Lung Cancer & Interstitial Lung Disease (CP1)

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  • Created by: NDumps97
  • Created on: 22-05-19 09:02
What is the most common risk factor for lung cancer? Is lung cancer more common in males or females?
Smoking (causative in ~90% of cases). 3:1 M:F incidence.
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What are the two main types of lung cancer? Which one is 80% of cases and which one makes up the remaining 20%?
Small cell lung cancer (20%) and non-small cell lung cancer (80%)
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Where do 70% of lung tumours arise?
In the main bronchi or hilum. The remaining 30% arise peripherally.
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What is the most common non-small cell lung cancer type?
SCC (squamous cell carcinoma)
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These arise from squamous metaplasia of what type of cells?
There is squamous metaplasia from the normal pseudostraitifed ciliated columnar epithelium in response to exposure to cigarette smoke.
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Where do they usually arise? What secondary effects does this lead to?
Usually near the carina - leading to secondary collapse or infection due to obstruction.
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What hormone might they secrete? What effect would this cause which might be the same as seen if someone had metastases to their bone?
Can secrete parathyroid hormone (release calcium from bone) which can lead to hypercalcaemia.
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SCCs are friable tumours. What does this mean?
It means they readily break up into smaller pieces given pressure applied to them - more susceptible to metastasising etc, means they can often be diagnosed with sputum cytology
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Adenocarcinomas (SCLC) are less related to smoking. Where do they characteristically originate from?
They characteristicallyWhat are located in peripheral locations.
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What is the remaining type of non-small cell lung cancer which is rare and has a poor prognosis?
Large cell anaplastic carcinoma (poorly differentiated & poor prognosis. Disseminated at the point of diagnosis)
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What does small cell lung cancer (oat cell) differentiate into? What does this mean they secrete?
They differentiate into neuroendocrine cells and secrete ADH (giving SIADH symptoms) or ACTH (giving Cushing's Sx)
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True or false - they are mostly contained at the point of diagnosis?
False: ~70% are disseminated at the point of diagnosis
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Name 4 main symptoms of lung carcinoma.
Persistent cough (80%); haemoptysis (70%); dysponea (60%); chest pain (40%) (may also have a slowly resolving pneumonia, lethargy, weight loss)
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Name 4 signs you might see.
Cachexia, anaemoa, clubbing, hypertrophic pulmonary osteoarthopathy (wrist and hand joint pain); due to metastases: bone tenderness, hepatomegaly etc (confusion..._`
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Which investigation should any patient with haemoptysis have which would be good at diagnosing whether there was a tumour?
CXR (symptomatic tumours are almost always seen on CXR)
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Where are mesothelioma located? And exposure to what is it associated with?
These develop in the pleura (occasionally in the peritoneum or other organs) and is associated with previous exposure to asbestos.
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What nerve is at risk of palsy due to local invasion? What symptom would this have in the person?
Recurrent laryngeal palsy - would result in changes to voice.
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What is a pancoast's tumour? What type of lung carcinoma is it mainly a complication of? Where is it located?
A malignant tumour of the lung apex. It is most commonly a NSCLC and can intefere with things such as the brachial plexus.
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Lambert–Eaton syndrome (LEMS) is a rare ________disorder characterised by muscle weakness of the limbs. Around __ % of those with LEMS have an underlying malignancy, most commonly ______-cell lung cancer (a 'paraneoplastic condition')
Lambert–Eaton syndrome (LEMS) is a rare autoimmune disorder characterised by muscle weakness of the limbs. Around 60 % of those with LEMS have an underlying malignancy, most commonly small-cell lung cancer (a 'paraneoplastic condition')
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What is acnthosis nigricans? Where is it commonly and what might it indicate?
Dark velvety skin discolouration in skin folds, most commonly, armpits, groin and neck. It can indicate an underlying malignancy
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Card 2

Front

What are the two main types of lung cancer? Which one is 80% of cases and which one makes up the remaining 20%?

Back

Small cell lung cancer (20%) and non-small cell lung cancer (80%)

Card 3

Front

Where do 70% of lung tumours arise?

Back

Preview of the front of card 3

Card 4

Front

What is the most common non-small cell lung cancer type?

Back

Preview of the front of card 4

Card 5

Front

These arise from squamous metaplasia of what type of cells?

Back

Preview of the front of card 5
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