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Oncology RIA > Lung cancer > Flashcards

Lung cancer Flashcards

1
Q

refer along 2 week suspected cancer pathway if:

A
  • CXR finding suggest lung cancer

- aged over 40 with unexplained haemoptysis

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2
Q

offer urgent CXR within 2 weeks to assess for lung cancer in people aged 40 and over if they have 2 or more of the following unexplained symptoms or have ever smoked and have 1 of following

A
  • cough
  • fatigue
  • SoB
  • chest pain
  • weight loss
  • apetite loss
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3
Q

consider urgent CXR to assess for lung cancer in people aged 40 and over with any of the following

A
  • persistent/recurrent chest infections
  • finger clubbing
  • supraclavicular lymphadenopathy
  • chest signs consistent with lung cancer
  • thrombocytosis
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4
Q

staging system for lung cancer

A

TNM
T - tumour
N - nodes
M - metastases

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5
Q

T1 tumour

A

less than 3 cm

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6
Q

T2 tumour

A

3-7 cm
or
involves main bronchus > 2cm from trache

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7
Q

T3 tumour

A 
> 7 cm
OR 
invades chest wall 
OR 
separate nodule same lobe
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8
Q

T4 tumour

A

invades local structures e.g. mediastinum, heart, trachea

inoperable

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9
Q

Nodal staging

A

N0 - no nodes
N1 - local ipsilateral node
N2 - ipsilateral mediastinal nodes
N3 - contralateral mediastinal nodes

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10
Q

brain metastases and lung cancer

A

1/3 those with lung cancers are thought to develop brain metastases

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11
Q

investigation of choice for Brain metastases

A

contrast enhanced brain MRI

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12
Q

management of brain mets w/ oedema

A

Dexamethasone 8mg BD PO

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13
Q

what should be checked prior to starting steroids

A

blood glucose

because steroids can exacerbate diabetes

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14
Q

what is the 1 year survival or patients diagnosed with lung cancer in the UK

A

30%

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15
Q

symptoms of SVC obstruction and how can they be relived instantly?

A
  • dilated veins on upper chest
  • red suffused eyes
  • SoB: worse on lying down
  • swelling of an arm

SVC stent

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16
Q

which lung cancer is more chemosensitive

A

small cell lung cancer

17
Q

possible curative treatments for small cell lung cancers (4)

A
  • chemotherapy followed by radiotherapy
  • radiotherapy alone
  • surgery alone
  • surgery followed by radiotherapy
18
Q

red flags for lung cancer (5)

A
  • dry/productive cough
  • haemoptysis
  • hoarse voice
  • chest pain
  • constitutional symptoms: apetite/weight loss, fatigue
19
Q

what are paraneoplastic syndromes

A

rare disorders caused by an immune response to cancer

20
Q

3 paraneoplastic syndromes linked to small cell lung cancer

A

SiADH
ACTH
Lambert Eaton syndrome

21
Q

what is SiADH + the management

A

ADH caused excessive retention causing hyponatraemia

manage: fluid restriction, vasopressin, demeclocycline

22
Q

vasopressin

A

ADH receptor antagonist

23
Q

effect of ACTH

A

bilateral adrenal hyperplasia –> high levels of cortisol –> hypokalaemic alkalosis

  • muscle weakness
  • hypertension
  • hypokalaemia
  • alkalosis
24
Q

what is Lambert eaton syndrome

A

when an antibody is directed against pre synaptic voltage gated calcium channels in the peripheral nervous system resulting in repeated muscle contractions, limb girdle weakness, hyporeflexia and autonomic symptoms

25
Q

name 4 paraneoplastic syndromes of squamous cell lung cancer

A
  • clubbing
  • PTH-rp
  • HPOA (hypertrophic pulmonary osteoarthropathy)
  • ectopic TSH
26
Q

types of lung cancer

A

small cell lung cancer

non small cell lung cancer

27
Q

3 subtypes of non small cell lung cancer

A
  • squamous cell lung cancer
  • adenocarcinoma
  • large cell lung cancer
28
Q

features of small cell lung cancer (15% cancers)

A
  • central
  • smoking related
  • rapid growth
  • arise from APUD cells
  • associated with ectopic secretion
29
Q

features of squamous cell carcinoma

A
  • centrally located
  • symptoms develop early
  • smoking related
30
Q

features of adenocarcinoma

A
  • peripheral
  • most common type in non smokers
  • slower growth
  • metastasise early
  • can respond to newer agents such as tyrosine kinase inhibitors
31
Q

features of large cell carcinoma

A
  • typically peripheral

- may secrete b-hcg

32
Q

investigations when suspecting lung cancer

A
  • fbc
  • renal function
  • bone profile
  • liver function
  • ct scan
  • pulmonary function tests
  • bronchoscopy + biopsy
  • PETCT
33
Q

causes of lung collapse

A

COPD, CF, pneumonia

34
Q

location of chest drain for tension pneumothorax

A

mid axillary 5th intercostal space

35
Q

what does a PET CT show

A

metabolically active tumours

36
Q

what is a unilateral pleural effusion caused by until proven otherwise

A

lung cancer

37
Q

2 causes of lower lobe collapse

A

cancer, mucus plug

38
Q

M1a

A

malignant effusion or separate tumour nodule

39
Q

M1b

A

distant metastases

Oncology RIA (7 decks)

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