Lung Cancer

benryan95's version from 2015-12-28 08:50

Section 1

Question Answer
What is the most common malignant tumour worldwide?Bronchial/lung carcinoma
What is the 1st, 2nd and 3rd most common cause of death in the UK?Heart disease, pneumonia, lung cancer
What is the male:female ratio for lung cancer?3:1
Which 3 carcinomas make up NSCC?Squamous, adenocarcinoma, large cell carcinoma
What % of all bronchial carcinomas are squamous cell?30%
How do squamous cell carcinomas typically present?Obstructive lesions leading to infection
What % of squamous cell carcinomas cavitate at presentation?10%
In squamous cell carcinoma is local spread common or rare?common
In squamous cell carcinoma, are widespread mets early or late?relatively late
Are squamous cell carcinomas typically central or peripheral?Central
Which hormone and electrolyte imbalance is squamous cell carcinoma related with?Parathyroid hormone related protein --> hypercalcaemia
Is squamous cell carcinoma a typical cause of clubbing?Yes, it is strongly associated with finger clubbing
Which arthropathy is squamous cell carcinoma related to?Hypertrophic pulmonary osteoarthropathy

Section 2

Question Answer
Where do adenocarcinomas arise from?Mucous cells in the bronchial epithelium
Where do adencarcinomas typically invade?Pleura and mediastinal lymph nodes
Where to adenocarcinomas typically metastases to?Brain, adrenal glands and bones
What % of all bronchial carcinomas are adenocarcinomas?40%
Is there an association with asbestos with adenocarcinoma?Yes
In which group is this carcinoma the most common?Non-smokers
Are adenocarcinomas typically centra lor peripheral?Peripheral

Section 3

Question Answer
How are large cell carcinomas different to squamous and adenocarcinomas?They are less differentiated
What % of all lung carcinomas are large cell carcinomas?10-15%
Are large cell carcinomas typically central or peripheral?Peripheral
What may large cellcarcinomas secrete?b-HCG
Do large cell carcinomas have a good or poor prognosis?poor prognosis

Section 4

Question Answer
What % of all lung cancers are small cell carcinomas?10-15%
What group of people are small cell carcinomas very rare in?non-smokers
Where do small cell carcinomas often start?In the bronchi near the centre of the chest
Do small cell carcinomas spread through the body early or late in the course of the disease?Fairly early
What cells do small cell carcinomas arise from?Kulchitsky cells/enterochromaffin cells
Are small cell carcinomas typically inoperable at presentation?Yes
Do small cell carcinomas respond to chemotherapy?Yes
Do small cell carcinomas respond to radiotherapy?Yes

Section 5

Question Answer
What is the most common presenting symptom of lung cancer?Cough at 41%
What are the 2nd, 3rd and 4th most common presenting symptoms of lung cancer?Chest pain (22%), cough and pain (15%), coughing blood (7%)
Name 5 other presentations of lung cancerChest infection, malaise, weight loss, shortness of breath, hoarseness
Name 9 structures that tumours may directly spread toPleura, ribs, lower brachial plexus, sympathetic ganglion, left recurrent laryngeal nerve, phrenic nerve, oesophagus, pericardium, superior vena cava obstruction
What is it called when a lung cancer in the apex erodes ribs and lower brachial plexus?Pancoast tumour
What symptoms are present in pancoast tumourSevere pain in shoulder and inner surface of the arm
What is it called when a bronchial carcinoma spreads to a sympathetic ganglion?Horner's syndrome
What symptoms are present when bronchial carcinomas involve the left recurrent laryngeal nerve?Hoarseness and bovine cough
What happens when a bronchial carcinoma invades the phrenic nerve?Paralysis of ipsilateral hemidiaphragm
What symptoms can be produced when the oesophagus is involved?Dysphagia
What can happen when the pericardium is involved?Pericardial effusion and malignant dysrhythmias
What signs and symptoms are present with superior vena caval obstruction?Early morning headache, congestion and oedema involving the upper limbs, distended jugular and chest veins

Section 6

Question Answer
Name 5 areas bronchial carcinomas typically metastasis toBones, liver, brain, spinal cord compression, adrenal gland
What happens with bony metastases?severe pain and pathological fractures
What happens with brain metastases?Change in personality, epilepsy or a focal neurological lesions
what % of small cell tumours produce ectopic hormones?10%
What hormones can small cell tumours produce?ADH and ACTH
What does inappropriate secretion of ADH cause?Slowly progressive hyponatraemia
What does inappropriate secretion of ACTH cause?Cushing's syndrome
Which myasthenic syndrome can small cell lung cancer cause?Lambert-Eaton myasthenic syndrome
What is polymyositis?Chronic inflammation of the muscles, which can be associated with lung cancer