LUNG CANCER

Question 1

represents the extent of the primary tumor

Answer 1

T

Question 2

denotes the lymph node involvement

Answer 2

N

Question 3

indicates the extent of metastasis

Answer 3

M

Question 4

No evidence of tumor.

Answer 4

TO

Question 5

Cannot be assessed or is not apparently radiologically or bronchoscopically

Answer 5

Tx

Question 6

Cancer in situ.

Answer 6

Tis

Question 7

<3 cm, in lobar bronchus or distal airways, no local invasion

Answer 7

T1

Question 8

> 3 cm, tumor in the main bronchus (w/in 2
cm of the carina) or with atelectasis and involves the visceral pleura.

Answer 8

T2

Question 9

any size, located in the main bronchus or tumor with atelectasis, invades the chest wall, diaphragm, mediastinal pleura, or parietal
pericardium.

Answer 9

T3

Question 10

• any size
• located as satellite tumor nodule(s) w/in the ipsilateral primary-tumor lobe of the lung
• INVADES:
  Mediastinum
  Heart
  Greatvessels
  Trachea
  Esophagus
  Vertebral body
  Carina

Answer 10

T4

Question 11

Regional lymph nodes cannot be assessed

Answer 11

Nx

Question 12

Absence of regional lymph node involvement

Answer 12

NO

Question 13

(+) metastasis to ipsilateral peribronchial or ipsilateral hilar lymphnodes or both

Answer 13

N1

Question 14

(+) metastasis to ipsilateral mediastinal or subcarinal lymph nodes or both

Answer 14

N2

Question 15

(+) metastasis to contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, supraclavicular

Answer 15

N3

Question 16

Metastasis cannot be assessed

Answer 16

Mx

Question 17

Absence of distant metastasis

Answer 17

MO

Question 18

(+) Distant metastasis

Answer 18

M1

Question 19

• The cancer is limited to the lining of the bronchial airways
• There is no involvement of the lung tissue or distant metastasis
• Usually found during bronchoscopy
• TisN0M0

Answer 19

Stage 0

Question 20

• Tumor is<3 cm and located in lobar or distal airways
• No lung tissue involvement or distant metastasis
• T1N0M0

Answer 20

Stage 1

Question 21

• The cancer has invaded neighboring lymph nodes or spread to the chest wall
• No distant metastasis
• T1N1M0

Answer 21

Stage 2

Question 22

• Tumor is any size, is in the main bronchus, or the tumor is accompanied by atelectasis or
  obstructive pneumonitis
• Local invasion includes chest wall, diaphragm, mediastinal, pleural, or parietal pericardium
• (+) metastasis to ipsilateral peribronchial or ipsilateral hilar lymph nodes or both
• No distant metastasis
• T3N1M0

Answer 22

Stage IIIa

Question 23

• Ca has spread locally to mediastinum, heart, great vessels, trachea, esophagus, vertebral body, carina
• (+) malignant pleural or pericardial effusion
• May be involvement of any of the lymph node groups
• No distant metastasis
• T4, any N, M0

Answer 23

Stage IIIb

Question 24

• Ca is any size
• Involves any of the lymph node groups
• Has spread to other parts of the body(e.g. liver, bones, or brain)
• T any, N any, M1

Answer 24

Stage IV

Question 25

Two types of small cell lung carcinoma

Answer 25

- limited - extensive

Question 26

Ca is confined to only one lung and to its neighboring lymph nodes

Answer 26

Limited

Question 27

- Cahas spread beyond one lung and nearby lymph nodes - May have invaded both lungs, more remote lymph nodes, or other organs

Answer 27

Extensive

Question 28

CARDIOPULMONARY CLINICAL MANIFESTATIONS

Answer 28

Weight loss Tachycardia Hypertension Cyanosis Cough, sputum production,hemoptysis Crackles, rhonchi, wheezing

Question 29

(PFT RESULTS) - malignancy obstructs major airways, esp when (+) COPD

Answer 29

Obstructive

Question 30

(PFT RESULTS) - large amounts of pulmonary tissue, chest wall, and/or diaphragm are involved

Answer 30

Restrictive

Question 31

(ABG RESULTS) - Acute alveolar hyperventilation with hypoxemia (acute respiratory alkalosis)

Answer 31

Localized Lung Ca

Question 32

(ABG RESULTS) - Acute ventilatory failure with hypoxemia (acute respiratory acidosis)

Answer 32

Extensive or Widespread Lung Ca

Question 33

Surgery for NSCLC limited to only one lung, up to -----

Answer 33

Stage IIIa

Question 34

partial removal of a lung lobe

Answer 34

Wedge resection

Question 35

removal of a lung segment or segments

Answer 35

Segmentectomy

Question 36

removal of one lung lobe

Answer 36

Lobectomy

Question 37

removal of two lung lobes

Answer 37

Bilobectomy

Question 38

removal of whole right or left lung

Answer 38

Pneumonectomy

Question 39

- any treatment involving the use of chemical agents or drugs that are selectively destructive to malignant Ca cells * S/E: N&V, dizziness, fatigue, increased risk for infection *Primary tx for SCLC (w/ radiation) *Cisplatin and etoposide * Carboplatin, gemcitabine, paclitaxel, vinorelbine, topotecan, irinotecan

Answer 39

Chemotherapy

Question 40

- often given w/ chemotherapy. * GOAL: kill Ca cells without hurting normal tissue cells * S/E: redness, swelling, sloughing of skin, increased risk for infxn, radiation fibrosis, N&V, change of taste, fatigue, malaise

Answer 40

Radiation therapy

Question 41

May be used w/ curative intent inpatients w/ NSCLC who are not eligible for surgery. - used when the tumor can be visualized w/ bronchoscopy; entails the use of small radioactive rods (seeds) implanted near or directly into the tumor

Answer 41

Brachytherapy

Question 42

is used in patients w/ limited-stage SCLC; used to minimize risk of Ca metastasis to the brain.

Answer 42

Prophylactic cranial irradiation (PCI)

Question 43

uses special equipment to position the patient and precisely deliver radiation to a tumor.

Answer 43

Stereotactic radiation therapy

Question 44

RT MANAGEMENT

Answer 44

Oxygen Therapy Bronchopulmonary Hygiene Therapy Lung Expansion Therapy Aerosolized Medication Therapy