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21 Cards in this Set
- Front
- Back
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Is any particular racial group more likely to get lung cancer? to die from it?
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AA men, both.
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WIll a family history of lung cancer increase risk even w/o smoking?
Are the following, or are they not risk factors for lung cancer: Smoking Previous tobacco related cancer occupational exposures COPD Gender If you quit smoking, will your lung cancer risk ever drop back to normal? |
yes, 2-3 fold in both smokers and non.
No. |
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Does smoking cessation slow the decline in PFT seen in chronic smokers?
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Yes.
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Does having a male or female relative with lung cancer raise your risk more? What is the increase in risk if you have a parent or a sibling w/ lung cancer?
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female (mother or sister).
30% |
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Genomic variation in particular regions on Crm ___ increase risk of lung cancer development.
1 copy of the gene? 2? |
15
30%, 80% |
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Non-small cell lung cancers account for what percentage of total lung cancers? of the NSCLCs, which is the most prevalent?
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85%; Adenocarcinoma.
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Bronchioloalveolar carcinoma is more common in which sex?
Smokers or non? Sx? CXR? |
women
non Cough and cronchorrhea (frothy sputum production) Variable: can be solitary , mutliple, bilateral, etc. |
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Which cancer arises:
- exclusively in smokers - generally in the proximal airways - may cause obstruction of the airway --> distal atelectasis (collapse) - may cause post obstructive pneumonia - may cavitate - Hypercalcemia (weakness, dehydration, mental changes) - clubbing |
squamous cell carcinoma
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Which cancer:
- exclusively in smokers - bronchial wall, generally - bulky central tumor w/ extensive mediastinal lymph node involvement - rapid growth & distant mets - paraneoplastic sx (especially \Na b/c of ADH secretion) |
small cell lung cancer
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Peripheral neuropathy
cushing syndrome SIADH Anorexia wt loss (cytokine mediated) Lamber-Eaton ...all suggest which lung cancer? hypercalcemia HPPO Clubbing ...? |
SCLC
NSCLC |
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Which lung cancer:
- may arise in area of previous scarring - peripheral - both smokers and non - more likely to spread to lymph nodes and other places - HPO (hypertrophic osteoarthropathy) or clubbing may be present |
adenocarcinoma
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Does a negative sputum cytology exclude cancer?
Which type of lesions is this analysis method best for? What types of lesions is Bronchoscopy best for? Dx yield? |
No
central, endobronchial lesions --> especially if pt has hemoptysis central, endobronchial lesions High |
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What types of lesions are best biopsied by transthoracic needle biopsy? Are neg results reliable?
When in a thoracentesis useful for lung cancer dx? |
peripheral lesions; performed under CT guidance.
- only if a another etioligy is dx'ed with the sample. pleurall effusions: will be either malignant or paramalignant (exudative but neg cancer cytology). |
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How is staging for NSCLC done?
What stage do most NSCLC present in? |
TNM (size/location/effusion; spread to adjacent structures/lymph; distant mets)
Stage IV |
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Is the TNM system useful for prog in SCLC?
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no.
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What is the convention used for SCLC staging?
Which is most prevelant @ presentation? |
limited stage vs extensive disease
- limited: dz confined to hemithorax, encompassed in one radiation port - extensive: tumor beyond a Xrt port, including malignant pleural effusion. 60% extensive. |
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Stage I and Stage II are classed as what in NSCLC?
IIIa and IIIb (no malig effusion)? IIIb (m.effus), stage IV? |
Early stage disease
Locally advanced dz Advanced dz |
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What is the tx for early stage NSCLC?
Locally advanced NSCLC? Advanced? |
Surgical resection; adjuvant chemo (chemo before surgery), NO data supports Xrt
Chemo --> surgery; chemo + Xrt --essentially, combo therapies. Incurable; Platinum based tx can prolong life, ^QoL Chemo is cost-effective |
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Advanced NSCLC... what should be used along with platinums? (1st line) In the elderly?
2nd line? 3rd? |
bevacizumab
Cb-based doublets pemetrexed, Erlotinib Erlotinib |
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Does SCLC respond to Chemo and Xrt?
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yes, but it is refractory.
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What kind of imaging is used for Lung Cancer screening? Lower limit of nodule detection size in mm?
Does LDCT detect more cancers than CXR? Are there lots of false positives? false negatives? Does early detection --> decreased mortality? Is this justified for wide, population use? |
Low-dose spiral CT (LDCT)
2-3mm Yes. Yes. (98%) Yes (26%) No. No. |
