Term
| most common cause of lung ca |
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Definition
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Term
| large central tumor (may obstruct). pnp syndrome=hypercalcemia |
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Definition
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Term
| peripheral tumor, most associated w/smoking but higher percent non-smokers than other lung tumors. radon exposure |
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Definition
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Term
| *large amts of mucoid secretions* (boards), may be multifocal |
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Definition
| bronchoalveolar subtype of adenocarcinoma |
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Term
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Definition
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Term
| affect of screening test on lung ca mortality |
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Definition
| no reduction in mortality- cxr sputum cytology, or ct. recommendations often change |
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Term
| bronchogenic carcinoma arise from |
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Definition
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Term
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Definition
| no 1, more than colorectal, breast, prostate combined. declining in men, rising in women |
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Term
| 1 ppd 40 yrs increases risk how much. stop, 15 years later risk is what. |
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Definition
| 20x. 2x. 90% lung ca associated w/smoking |
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Term
| female non-smoker- what kind of lung ca |
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Definition
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Term
| arises from neuroendocrine cells. may be small primary w/prominent adeonpathy. may be bulky primary. often metastasizes early. what are the pnp sx? |
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Definition
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Term
| BQ?: How do most pts w/ primary lung ca present at dx? secondary lung ca? |
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Definition
| primary: most pts symptomatic. anorexia, weight loss, or asthenia occus in 55-90% of cases. up to 60% have new cough/change in chronic coug. Less than 1/2 have hemoptysis, pain, or pleural effusion or pnp sx. secondary: sx are uncommon but include cough hemoptysis dyspnea and hypoxemia. sx are more often referable to the site of the primary tumor. |
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Term
| BQ: what is the most important imaging modality for staging nsclc pts for resection? |
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Definition
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Term
| BQ: what do all nsclc pts considered for surgery require? |
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Definition
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Term
| BQ: How do mets to the lung typically occur and present? |
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Definition
| usually occur via pulmonary a and typically present as multiple nodules or masses on cxr |
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Term
| BQ: Where in the lung are most mets to the lung found? |
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Definition
| most are intraparenchymal |
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Term
| BQ: what are the most likely primary tumors that met to lungs? |
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Definition
| breast, kidney, colon, cervix |
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Term
| BQ: how is the dx of secondary lung ca most often established? |
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Definition
| identifying primary tumor |
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Term
| BQ: are nodules in mets to lungs most often: large or small, unilateral or bilateral, pleural subpleural or alveolar, and in upper middle or lower lungs? |
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Definition
| nearly all are less than 5 cm, usually bilateral, pleural or subpleural, and more common in lower lung zones. |
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Term
| How is prognosis different w/tumors closer or further from carina? |
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Definition
| closer to carina, harder to resect |
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Term
| Why might the diaphragm be elevated in ca? |
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Definition
| whack the phrenic n, raised diaphragm |
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Term
| What is the most common sx of lung ca? |
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Definition
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Term
| What type of ca is suggested by lg amts of clear mucoid sputum? |
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Definition
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Term
| why might lung ca present w/hoarseness? |
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Definition
| recurrent laryngeal n involved |
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Term
| Pt presents w/cough, hemoptysis, chest pain, dyspnea, hoarseness, weight loss, anorexia, asthenia (loss of physical strength), and pleural effusion. What leads your d/d? |
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Definition
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Term
| Pt presents w/dilated neck vv, facial edema, prominent vv in arms and torso. What do you suspect? |
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Definition
| superior vena cava syndrome, more common in scls than nsclc |
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Term
| What type of lung ca is located in the superior sulcus, is more commonly present in nsclc, and presents w/pain in shoulder and arm and horners sx? |
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Definition
| pancoast tumor. horners: ptosis, miosis, anhydrosis |
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Term
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Definition
| liver bone adrenal brain: BLAB. |
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Term
| What pnp sx of lung ca is like myasthenia in that the pt gets weaker as the day goes on? |
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Definition
| neurologic: lambert-eaton |
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Term
| What are 2 pnp sx from lung ca that involve the blood? |
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Definition
| anemia, hypercoaguable states |
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Term
| What pnp sxs from lung "disease of muscle featuring inflammation of the muscle fibers" and/or skin? |
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Definition
| polymositis, dermatomyositis |
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Term
| What pnp from lung ca involves cortisol? |
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Definition
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Term
| What pnp sx from lung ca involves bone? |
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Definition
| hypertrophic osteoarthropathy, hypercalcemia due to PTHrP |
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Term
| What pnp sx from lung ca involves changes in fluid retention? |
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Definition
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Term
| What lung ca sequelae involves the hands? |
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Definition
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Term
| Pt w/copd develops hemoptysis and weight loss. How do you proceed? |
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Definition
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Term
| What "scopy" methods are useful for tissue dx in lung ca? what are some needle methods? what is another method? |
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Definition
| bronchoscopy, mediastinoscopy, thoracoscopy. needle aspiration of palpable lesion, thoracentesis. image guided sampling |
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Term
| What is an image guided method for tissue sampling and what is its risk? |
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Definition
| ct dir bx. pneumothorax and bleeding |
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Term
| what should be asked for tx localized nsclc? how should locally advanced or mets be tx? how is chemo used? |
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Definition
| is it resectable? can pt tolerate sx? team approach, palliation. no terribly effective chemo at this time |
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Term
| How is a preop eval done? |
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Definition
| can pt tolerate pneumonectomy? pfts, exercise testing |
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Term
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Definition
| localized may be resected, usually needs chemo |
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Term
| How advanced is sclc generally at time of dx? how does it respond to chemo? what is the reported range of median survival for ls-sclc and es-sclc? |
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Definition
| often met at time of dx. responds to chemo fro 6-8 mos then recurs. survival at recurrence 4 mos. from time of dx, median survival for ls-sclc is 14-20 mos. es-sclc 8-13 mos. |
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Term
| What are 2 platinum comp's for tx sclc? |
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Definition
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Term
| What are 2 podophyllotoxins for tx sclc? |
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Definition
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Term
| What are 2 camptothecins for tx sclc? |
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Definition
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Term
| What are 2 alkylating agents for tx sclc? |
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Definition
| ifosfamide, cyclophosphamide |
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Term
| What are 2 anthracyclines for tx sclc? |
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Definition
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Term
| What are 2 taxanes for tx sclc? |
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Definition
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Term
| What is a mitotic inhibitor for sclc? |
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Definition
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Term
| What are neuroendocrine tumors that arise from various other sites in body? what percent of lung malignancies in adults are caused by this and what is the incidence per 100,000 population? |
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Definition
| pulmonary carcinoid tumor. 1-2% of lung malignancies in adults. incidence 0.2-2 per 100,000 |
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Term
| What is the most common primary lung neoplasm in children, mostly late teens? |
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Definition
| pulmonary carcinoid tumor |
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Term
| Are carcinoids typical or atypical? what is the average age at presentation |
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Definition
| may be typical(ave age 45yo) or atypical (ave age 55yo) |
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Term
| In what part of the lungs do most pulmonary carcinoids arise? |
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Definition
| 3/4 proximal bronchi, 1/4 peripheral |
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Term
| What is the association btwn carcinoids and genetics and smoking? |
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Definition
| slight association w/smoking but not enough for cause/effect. some familial sx |
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Term
| Pt presents w/cough, obstruction, hemoptysis, focal wheezing, recurrent infections. What might the pt have? |
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Definition
| carcinoid tumor- proximal. peripheral tumors are usually asymptomatic |
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Term
| How common is carcinoid sx in pulmonary lesions? if it is present, usually how large, and what is usually involved? |
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Definition
| rare-1-5%. if present, primary usually >5cm and/or liver involvement. |
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Term
| Pt presents w/cough, obstruction, hemoptysis, focal wheezing, recurrent infections, flushing, diarrhea, and right sided heart disease |
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Definition
| carcinoid disease, proximal bronchi tumor. most peripheral tumors asymptomatic |
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Term
| is cushings syndrome seen more often in small or large carcinoid tumors? |
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Definition
| more often in small tumors |
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Term
| if tissue's the issue, what's the answer? |
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Definition
| if tissue's the issue, ca's the answer: must determine cell type |
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Term
| What lung ca sequelae presents w/flushing, wheezing diarrhea? |
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Definition
| right sided heart diesease |
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Term
| How should you NOT confirm dx for carcinoid? |
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Definition
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Term
| What can met to lungs from "you name it- breast, colon, renal cell, etc"? |
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Definition
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Term
| What does sarcomas met to lungs include? |
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Definition
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Term
| What met to lungs is called the great mimicker? |
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Definition
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Term
| What pulmonary met comes from cells that "normally occur inside the gonads (ovary and testis)"? |
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Definition
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Term
| What pulmonary met comes from the circulatory system? |
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Definition
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Term
| What met to lungs is esp known to spread lymphangitically? |
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Definition
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Term
| Which part of lungs is often involved w/mets to lungs? |
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Definition
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Term
| how can mets to lungs be tx? |
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Definition
| some resected, also chemo/xrt |
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Term
| What is aka "coin lesion" found incidentally on xray? what is the first question you ask? |
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Definition
| solitary pulmonary nodule, ask: "when was your last xray and how do we get it?" |
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Term
| What are neoplastic lung tumors? |
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Definition
| hamartoma, rare pulmonary tumors |
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Term
| What lung tumor is nml tissue that forms a mass- fat, cartilage, mm, myxomatous tissue? |
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Definition
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Term
| BQ: what are most benign nodules in lung? |
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Definition
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Term
| BQ: what is important in determining malignancy of lung tumors? |
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Definition
| age. malignant nodules rare in pts under 30. over 30 likelihood increases w/age. |
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Term
| BQ: in which compartment are most mediastinal masses located? |
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Definition
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Term
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Definition
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Term
| are pancoast tumors more common in sclc or nsclc? |
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Definition
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Term
| pt presents w/drooping right eyelid, right pupil constriction, and lack of perspiration on right side of face. what type of lung tumor is most likely? |
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Definition
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Term
| hypercalcemia occurs w/what lung tumor? |
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Definition
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