Surgery Pulmonary Nodules
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| 5-yr survival of lung cancer | 14% (colon-63%, breast-85%, Prostate - 93%)
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| Most important risk factors for lung cancer | smoking, family hx, increasing age, COPD, asbestos exposure, ionizing radiation (indoor radon gas, therapeutic radiation)
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| ________ 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
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| ________ accounts for more than 80% of total cases of lung cancer | non-small cell lung cancer. Squamous, adenocarcinoma, carcinoid, large cell, other
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| Most serious Lung Cancer | adenocarcinoma
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| _______ is usually a central lesion, accounts for approximately half of the non-small cell cases | Squamous cell carcinoma
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| ______ accounts for approximately half of the total cases of non-small cell lung cancer. | Adenocarcinoma
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| _________ is usually associated with more peripheral lesions | Adenocarcinoma
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| N3 node is located | Contralateral to tumor
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| Approximately ____ of patients with lung cancer present to their PCPs wtih stage III or IV dz | 2/3. Lungs don't have nerve endings.
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| Most frequent sx of lung cancer | cough, weight loss, dyspnea, chest pain, hemoptysis, bone pain, lymphadenopathy, hepatomegaly, clubbing, hoarseness, SVC syndrome
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| What is your first step when you are suspcious of lung cancer? | CXR
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| Calcified lesions are usually a sign of | prior infection. Non-calcified associated with malignancy
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| Does calicification show up on CXR? | Yes
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| Which test is used for information regarding lymph node status | CT
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| 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
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| In what order to you order scans for lung cancer? | CXR, CT, PET
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| Contrast or not contrast in brain CT? | Contrast is best. Next step is MRI
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| 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.
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| No smoking for at least ____ weeks prior to surgery | 2
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| FEV1, RV, DLCO reduced think | restrictive
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| FEV1, DLCO reduced but RV high think | Obstructive diseaes
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| Diffusion capacity of carbon dioxide across the alveolar capillary membrane | DLCO
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| 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
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| Stage IIIb and Stage IV | Chemotherapy and radiation. No indication for surgery
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