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PtWithCancer
lecture 7 hughes
| Question | Answer |
|---|---|
| sx of lymphoma | night sweats, weight loss, fever without obvious infection |
| general sx suggestive of ca | unusual fatigue, obvious loss of appetite, loss of taste for food |
| ways malignancy can produce sx | 1) direct mass effect with or without invasion // 2) metabolic derangement, release of hormones or other biologically active agents (paraneoplastic syndrome) |
| SVC syndrome usually secondary to lung ca, lymphoma or breast ca | obstruction of SVC leads to collateral venous formation (azygous, internal mammary), thoracic and chest wall veins affected. sx: dyspnea, facial/arm swelling, cough, cyanosis |
| Horner's syndrome | usually seen with high apical tumors of the lung that obliterate sympathetics traveling up towards head. sx: classic triad of miosis, anhidrosis and mild ptosis |
| hypocalcemia as metabolic derangement secondary to ca | Ca levels drop due to tumor lysis syndrome and release of massive amts of phosphate into blood, which sinks serum Ca levels |
| #1 metabolic emergency in ca pts | hypercalcemia, pattern of hyperthyroidism with increased serum Ca, decreased serum phosphate and increased urinary cAMP |
| humoral hypercalcemia of malignancy (non-small cell lung, breast, head/neck) | primary tumor produces hormones released into circulation, causes indirect release of Ca from bone |
| PTH-RP | parathyroid hormone-related protein that is released by ca cells, most common paraneoplastic cause of hypercalcemia |
| cytokines released with myeloma that cause local osteolytic hypercalcemia | IL-1 and IL-6 |
| dermatomyositis (inflammatory neuropathy) | causes proximal muscle weakness, is diagnosed by electromyogram or nerve conduction studies, associated 10% of time with breast or lung malignancies |
| 2 pathognomic physical exam findings of dermatomyositis pt | heliotrope rash = violaceous erythema of eyelids; Gottron's papules = telangiectasis on knuckles |
| Eaton-Lambert syndrome | 60% of time caused by small lung ca, proximal muscle weakness like myasthenia, Ab to presynaptic Ca channels blocks ACh release, improvement with repeated contraction |
| stains to be used to highlight glycogen, catecholamines, glandular differentiation in adenocarcinomas | PAS stain, silver stain, mucin stain |
| keratin | epithelial origin (carcinoma) |
| vimentin | mesenchymal origin (fibroma, sarcoma) |
| LCA | leukocyte common Ag, specific for leukocytes |
| UCHL1 | specific marker for T cells |
| L-26 | specific marker for B-cells |
| CEA | carcinoembryonic Ag, specific for most adenocarcinomas |
| HCG, AFP | specific for germ cell tumors |
Created by:
sirprakes
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