Sketchy Path: Lung Carcinoma Flashcards Preview

MS2 - USMLE Step 1: Part 2 > Sketchy Path: Lung Carcinoma > Flashcards

Flashcards in Sketchy Path: Lung Carcinoma Deck (27)
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1
Q

Most cancers found in the lungs are actually ______________.

A

metastases (like the crab bra, the crab kidney bag, and the crab colon belt)

2
Q

Although most lung cancers are caused by smoking (like the guys smoking next to the red risky dice), there are other risk factors: __________________.

A
  • Radiation (like the radioactive microwave)
  • Pulmonary fibrosis (like the lung bonsai on their table)
  • Workplace exposures (like the guy coughing in the crawl space)
3
Q

What age is most common for lung cancer?

A

60s (like the gray-haired old man)

4
Q

Lung cancer can cause what symptoms?

A
  • Decreased appetite (old man who’s dropped his cake)
  • Dyspnea (he can’t breathe)
  • Weight loss (he’s really skinny)
  • Chest pain (he’s clutching his chest)
5
Q

What signs are suggestive of lung cancer?

A
  • Wheezing (party blower)
  • Hemoptysis (bleeding ducts)
  • Recurrent pneumonia (repeating bacteria party streamers)
6
Q

___________ lung cancers are more likely to cause hemoptysis.

A

Central (like how SCC and small cell are beneath the central ducts and have blood dripping in)

7
Q

_______________ occur almost exclusively in smokers.

A

SCC and small cell carcinoma (like the smoke drifting into those two cells)

8
Q

______________ is the number one lung cancer in non-smokers.

A

Adenocarcinoma (like the “No Smoking” sign in the dining DEN)

9
Q

Adenocarcinoma is most common in which demographic?

A

Women younger than 40

10
Q

Adenocarcinomas glands can appear as _____________.

A

mucinous, acinar, or papillary

11
Q

Adenocarcinoma in situ is said to have a _______________ growth pattern.

A

lepidic (meaning butterfly-like)

It forms glands that thicken the alveoli.

12
Q

Adenocarcinoma can produce __________.

A

mucus (like the guy coughing up mucus)

13
Q

In addition to being columnar, adenocarcinoma can present with ___________ cells.

A

cuboidal (like the purple jello cubes on the inmate’s plate)

14
Q

What metaplasia occurs prior to the development of squamous cell carcinoma?

A

Pseudostratified columnar to stratified squamous (like the pseudostratified columnar brick wall morphing into the stratified tile floor)

15
Q

Squamous dysplasia can present with ______________.

A

necrosis and keratin pearls (like the skull and pearls beneath the squamous tile)

16
Q

Which lung neoplasm has especially basophilic cells?

A

Small cell carcinoma (like the blue bubble wrap on the walls of the small cell)

17
Q

The chromatin pattern of small cell carcinoma is said to be __________________.

A

salt and pepper like (like the dotted granite in the small cell)

18
Q

Small cell carcinoma stains positive for ______________.

A

chromogranin (like the GRANite cell), synaptophysin (like the synapse wiring –because synaptophysin is a neuronal marker), and enolase

19
Q

Although small cell carcinoma is not amenable to surgery, it usually responds INITIALLY to ______________.

A

radiation and chemotherapy (like the nuclear window and the chemistry set in his cell)

20
Q

How does large cell carcinoma present histologically?

A

Large, anaplastic cells with prominent nucleoli (like the large man with the shining spot on his bald – anaplastic –head)

21
Q

Regional spread of lung cancers can lead to ________________.

A
  • Pleural or pericardial effusions (like the guy with the wet shirt and wet briefcase)
  • Pancoast tumors with Horner syndrome (like the Pancoast airline in the background and the prison horns with ganglia powering them)
22
Q

Pancoast invasion of the brachial plexus can lead to ____________.

A

pain in an ulnar distribution from invasion into C8 - T2

23
Q

What symptoms can result from mediastinal invasion?

A
  • SVC syndrome (like the SVC hot air balloon above the mediastinal mast)
  • Hoarseness due to impingement of the recurrent laryngeal nerve (like the horse with yellow reins)
24
Q

Small cell carcinoma can cause what two paraneoplastic syndromes?

A
  • SIADH (like the spilled water jug)
  • Lambert-Eaton myasthenic syndrome (guard unable to reach calcium because small cell inmate is grabbing his antibody keys)
  • Antibodies against the cerebellar Purkinje cells (like the other guard removing his red turban to get the keys underneath)
  • Cushing’s syndrome (like the cushion beneath the fat guard)
25
Q

LEMS presents with what kind of muscle weakness?

A

Symmetric proximal (like how the guard can’t rise from his chair)

26
Q

What paraneoplastic syndrome can adenocarcinoma cause?

A

Hypertrophic osteoarthropathy: sudden swelling and clubbing of the distal phalanges (like the guy’s swollen finger when the lunch lady hit him for trying to reach over the glass)

27
Q

What causes the hypercalcemia seen in SCC?

A

PTHrp (like the prisoner PRETENDING to be the PHd psychologist and stealing his ice cream)

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