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Year 1: Respiratory System > 6. Respiratory Pathology > Flashcards

6. Respiratory Pathology Flashcards

1
Q

In the UK how common is the lung cancer the cause of death?

A

Third most common

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2
Q

How many deaths per year are caused from lung cancer?

A

40000

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3
Q

List 3 causative factors of lung cancer in Non-smokers

A

Tobacco
Radon
Asbestos

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4
Q

List the clinical features of lung cancer?

A

Haemoptysis
Nail bed should be less than 180 degrees
Unexplained or persistant: cough, chest/shoulder pain, chest signs, dyspnoea, hoarseness, finger clubbing

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5
Q

How is staging of cancer performed?

A

Tumour, Nodes, Metastases

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6
Q

What does T staging indicate?

A

The location, size and proximity to other organs of the tumour

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7
Q

In terms of location what indicates a higher T staging?

A

If the tumour is closer to the mediastinum or chest wall (irrespective of its size)
Also if it has spread to the lymph nodes

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8
Q

What is fine needle aspiration?

A

This is used to sample a few cells which can be looked at by pathologists

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9
Q

Describe how a PET scan is performed?

A

The patient fasts for 4 hours
Given radiolabelled glucose
The tumour is very metabolically active so will show up clearly on the scan in contrast to the lungs

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10
Q

How is much of M staging performed?

A

By looking at scans

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11
Q

What is a tumour lung related reason to why patients can get throbbing headaches?

A

The throbbing headaches can be caused by the build up of tumour in the lymph nodes near the SVC and the build up of pressure in the superior venous system

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12
Q

What is the typical pattern of small cell lung cancer growth?

A

It grows rapidly and metastasise early

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13
Q

What is the treatment for small cell lung cancer?

A

Chemotherapy and radiotherapy

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14
Q

What treatment is given if small cell lung cancer patients are very debilitated?

A

They are given palliative radiotherapy

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15
Q

What is the procedure when the small cell lung cancer tumour disappears?

A

Prophylactic brain radiotherapy

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16
Q

What is the treatment for local non-small cell lung cancer?

A

Surgery

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17
Q

What is the 5 year survival for those with local non-small cell lung cancer?

A

70%

18
Q

What is the procedure when dealing with advanced non-small cell lung cancer?

A

This means it has usually spread to the lymph nodes. Chemotherapy to reduce the extent of spread

19
Q

What is the earliest point before a diagnosis of the tumour can be made?

A

10mm

20
Q

What tumour grows slowly?

A

adenocarcinoma

21
Q

How does a carcinoma develop?

A

It is a multistep accumulation of mutations

22
Q

What are the types of lung tumour?

A

Benign lung tumours

Malignant lung tumours

23
Q

What are the features of benign lung tumours?

A

Do not metastasise
Can cause local complications (airway obstruction)

Chondroma

24
Q

What are the features of malignant lung tumours?

A

Potential to metastasise but variable clinical behavious. Can be aggressive

Epithelial tumours - carcinomas

25
Q

What are the two types of carcinoma?

A

Non-small cell carcinoma

Small cell carcinoma

26
Q

List 3 non-small cell carcinomas

A

Squamous cell carcinoma
Adenocarcinoma
Large cell carcinoma

27
Q

Which non-small cell carcinoma is closely associated with smoking?

A

squamous cell cacinoma

28
Q

Where does squamous cell carcinoma traditionally arise?

A

Bronchial epithelium but recently in peripheral SqCC

29
Q

Define atypical adenomatous hyperplasia

A

Proliferation of atypical cells lining the alveolar walls. Increases in size and can become invasive

30
Q

What does AAH become?

A

Adenocarcinoma-in-situ

31
Q

What is the molecular pathway of adenocarcinoma in a smoker?

A

A precursor undergoes K ras mutation and DNA methylation p53 to form a adenocarcinoma

32
Q

What is the molecular pathway of a adenocarcinoma in a non-smoker?

A

A precursor undergoes EGFR mutation/amplification to form a adenocarcinoma

33
Q

Who group of people are adenocarcinomas common in?

A

Far east, females and non-smokers

34
Q

Where are adenocarcinomas often found?

A

Peripherally

35
Q

Do adenocarcinomas metastasise?

A

Yes, extrathoracic metastases are common and early

36
Q

Describe large cell carcinomas

A

Poorly differentiated tumours composed of large cells

37
Q

How do you treat small and non small cell carcinomas?

A

Small cell - chemotherapy

non-small cell - Surgery

38
Q

Do small or non-small cell carcinomas have a better survival rate?

A

non-small cell

39
Q

In the TNM staging system - what does T stand for?

A

Tumour T1-4

40
Q

In the TNM staging system - what does N stand for?

A

Lymph node metastasis N0-3

N0 - lymph node not involved by tumour

41
Q

In the TNM staging system - what does M stand for?

A

Distant metastasis M0-1

M1 tumour has spread

Year 1: Respiratory System (19 decks)

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