Brainscape's Knowledge GenomeTM

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


See full index

Year 3 > Case 17 - Lung Cancer > Flashcards

Case 17 - Lung Cancer Flashcards

1
Q

What are the red Flag symptoms for lung cancer?

A 
Haemoptysis 
Weight loss
Persistent Cough 
Persistent Breathlessness
Clubbing
Hypertrophic oesteoarthropathy (pain in limbs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the main non metastatic manifestations of lung cancer? (Where another disease presents itself secondary to underlying cancer)

A 
Easton lambert syndrome 
Myasthenia gravis 
SIADH - tumour secretion of ADH 
Hypertrophic osteoarthropathy 
Cushings - due to tumour secretion of ACTH 
Hypercalcaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What type of lung cancer is more likely to present with a non metastatic manifestation?

A

Small cell lung cancer

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

What are the risk factors for developing lung cancer?

A

Tobacco smoke
Asbestos exposure
Fibrotic lung disease
COPD (2-5x greater than someone without COPD)

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

What are the two types of lung cancer?

A 
Small Cell (24%)
Non small cell (76%)
- squamous cell
- adenocarcinoma
- large cell
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a pancoast tumour?

A

Cancerous growth at the apex (top of lungs)

Leads to destructive lesions of the thoracic inlet, and involvement of brachial plexus and cervical sympathetic nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is horners syndrome and how can lung tumours cause it?

A

Miosis (constriction of one pupil)
Ptosis (drooping of the upper eyelid)
Caused by damage to sympathetic nerves to the face
This can occur in a pancoast tumour - malignancy of lung tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the local complications of lung tumours?

A 
Recurrent laryngeal palsy
Phrenic nerve palsy 
Superior venal caval obstruction 
Horners syndrome
Rib erosion 
Pericarditis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the stepwise diagnosis of lung cancer?

A 
History 
Exam
Bloods (FBC, LFTs, Bone Profile)
Chest X Ray 
CT scan 
Bronchoscopy with ultrasound guided sampling of subcranial nodes
PET scan - check for distant mets
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where do lung cancers metastasise to?

A

Brain
Bone
Liver
Adrenal gland

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

What hormones can small cell lung cancers produce?

A

ADH - resulting in SIADH

ACTH - resulting in secondary cushings

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

How can squamous cell lung cancer cause an hypercalcaemic emergnacy?

A

Squamous cell lung cancers typically release parathyroid hormone
PTH causes bone to breakdown releasing calcium into the body
Calcium levels >2.6mmol/L is an emergency

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

What are the signs of a hypercalcemic emergency

A

Cognitive changes, lethargy
Muscle cramping
GI symptoms
Tachycardia

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

What is the treatment for a hypercalcemic emergency?

A

Bisphosphonates

Denosumab

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

Before using any CT scan with contrast what blood test must you do and why?

A

U&Es

The contrast can cause kidney damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the differentials for a nodule in the lung on a CXR?

A 
Lung malignancy (primary or secondary)
Benign nodule 
Sarcoidosis 
Encysted effusion (fluid, blood, pus)
TB
Rounded pneumonia
17
Q

What is asbestosis?

A

A lung condition which is associated with lung fibrosis that follows chronic exposure to asbestos

18
Q

What are the causes of asbestos exposure?

A

Factor workers
Construction workers
Working with materials used for roofing, cladding, insulation
Demolition of old buildings in which asbestos was

19
Q

What type of cancer does asbestos exposure increase your risk of?

A

Mesothelioma

20
Q

How does asbestos exposure effect your lungs?

A

Causes a thickening of the pleura

21
Q

What is a pleural effusion?

A

Any fluid that builds up in the pleural space of the lungs

22
Q

How do you analyse a plural effusion

A

Thoracentesis - needle into the thorax which drains the pleural fluid

23
Q

What can cause a pleural effusion?

A 
Malignancy 
TB
Fungal infection 
Lupus 
Haemothorax 
Peritoneal dialysis
24
Q

How do you treat pleural effusions?

A

Pleurodesis
Drain fluid
Install talc mixed with lidocaine - talc this causes pluera to stick together to prevent further pleural effusions

25
Q

What is the difference between transudate and exudate pleural effusion?

A

Transudate - fluid leaks out due to increased pressure

Exudate - fluid leaks out due to inflammation and infection, so will also contain proteins

26
Q

What is lights criteria?

A

Lights criteria determines the presence of exudate pleural effusion by measuring protein and LDH levels.

If one of the following below is met, then it is exudate:
Pleural fluid protein/serum protein >0.5
Pleural fluid LDH/serum LDH >0.6
Pleural fluid LDH > 2/3rds the upper limits of normal serum LDH

27
Q

What are the exudate causes of pleural effusion?

A 
Malignancy 
TB 
Fungal infection 
Pneumonia (bacterial or viral)
Multiple myeloma
28
Q

What are the transudate causes of pleural effusion?

A 
Heart failure 
Cirrhosis of the liver 
Nephrotic syndrome 
Hypoalbuminaemia 
Pulmonary embolism
29
Q

What is an EGFR positive lung cancer?

What type of lung cancer are they most common in?

A

Lung cancers that are positive for epidermal growth factor receptor mutation

Most common in adenocarcinomas

30
Q

What is the PS (performance status) in cancer?

A

Performance status is used to shave prognosis and determining treatment. It is a score based on the patients abilities to perform certain activities of daily living:
PS0 - normal activity
PS1 - symptomatic and ambulatory, cares for self
PS2 - ambulatory >50% of the time, occasional assistance
PS3 - ambulatory <50% of the time, nursing care needed
PS4 - bedridden

31
Q

What is an EBUS procedure?

A

Endobronchial ultrasound

Similar to a bronchoscopy but allows doctors to take samples of the nodes in the mediastinum using the aid of an ultrasound scan

32
Q

What are the causes for low serum sodium?

A

Hypervolemic:
Fluid overload (excess of fluid relative to solute) - seen in heart failure, liver disease, renal failure (nephrotic syndrome)
SIADH

Hypovolemic:
Diuretics - force sodium out so water follows
Renal fluid loss - causes low volume and low sodium

33
Q

What type of cancer would you suspect in a patient with anti Hu antibodies present?

A

Small cell lung cancer

34
Q

What is the treatment for an EGFR positive adenocarcinoma of the lung?

A

Gefitnib (or erlotinib)

35
Q

What is the treatment for non small cell tumours of the lung?

A

Surgery (preferred treatment)
Radiotherapy (if respiratory function is poor)
Chemotherapy + radiotherapy (for advanced lung disease)

36
Q

What is the treatment for small cell lung cancers?

A

These are usually much more disseminated at presentation so cannot be cured

Chemotherapy and palliative treatment

Year 3 (24 decks)

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