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USMLE Step 1: Things I Cannot Remember > Respiratory > Flashcards

Flashcards in Respiratory Deck (10):
1

What is the most common lung cancer?

Metastasis

  • bladder, breast, colon and prostate

2

What is the most common primary lung cancer overall?

Adenocarcinoma

3

Adenocarcinoma

  • Location: 
  • Mutations: 
  • Clinical associtation:
  • Stain:

  • Location: Peripheral
  • Mutations: 
    • Activating mutations in KRAS, EGFR, and ALK
  • Clinical associtation:
    • hypertrophic osteoarthropathy (clubbing)
  • Stain: Mucin (+); glandular pattern

4

What is the subtype of adenocarcinoma of the lung?

Bronchioalveolar subtype

  • Grows along the alveolar septa ⇒ apparent "thickening" of alveolar walls
  • CXR often shows hazy infiltrates similar to pneumonia
  • Excellent prognosis

5

  • Which lung cancers are centrally located?
  • How are they treated?
  • What is their histology?

  • Small cell (oat cell) and squamous cell
  • Treated with chemotherapy
  • Histology:
    • Small cell: Chromogranin A (+) 
      • Kulchitsky cells ("blue" neuroendocrine cells)
    • Squamous cell: keratin pearls and intercellular bridges

6

What lung cancers have endocrine associations?

  1. Small cell (oat cell) carcinoma
    • ACTH (Cushing syndrome), SIADH or Antibodies against presynaptic Ca2+ channels (Lambert-Eaton myasthenic syndrome), Amplification of myc genes
  2. Squamous cell carcinoma
    • Cavitation, Cigarettes, hyperCalcemia (PTHrP) 
  3. Large cell carcinoma
    • Can secrete ß-hCG
  4. Bronchial carcinoid tumor
    • Symptoms are usually due to mass effect; occasionally carinoid syndrome (5-HT secretion ⇒ flushing, diarrhea and wheezing)

7

What is the histology of large cell carcinoma of the lung? 

pleomorphic giant cells

8

What are the pneumoconioses?

  1. Asbestosis
  2. Berylliosis
  3. Coal worker's pneumoconiosis
  4. Silicosis

9

What areas of the lungs are affected by the different pneumoconioses?

  • Lower lobes:
    • Asbestosis
  • Upper lobes:
    • Berylliosis, coal worker's pneumoconiosis, silicosis

10