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Block 13 - The Development of Cardiorespiratory Disease > ALS Lecture 2 - Intrathoracic Malignancy DONE > Flashcards

ALS Lecture 2 - Intrathoracic Malignancy DONE Flashcards

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1
Q

2 main types of primary intrathoracic malignancy

A

lung carcinoma, pleura malignant mesothelioma

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2
Q

leading cause of cancer mortality in men and women

A

lung

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3
Q

90% of lung cancer cases are caused by

A

smoking

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4
Q

> 90% of lung cancer cases are in people

A

over 40

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5
Q

changes in lung cancer incidence and mortality have paralleled past trends in

A

cigarette smoking

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6
Q

marked increase in incidence and mortality of lung carcinoma in the 20th century followed the introduction of

A

manufactured cigarettes with addictive properties

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7
Q

risk of lung cancer progressively declines following

A

smoking cessation

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8
Q

cigarette smoke contains at least __ known carcinogens

A

43

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9
Q

other causes of lung carcinoma (5)

A

occupational carcinogens, environmental radon, air pollution, chronic lung disease, FH

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10
Q

radon once inhaled continues to

A

decay and emit alpha particles

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11
Q

occupations associated with radon higher risk (3)

A

air crew, nuclear fuel plant, power station workers

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12
Q

asbestos workers increased risk of cancer

A

5 fold

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13
Q

asbestos workers increased risk of smokers

A

11 fold

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14
Q

asbestos workers who are also smokers increased risk of cancer

A

53 fold

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15
Q

driver mutations

A

genetic factor of lung carcinoma, essential for tumour cell survival

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16
Q

common genetic mutations in adenocarcinoma in non-smokers

A

EGFR, ALK, RET, ROS1

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17
Q

common genetic mutations in adenocarcinoma in smokers

A

KRAS, BRAF

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18
Q

targeted drug for EGFR mutations

A

EGFR tyrosine kinase inhibitor

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19
Q

targeted drug for ALK mutations

A

ALK inhibitor

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20
Q

squamous cell carcinoma of the lung genetic mutation steps

A
  1. LOH of 3p and 9p 2. Oncogene OSX2 amplification in 3q
  2. TP53 inactivation
  3. LOH of 8p and 5q
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21
Q

which genes are ALWAYS inactivated in squamous cell carcinoma of the lung?

A

TP53, RB1

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22
Q

RB1 mutation is a hallmark of

A

small cell carcinoma

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23
Q

other genes involved in small cell carcinoma of the lung

A

PTEN, FGFR1, SOX2, SLIT, EPHA7

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24
Q

carcinoma of the lung symptoms (7)(9)

A

progressive SOB, cough, weight loss, chest pain, hoarseness, sputum, haemoptysis

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25
symptoms related to lung carcinoma clinical features caused by tumour obstruction of airway (3)
pneumonia, abscess, lobar collapse
26
symptom related to lung carcinoma clinical features caused by tumour spread to pleura
pleural effusion
27
symptom related to lung carcinoma clinical features caused by tumour invasion of recurrent laryngeal nerve
hoarseness
28
symptom related to lung carcinoma clinical features caused by tumour invasion of oesophagus
dysphagia
29
symptom related to lung carcinoma clinical features caused by tumour invasion of phrenic nerve
diaphragm paralysis
30
symptom related to lung carcinoma clinical features caused by tumour invasion of chest wall
rib destruction
31
symptom related to lung carcinoma clinical features caused by tumour compressing SVC
superior vena cava syndrome
32
symptom related to lung carcinoma clinical features caused by apical tumour invasion of sympathetic ganglia
horner's syndrome
33
symptoms related to lung carcinoma clinical features caused by pericardial involvement (2)
pericarditis, cardiac tamponade
34
common metastatic sites of lung carcinoma (6)
regional lymph nodes, bone, brain, liver, skin, adrenal glands
35
syndrome caused by ADH production by lung cancer cells
hyponatraemia
36
syndrome caused by ACTH production by lung cancer cells
Cushing syndrome
37
syndrome caused by parathyroid hormone production by lung cancer cells
hypercalcaemia
38
syndrome caused by calcitonin production by lung cancer cells
hypocalcaemia
39
syndrome caused by gonadotropins production by lung cancer cells
gynaecomastia
40
syndrome caused by serotonin and bradykinin production by lung cancer cells
carcinoid syndrome
41
syndrome caused by auto-antibodies against neuronal calcium channels production by lung cancer cells
Lambert-Eaton myaesthenic syndrome
42
other syndromes caused by lung cancer cells (4)
peripheral sensory neuropathy, acanthosis nigricans, Trousseau syndrome, finger clubing
43
diagnostic tools for lung carcinoma
CXR, CT, PET, MRI, bronchoscopy, cytology, biopsy, surgery
44
surgeries for lung cancer (2)
lobectomy, pneumonectomy
45
WHO classification of lung tumours
primary, benign and malignant, metastatic
46
main histological types of epithelial tumours (2)
non-small cell carcinoma, small cell carcinoma
47
types of non-small cell carcinoma (5)
adenocarcinoma, squamous cell, large cell, carcinoid, sarcoma
48
label the histological diagrams of carcinomas
done
49
atypical adenomatous hyperplasia histology
alveoli lined by atypical cuboidal epithelial cells
50
normal respiratory tract-type epithelium histology (3)
pseudostratified, columnar-shaped, ciliated
51
squamous metaplasia histology (1)
replacement of bronchial epithelium by mature squamous epithelium
52
dysplasia and carcinoma in situ histology (4)
disordered growth, loss of architecture and uniformity, pleomorphic, hyperchromatic nuclei
53
dysplasia and carcinoma in situ and cancer
precedes cancer, doesn't always lead to it
54
squamous cell carcinoma cytology (3)
normal, metaplastic and highly atypical squamous epithelia, exfoliated cells in sputum
55
squamous cell carcinoma histology (4)
excessive growth of abnormal squamous cells, levels of differentiation (well, moderate, poor), intercellular bridges, keratinisation
56
small cell carcinoma histology (3)
small round blue cell tumour, high mitotic count, neurosecretory granules
57
choice of treatment for carcinoma of the lung depends on (2)
histological subtype, TNM stage
58
types of treatment for lung carcinoma (4)
surgery, chemo, radiotherapy, targeted and immunotherapy
59
TNM stages stand for
tumour, node, metastasis
60
T stage of TNM
1 - 4, 1 is small, 4 large
61
N stage of TNM
0-3, 0 no nodes involved, 3 lots
62
M stage of TNM
0 no mets, 1 mets
63
number stages cancer
1 - small, contained 2 - larger (in some cancers lymph nodes) 3 - larger, in nodes/nearby tissue 4 - mets
64
treatment for non-small cell lung cancer in stage 1-2 (2)
resection, radical radiotherapy (if unfit/refuse surgery)
65
prognosis for non-small cell lung cancer in stage 1-2
5 year survival 23-60%
66
treatment for non-small cell lung cancer in stage 3-4
palliative chemo/radiotherapy
67
prognosis for non-small cell lung cancer in stage 3-4
5 year survival <1%
68
treatment for small cell lung cancer, limited disease
radical chemo, radiotherapy
69
prognosis for small cell lung cancer, limited disease (3)
median survival 18months, <20% cured, 5 year survival 25%
70
treatment for small cell lung cancer, extensive disease
palliative chemo, radiotherapy
71
prognosis for small cell lung cancer, extensive disease
median survival 9 months
72
in non-small cell carcinomas with EGFR mutation we can use
tyrosine kinase inhibitors (e.g. erlotinib, gefitinib, osimertinib)
73
in non-small cell carcinomas with ALK translocation we can use
inhibit ALK (e.g. crizonitinib, ceritinib, alectinib, brigatinib, lorlatinib)
74
in non-small cell carcinomas with ROS1 translocation we can use (names)
crizonitib, ceritinib, entrectinib
75
if a cell carries PDL-1 it is
our own cell, so won't attack it
76
some cancers develop PDL-1 to
trick our T-cells
77
some cancer drugs target the tumour's fake ligand (PDL-1) or the T-cell receptor, e.g. (4)
pembrolizumab, nivolumab, atezolizumab, durvalumab,
78
malignant mesothelioma is a cancer of the
pleura
79
> 90% of cases of malignant mesothelioma are associated with previous
exposure to asbestos
80
latent period between exposure to asbestos and detection of malignant mesothelioma tumour
up to 50 years
81
with asbestos, the ____ ___ is more important than the ____ __ _____
cumulative dose, duration of exposure
82
Incidence of malignant mesothelioma in the UK is expected to peak in what year and why?
2020, asbestos banned 50 years ago
83
malignant mesothelioma usual age group
older adults
84
malignant mesothelioma gender
M > F, occupational exposure
85
malignant mesothelioma symptoms (11)
SOB, cough, chest pain, weakness, fatigue, weight loss, chest fullness, fever, sweating, pleurisy, pleural effusion
86
WHO classification of tumours of the pleura
primary (mesothelial, mesenchymal, lymphoproliferative), malignant, metastatic
87
main malignant mesothelioma histological types (4)
epitheloid, sarcomatoid, biphasic, desmoplastic
88
malignant mesothelioma locations can be (2)
localised, diffuse
89
possible surgery for malignant mesothelioma (2)
pneumonectomy, pleurectomy (not curative)
90
malignant mesothelioma prognosis
1 year survival, rarely >2 years
91
malignant mesothelioma compensation (2)
state, previous employer

Block 13 - The Development of Cardiorespiratory Disease (14 decks)

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