Lung Cancer and Paraneoplastic Syndromes Quiz

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Questions and Answers

Which neurologic syndrome is characterized by proximal muscle weakness and autonomic dysfunction?

Guillain-Barré Syndrome

Eaton-Lambert Syndrome (correct)

Multiple Sclerosis

Paraneoplastic Cerebellar Degeneration

What is a common clinical manifestation associated with adenocarcinomas?

Osteoporosis

Hypertrophic Osteoarthropathy (correct)

Peripheral Neuropathy

Rheumatoid Arthritis

Which condition is indicative of a thrombotic or hematologic syndrome?

Chronic Kidney Disease

Systemic Lupus Erythematosus

Hyperthyroidism

Trousseau’s syndrome (correct)

Which rare manifestation may be associated with paraneoplastic syndromes?

Dermatomyositis Signup and view all the answers

Which symptom would most likely rule out Chronic Obstructive Pulmonary Disease (COPD)?

Progressive, non-malignant emphysema on imaging Signup and view all the answers

What is the estimated lifetime probability of developing lung cancer for males?

8% Signup and view all the answers

At what age does the rate of lung cancer diagnoses begin to increase significantly?

40 Signup and view all the answers

Which type of lung cancer is most commonly associated with smoking?

Small-cell carcinoma Signup and view all the answers

What is the effect of smoking cessation before middle age on lung cancer risk?

Reduces risk by 90% Signup and view all the answers

Which of the following is a common systemic symptom in lung cancer patients?

Anorexia Signup and view all the answers

Which syndrome is common in patients with small cell lung cancer and can be the first sign of recurrence?

Paraneoplastic syndrome Signup and view all the answers

Which of the following is the most common lung cancer in lifetime never smokers or former light smokers?

Adenocarcinoma Signup and view all the answers

What is the purpose of sputum cytology in lung cancer diagnosis?

To find cancer cells in mucus from the lungs. Signup and view all the answers

What is a significant consequence of late-stage diagnosis of lung cancer?

Higher mortality rate Signup and view all the answers

What is considered the gold standard for lung cancer diagnosis?

Biopsy of the tumor tissue. Signup and view all the answers

Which treatment is preferred for Stage I and II Non-Small-Cell Lung Cancer (NSCLC)?

Lobectomy (surgery). Signup and view all the answers

In extensive stage Small-Cell Lung Cancer (SCLC), what is often included in the treatment plan?

Combination chemotherapy with prophylactic cranial irradiation. Signup and view all the answers

What role do targeted agents play in lung cancer treatment?

Treating genetic mutations like EGFR and ALK. Signup and view all the answers

Which therapy is standard for unresectable Stage III Non-Small-Cell Lung Cancer?

Concurrent chemoradiotherapy. Signup and view all the answers

What aspect of care does palliative treatment focus on in lung cancer patients?

Alleviating symptoms and managing side effects. Signup and view all the answers

How does the TNM system contribute to lung cancer treatment?

It is essential for accurate staging and treatment strategies. Signup and view all the answers

What is a common symptom of Pulmonary Tuberculosis?

Weight loss Signup and view all the answers

Which imaging test is often the first performed if lung cancer is suspected?

Chest X-Ray Signup and view all the answers

What is the gold standard for staging and identifying metastasis in lung cancer?

CT PET Scan Signup and view all the answers

What symptom distinguishes pneumonia from pulmonary tuberculosis?

Acute fever and productive cough Signup and view all the answers

Which test provides precise information about tumor size and location in lung cancer patients?

CT Scan Signup and view all the answers

What condition can a sputum culture reveal if positive?

Pulmonary Tuberculosis Signup and view all the answers

What is a characteristic feature of a CT PET scan in lung cancer diagnosis?

Detection of nodules greater than 15 mm Signup and view all the answers

Which symptom is not commonly associated with Pulmonary Tuberculosis?

Pleuritic chest pain Signup and view all the answers

Study Notes

Epidemiology of Lung Cancer

Lung cancer is a prevalent cancer, especially among men, ranking as the second most common cancer in the Philippines.
It is rare in individuals under 40, with incidence rising until age 80, then declining.
The lifetime risk of developing lung cancer is estimated at ~8% for males and ~6% for females.
Lung cancer has a high mortality rate due to late diagnosis, making it a leading cause of cancer deaths in the Philippines.

Risk Factors for Lung Cancer

Cigarette smoking significantly increases lung cancer risk (10-fold or more).
Occupational exposures contribute to risk.
Smoking cessation, ideally before middle age, dramatically reduces lung cancer risk (by >90%).
Genetic predisposition plays a role.

Lung Cancer Pathology

Epithelial Lung Cancers:
- Small-cell carcinoma (SCLC): Strongly associated with smoking.
- Non-small cell carcinoma (NSCLC):
  - Adenocarcinoma: The most prevalent type in lifetime non-smokers or former light smokers. It accounts for 95% of NSCLC cases.

Clinical Manifestations of Lung Cancer

Paraneoplastic Syndromes: Common in SCLC, can be the first sign of recurrence.
Systemic Symptoms: Anorexia, cachexia, weight loss (poor prognosis), fever, immunosuppression.
Endocrine Syndromes: Hypercalcemia, SIADH, Cushing's syndrome.
Skeletal-Connective Tissue Syndromes: Clubbing (NSCLC), hypertrophic osteoarthropathy (common in adenocarcinomas, presenting with bone pain).
Neurologic Syndromes: Eaton-Lambert syndrome (proximal muscle weakness, autonomic dysfunction), paraneoplastic cerebellar degeneration and encephalomyelitis.
Thrombotic or Hematologic Syndromes: Trousseau's syndrome, nonbacterial thrombotic endocarditis, disseminated intravascular coagulation (DIC).
Rare Manifestations: Dermatomyositis, acanthosis nigricans, nephrotic syndrome, glomerulonephritis, adrenal metastases.

Differential Diagnosis of Lung Cancer

To rule in lung cancer, consider progressive symptoms, imaging findings, and pulmonary function tests (PFTs) to differentiate from conditions like COPD.
To rule out lung cancer, consider a positive TB skin test or IGRA, cavitary lesions on chest X-ray, and positive sputum culture for tuberculosis when considering pulmonary tuberculosis.
Pneumonia is ruled out via its acute onset, response to antibiotics, and consolidation indicated by chest X-ray or CT.

Diagnostic Workup for Lung Cancer

Chest X-ray: Initial imaging test, detects large tumors, lung collapse, or fluid accumulation.
CT scan: Precisely identifies tumor size, location, and involvement of adjacent tissues or lymph nodes; crucial for NSCLC staging.
CT PET scan: Used for staging, metastasis detection, and identifying nodules >15 mm; often combined with CT (PET-CT); the gold standard for staging and metastasis detection.
Sputum cytology: Non-invasive test detecting cancer cells in sputum or fluid samples.
Biopsy: Tissue biopsy for definitive diagnosis, determining cancer type and characteristics; the gold standard for diagnosis.
Bronchoscopy and Thoracentesis: Additional diagnostic procedures.

Principles of Lung Cancer Treatment

Staging: Accurate TNM staging is crucial for treatment planning.
Non-Small-Cell Lung Cancer (NSCLC):
- Stages I & II: Surgery (lobectomy) is preferred; adjuvant chemotherapy for stages II & IIIA.
- Stage III: Concurrent chemoradiotherapy.
- Stage IV: Systemic therapy (chemotherapy, targeted therapy, immunotherapy based on genetic mutations).
Small-Cell Lung Cancer (SCLC):
- Limited stage: Concurrent chemoradiotherapy.
- Extensive stage: Combination chemotherapy, with prophylactic cranial irradiation (PCI) for responders.
Molecular and Targeted Therapy: Based on genetic mutations (e.g., EGFR, ALK).

Other Information Regarding Lung Cancer

Palliative Care: Focuses on symptom management (pain, dyspnea, cough), nutritional and psychological support, and side effect management.

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Description

Test your knowledge on lung cancer, its symptoms, associated syndromes, and the impact of smoking. This quiz covers key clinical manifestations, risk factors, and the relationship between lung cancer and paraneoplastic syndromes. Ideal for students and professionals in the medical field.