Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CSI > lung cancer > Flashcards

lung cancer Flashcards

1
Q

more pts die of lung ca than..

A

colorectal, breast, prostate ca combined

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

this causes 85-90% lung ca

A

smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

over past 30 years: mortality dec or inc in MEN? why?

A

dec, change in tobacco use

Females: started falling in 2003

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

median age of dx

A

70

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

worldwide, this % of M/F lung ca pts are nonsmokers

why?

A

15% men, 50% women

biomass cooking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

other risk factors

A

radon gas
asbestos
metals (arseninc, chromium, Ni, iron oxide)
industrial carcinogens
familial predis.
preexisting disease: pulm. fibrosis, COPD (4x inc.), sarcoidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q 
lung ca breakdown: 
30-40% 
22%
13-20%
16%
2%
A 
adenocarcinoma
SqCC
SmCC
non-small cell
large cell
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

SqCC

A

From the bronchial epithelium, centrally located, can be intraluminal sessile or polyps
More likely to present with hemoptysis; can cavitate
Highly associated with smoking history
Tend to spread locally and may be associated with hilar adenopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

adenocarcinoma

A

From mucous glands or epithelial cells in terminal bronchioles
Never smokers, higher rate of metastatic disease
Peripheral nodules/masses
Adenocarcinoma in Situ (previously Bronchoalveolar cell carcinoma)
Spreads along preexisting alveolar structures without evidence of invasion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

large cell carcinoma

A

Relatively undifferentiated cancers that do not fit into other categories but share large cells
Aggressive clinical course with rapid doubling times
Central OR peripheral masses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

non-small cell carcinoma

A

Can’t be better differentiated on pathological review

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

SmCC

A

Bronchial origin typicall centrally located
Highly associated with smoking
Infiltrates submucosa causing narrowing or obstruction of the bronchus without discrete luminal mass
Often involves lymph nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

for staging, divided into

A

SmCC vs non-SmCC (included other 4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what type is more prone for hematogenous spread and rarely approp. for surg. resection
more or less aggressive course?
median survival?

A

SmCC
MORE aggressive
only 6-18 wk survival

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

s/s lung ca

A 
anorexia, wl, asthenia
new/change in cough
hemoptysis
pain (bony, nonsp. chest)
postobstr. pneumonia
pleural effusion (12-33%)
change in voice (rec. lary. n)
SVC syndrome
Horner's 
invol. inf cervical ganglion, paravert. symp. chain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

brain metastasis more common in these lung ca

and cause ???

A

adenocarcinoma, SmCC

cause ha, nausea, seizures, dizziness, AMS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

paraneoplastic syndrome caused by

occurs in what %

A

immune-med. or secretory effects of neoplasms

in 10-20% lung ca pts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

PNP syndrome comps

A

SIADH (10-15% SmCC)
hypercalcemia (10% SqCC)
inc. ACTH, anemia, hypercoag, peripheral neuropathy, labert eaton myasthenic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

lung ca dx

A 
sputum cytology
thoracentesis
thoracoscopy
fine needle aspiration 
fiberoptic bronchoscopy
mediastinoscopy
video assisted thorascopic surgery (VATS)
open thoracotomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

sputum cytology: sp or sn?

more like to be positive if ??? lesion

A

highly specific, v. insensitive

central lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

thoracentesis used for..
sens. of ??
do this to inc. yield

A

malignant pleural effusion
sn 50-60%
repeat 3x

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

thorascoscopy for..

preferred over ??

A

malignant pleural effusion

pref. over blind pleural biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is fine needle aspirated?

A

supraclavicular LNs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

fiberoptic bronchoscopy allows visualization of ??

accompanies…

A

major airways

w/ BAL of lung segs + cytology/biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

can also FNA ??

blindly or with ??

A

mediastinal LNs

endobronchial US guidance (EBUS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

this helps properly biopsy peripheral nodules

A

electromagnetic navigational bronchoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

this is a high risk for pts (peripheral nodules) esp. with ??

A

pneumothorax!

underlying emphysema

28
Q

this can be used then less invasive techniques fail

A

mediastinoscopy, VATS, open thoracotomy
-wedge biopsy-imm. analysis on simult. tx/lobectomy
(wait on management as frozen sects. can be inaccurate?)

29
Q

if multiple nodules on imaging, be more suspicious for ??? than ???

A

metastatic disease

primary lung ca

30
Q

TNM staging used for..

A

tx guidance, prognosis, to standardize trials

31
Q

TNM…

A

T: tumor (primary) size/location (where, how big?)
N: nodal metastasis presence/location (+/-, where?)
M: metastasis (distant) presence/absence (+/-)

32
Q

TNM stages grouped into prognostic categories

A

stages I-IV

33
Q

need to ?? in order to stage

A

evaluate LNs

34
Q

if no LNs on imaging larger than 1 cm…

A

resection of primary tumor and sample mediastinum at thoracotomy

35
Q

if suspect metastatic disease, LNs > 1-2 cm

A

CT guided FNA, mediastinoscopy, EBUS, EUS, limited thoracotomy to eval. LNs (prior to decision about thoracotomy?)

36
Q

PET scanning uses ??? to identify ???

specificity depends on ??

A

18F fluoro-2-deoxyglucose (FDG) to ID metastatic foci

size of mediastinal LN

37
Q

freq. obtain this to eval. for metastatic disease and determine surgical candidates
limited resolution if ???
false positive if ???

A

whole body fusion PET-CT imaging

if nodule

38
Q

with PET, need separate ??? to r/o brain metastasis in pts with at least Stage ??? disease

A

MRI of brain

Stage II

39
Q

periop. assessment for tumor resection is necessary b/c most pts have ???
most pts req ??? to evaluated how tolerate post-resection ???

A

other chronic lung diseases
spirometry
pulmonary insufficiency

40
Q

if pre-op. FEV1 is ??? have low risk of compl. from lobectomy/pneumonectomy

A

> 2L

41
Q

if FEV1 ??? need to calculate an est. ???

if ??? have low incident peri-op complications

A

800mL

42
Q

if borderline spirometry, can do ??? to determine if resection is an option
??? is desired

A

cardiopulmonary exercise testing

high max. O2 uptake

43
Q

national lung screening trial done on..

A

former heavy smokers

44
Q

USPSTF recommends annula screening for lung ca w/ ???

for ages ??? who have ??? smoking hx or ???

A

low-dose CT (LDCT)
55-80 yo
30 pk-yr hx and currently smoke or have quit w/in past 15 years

45
Q

screening should discontinue once person has not smoked in ??? OR develops ???

A

15 years

health problem that subst. limits life expectancy or willingness to have curative lung surgery

46
Q

ddx for solitary pulmonary nodule

A 
non-sp. healed granuloma
hamartoma
lymphoma
fibroma
lunc abscess
round atelectasis
AVM (art-ven malform.)
hematoma
granulomatosis w/ polyangiitis
47
Q

radiological prob. of ca increases if…

A

inc. diameter
spiculation
upper lobe location

48
Q

if ??? zero likelihood of ca

A

calcified completely

49
Q

non-SmCC (NSCLC) tx:

first ID if ??? is feasible and if pt can tolerate it

A

complete surgical resection

50
Q

these prevent surgery

A

Extrathoracic metastases, malignant pleural effusion, tumor involving heart, pericardium, great vessels, esophagus, trachea, contralateral mediastinal LNs

51
Q

NSCLC Stage I and II

A

surgical resection (when possible)

52
Q

NSCLC IB and II

A

adjuvant chemotherapy

53
Q

NSCLC Stage IIIA

A

resection and chemo and/or radiotherapy

54
Q

NSCLC Stage IV

A

chemotherapy and palliation

55
Q

??? for early stage primary NSCLC -non-surg. candidate

A

stereotactic body radiotherapy (Cyberknife)

56
Q

??? gives antineoplastic drugs in advance of sx or radiation

used in stages ???

A 
neoadjuvent chemotherapy (NSCLC)
Stage IIIA/B (no impact I/II)
57
Q

??? admin antineoplastic drugs FOLLOWING sx, radiation

??? regimens for stages ???

A 
adjuvent chemotherapy (NSCLC)
Cisplatin, Stage II or IB
58
Q

chemo in Stages IIIB and IV (NSCLC): curative?
improves survival from ?? to ??
also improves ??

A

not curative
5 mos–>7-11 mos
improved quality of life and symptom control

59
Q

chemo drugs for NSCLC Stage IIIB, IV

A

cisplatin or carboplatin combined with pemetrexed, gemcitabine, taxane or vinorelbine

60
Q

NSCLC advanced molecular profiling: target tx for these mutations

A

EGFR, EML4-ALK, more

61
Q

SCLC tx: response to ??? are excellent (80-90%) in ??? and 60-80% partial response in ???

A

cisplatin and etoposide
limited stage disease
extensive disease

62
Q

SCLC tx: remission is ?? and if recurred med. survival is ??

A

short-lived

3-4 mos

63
Q

overall 2 yr survival ??? in limited stage and ?? in extensive stage

A

20-40%

5%

64
Q

pallliative tx relieves ??? and also ???

A

endobronchial obstruction

improves dyspnea, contols hemoptysis

65
Q

this improves quality of life if no evidence of other metastatic disease

A

resection for solitary brain metastasis

CSI (75 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions