Term
| what does bronchogenic carcinoma mean? |
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Definition
| that the tumor originated in the lung |
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Term
| what is the leading cause of preventable death in the US? why is this? |
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Definition
| bronchogenic carcinoma (which is also the leading cause of cancer-related deaths in the world), mainly due to the fact that when this tumor is found, usually it is 85% through its life already b/c the lungs are very compliant and tumors take longer to make their presence known |
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Term
| how do smoking rates compare among men and women? |
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Definition
| men's smoking rates are decreasing, women's are still increasing slightly |
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Term
| is there a correlation between higher education and smoking? |
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Definition
| yes, people with higher educational degrees are generally less likely to smoke |
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Term
| are rates of bronchogenic carcinoma higher among african americans? |
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Definition
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Term
| what kind of bronchogenic carcinoma do women tend to get more than men? |
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Definition
| adenocarcinoma. they are also younger when they present |
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Term
| what is the 5 year survival rate for pts with bronchogenic carcinoma? |
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Definition
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Term
| what age group is predominately affected by bronchogenic carcinoma? |
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Definition
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Term
| who are the pts with bronchogenic carcinoma that tend to have a better prognosis? |
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Definition
| pts whose bronchogenic carcinoma was found by accident (CT scan for something else, etc), and were not presenting with respiratory symptoms yet |
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Term
| can cured meat/deep-fried food/chili increase risk of bronchogenic carcinoma w/smoking? |
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Definition
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Term
| what occupational exposures are correlated with a higher bronchogenic carcinoma risk? |
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Definition
| crystalline silica, asbestos and nuclear power plant workers |
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Term
| what genetic mutations are associated with a higher risk of bronchogenic carcinoma? |
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Definition
| there is a marker on chr 15 which codes for subunits of nicotinic ACh receptors if found w/1 copy in a pt: 30% higher risk of lung CA, and w/2 copies: 70-805 increased risk of lung CA |
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Term
| what is the number one malignancy associated with asbestos? |
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Definition
| not mesothelioma, but bronchogenic carcinoma b/c mesotheliomas on their own are rare - but asbestos exposure+smoking is a multiplicative risk for bronchogenic carcinoma |
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Term
| what are protective anti-bronchogenic carcinoma factors? |
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Definition
| *moderate to high level of physical activity*, vit C (not vit A), lutein, lycopene, alpha-carotene, and the risk/benefit of carotenoids is ambiguous |
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Term
| what are symptoms for endobronchial bronchogenic carcinoma? |
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Definition
| cough, hemoptysis, and *post obstructive pneumonia |
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Term
| what are the symptoms for pleural bronchogenic carcinoma? |
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Definition
| chest pain (the lung has no pain fibers - just the pleura), dyspnea, and cough |
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Term
| what are the symptoms for mediastinal bronchogenic carcinoma? |
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Definition
| dyspnea, palpitations, hoarseness (recurrent laryngeal), dysphagia, and stridor |
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Term
| what are the symptoms for metastatic bronchogenic carcinoma (usually bone or head)? |
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Definition
| weight loss, seizures, ataxia, headache, and altered mental status |
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Term
| what are the signs of a bronchogenic carcinoma? |
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Definition
| asymmetric breath sounds/increased work of breathing, evidence of pleural effusion, rales suggesting a pneumonitis, adenoparhy, clubbing (190 degrees+), dilated neck veins/upper extremity+facial edema/facial cyanosis(SVC syndrome) |
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Term
| what are paraneoplastic syndromes associated with bronchogenic carcinomas? |
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Definition
| eaton-lambert syndrome (proximal muscle weakness which improves w/repetition, worse in the morning - exact opposite of myasthenia gravis), hypercalcemia, syndrome of inappropriate ADH, hypertrophic osteoarthropathy (painful/swollen joints), and migratory thrombophlebitis |
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Term
| what is the most common bronchogenic carcinoma? |
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Definition
| adenocarcinoma in both men and women, followed by squamous cell and then large cell and small cell in men, (only difference w/women: get large cell less often than small cell) |
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Term
| what characterizes adenocarcinomas? |
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Definition
| adenocarcinomas can be acinar, papillary, solid, or bronchoalveolar. their incidence has significantly increases in the last 2 years, they are more common in women and >75% are found in smokers. they tend to be *more peripheral, grow slower and metastasize earlier. |
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Term
| what is still the classic lung CA type associated with smokers? |
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Definition
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Term
| who is squamous cell seen in more often? where is it seen arising in the lung? |
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Definition
| squamous cell carcinoma is seen more often in men who are smokers (98%), and is usually seen arising from the central/proximal airway - though the incidence of peripheral squamous is increasing |
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Term
| what characterizes small cell lung CA? |
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Definition
| small cell (oat cell) is the *most aggressive of the lung tumors, it *metastasizes widely and early. small cell lung CA is virtually incurable by sx (but responds well to chemo), is commonly a central (proximal) mass, and is associated with smoking (>98%) |
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Term
| what characterizes large cell CA? |
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Definition
| large cell CA is probably either squamous or adenocarcinoma that is so *undifferentiated that it can no longer be recognized |
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Term
| what is the treatment regiment for small cell lung CA? |
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Definition
| very aggressive w/early mets, so sx is usually not considered. SCLC initially response well to chemo/radiation and survival does not follow TNM staging |
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Term
| what is the tx for non small cell lung CA? |
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Definition
| survival for NSCLC (large, adenocarcinoma, squamous) is related to staging and sx should always be considered except for IIIb or IV |
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Term
| what is the difference between resectability and operability? (*exam question*) |
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Definition
| *resectability has to do w/cell type and lung stage based on TNM classification. *operability has to do w/overall health+wellness (age, heart condition, BP, PFT, renal status, and nutritional status). you need both to go to the OR |
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Term
| all spots on the CXR are not: |
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Definition
| CA, a bx is necessary to dx |
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Term
| what are the lung CA bx modalities? |
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Definition
| fine needle aspiration (FNA - "tumor juice" used w/CT scan), bronchoscopy (good for proximal lesions), mediastinoscopy, video assisted thorascopic sx (VATS - gives you a chunk), and open thoracotomy |
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