Pathology, principles, resp, cardio, GI. Flashcards

1
Q

What are local effects of lung cancer?

A

Airway obstruction - pneumonia.
Chest wall invasion - pain.
Ulceration - haemoptysis.

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2
Q

What does PTH suggest in regards to lung cancer?

A

Squamous cell lung cancer.

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3
Q

What does ACHT suggest in regards to lung cancer?

A

Small cell lung cancer.

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4
Q

What are the 4 common smoking-associated types of lung tumour?

A
  1. Adenocarcinoma.
  2. Squamous cell carcinoma.
  3. Small cell carcinoma.
  4. Large cell carcinoma.
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5
Q

How may histological diagnosis of lung cancer be made?

A

Bronchoscopy and biopsy of tumour.

Biopsy or needle aspiration of metastases.

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6
Q

Feature of squamous cell lung carcinoma?

A

Keratinising.

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7
Q

Feature of lung adenocarcinoma?

A

Gland forming, mucin production

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8
Q

Which type of lung cancer has the worst prognosis?

A

Small cell, almost all diagnosed are dead at one year.

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9
Q

Main treatment for small cell lung cancer?

A

Chemotherapy, but has shown rapidly emerging resistance.

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10
Q

What is the treatment of choice in non-small cell lung cancers?

A

Surgery.

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11
Q

Which oncogene do small cell and non-small cell lung cancer share?

A

myc.

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12
Q

what are typical bronchial (large airway tumours)?

A

Squamous cell carcinoma. Often dysplastic, or carcinoma in situ, eventually displaying invasive malignancy.

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13
Q

Describe peripheral adenocarcinomas.

A

Display atypical adenomatous hyperplasia, and spread of neoplastic cells along alveolar walls. They are true invasive adenocarcinomas, becoming more common.

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14
Q

What are prognostic indicators in lung cancer?

A

Tumour staging and histological subtype.

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15
Q

What are carcinoid lung neoplasms?

A

Neuroendocrine neoplasms of low-grade malignancy.

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16
Q

Define neoplasm.

A

New and abnormal growth. commonly referred to as a tumour.

17
Q

What is a lung abscess?

A

A localized collection of pus, tumour-like. Causes chronic malaise and fever. May result from aspiration.

18
Q

Pathogenesis of ARDS?

A

Injury (e.g. by bacterial endotoxin), causing infiltration of inflammatory cells, cytokines, oxygen free radicals and injury to cell membranes.
This results in a fibrinous exudate lining alveolar walls (hyaline membrane), cellular regeneration and inflammation.

19
Q

Define embolus.

A

Embolus is a mass (typically thrombus, but may be fat, foreign bodies, gas, tumour clumps), carried by the blood to a site in the body, distant of its origin.

20
Q

Virchow’s triad.

A
  1. Endothelial injury
  2. Hypercoagulability (cancer, post MI)
  3. Stasis of blood flow
21
Q

Pathology of pulmonary hypertension.

A

Hypoxia, increased flow through pulmonary circulation (congenital heart disease), blockage or loss of pulmonary vascular bed, back pressure from left-sided heart failure.

22
Q

Morphology of pulmonary hypertension.

A

Medial hypertrophy of arteries, intimal thickening (fibrosis), atheroma, RV hypertrophy, extreme cases (congenital heart disease, primary pulmonary hypertension).

23
Q

Purulent effusion.

A

Effusion filled with acute inflammatory cells, aka empyema. It may become chronic.

24
Q

Define pneumothorax.

A

Air in the pleural space, may occur due to trauma or rupture of bulla.

25
Q

Primary pleural neoplasia.

A

Most likely malignant mesothelioma, rarely benign.

26
Q

Secondary pleural neoplasia.

A

Common, e.g. adenocarcinomas of the lung.

27
Q

Mesothelioma.

A

Related to asbestos exposure, results in mixed epithelial/mesenchymal differentiation. Dismal prognosis.

28
Q

Acute anaphylaxis.

A

Type 1 hypersensitivity (IgE) reaction. Causes flushing, pruritis, urticarial, angioneurotic oedema, abdo. pain, vomiting, hypotension, shock, stridor, wheeze, respiratory failure.