lung cancer Flashcards

1
Q

what are the 4 main causes of lung cancer?

A

smoking
passive smoking
exposure to asbestos and air pollution

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

how is adenocarcinoma formed?

A

bronchioalveolar stem cells transform in the lung periphery

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

how is squamous cell carcinoma formed?

A

bronchial epithelial stem cells from central lung airways

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

what do simple and complex molecular backgrounds mean?

A

simple - not related to tobacco
complex - related to tobacco

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

what are 2 histological types of lung cancer?

3 types of nonsclc

A

small cell lung carcinoma (15%)
- small cell and neuroendocrine differentiation

non-small cell lung carcinoma (85%)
- adenocarcinoma [glandular]
- squamous cell carcinoma [squamous differentiation]
- large cell carcinoma [hypertrophied cell]

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

what are 4 main sites of lung cancer metastasis?

metastasis - the spread of cancer cells from the place where they first formed to another part of the body

A

liver
brain
bone
adrenal

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

what are 3 differential diagnoses of lung cancer?

A

community-acquired pneumonia
tuberculosis
lung abscess

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

what are 7 presentations of lung cancer?

C C C D H W W

A

cough
chest pain
chest infections
dyspnoea
haemoptysis
weight loss
wheeze

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

what are the 9 systemic symptoms of lung cancer?

D D H H L N P R S

A

dysphagia (difficulty swallowing)

diaphragmatic paralysis
- invasion of the phrenic nerve

hepatomegaly (liver enlargement)

horner’s syndrome
- Pancoast (pulmonary apex) tumour pressing sympathetic ganglion
-> Anhidrosis, miosis, ptosis

lymphadenopathy
- swollen lymph nodes)

nail clubbing

Pancoast T1 damage
- invasion to brachial plexus
-> upper limbs

raspy, hoarse voice
- tumour pressing left recurrent laryngeal nerve

super vena cava obstruction (SVCO)
- tumour pressing
- face swelling, difficulty breathing, distended chest and neck veins.
- pemberton’s sign
-> Raise hands over head
-> Facial congestion and cyanosis

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

what are 7 paraneoplastic presentations of lung cancer?

C D H H L L P
P and D both same disease

A

cushing’s syndrome
- secondary to ACTH secreting SCLC - - body has too much cortisol hormone over time.

dermatomyositis
- muscle inflammation and skin lesions

polymyositis
- muscle inflammation

hypercalcemia
- secondary to PTH secreting small cell carcinoma
- increased parathyroid hormone secretion
- increased calcium
- cancer spread to the bone

Hyponatraemia
- secondary to ADH secreting SCLC
- water intake exceeds reduced urine output
- water retention
- low-sodium due to water dilution

Lambert – Eaton myasthenic syndrome (LEMS)

limbic encephalitis (SCLC)
- immune system produces antibodies to brain tissues
- Inflammation
- anaemia

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

What are they looking for in the blood tests?

A
  • full blood count

renal function
- U&E, uranalysis, creatinine protein
- increased calcium due to metastasis /paraneoplastic effect

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

What do you look for in a chest x-ray?

A
  • hilar enlargement
  • pleural effusion (usually unilateral)
  • peripheral opacity (lesion in the lung)
  • collapse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why do you use a CT-guided/ bronchoscopy biopsy?

A
  • Confirms diagnosis
  • guides treatment based on histology
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What 3 things are used for metastatic assessment and staging of lung cancer?

A
  • CT scan
  • PET/CT
  • TNM (tumour, node, metastasis) classification of malignant tumours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the ECOG performance scores of patient functionality?

A

0 - fully active

1 - can walk with their cancer symptoms

2 - rest for 50% in the day due to cancer symptoms, can’t work

3 - sit/lie down for more than 50% in the day due to cancer symptoms and struggles with self care

4 - bedbound

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

When do you do a 2-week wait referral for a chest x-ray?

A

for suggested lung cancer or
> 40 years old with unexplained haemoptysis

17
Q

What are treatments for lung cancer?

A

MDT approach - oncologists pathologist, surgeons, radiologist

surgery best for NSCLC in early stages + radiotherapy

chemotherapy first for SCLC + radiotherapy

targeted agents