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22 Cards in this Set
- Front
- Back
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T/F Lung cancer is the leading cause of death in the US in men & women |
true
5 yr survival only 15% |
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Lung cancer commonly metastasizes to _________ |
BLAB Brain Liver Adrenal glands Bone |
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___________ is the leading cause of lung cancer |
smoking (90%)
(asbestos, radon (in miners), & COPD are risk factors) |
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Lung cancer does not show symptoms until late in the course. What are the 4 categories of symptoms? |
1. local tumor growth 2. invasion of adjacent structures 3. metastatic disease 4. paraneoplastic syndromes |
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List the symptoms caused by local tumor growth |
-new cough or change in chronic cough -hemoptysis -wheezing -pleural effusion |
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What is the most common presenting symptom of bronchogenic (lung) carcinoma? |
new cough or change in chronic cough |
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List symptoms caused be invasion of adjacent structures |
-chest pain -dyspnea -malignant pleural effusion -superior vena cava syndrome -horner's syndrome -pancoast syndrome |
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Describe symptoms, diagnosis, & treatment of superior vena cava syndrome |
symptoms: facial & neck swelling due to blockage of the superior vena cava (by tumor or thrombosis)
diagnosis: CXR, venogram, & CT
treatment: chemo, radiation, diuretics, sterioids, anticoagulants, surgical removal |
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____________ causes unilateral facial hemi-anhidrosis, ptosis, & miosis due to disruption of cervical sympathetic nerves. |
Horner's syndrome
treat by erradicating cause
(may also cause hoarsness of recurrent laryngeal involved) |
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__________ may occur w/ Horner's syndrome, causes shoulder & arm pain, due to invasion of brachial plexus (& cervical sympathetics) |
Pancoast syndrome
--> malignant neoplasm of superior sulcus of lung |
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What is paraneoplastic syndrome? |
neurological symptoms triggered by a persons immune response to cancer or tumor, symptoms usually occur before diagnosis of cancer |
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Symptoms of Metastatic Disease.
Which of these is ALWAYS a clue for cancer? |
-cervical & supraclavicular lymphadenopathy -lesions in brain, liver, adrenal, bone (BLAB, esp in smokers) -weight loss * = ALWAYS a clue for cancer |
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Paraneoplastic syndrome is treated by treating the cancer & ___________ |
decreaseing the autoimmune response (steroids, immunoglobulin, radiation, & plasmapheresis= remove Ab from plasma) |
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what findings on physical exam would alert you to lung cancer? |
lymph node enlargment* crackles, wheezes, dullness on percussion |
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Q: 58 yr M w/ blurry vision. Right side of face perspires less than left, R upper eyelid droop, R pupillary constriction & large R cervical lymph node. No confusion or arm/leg weakness. Differential diagnosis? |
Horner's syndrome |
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Most cases of lung cancer are do to _________, which has a better prognosis than other kinds |
NSCLC (non-small cell), specifically adenocarcinomas & squamous cell cancer |
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What is the most fatal kind of bronchogenic carcinoma? Why? |
small-cell carcinoma
metastasize rapidly, most pt present w/ metastatic disease at time of presentation, & often associated w/ paraneoplastic syndromes
w/o tx (chemo) median survival < 5 mnths
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How is lung cancer diagnosed? |
chest x-ray Ct in pt w/ suspicious nodules PET scan sputum cytology pleural fluid cytology biopsy or aspiration of enlarged nodes bronchoscopy |
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Q: 48 yr F brought in for mental status eval. Pt suffered from recent memory loss & difficulty walking. No recent trauma, fevers, or arm/leg weakness. No family history of heart or brain disease. Personal history of breast cancer. Lab work & CT brain are normal. Differential diagnosis? |
A: Paraneoplastic syndrom |
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___________ is necessary to determine the best course of tx for lung cancer |
staging
(what stage, each has diff tx that is preferred) |
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What tx offers the best chance for cure for pt w/ stages I-IIIA lung CA? |
surgery |
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What is a solitary pulmonary nodule?
How are they treated? |
a spherical lesion less than 3 cm, usually found on CXR, 50% malignant
tx: surgical resection or needle aspiration |
