Haemoptysis Flashcards
What other symptoms can be mistaken by the patient for haemoptysis? (3)
Haematemesis
Epistaxis (can be posterior in the nose without much visible bleeding out the front of the nose)
Oral bleeding (explore dental health)
What are two vascular causes of haemoptysis?
Pulmonary emboli
Arteriovenous malformations
What age group does vasculitis commonly affect?
Adults over 50 (also more common in women than men).
What are the two broad divisions of lung cancer?
Small cell (15-20%) and non-small-cell (80-85%).
What are the main subtypes of non-small-cell lung cancer? (3)
Adenocarcinoma
Squamous cell
Large cell
Describe adenocarcinoma lung cancer.
Adenocarcinoma originates in the glandular cells which secrete mucus, and tend to develop in small airways, hence are more peripheral on imaging and can resemble pneumonia.
Describe squamous cell lung cancer.
Squamous cell cancer originates from the transformation of the squamous cells lining the airways, and therefore tend to be more central. They can often form a cavity and are smoking related.
Describe large cell lung cancer.
Large cell lung cancer can appear anywhere within the lung and often grow and spread quicker than the other subtypes.
What are the differences in prognosis between small cell and non-small-cell lung cancer?
Small cell lung cancer tends to grow and spread faster than non-small-cell, and commonly presents with stage 4 disease at the outset. It tends to be more chemotherapy responsive, however generally has a poorer prognosis than non-small-cell cancer.
What are the NICE guideline indications for a suspected lung cancer referral? (2)
Chest x-ray findings that suggest lung cancer OR patient is aged 40 or over and has unexplained haemoptysis.
What do rapid access lung cancer clinics usually involve?
Straight to CT scan from referral, followed by a timely radiology report, and then a physician review.
Name four paraneoplastic syndromes which can manifest as a result of lung cancer.
Lambert-Eaton Syndrome
SIADH
Hypertrophic osteoarthropathy
Cushings Syndrome
In the TNM cancer staging system, what are each of the categories used?
T = tumour characteristics
N = nodal disease (involvement of lymph nodes)
M = any sites of metastatic disease
What is involved in measuring ‘shuttle walk distance’?
Patient walks back and forth between two markers, typically 10m apart, with increasing speed in a graded fashion - the number of shuttles that can be completed before becoming too breathless or cannot keep up with the pace is indicative of cardiopulmonary exercise capacity.
What is the ECOG Performance Status Scale?
A scale of grades 0 (fully active) to 5 (deceased), used to assess a patient’s level of daily functioning and fitness for treatment, based on activities of daily living, mobility and independence.
