Pulm Vascular Disorder: Lung CA Flashcards

1
Q

Lung CA is a major cause of _____ and can be both ______ and _______

A

death

primary and secondary

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2
Q

The lungs are ______ and _________ and is a common place for _______

A

large and vascularized

metastases

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3
Q

Lung CA is ________ and _______.

A

aggressive and invasive

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4
Q

What are the 3 preferred sec sites lung CA mets to?

A

skeleton, brain, and liver

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5
Q

What are the 4 primary types of Lung CA? (%?)

A
  1. small cell carcinoma (~12%)
  2. large cell carcinoma (~12%)
  3. squamous cell carcinoma (~27%)
  4. adenocarcinoma (~30%)
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6
Q

Which types of Lung CA are Small Cell Lung CA (SCLC)? Which are Non-small Cell Lung CA (NSCLC)?

A
  1. small cell carcinoma

2. large cell carcinoma, squamous cell carcinoma, and adenocarcinoma

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7
Q

Which type of Lung CA have the highest prevalence?

A

adenocarcinoma

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8
Q

Etiology of Lung CA (3)

A
  1. > 85% is d/t smoking: contain carcinogens
  2. toxins (eg asbestos–> used in insulation in building but banned now)
  3. marijuana (increase smoking)
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9
Q

What are warning signs?

A

signs that are unexplained by other underlying cause

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10
Q

What are the 6 warning signs?

A
  1. chronic coughs
  2. dyspnea
  3. chest, arm, and shoulder pain: r/t to cardiac issue
  4. blood-tinged sputum: blood in sputum
  5. alternate respiratory pattern: r/t asthma, emphysema, or bronchitis
  6. hemoptysis:
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11
Q

What is hemoptysis?

A

coughing up blood

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12
Q

Where is the central malignancy located in a/w? Peripheral malignancy?

A
  1. larger a/w –> bronchus

2. smaller a/w –>alveoli and bronchioles

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13
Q

Patho: Small Cell Carcinoma (SCLC) (5)

A
  • 99% smokers
  • small oval (oat cells)–> non-resectable
  • aggressive, invasive, early mets (esp brain)
  • mets at diagnosis –> 70%
  • paraneoplastic syndromes
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14
Q

Small Cell Carcinoma is the ________ type of Lung CA and most _________ and mets _______

A

worst

aggressive

early

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15
Q

Small Call Carcinoma: How are the cells described as? Why is tumor excision not an option for this type?

A

small oval malignant cells resembles grains of oat

They are non-resectable b/c the cells are diffused in terms of location –> no uniform mass to excise

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16
Q

Small Call Carcinoma: Is the prognosis good or poor? Where does it mets to especially?

A

POOOORRRR

BRAIINNNZZZ

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17
Q

Small Call Carcinoma: At dx, mets has spread ____%

A

70

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18
Q

Small Call Carcinoma:
What is paraneoplastic syndrome? Examples?

How does it contribute to this type?

What is this tumor called?

A

Disorders that relates to the abn secretion of ACTH.

Examples: syndrome of inappropriate ADH (SIADH) or Cushing’s

Tumor in the lungs may secrete hormone-like substance that have similar action to ACTH –> give Cushing- or SIADH-like symptoms

Ectopic tumors

19
Q

Patho: Adenocarcinoma (NSCLC) (3)

A
  • most common form
  • in females and non-smokers
  • origin in bronchioles and alveoli
20
Q

What does adeno- refer to? What does it secrete?

A

granular epithelium –>secretes mucus

21
Q

Adenocarcinoma: Central or Peripheral Origin? Explain.

A

Peripheral origin –> smaller origin eg alveoli and bronchioles

away from large a/w or mediastinum

22
Q

Adenocarcinoma: If lung CA occur in ___-_____, it is likely this form.

A

non-smoker

23
Q

Adenocarcinoma: Prevalence? Can men get this type?

A

higher prevalence in women and non-smoker but not exclusive

YESS

24
Q

Can the tumor be excised? Why?

A

YES

the mass is uniform

25
Q

Patho: Squamous Cell Carcinoma (NSCLC) (6)

A
  • more common in males
  • central origin (bronchi)
  • intraluminal
  • impacts mediastinum
  • spread to hilar nodes
26
Q

Squamous Cell Carcinoma: Which a/w is impacted? What can it impact?

A

large a/w towards bronchi and mediastinum –> may impact heart

27
Q

Squamous Cell Carcinoma: What is the hilar nodes?

A

refers to the area of lung where vessels and bronchi enter

28
Q

Squamous Cell Carcinoma: Most proximal nodes are ______ nodes and are immediately ______ as the tumor advances

A

lymph

affected

29
Q

Patho: Larger Cell Carcinoma (NSCLC) (4)

A
  1. large, undifferentiated cells
  2. peripheral origin
  3. eary mets–> happens quickly
  4. poor prognosis
30
Q

Larger Cell Carcinoma: What does large, undifferentiated cells mean?

A

cells in the early differentiation stage are large and cannot carry out their function b/c it is undifferentiated

31
Q

Larger Cell Carcinoma: Which a/w is affected?

A

affects the smaller a/w but affect rest of lung as it advance

32
Q

What are the mnfst if central in origin? (2)

A
  1. coughing, wheezing, and dyspnea

2. cardiac mnfst

33
Q

Why does coughing, wheezing, and dyspnea occur in central origin?

A

centrally located tumor obstr large a/w —> ventilation is impaired–> mnfst occur

34
Q

Why do cardiac mnfst occur? What is the first structure impacted?

A

first structure impacted is the pericardium

accum of fluids apply external pressure on the heart–> compromise filling/emptying of the heart

35
Q

What are the 2 typical mnfst?

A
  1. hemoptysis: coughing up blood

2. pain

36
Q

What is the pain associated with (2)?

A
  1. inflm

2. perivascular nerves around blood vessels

37
Q

What does manifestations depends on? (4)

A
  1. site (type): central or peripheral
  2. stage of CA
  3. extent, mets
  4. paraneoplastic syndrome
38
Q

Diagnosis of Lung CA (4)

A
  1. hx and px
  2. imaging
  3. bronchoscopy and biopsy
  4. cytology
39
Q

What 3 imaging are used?

A
  1. CXR w/ cardiac mnfst
  2. U/S initally
  3. CT and MRI to identify location and size precisely
40
Q

What is a bronchoscopy? ______ _________ is used to take sample of fluid percutaneously. What else is done

A

insert a scope to visualize the a/w eg alveoli

needle aspiration

biopsy

41
Q

Cytology is a _____ / _____ ______. WHY?

A

sputum/bronchial wash –> analyzing expectorate to identify neoplastic malignant cells

42
Q

Treatment of for SCLC? ____ is not used because it is not a uniform mass

A

chemo and radiation

sx

43
Q

Treatment for NSCLC? What is done first to shrink tumor?

A

chemo and radiation is used first to shrink tumor and the surgically remove tumor

  1. chemo/radiation
  2. sx
44
Q

Unless detected and intervened early, the prognosis is ____ and many go into _______ w/ lung CA

A

poor

remission