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Surg Pulm Nodules

Surgery Pulmonary Nodules

QuestionAnswer
5-yr survival of lung cancer 14% (colon-63%, breast-85%, Prostate - 93%)
Most important risk factors for lung cancer smoking, family hx, increasing age, COPD, asbestos exposure, ionizing radiation (indoor radon gas, therapeutic radiation)
________ lung cancer most frequently presents as a systemic dz small cell. Brain and bone mets. NOT SURGICALLY TREATED. Limited dz is treated with combination chemotherapy and radiation. Less than 20% of new cases
________ accounts for more than 80% of total cases of lung cancer non-small cell lung cancer. Squamous, adenocarcinoma, carcinoid, large cell, other
Most serious Lung Cancer adenocarcinoma
_______ is usually a central lesion, accounts for approximately half of the non-small cell cases Squamous cell carcinoma
______ accounts for approximately half of the total cases of non-small cell lung cancer. Adenocarcinoma
_________ is usually associated with more peripheral lesions Adenocarcinoma
N3 node is located Contralateral to tumor
Approximately ____ of patients with lung cancer present to their PCPs wtih stage III or IV dz 2/3. Lungs don't have nerve endings.
Most frequent sx of lung cancer cough, weight loss, dyspnea, chest pain, hemoptysis, bone pain, lymphadenopathy, hepatomegaly, clubbing, hoarseness, SVC syndrome
What is your first step when you are suspcious of lung cancer? CXR
Calcified lesions are usually a sign of prior infection. Non-calcified associated with malignancy
Does calicification show up on CXR? Yes
Which test is used for information regarding lymph node status CT
PET is what kind of scan? metabolic not anatomic; helpful in making a diagnosis of lung cancer. demonstrates uptake in reactive lymph nodes. Provides excellent metastatic survey. Must be read with a CT. Resolution is limited to findings >1cm
In what order to you order scans for lung cancer? CXR, CT, PET
Contrast or not contrast in brain CT? Contrast is best. Next step is MRI
The standard on which lymph node status is based Cervical Mediastinoscopy, can be performed at the time of planned resection, usually last step to determine stage.
No smoking for at least ____ weeks prior to surgery 2
FEV1, RV, DLCO reduced think restrictive
FEV1, DLCO reduced but RV high think Obstructive diseaes
Diffusion capacity of carbon dioxide across the alveolar capillary membrane DLCO
is performed after patient has been proven to be a candidate for surgical biopsy or resection based on node and metastasis status Thoracoscopy (VATS). Facilitates minimally invasive approach for diagnosis and resection
Stage IIIb and Stage IV Chemotherapy and radiation. No indication for surgery
Created by: ltm12
 

 



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