PULMONARY NEOPLASMS QUESTIONS AND ANSWERS A+
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What is the most common symptom of lung cancer?
Cough
Hemopytsis-other
What are the ssx for lung cancer?
HINT: BREATHE
Blood
Recurring respiratory infections
Enduring cough that is new or different
Aches or pains in shoulder, back, chest
Trouble breathing
Hoarseness or wheezing
Exhaustion, weakness or loss of appetite
What is the largest risk factor for lung cancer?
Smoking-those who have smoked a long time (dose dependent relationship)
80-90% of cases are associated with lung cancer
What is the second leading risk factor for smoking?
Radon exposure
How are high risk invidividuals defined for lung cancer?
50-80 years with > 20 pack a year hx-->quit within the last 15 years or is a current
smoker
Those with a moderate to high suspicion for lung cancer should have what
imaging done even if CXR is normal?
CT scan
If new nodules are found on x-rays by incidental findings, what is required to get
next?
CT scan
May need biopsy
How do we define pulmonary nodules?
Lesion lesion than 3cm in diameter
-will be gray circular
-calcified will be whiter
What is considered a mass in the lungs?
Lesion greater than 3cm
What is the most common cause of solitary pulmonary nodules?
Healed infectious granuloma
Fungal infections can cause this
When are SPN most likely benign?
, Less than 1cm
Stable (not changing over time)
Has no smoking hx
Young in age
Has known prior TB or fungal infx
Asymptomatic
Calcified
rough with regular borders
What is the workup for solitary pulmonary lesions?
Thorough patient hx
Comparison of old chest imaging-if available
CT scan for new or changing lesions
Biopsy
When is it recommended to stop imaging for a lesion?
If lesion is small and stable over 2 years
What two groups are lung cancers divided into?
Small cell lung cancer
Non-small cell lung cancer
Non-small cell lung cancer is divided into 3 subtype groups?
Adenocarcinoma
Squamous cell carcinoma
Large Cell carcinoma
What type of lung cancer is more aggressive?
small cell lung cancer
What is the prognosis for small cell lung cancer?
under 18 months
Centrally located-often multiple tumors which eliminates surgical options
Neuroendocrine tumor and is associated with several paraneoplastic syndromes
What is the treatment for small cell lung cancer?
Chemotherapy
What are the paraneoplastic syndromes associated with SCLC?
Lambert-eaton
SIADH (syndrome of inappropriate antidiuretic hormone
SVC syndrome (superior vena cava syndrome)
What is the consequences of Lambert-Eaton syndrome?
Leads to decreased release of ACH-needed for muscle contraction
Does lambert-eaton improve with exercise?
Yes
What happens in SIADH?
Retains water-tumor from SCLC release ADH
Leads to hyponatremia
What is the tx for SIADH?
Restrict fluids
Increase salt
GRADED .Buy Quality Materials!
What is the most common symptom of lung cancer?
Cough
Hemopytsis-other
What are the ssx for lung cancer?
HINT: BREATHE
Blood
Recurring respiratory infections
Enduring cough that is new or different
Aches or pains in shoulder, back, chest
Trouble breathing
Hoarseness or wheezing
Exhaustion, weakness or loss of appetite
What is the largest risk factor for lung cancer?
Smoking-those who have smoked a long time (dose dependent relationship)
80-90% of cases are associated with lung cancer
What is the second leading risk factor for smoking?
Radon exposure
How are high risk invidividuals defined for lung cancer?
50-80 years with > 20 pack a year hx-->quit within the last 15 years or is a current
smoker
Those with a moderate to high suspicion for lung cancer should have what
imaging done even if CXR is normal?
CT scan
If new nodules are found on x-rays by incidental findings, what is required to get
next?
CT scan
May need biopsy
How do we define pulmonary nodules?
Lesion lesion than 3cm in diameter
-will be gray circular
-calcified will be whiter
What is considered a mass in the lungs?
Lesion greater than 3cm
What is the most common cause of solitary pulmonary nodules?
Healed infectious granuloma
Fungal infections can cause this
When are SPN most likely benign?
, Less than 1cm
Stable (not changing over time)
Has no smoking hx
Young in age
Has known prior TB or fungal infx
Asymptomatic
Calcified
rough with regular borders
What is the workup for solitary pulmonary lesions?
Thorough patient hx
Comparison of old chest imaging-if available
CT scan for new or changing lesions
Biopsy
When is it recommended to stop imaging for a lesion?
If lesion is small and stable over 2 years
What two groups are lung cancers divided into?
Small cell lung cancer
Non-small cell lung cancer
Non-small cell lung cancer is divided into 3 subtype groups?
Adenocarcinoma
Squamous cell carcinoma
Large Cell carcinoma
What type of lung cancer is more aggressive?
small cell lung cancer
What is the prognosis for small cell lung cancer?
under 18 months
Centrally located-often multiple tumors which eliminates surgical options
Neuroendocrine tumor and is associated with several paraneoplastic syndromes
What is the treatment for small cell lung cancer?
Chemotherapy
What are the paraneoplastic syndromes associated with SCLC?
Lambert-eaton
SIADH (syndrome of inappropriate antidiuretic hormone
SVC syndrome (superior vena cava syndrome)
What is the consequences of Lambert-Eaton syndrome?
Leads to decreased release of ACH-needed for muscle contraction
Does lambert-eaton improve with exercise?
Yes
What happens in SIADH?
Retains water-tumor from SCLC release ADH
Leads to hyponatremia
What is the tx for SIADH?
Restrict fluids
Increase salt
