Lung CA

Question 1

5. Describe the diagnostic evaluation of lung cancer including laboratory and other diagnostic procedures

Answer 1

Complete Hx and Physical!!! (general app, lymph, chest/lungs, abdomen, extremeties
Neurologic)

CXR – compare with old films if available

Labs – electrolites(including Ca+), LFTs, albumin, CBC, coat times

CT/PET

BIOPSY!!! (bronchoscopy, mediastinoscopy, thoroscopy, percutaneous, thoracentesis)

Question 2

True or False: you can diagnose lung CA based off the combination of laboratory results and CXR/CT results.

Answer 2

False! you MUST biopsy. Biopsy needed for dx, staging and tx

Question 3

True or False: Tumor Markers alone are utilized in screening the general population for CA

Answer 3

False: there is no specific blood test that can dx cancer, and no currently available tumor marker has been proven sensitive and specific enough to be used alone for screening the general population

Question 4

Paraneoplastic Syndromes may present clinically as:

Answer 4

• Cushing’s syndrom (due to tumor production of ACTH)
  - typical of Sm.cell carcinoma
• Hypercalcemia( due to tumor production of
  PTH-like hormone) pt appears goofy in renal failure
  - typical of squamous cell carcinoma
• SIADH (tumor production of ADH) pt w/hyponatremia
  and often asymptomatic.
  - small cell carcinoma