Lung Cancer: clinical features, staging and diagnosis Flashcards Preview

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Flashcards in Lung Cancer: clinical features, staging and diagnosis Deck (29)
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1
Q

Metastatic symptoms (4)

A

Bone pain
Spinal cord compression
Cerebral metastases
Thrombosis

2
Q

Paraneoplastic Symptoms (3)

A

Hyponatraemia
Anaemia
Hypercalcaemia

3
Q

Clinical signs

A
Chest signs
Clibbing
Lymphadenopathy
Horner's syndrome
Pancoast tumour
SVC obstruction
Hepatomegaly
Skin nodules
4
Q

What is horner’s syndrome

A

a condition marked by a contracted pupil, drooping upper eyelid, and local inability to sweat on one side of the face, caused by damage to sympathetic nerves on that side of the neck.

5
Q

What is a pancoast tumour

A

Tumour of the pulmonary apex

6
Q

Initial investigations done by GP

A
CXR
FBC
Renal, liver functions and calcium
Clotting screen
Spirometry
7
Q

Investigations- Tissue Diagnosis

A
Bronchoscopy
EBUS
Image guided lung/liver biopsy
FNA of neck node or skin metastases
Bone biopsy
Mediastinoscopy
Surgical excision biopsy
8
Q

Treatment

A

Surgery (wedge resection, lobectomy, pneumonectomy)
Radiotherapy (radical or palliative or stereoactive)
Chemotherapy
Targeted agents

9
Q

What are examples of target agents

A

Tyrosine kinase inhibitors and monoclonal antibodies (erlotinib, geftinib and crizotinib)

10
Q

Small cell carcinoma treatment

A

Cisplatin/etoposide

11
Q

Adenocarcinoma treatment

A

Cisplatin/pemetrexed

12
Q

Squamous cell carcinoma treatment

A

Cisplatin/gemcitabine

13
Q

TNM

A

T: how big it is and the spread
N: Lymph node involvement
M: Metastases

14
Q

What can be used to investigate T

A

CT
PET-CT
Bronchoscopy

15
Q

What can be used to investigate N

A

PET-CT
Mediastinoscopy
CT
EBUS/EUS

16
Q

What can be used to investigate M

A

PET-CT
CT
Bone scan

17
Q

What is the half life post injection of FDG in PET scan

A

60 minutes

18
Q

Tx/T0/Tis

A

Primary tumour can’t be assessed
No evidence of primary tumour
Carcinoma in situ

19
Q

T1

A

< or equal to 3cm in dimension

20
Q

T2

A

Tumour is between 3-5cm and involves main bronchos but not carina and invades visceral pleura

21
Q

T3

A

Tumour between 5-7cm and invades chest wall, phrenic nerve

22
Q

T4

A
Tumour greater then 7cm and invades:
Diaphragm
Mediatinum
Heart
Great vessels
Trachea
Recurrent laryngeal nerve
Oesophagus
Vertebral body
Carina
23
Q

N0

A

No regional LN metastases

24
Q

N1

A

Ipsilateral peribronchial, hilar or intrapulmonary nodes

25
Q

N2

A

Ipsilateral mediastinal, subcarinal

26
Q

N3

A

Contralateral mediastinal, contralateral hilar, scalene, supraclavicular

27
Q

M0

A

No distant metastasis

28
Q

M1

A

Distant metastases

29
Q

PET/CT staging

A

Performs whole body staging