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Flashcards in lung cancer Deck (26):
1

cough
hemoptysis
chest pain
weight loss, night sweats
pneumonia
pleural effusion
airway obstruction
paraneoplastic syndrome
hoarseness: recurrent laryngeal nerve
Horner syndrome: pancoast tumor
dysphagia: esophageal invasion
superior vena cava syndrome

lung cancer presentation

2

most common cause of death in men and women

lung cancer

3

4 types of lung cancer (based on histological type)

1) small cell lung carcinoma
2) non-small cell carcinoma: adenocarcinoma, squamous cell carcinoma, large cell carcinoma

4

most common type of primary lung cancer OVERALL

adenocarcinoma

5

PERIPHERAL location
most common lung cancer in NON-SMOKERS + FEMALES, also found in SMOKERS

adenocarcinoma

6

activating mutations associated with this lung cancer: EGFR, ALK, ROS, RET, KRAS genes

adenocarcinoma

7

2nd most common type of primary lung cancer

squamous cell carcinoma

8

CENTRAL location
hilar mass arising from bronchus
cavitated lesion on xray or CT
associated with SMOKING
↑Ca

squamous cell carcinoma

9

keratin pearls

squamous cell carcinoma (characteristic of many squamous cell cancers)

10

squamous cell cancer characteristics

keratin pearls
secrete PTRrP →↑ Ca

11

PERIPHERAL location
associated with SMOKING
anaplastic, undifferentiated cells
giant cells
poor prognosis (poor response to chemo)

large cell carcinoma

12

high nucleus: cytoplasm ratio
CENTRAL location
associated with SMOKING
cushing syndrome or
SIADH (hyponatremia) or Lambert-Eaton syndrome (muscle weakness that IMPROVES with use)
undifferentiated, aggressive - poor prognosis

small cell carcinoma

13

Central
Smokers
Secreting

squamous cell carcinoma (PTHrP)
small cell carcinoma (ACTH, ADH, or Abs against Ca channel)

all S sounds

14

paraneoplastic syndrome associated with squamous cell carcinoma lung cancer

secretes PTHrP → hypercalcemia

15

3 paraneoplastic syndromes associated with small cell carcinoma

lung cancer secretes:
1) ACTH → cushing syndrome
2) ADH → SIADH (hyponatremia)
3) Abs against presynaptic Ca channels → Lambert-Eaton syndrome (muscle weakness that IMPROVES with use)

16

mutations in TP53, Rb, amplification MYC

small cell carcinoma

17

low-grade malignant epithelial tumor
bronchospasm + wheezing, flushing, diarrhea, right-sided heart lesions

carcinoid tumor

18

paraneoplastic syndrome associated with carcinoid

5HT secretion → carcinoid syndrome: BFDR
Bronchospasm and wheezing
Flushing
Diarrhea
Right-sided heart lesions (murmur)

19

most common location for carcinoid tumors

lung
GI tract (most common tumor of appendix)
only get ↑5HT if tumor in lung or mets from GI to liver b/c 5HT goes directly in systemic circulation instead of GI → portal vein → liver for metabolism)

20

defined by where it is found: APEX of lung → compress cervical sympathetic system → horner syndrome (ipsilateral PAM), SVC syndrome, hoarseness)
most are non-small cell lung carcinomas

pancoast tumor

21

obstruction of superior vena cava → impaired drainage from head "facial plethora", neck (jugular venous distention), upper extremitity (edema)
commonly caused by malignancy or indwelling cathether

superior vena cava syndrome

EMERGENCY

22

located in PLEURA (outer lining of lung)
associated with asbestos exposure
poor prognosis
NOT ASSOCIATED WITH SMOKING

mesothelioma

23

lung cancer mets goes to

brain
bone
liver
adrenal glands

24

lung receives mets from

breast
colon
prostate
bladder

25

risk factors for lung cancer

smoking
silica: coal mines
radon: heavy gas that settles in basements or coal mines
asbestos (mesothelioma)

26

lung cancers not associated with smoking

carcinoid tumor
mesothelioma