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respiration > lung cancer > Flashcards

lung cancer Flashcards

1
Q

what is lung cancer morbidity vs other cancers

A

The Most Common Malignancy and Leading Cause of Cancer-Related Mortality

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2
Q

what are some diagnostic imaging technique for lung cancer

A

chest x-ray

CT

bronchoscopy

staging PET scan

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3
Q

what is the 4 types of lung cancer

A

Non-small cell - squamous

non-small cell - adenocarcinoma

small cell lung cancer (15%)

large cell carcinoma

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4
Q

what is the doubling time for non small cell lung cancer

A

129 days

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5
Q

what % of non-small cell lung cancers are operable/ resectable

A

25%

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6
Q

5 year survival of Non small cell is

A

40%

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7
Q

what is the doubling time of small cell lung cancers

A

29 days

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8
Q

what is the treatment of non small cell LCs

A

surgery then adjuvant chemotherapy

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9
Q

what is the treatment choice of small cell lung cancers

A

4 cycles - combination chemotherapy

cisplatin and etoposide

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10
Q

what is true about Non small cell lung cancers

A

90% of patients are effected by stage 3/4

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11
Q

what is true about stage 4 NSCLC

A

incurable

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12
Q

where might lung cancer metastases

A

bone

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13
Q

what is true about all lung disease

A

for 80% of patients it is too late to cure

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14
Q

what is the aetiology of lung cancer

A

TOBACCO!!!!!

asbestos

environmental radiation

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15
Q

what are the two main pathways of carcinogens in the lungs

A

in the lung periphery (bronchioalveolar epithelium)

the central lung airways (bronchial epithelium)

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16
Q

what cancer appears in the lung periphery

A

adenosarcoma

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17
Q

what cancer appears in the central lung airways

A

squamous cell carcinomas

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18
Q

which of the lung cancers is more strongly associated with smoking

A

squamous cell carcinomas

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19
Q

what oncogenes are smoking endued

A

KRAS

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20
Q

what oncogenes are not related to carcinogenesis

A

EGFR

BRAF

HER2

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21
Q

how common is lung metastases

A

very common

22
Q

when do primary lung cancers present

A

late presentation

symptomatic lung cancers - very advanced - fatal

23
Q

what are the local effects of lung cancers

A

bronchial obstruction

pleural inflammation/metastases

direct evasion of the chest wall

lymph node metastases

24
Q

where does lung cancer metastasis too

A

liver
bone
brain
skin

25
Q

what are some non metastatic effects

A

finger clubbing

hypertrophic pulmonary osteoarthropathy (inflamed joints and bones)

26
Q

what are some lung cancer investigations

A

chest x-ray

pleural effusion - biopsy

bronchoscopy

bronchoscopy - biopsy

CT, MRI, PET

27
Q

what are the prognostic factors of lung cancer

A

stage of disease

classification of disease

in general its bad

28
Q

which gender is more likely to die of lung cancer

A

men

29
Q

what is the prognosis of a patent after a year with stage 1 lung cancer

A

80% survival

30
Q

what is the prognosis of a patent after a year with stage 2 lung cancer

A

75% survival

31
Q

what is the prognosis of a patent after a year with stage 3 lung cancer

A

50% survival

32
Q

what is the prognosis of a patent after a year with stage 4 lung cancer

A

20% survival

33
Q

what are the types of surgery patients can have for lung cancer

A

wedge resection

lobectomy

pneumonectomy

34
Q

how many patients get surgery

A

18%

35
Q

what are the 3 types of radiotherapy offered to patients

A

radical

palliative

stereotactic

36
Q

when is chemotherapy used

A

alone, combined with radiotherapy, adjuvant after surgery

37
Q

what is done for lung cancer in the case of palliative care

A

chemotherapy
radio therapy

opiates, benzodiazepines

treatment of secondary conditions

38
Q

where should you look for lung cancers on a x-ray

A

lung apices

Hila

behind the heart

behind the diaphragm (bases)

39
Q

what is a pulmonary nodule

A

a opacity in the lung up to 3cm in size

no mediastinal lymph node enlargement or lung collapse

40
Q

what might a pulmonary module suggest

A

lung cancer
a metastasis
benign lump
vascular hematoma

41
Q

how is a lung cancer stages

A

clinical history, exam

performance status, pulmonary function

TNM staging

42
Q

what is TNM staging

A

T - size of Tumour

N - lymph Node spread

M - are there any Metastasis

43
Q

what scans are used to look at T in TMN (the tumour)

A

CT
PET-CT
bronchoscopy

44
Q

what scans are used to look at N in TNM (lymph nodes)

A

PET-CT

mediastinoscopy

CT

45
Q

what scans are used to look for M in TNM (metastasise)

A

PET - CT
CT
bone scan

46
Q

what are blood tests that would be ordered for the staging of cancers

A

anaemia

abnormal Liver function tests (LFTs)

abnormal bone profile

47
Q

why would a ECHO be used

A

to see if there was a pericardial effusion

48
Q

what is the operative mortality of a pneumonectomy

A

5-10%

49
Q

what is the operative mortality of a lobectomy

A

3-5%

50
Q

what is the operative mortality of a wedge resection

A

2-3%

51
Q

what might lung surgery be for if not cancer

A

TB

abscess

benign tumour

granuloma

fibrosis

respiration (17 decks)

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