SM_183a: Lung Cancer Flashcards

1
Q

Lung cancer is the _____ cause of cancer related deaths

A

Lung cancer is the leading cause of cancer related deaths

(not the most common cancer)

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2
Q

Most lung cancer patients present with ______ disease

A

Most lung cancer patients present with advanced disease

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3
Q

The greatest risk factor for lung cancer is _______

A

The greatest risk factor for lung cancer is tobacco

(mostly smoking, but also second hand smoke)

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4
Q

Patients with early stage lung cancer are often ______

A

Patients with early stage lung cancer are often asymptomatic

(often found incidentally or through lung cancer screening)

(may have a cough, hemoptysis, or dyspnea)

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5
Q

_______ is the classic radiographic finding of lung cancer

A

Coil lesion is the classic radiographic finding of lung cancer

(but lung cancer can look like anything)

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6
Q

Describe the presenting signs and symptoms of lung cancer

A
  • Often asymptomatic
  • Cough
  • Weight loss
  • Dyspnea
  • Chest pain
  • Hemoptysis
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7
Q

Lung tumors can cause _____, _____, or _____ in advanced disease

A

Lung tumors can cause superior vena cava syndrome, nerve impingement, or hoarseness in advanced disease

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8
Q

Superior vena cava syndrome occurs when ______

A

Superior vena cava syndrome occurs when SVC is obstructed, leading to vessel obstruction

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9
Q

Symptoms of superior vena cava syndrome include ______, ______, ______, and ______

A

Symptoms of superior vena cava syndrome include facial plethora, dilated collateral veins along chest, extremity edema, and headaches

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10
Q

Pancoast tumor is a(n) _____ tumor causing _____, with symptoms of ______, ______, or ______

A

Pancoast tumor is an apical tumor causing nerve impingement, with symptoms of shoulder pain, brachial plexus, and Horner’s syndrome

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11
Q

Horner’s syndrome is caused by a ______ tumor and involves symptoms of ______, ______, and ______

A

Horner’s syndrome is caused by a pancoast tumor and involves symptoms of constricted pupil (miosis), drooping of upper eyelid (ptosis), and absence of sweating of the face (anhidrosis)

(sympathetic nerve constricted)

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12
Q

Pancoast tumor can cause hoarseness if _____ is compressed

A

Pancoast tumor can cause hoarseness if laryngeal nerve is compressed

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13
Q

What are the most common sites of lung cancer metastases?

A

Pleura, brain, bone, adrenal, and liver

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14
Q

______ is redness of the face after lifting arms and is associated with _____ secondary to lung tumor

A

Pemberton’s sign is is redness of the face after lifting arms and is associated with superior vena cava syndrome secondary to lung tumor

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15
Q

_____ is required to make a diagnosis of lung cancer

A

Tissue sampling is required to make a diagnosis of lung cancer

(if metastatic disease is suspected, a biopsy of a distant site is preferred because it confirms both the diagnosis and the stage)

  • Histology: cell type
  • Molecular analysis: what is driving cell to grow
  • PDL1 analysis: interaction between tumor and immune system
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16
Q

Lung cancer is categorized as _____ or _____

A

Lung cancer is categorized as non-small cell lung cancer (most lung cancers) or small cell lung cancer

17
Q

Non-small cell lung cancer is divded into _____, _____, or _____

A

Non-small cell lung cancer is divded into adenocarcinoma, squamous cell carcinoma, or large cell carcinoma

18
Q

Describe adenocarcinoma

A

Adenocarcinoma

  • Most frequent histology in non-small cell lung cancer
  • Derived from gland cells
  • Biopsy: glandular structures
  • Central or peripheral tumors
  • Seen in non-smokers and smokers
19
Q

Describe squamous cell carcinoma

A

Squamous cell carcinoma

  • 2nd most common type of non-small cell lung cancer
  • Occurs in smokers
  • Central tumors, near hilum, cavitary lesions
  • Paraneoplastic syndrome: PTHrp -> hypercalcemia
  • Biopsy: keratin pearls
20
Q

Describe small cell lung cancer

A

Small cell lung cancer

  • Aggressive tumors (poor prognosis)
  • Neuroendocrine tumor
  • Occurs in smokers
  • Central tumors
  • Biopsy: small, densely packed blue cells
  • Associated with paraneoplastic syndromes
21
Q

Which type of lung cancer is this?

A

Adenocarcinoma

22
Q

Which type of lung cancer is this?

A

Squamous cell carcinoma

23
Q

Which type of lung cancer is this?

A

Small cell lung cancer

24
Q

What is the biopsy finding of this type of lung cancer?

A

Glandular structure (adenocarcinoma)

25
Q

What is the biopsy finding of this type of lung cancer?

A

Keratin pearls (squamous cell carcinoma)

26
Q

What is the biopsy finding of this type of lung cancer?

A

Small, densely packed blue cells (small cell lung cancer)

27
Q

______ and ______ are lung cancers that occur in smokers

A

Squamous cell carcinoma and small cell carcinoma are lung cancers that occur in smokers

28
Q

_____ is a type of lung cancer that is seen in non-smokers in addition to smokers

A

Adenocarcinoma is a type of lung cancer that is seen in non-smokers in addition to smokers

29
Q

Central tumors include ______ and _______

A

Central tumors include squamous cell and small cell

30
Q

Peripheral tumors include ______ and ______

A

Peripheral tumors include adenocarcinoma and large cell

31
Q

_____ is the most aggressive form of lung cancer

A

Small cell lung cancer is the most aggressive form of lung cancer

(almost exclusively in smokers, rapid growth and aggressive disease, associated with paraneoplastic syndromes)

32
Q

Describe limited stage and extensive stage of small cell lung cancer

A

Small cell lung cancer

  • Limited stage: confined to a single hemithorax (one side of chest) and requires all disease be encompassed in a single radiation port
  • Extensive stage: extends beyond a single hemithorax (anything outside of the chest as well) - chest cannot fit into one radiation field so cannot be cured
33
Q

______ tumor is a ______ tumor occurring in the chest

A

Carcinoid tumor is a neuroendocrine tumor occurring in the chest

  • typical carcinoid: well differentiated
  • atypical carcinoid: intermediate grade tumor
  • can overproduce serotonin -> carcinoid syndrome (flushing, diarrhea)
34
Q

A patient with a tumor in the chest along with flushing and diarrhea has _______ due to _______

A

A patient with a tumor in the chest along with flushing and diarrhea has carcinoid syndrome due to overproduction of serotonin

35
Q

_____ is a pleural tumor due to ______ exposure

A

Mesothelioma is a pleural tumor due to asbestos exposure