Lung Cancer Flashcards

1
Q

Which two cancers does lung cancer kill more than combined?

A

Prostate and breast

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2
Q

What is the usual aetiology of lung canceR?

A

Environmental

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3
Q

What environmental factors usually are the aetiology of lung cancer?

A
  • Smoking
  • Asbestos
  • Environmental radon
  • Occupational exposure
  • Pollution
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4
Q

What precondition can result in a lung tumour?

A

Pulmonary fibrosis

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5
Q

What percentage of lung cancer cases are related to smoking tobacco?

A

85%

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6
Q

What percentage of smokers get lung cancer?

A

10%

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7
Q

Which gender is more at risk of developing lung cancer from smoking?

A

Males

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8
Q

What percentage risk does passive smoking increase the chances of developing lung cancer by?

A

50-100%

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9
Q

What percentage of non-smoker lung cancer is related to passive smoking?

A

25%

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10
Q

What are the 2 major chemical carcinogens in cigarettes?

A
  • Polycyclic aromatic hydrocarbons

- N-nitrosamines

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11
Q

What are polycyclic aromatic hydrocarbons said to be linked to?

A

Squamous small cell lung cancer

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12
Q

What are N-nitrosamines said to be linked to?

A

Adenocarcinomas

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13
Q

What cells are effected by tobacco smoke?

A

Epithelial cells

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14
Q

Where do adenocarcinomas usually form?

A
  • Lung periphery

- Bronchioalveolar epithelial stem cells transform

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15
Q

What are the stages of invasive bronchogenic carcinoma?

A
  • Squamous dysplasia
  • Carcinoma in situ
    Then invasive bronchogenic carcinoma
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16
Q

What are the stages of invasive adenocarcinoma?

A
  • Atypical adenomatous hyperplasia
  • Adenocarcinoma in situ
    Then invasive carcinoma
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17
Q

What tumours can occur in the lung?

A
  • Benign tumours
  • Carcinoid tumour
  • Tumours of bronchial gland (really rare)
  • Lymphoma
  • Sarcoma
  • Secondary tumours
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18
Q

What could cause a benign growth in the lung?

A

Fibroma during pneumonia

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19
Q

Examples of bronchial gland tumours

A
  • Adenoid cystic carcinoma
  • Mucoepidermoid carcinoma
  • Benign adenoma
20
Q

4 main carcinomas of the lung?

A
  • Adenocarcinoma (NSCLC)
  • Squamous cell (SCLC & NSCLC)
  • Small cell carcinoma (SCLC)
  • Large cell carcinoma (NSCLC)
21
Q

What are the two histological categorisations of lung cancer?

A
  • Small cell carcinoma (SCLC)

- Non small cell carcinomas (NSCLC)

22
Q

What is the biggest problem with regards to primary lung cancer?

A

They grow silently for many years and then present later when they are advanced

23
Q

Local effects of lung cancer?

A
  • Bronchial obstruction
  • Pleural invasion
  • Direct invasion
  • Lymph node metastasis
24
Q

What effect can cancer have on the pleura?

A
  • Inflammation

- Metastasis

25
Q

What anatomical structures can be the location of direct invasion in lung cancer?

A
  • Chest wall
  • Nerves
  • Mediastinum
26
Q

What nerve structures can be affected by invasion of lung cancer?

A
  • Phrenic nerve
  • Left recurrent laryngeal
  • Brachial plexus
  • Cervical sympathetic
27
Q

What will phrenic nerve invasion result in?

A

Diaphragmatic paralysis

28
Q

What will left recurrent laryngeal invasion result in?

A

Hoarse, bovine cough

29
Q

What is cervical sympathetic invasion better known as?

A

Horner’s syndrome

30
Q

What structures can be affected by mediastinum invasion from lung cancer?

A
  • Superior Vena Cava

- Pericardium

31
Q

What common locations does lung cancer spread to?

A
  • Liver
  • Adrenal gland
  • Bone
  • Brain
  • Skin
32
Q

What non metastatic paraneoplastic effects of lung cancer are apparent in the SKELETAL system?

A
  • Clubbing

- HPOA (hypertonic pulmonary osteoarthropy)

33
Q

What non metastatic paraneoplastic effects of lung cancer are apparent in the ENDOCRINE system?

A
  • Carcinoid syndrome

- Gynecomastia

34
Q

What non metastatic paraneoplastic effects of lung cancer are apparent in the NERVOUS system?

A
  • Polyneuropathy
  • Encephalopathy
  • Cerebellar degeneration
  • Myasthenia
35
Q

What non metastatic paraneoplastic effects of lung cancer are apparent in the CUTANEOUS system?

A
  • Acanthosis nigricans

- Dermatomyositis

36
Q

What non metastatic paraneoplastic effects of lung cancer are apparent in the HEAMOTOLOGICAL system?

A
  • Granulocytosis

- Eosinophilia

37
Q

What non metastatic paraneoplastic effects of lung cancer are apparent in the CARDIOVASCULAR system?

A

Thrombophlebitis migrans

38
Q

What non metastatic paraneoplastic effects of lung cancer are apparent in the RENAL system?

A

Nephrotic syndrome

39
Q

What does hypertonic pulmonary osteoarthropy cause?

A

Sore ankles and wrists

40
Q

What initial tests are done in lung cancer?

A
  • CXR
  • Bronchoscopy
  • Trans thoracic fine needle aspiration
  • Trans thoracic core biopsy
  • Pleural effusion
41
Q

What types of bronchoscopies can be carried out in lung cancer?

A
  • Bronchial biopsy
  • Bronchial brushings and washings
  • Endobronchial ultrasound guided aspiration
42
Q

Prognoses of type 1 and 2 lung cancers with surgical intervention

A
  • Type 1 >60% 5yrS

- Type 2 = 35% 5yrS

43
Q

5yr survival rate for small cell lung cancer

A

10-25%

44
Q

What do immune checkpoints do?

A

Control immune responses

45
Q

How do tumours use immune checkpoints?

A

Hide from immune destruction