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STEP 2 Pulmonary > Pulm. Cancer > Flashcards

Pulm. Cancer Flashcards

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1
Q
A
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2
Q

Screening. what 2 criteria?

A

recommended for patients that fullfill 2 criteria:
1. >20 pack years smoking history

  1. Currently smoking or quit smoking within the past 15 years. (if stopped >= 15 years, do not needed to be screened)
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3
Q

Screening. what recommended test?

A

low dose CT scan of the chest

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4
Q

Screening. Recommended interval?

A

Yearly

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5
Q

Screening. age?

A

50-80 years

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6
Q

Screening. termination of screening? 2

A

Patient successfully quit smoking for >= 15 years
OR
Patient has medical conditions that significantly limit life expectancy

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7
Q

Adenocarcinoma. Incidence?

A

40-50 proc.

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8
Q

Adenocarcinoma. location?
treatment?

A

peripheral (involves pleura)

Stage
Chemoradiation
Resection

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9
Q

Adenocarcinoma. clinical associations? 2

A

Clubbing
Hyperthrophic osteoarthropathy

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10
Q

Squamous cell carcinoma. incidence?

A

20-25 proc.

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11
Q

Squamous cell carcinoma. location?
treatment?

A

Central
Necrosis and cavitation

Stage
Chemoradiation
Resection

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12
Q

Squamous cell carcinoma. clinical assoc?

A

Hypercalcemia (PTH-rp)

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13
Q

Small cell carcinoma. incidence?

A

10-15 proc.

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14
Q

Small cell carcinoma. location?
Treatment?

A

Central
Chemoradiation

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15
Q

Small cell carcinoma. clinical assoc?

A

Cushing syndrome (ACTH)
SIADH (ADH)
Lambert-Eaton syndrome

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16
Q

Large cell carcinoma. incidence?

A

5-10 proc.

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17
Q

Large cell carcinoma. location?

A

Peripheral

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18
Q

Large cell carcinoma. clinical assoc?

A

Gynecomastia
Galactorrhea

Secretes b-hcg

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19
Q

Solitary pulmonary nodule. definition?

A

It is defined by the features of round opacity, up to 3 cm in diameter, and surrounded by
pulmonary parenchyma
+ no assoc LN enlargement

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20
Q

Solitary pulmonary nodule.
by convention is must not be assoc. with what?

A

pleural effusion, adenopathy, or atelectasis

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21
Q

Solitary pulmonary nodule.
Most nodules are benign (eg, infectious granuloma, hamartoma)

A

.

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22
Q

Solitary pulmonary nodule. causes.
Primary lung cancer?

A

Squamous cell, adenocarcinoma , small cell, large cell & carcinoid [can be first in lung then go to intestine]

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23
Q

Solitary pulmonary nodule. causes. metastatic?

A

Melanoma , breast, head & neck, renal cell, colon, germ cell & sarcoma

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24
Q

Solitary pulmonary nodule. causes. benign infectious granulomas?

A

Tuberculosis , histoplasmosis , atypical mycobacteria , granulomas coccidioidomycosis , Cryptococcus & blastomycosis

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25
Solitary pulmonary nodule. causes. benign neoplasmas?
Lipoma , hamartoma & fibroma
26
Solitary pulmonary nodule. causes. vascular?
Arteriovenous malformations
27
Solitary pulmonary nodule. findings that favour carcinoma? CT findings
CT scan findings i. Large nodule size > 3 ii. Low density iii. Spiculated borders iv. Eccentric calcifications
28
Solitary pulmonary nodule. findings that favour carcinoma? clinical findings
Clinical findings: i. Age >40 ii. History of smoking iii. Weight loss iv. Previous malignancy
29
Solitary pulmonary nodule. Management based on CT. Bening features -->?
Serial CT scans for 2-3 years
30
Solitary pulmonary nodule. Management based on CT. Ground glass appearance -->?
Yearly assessment (even with stable appearance and size)
31
Solitary pulmonary nodule. Management based on CT. Intermediate features -->?
Further investigation with biopsy or PET
32
Solitary pulmonary nodule. Management based on CT. Highly malignant features-->?
Surgical excision
33
Solitary pulmonary nodule. yra algoritmas faile, is esmes kortose parasyta ka daryti pagal CT findings
.
34
Assessment of malignancy risk for solitary pulmonary nodule. Low risk. size?
<0,8 cm
35
Assessment of malignancy risk for solitary pulmonary nodule. immediate risk. size?
0,8 - 2 cm
36
Assessment of malignancy risk for solitary pulmonary nodule. high risk. size?
>= 2 cm
37
Assessment of malignancy risk for solitary pulmonary nodule. Low risk. age?
< 40
38
Assessment of malignancy risk for solitary pulmonary nodule. intermediate risk. age?
40-60
39
Assessment of malignancy risk for solitary pulmonary nodule. high risk. age?
> 60
40
Assessment of malignancy risk for solitary pulmonary nodule. Low risk. smoking status?
Never smoked
41
Assessment of malignancy risk for solitary pulmonary nodule. Intermediate risk. smoking status?
current
42
Assessment of malignancy risk for solitary pulmonary nodule. High risk. smoking status?
current
43
Assessment of malignancy risk for solitary pulmonary nodule. Low risk. smoking cessation?
> 15 years
44
Assessment of malignancy risk for solitary pulmonary nodule. Intermediate risk. smoking cessation?
5-15 years
45
Assessment of malignancy risk for solitary pulmonary nodule. High risk. smoking cessation?
<5 years
46
Assessment of malignancy risk for solitary pulmonary nodule. Low risk. Nodule margin characteristics?
Smooth
47
Assessment of malignancy risk for solitary pulmonary nodule. Intermediate risk. Nodule margin characteristics?
Scalloped
48
Assessment of malignancy risk for solitary pulmonary nodule. High risk. Nodule margin characteristics?
Corona radiate or spiculated
49
Cancer. clinical presentation?
● Fever. ● Weight loss. ● Hemoptysis.
50
Cancer. diagnosis. Xray. Nothing ->
Check for paraneoplastic syndrome. Positive --> cancer Negative --> no cancer
51
Cancer. diagnosis. Xray. Effusion -->?
Do troracenthesis Malignant cells --> cancer (stage 4 - metastatic disease) No malignant cells --> no cancer
52
Cancer. diagnosis. Xray. Cancer (gali tipo tiesiog matytis). --> Do CT
.
53
Cancer. diagnosis. CT scan. Find in the large airway -->?
bronchoscopy and biopsy.
54
Cancer. diagnosis. CT scan. Found outside the lung -->?
Endobronchial US
55
Cancer. diagnosis. CT scan. Periphery ->?
CT guided percutaneous biopsy
55
Cancer. diagnosis. CT scan. Middle -->?
Video assisted thoracoscopic surgery
56
Cancer. diagnosis. CT scan. Thoracenthesis with effusion -->?
--> positive malignant cells --> stage 4 lung cancer.
57
Cancer. diagnosis. what for staging?
PET CT for staging
58
Cancer. diagnosis. What test to do if candidate of surgery?
PFT
59
Cancer. diagnosis. treatment?
Treatment either chemotherapy, radiation, or surgery. ▪ Lobectomy if FEV1>1.5L and DLCO>60%.
60
Cancer: Primary prevention?
Quit smoking and secondhand smoking.
61
Infectious granulomas are the MCC of benign pulmonary nodules; multiple rather than single, and associated with active disease (fever, cough, weight loss).
.
62
Solitary pulmonary nodules. Factors increasing malignant probability?
Large size (> 2 cm), agvanced age, female, active or previous smoking, family/personal history of cancer, upper lobe location, spiculated radiograph appearance
63
Solitary pulmonary nodule. Algo. High risk malignancy -->?
Surgical excision
64
Solitary pulmonary nodule. Algo. Low-intermediate risk malignancy -->?
Evaluate nodule size
65
Solitary pulmonary nodule. Algo. Low-intermediate risk malignancy --> size >= 8 mm --> what tests to do?
FDG-PET or biopsy
66
Solitary pulmonary nodule. Algo. Low-intermediate risk malignancy --> size >= 8 mm -->FDG-PET or biopsy --> suspicious for malignancy -->?
Surgical excision
67
Solitary pulmonary nodule. Algo. Low-intermediate risk malignancy --> size >= 8 mm -->FDG-PET or biopsy --> NO suspicious for malignancy -->?
Serial CT scans
68
Solitary pulmonary nodule. Algo. Low-intermediate risk malignancy --> size < 8 mm --> if nodule 5-7 mm?-->?
Serial CT scans
69
Solitary pulmonary nodule. Algo. Low-intermediate risk malignancy --> size < 8 mm --> if nodule =< 4?-->?
Evaluate malignancy risk: If low --> no follow up If intermediate --> Serial CT scans
70
Bronchoalveolar carcinoma. Peripheral location (pneumonia-alike on xray) Treatment: stage, chemoradiation, resection
.

STEP 2 Pulmonary (30 decks)

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