Brainscape's Knowledge GenomeTM

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


See full index

Respiratory System > Lecture 10.1: Lung Cancer > Flashcards

Lecture 10.1: Lung Cancer Flashcards

1
Q

What are some Risk Factors of Lung Cancer? (8)

A
  • Smoking
  • Exposure to secondhand smoke
  • Previous radiation therapy
  • Exposure to radon gas
  • Exposure to asbestos and other carcinogens
  • Inhaled dusts-uranium and silica
  • Others-nickel chromates, coal tar distilleries,
    arsenic
  • Family history of lung cancer/Genetics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Signs and Symptoms of Lung Cancer (8)

A
  • A new cough that doesn’t go away
  • Coughing up blood, even a small amount
  • Shortness of breath
  • Chest pain
  • Hoarseness
  • Losing weight without trying
  • Bone pain
  • Headache
  • Nail Clubbing
  • Wheezing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Clinical Features of Regional Spread of Lung Cancer: Phrenic Nerve Paralysis (Palsy)

A
  • Elevated Hemidiaphragm
  • Breathlessness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Clinical Features of Regional Spread of Lung Cancer: Left Recurrent Laryngeal Nerve Palsy

A
  • Hoarseness/ Weak Voice
  • Eating Difficulties
  • Poor Cough
  • Repeated Chest Infections because of
    aspiration pneumonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Clinical Features of Regional Spread of Lung Cancer: Sympathetic Chain Involvement

A

Horner’s Syndrome characterised by:
* Constricted pupil (miosis)
* Drooping of the upper eyelid (ptosis)
* Absence of sweating of the face (anhidrosis)
* Sinking of the eyeball into the bony cavity that
protects the eye (enophthalmos)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Clinical Features of Regional Spread of Lung Cancer: Brachial Plexus (Pancoast Tumour)

A
  • Pain in the inner arm and shoulder
  • Swelling in the upper arm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Clinical Features of Regional Spread of Lung Cancer: Compression of Oesophagus (effect)

A

Dysphagia

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

Clinical Features of Regional Spread of Lung Cancer: Pericardial Involvement (effect)

A

Difficulty Breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Clinical Features of Regional Spread of Lung Cancer: Pleural Involvement (effect)

A

Difficulty Breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Clinical Features of Regional Spread of Lung Cancer: Chest Wall Invasion (effect)

A

Chest Pain

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

Clinical Features of Distant Metastasis (7)

A
  • Bone pain secondary to fractures
  • CNS signs and symptoms
  • Seizures (due to brain mets)
  • Personality Changes (due to brain mets)
  • Abdominal Pain
  • Liver capsular pain from liver metastasis and
    elevated LFTs
  • Lymphadenopathy in the neck
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are Paraneoplastic Syndromes?

A

A group of rare disorders that are triggered by an abnormal immune system response to a cancerous tumour

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

Paraneoplastic Syndromes: Endocrine (3)

A
  • Hypercalcaemia (PTH squamous cell
    carcinoma)
  • Cushing’s syndrome (ectopic ACTH secretion)
  • Inappropriate ADH secretion (small cell
    carcinomas)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Paraneoplastic Syndromes: Haematological (2)

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

Paraneoplastic Syndromes: Cutaneous (1)

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

Paraneoplastic Syndromes: Skeletal (1)

A
  • Finger clubbing (Hypertrophic
    osteoarthopathy)
17
Q

Investigations for Lung Cancer (6)

A
  • CT Scan
  • Bronchoscopy
  • Biopsy
  • MRI
  • PET CT
  • Isotope Bone scan
18
Q

How do clinicians get lung tissue in a biopsy? (6 Steps)

A

1) Transbronchial biopsy
2) Trans thoracic CT guided biopsy for peripheral
tumours
3) Fine needle aspirates of lymph nodes
4) EBUS for staging purposes and for initial
diagnosis
5) Pleural tap and Pleural biopsy
6) Mediastinal biopsy

19
Q

Why are tissue samples so important?

A

Sampling allows staging and pathological sub-typing (immunohistochemical and
molecular analysis)

20
Q

What is Cytology?

A

The analysis of a single cell type, as often found in fluid specimens

21
Q

Where are Cytology samples (for lung cancer) collected from? (5)

A
  • Sputum
  • Bronchial lavage
  • Fine needle aspirate of lymph nodes
  • EBUS aspirates of lymph nodes
  • Pleural fluid
22
Q

What are the different types of tissue biopsies (for lung cancer)? (3)

A
  • Trans bronchial biopsy
  • Transthoracic biopsy
  • Biopsy of metastasis (lymph nodes, liver or
    bone)
23
Q

Investigations to assess patient suitability for
major resections (2)

A
  • Pulmonary function tests incl. transfer capacity
  • ECHO cardiogram
24
Q

What are Major Resections?

A

Surgery to remove part or all of a damaged or diseased lung

25
Q

Blood Tests for Lung Cancer (4)

A
  • No specific tests
  • Sodium
  • Calcium
  • Liver function tests
  • TBC
26
Q

What are the 3 Main Types of Lung Cancer?

A
  • Non-Small Cell Carcinoma (75%)
  • Small Cell Carcinoma (15-20%)
  • Unusual tumours e.g. neuroendocrine tumour
    (5%)
27
Q

What are the subtypes Non-Small Cell Carcinoma and their percentage incidence?

A
  • Squamous cell carcinoma (20-30%)
  • Adenocarcinoma (30-40%)
  • Large cell carcinoma (10-15%)
28
Q

Features of Lung Squamous Cell Carcinoma (7)

A
  • Often central tumours
  • Angulate cells
  • Eosinophilic cytoplasm
  • Keratinisation
  • Intercellular bridges (prickles)
  • Keratin pearls
  • Immunocytochemistry (CK 5/6 &p63+)
29
Q

Features of Lung Adenocarcinoma (7)

A
  • Often peripheral
  • Columnar/cuboidal cells
  • Form glands (acini)
  • Papillary structures
  • May line alveoli (bronchioalveolar carcinoma)
  • Some produce mucin
  • Immunocytochemistry [Most TTF-1+ (about 70%
    of cases)]
30
Q

Features of Lung Small Cell Carcinoma (7)

A
  • “oat cell carcinoma”
  • Very cellular
  • Small nuclei
  • Little cytoplasm
  • Nuclear moulding
  • Often necrosis and lots of mitoses
  • Immunocytochemistry (CD56, Synaptophysin +)
31
Q

Where are Lung Metastasis often found (secondary tumours)? (8)

A
  • Breast
  • Colon
  • Endometrial
  • Melanoma
  • Sarcoma
  • Pharyngeal
  • Prostate
  • Kidney
32
Q

Why is tissue diagnosis important? (4)

A
  • Benign versus malignant
  • Is it a primary or secondary tumour
  • Is it small cell or non small cell carcinoma
    as treatment is different
  • Adenocarcinomas can be assessed for specific
    molecular alterations to guide further treatment
33
Q

Consequences of Spread of Lung Cancer Locally in the Lung? (4)

A
  • Necrosis –> cavitation)
  • Ulceration (occurs in 50%) –> haemoptysis
  • Infection –> abscess formation
  • Bronchial obstruction –> collapse, consolidation
34
Q

Consequences of Spread of Lung Cancer Locally in the Thorax? (5)

A
  • Direct spread or metastasis
  • Pleural/pericardial effusions
  • Mediastinal structures –> SVC obstruction,
    dysphagia
  • Recurrent laryngeal nerve –> Vocal chord palsy
  • Phrenic nerve –> Diaphragm palsy
35
Q

Staging of Lung Cancer: T0

A

No tumours

36
Q

Staging of Lung Cancer: T1

A

Tumours ≤ 3cm

37
Q

Staging of Lung Cancer: T2 (4)

A
  • 3cm < Tumour ≤ 7cm
    OR TUMOUR WITH ANY OF FOLLOWING
  • Tumour that invades visceral pleura
  • Involves main bronchus ≥ 2cm distal to carina
  • Atelectasis/obstructive pneumonia extending to
    hilum but not involving entire lung
38
Q

Staging of Lung Cancer: T3 (6)

A
  • Tumour > 7cm
  • Or there is more than one tumour in the same
    lobe of the lung
    OR CANCER HAS SPREAD INTO:
  • The chest wall
  • The outer lining of the chest cavity (the parietal
    pleura)
  • The nerve close to the lung (phrenic nerve)
  • The outer covering of the heart (the
    pericardium)
39
Q

Staging of Lung Cancer: T4 (8)

A

Tumour of any size with invasion of:
* Heart
* Great Vessels
* Trachea
* Recurrent Laryngeal Nerve
* Oesophagus
* Vertebral Body
* Carina
* Separate tumour nodules in a different
ipsilateral lobe

Respiratory System (19 decks)

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