Lung cancer Flashcards
(52 cards)
What is haemoptysis?
Coughing up blood
due to ulceration
What is the link between recurrent pneumonia and lung cancer?
Recurrent pneumonia can be a sign of lung cancer. The obstruction leads to frequent infection.
What is stridor?
Inspiratory wheeze, caused by an obstruction in the upper airway making it difficult to breathe in
(asthma and COPD produce expiratory wheeze)
List 6 structures that neighbour the lungs that lung cancer may effect (local invasion)
- Recurrent laryngeal nerve
- Oesophagus
- Pericardium
- Brachial pleuxus
- Pleural cavity
- Superior vena cava
Explain how a hoarse voice can be a symptom for lung cancer
The tumour may invade the reccurrent laryngeal nerve resulting in paralysis of a vocal cord
Give 3 symptoms of local invasion of the pericardium
Breathlessness
Atrial fibrillation
Pericaridial effusion
What symptom shows local invasion of the oesophagus?
Dysphagia (difficulty/uncomfortable swallowing
What is a Pancoast tumour?
Tumour of the pulmonary apex. It typically spreads to nearby tissues such as ribs and vertebrae
Why would a patient with lung cancer have weakness in their hand?
Invasion of the brachial plexus
What is a common presenting symptom in someone with a pleural effusion?
Breathlessness
What are symptoms of superior vena cava invasion?
Puffy eyelids and headache
Distension of the superficial veins, even when standing upright. Normal pulsation is lost
Anastamoses to inferior vena cava
How can the symptoms of invasion of the superior vena cava be palliated?
Insertion of a stent to open up the occluded vein - must be done before the vein is permanently occluded by thrombosis
What would be the presenting symptom if there was chest wall invasion?
Localised chest pain that is worse on movement
If the tumour has eroded through bone, the pain may be worse at night
Erosion of what structure would cause massive haemoptysis and ultimately death?
If the tumour erodes into the left pulmonary artery and into a major bronchus
What are the 6 commons sites of metastases from a primary lung cancer?
Liver Brain Bone Adrenal Skin Lung
What are the symptoms of cerebral metastases?
Weakness (may mimic a stroke but have gradual onset)
Visual disturbance
Headaches that are non-photophobic and are worse in the morning
Fits (if it involves the cortex)
What symptoms show liver metastasis?
May have liver pain
In rare cases the biliary can be obstructed resulting in obstructive jaundice
Abnormal liver function tests
What are the common presentations of bone metastases?
Localised pain which is worse at night
Pathological fracture due to stress on the bone
What kind of scan can be used to show bone metastases?
Isotope bone scan
What are signs of cancer that are non-metastatic i.e. due to the biochemically active products of the primary tumour?
Finger clubbing Hypertrophic pulmonary osteoarthropathy - HPOA Weight loss Thrombophlebitis Hypercalcaemia Hypoatraemia – SIADH Weakness
What 9 key things should be asked about when taking a history for suspected lung cancer
Cough
Haemoptysis
Weight loss
Breathlessness
Chest wall pain
Cigarette smoker
Tiredness
Recurrent infection
Other smoking related disease
("Anything else worrying you?")What 11 things should be looked for on clinical examination for lung cancer?
Finger clubbing Breathless Coughing Weight loss Bloated face Hoarse voice Lymphadenopathy Tracheal deviation Dull percussion Stridor Enlarged liver
What investigations may be done to diagnose lung cancer?
Chest x-ray CT scan of thorax PET scan Bronchoscopy Endobronchial ultrasound Full blood count Coagulation screen Na, K, Ca, Alk Phos Spirometry, FEV1
What 4 investigations are used to make a tissue diagnosis?
Bronchoscopy
CT guided biopsy
Lymph node biopsy
Aspiration of pleural fluid
