its metastases

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15
Q

The syndrome of inappropriate anti diuretic hormone secretion is most common with which type of lung cancer

A

Small cell cancer

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16
Q

What might hypercalcaemia in patients with lung cancer be indicative of

A

Bone metastases

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17
Q

What might cause paralysis of the phrenic nerve

A

Direct invasion of the mediastinum

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18
Q

What can cause facial oedema, headache, distended pulseless jugular veins and enlarged collateral veins over the chest and arms

A

Obstruction of the superior vena cava

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19
Q

What is a pancoast tumour

A

A carcinoma situated in the superior sulcus of the lung where the subclavian artery forms a groove over the lung apex

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20
Q

How many lung cancers are visible during bronchoscopy

A

2/3rds

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21
Q

How can samples from a tumour be taken during bronchoscopy

A

Biopsy forceps or cytology brush can be passed through the channel

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22
Q

Who is bronchoscopy contra-indicated in?

A

Those with uncontrolled angina or recent MI

23
Q

What does endobronchial ultrasound allow

A

Needle aspiration to be performed

24
Q

What does endobronchial ultrasound allow

A

Needle aspiration to be performed

25
Q

Treatment of lung cancer depends on what 3 things

A

the cell type and stage of the disease and the fitness of the patient

26
Q

What is the main treatment for small cell carcinoma

A

Chemotherapy

27
Q

Are untreated patients with small cell carcinoma usually symptomatic or asymptomatic

A

Very symptomatic

28
Q

How long is the chance of survival for untreated small cell carcinoma

A

3 months

29
Q

Describe limited disease

A

When the small cell cancer has spread minimally and radiotherapy can be used

30
Q

Describe extensive disease

A

When the small cell ccarcinoma has spread beyond a radiotherapy port (distant metastases)

31
Q

Where is consolidation radiotherapy usually given

A

To the site of the tumour and mediastinal nodes

32
Q

Where is a common place for metastases

A

Cerebral

33
Q

What is the best chance of cure in non-small cell carcinoma

A

Surgical resection

34
Q

What is the staging system used in lung cancer

A

TNM

35
Q

What is the key radiological investigation for staging lung cancer

A

CT scanning

36
Q

What can be used to investigate the active disease in mediastinal nodes

A

PET (positron emission tomography )

37
Q

What can be used to investigate the active disease in mediastinal nodes

A

PET (positron emission tomography )

38
Q

Over expression of what receptor is a feature of non-small cell lung cancer

A

Epidermal growth factor receptor (EGFR)

39
Q

Over expression of what receptor is a feature of non-small cell lung cancer

A

Epidermal growth factor receptor (EGFR)

40
Q

What does palliative care focus on

A

Improving the patient’s functioning and psychosocial wellbeing with relief of symptoms

41
Q

What should opiates be prescribed with

A

Laxatives and an anti-emetic

42
Q

What drug might be helpful in bossting the appetite

A

Prednisolone

43
Q

Where does alveolar cell carcinoma spread

A

It arises in the alveoli of the lung and spreads along the alveolar and bronchiolar epithelium

44
Q

What does alveolar cell carcinoma resemble histologically

A

Adenocarcinoma

45
Q

What is required to diagnose alveolar cell carcinoma

A

A transbronchial biopsy of alveolar tissue

46
Q

What is the treatment of choice when the tumour in alveolar cell carcinoma is confined to one lobe

A

Surgical resection

47
Q

Carcinoid tumours are less likely to metastasis. True or false

A

True

48
Q

What age are patients with a carcinoid tumour likely to be affected at?

A

Young age

49
Q

Are carcinoid tumours related to smoking

A

No

50
Q

What are the two common presentations of carcinoid tumours

A

Haemoptysis and wheeze

51
Q

What is the treatment of choice for a carcinoid tumour

A

Surgical resection

52
Q

How does a superior vena caval obstruction present?

A

With headache, distended neck veins that are non-pulsatile, oedema of the face and arms, dilated collateral veins over the chest

53
Q

What is the most common cause of SVCO

A

Lung cancer

54
Q

What is sometimes useful in reducing oedema and inflammation around a tumour

A

Dexamethasone

Respiratory (LECTURE NOTES) (19 decks)

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