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WEEK 2
1. ADENOCARCINOMA OF THE LUNG
● LUNG CARCINOMA is typically divided into two categories, small cell carcinoma and non-small cell carcinoma. ● NON-SMALL CELL carcinoma subtypes include adenocarcinoma, squamous cell carcinoma, large cell carcinoma and carcinoid tumor. ● ADENOCARCINOMA is the most common lung cancer and is the most common lung cancer in nonsmokers. It typically arises in the periphery of the lunch and may present with hemoptysis or finger clubbing. This cancer is associate with the KRAS, EGFR and ALK mutations. ● On history, adenocarcinoma displays a glandular pattern and often stains mucin positive. ● In the early stages, treatment involves surgical resection. In the later stages, treatment involves radiation and chemotherapy. QUESTIONS:
- Which of the following microscopic findings or histological descriptions is most likely associated with adenocarcinoma of the lung? ANSWER: Often stains with mucin
- Which of the following is most likely associated with the pathophysiology of adenocarcinoma of the lung? ANSWER: KRAS, EGFR, and ALK mutations
- Which of the following is most likely associated with adenocarcinoma of the lung? ANSWER: most common in nonsmokers
- Which of the following is most likely associated with adenocarcinoma of the lung? ANSWER: presents with hemoptysis
- Which of the following treatments is most likely associated with localized adenocarcinoma of the lung? ANSWER: Surgical resection
- Which of the following treatments is most likely associated with metastatic adenocarcinoma of the lung? ANSWER: chemotherapy and radiation
- Which of the following is most likely associated with adenocarcinoma of the lung? ANSWER: most common lung cancer
- Which of the following clinical features us most likely associated with adenocarcinoma of the lung?
- Which of the microscopic finding or histological description is best associated with bronchial carcinoid tumor? ANSWER: Nests of neuroendocrine cells
- Which of the following facts is most commonly associated with bronchial carcinoid tumor? ANSWER: often asymptomatic
- Which of the following facts is best associated with bronchial carcinoid tumor? ANSWER: symptoms of bronchial obstruction
- Which of the following facts best describes bronchial carcinoid tumor? ANSWER: excellent prognosis
- Which microscopic finding or histological description is best associated with bronchial carcinoid tumor? ANSWER: Chromogranin A positive
- Which of the following signs, symptoms, or diseases is most likely to be seen in a patient with bronchial carcinoid tumor? ANSWER: flushing
- Which of the following signs, symptoms, or diseases is most likely to be seen in a patient with bronchial carcinoid tumor? ANSWER: diarrhea
- Which of the following signs, symptoms, or diseases is most likely to be seen in a patient with bronchial carcinoid tumor?
ANSWER: wheezing
3. LARGE CELL CARCINOMA
● LUNG CARCINOMA is typically divided into two categories, small cell carcinoma and non-small cell carcinoma. ● NON-SMALL CELL carcinoma subtypes include adenocarcinoma, squamous cell carcinoma, large cell carcinoma and carcinoid tumor. ● LARGE CELL CARCINOMA of the lung has a strong correlation with smoking and typically has a poor prognosis. ● It is commonly located in the periphery of the lung. ● Patients may present with GYNECOMASTIA and GALACTORRHEA since some tumors secrete beta-hCG. ● Large cell carcinoma is often a diagnosis of exclusion and histology shows anaplastic cells and pleomorphic giant cells.
- Which of the following is indicates as treatment for large cell carcinoma? ANSWER: surgical resection
- Which of the following cell types most closely relates to large cell carcinoma? ANSWER: pleomorphic giant cells
- Which of the following descriptions is most closely associated with large cell carcinoma? ANSWER: poor prognosis
- Which of the following is true regarding large cell carcinoma? ANSWER: strong correlation with smoking
- Which of the following is true regarding large cell carcinoma? ANSWER: may produce beta-hCG
- During your assessment of a patient with large cell carcinoma, which of the following is most likely to be seen? ANSWER: galactorrhea
- During your assessment of a patient with early large cell carcinoma, which of the following is most likely to be seen? ANSWER: peripheral lesions
- Which of the following is most true of large cell carcinoma? ANSWER: less responsive to chemotherapy and radiation
- Which of the following is most closely associated with large cell carcinoma? ANSWER: Gynecomastia
- Which off the following is most accurate regarding the diagnosis of large cell carcinoma? ANSWER: diagnosis of exclusion
4. SMALL CELL (OAT CELL) CARCINOMA
● LUNG CARCINOMA is typically divided into two categories, small cell carcinoma and non-small cell carcinoma. ● NON-SMALL CELL carcinoma subtypes include adenocarcinoma, squamous cell carcinoma, large cell carcinoma and carcinoid tumor.
● SMALL CELL LUNG CANCER (SCLC), formerly known as OAT CELL CARCINOMA, is a highly malignant cancer that is strongly correlated with smoking. It often arises in the central portion of the lungs and causes narrowing of the bronchial airways.
- Which of the following thoracic locations is most likely associated with small cell (oat cell) carcinoma of the lung? ANSWER: central location
- Which of the following is a treatment best associated with Small cell (oat cell) carcinoma? ANSWER: chemotherapy and radiation
- Which of the following is associated with symptoms of small cell (oat cell) carcinoma? ANSWER: narrowing of bronchial airways
5. SQUAMOUS CELL CARCINOMA OF THE LUNG
● LUNG CARCINOMA is typically divided into two categories, small cell carcinoma and non-small cell carcinoma. ● NON-SMALL CELL carcinoma subtypes include adenocarcinoma, squamous cell carcinoma, large cell carcinoma and carcinoid tumor. ● SQUAMOUS CELL CARCINOMA OF THE LUNG is more common in males and has a strong correlation with smoking. It typically arises from the central portion of the lung and is characterized as a cavitating lesion extending to the hilum. ● It is important to note that this tumor may produce PTHrP causing HYPERCALCEMIA. ● Histologic diagnosis of squamous cell carcinoma is based upon the presence of keratin pearls or intercellular bridges. ● In the early stages, treatment involves surgical resection. ● In the later stages, treatment involves radiation and chemotherapy QUESTIONS:
- Which microscopic finding or histological description is associated with squamous cell carcinoma of the lung? ANSWER: intercellular bridges
- Which finding or description is association with squamous cell carcinoma of the lung? ANSWER: cavitating lesion extending to hilum
- Which paraneoplastic syndrome is best associated with squamous cell carcinoma of the lung? ANSWER: PTHrP causes Hypercalcemia
- Which of the following groups of people are associated with squamous cell carcinoma of the lung? ANSWER: more common in men
- Where would you expect squamous cell carcinoma of the lung to develop first? ANSWER: central location
- Which of the following is most likely the cause of superior vena cava syndrome? ANSWER: thrombosis
- Which of the following is typically seen in superior vena cava syndrome? ANSWER: venous engorgement over upper extremity, face, and chest
7. PROSTATE ADENOCARCINOMA CHARACTERISTICS AND PRESENTATION
● PROSTATE ADENOCARCINOMA is one of the most common cancers in men. ● A screening test, prostate specific antigen, is recommended in high-risk patients. ● The peripheral zone of the prostate is the most common area affected. ● African-american and elderly men have an increased risk of developing prostate adenocarcinoma. ● Patients are usually asymptomatic but can develop terminal hematuria, urinary retention or incontinence, and lower back pain. QUESTIONS:
- Which of the following symptoms can be seen in patients with prostate adenocarcinoma? ANSWER: Urinary retention or incontinence
- Which of the following best describes the area of the prostate most often affected by prostate adenocarcinoma? ANSWER: peripheral zone
- Which of the following tests is most likely suitable for prostate adenocarcinoma screening? ANSWER: Prostate specific antigen (PSA)
- Which of the following is most likely a risk factor for prostate adenocarcinoma? ANSWER: advanced age
- Which of the following is most likely a risk factor for prostate adenocarcinoma? ANSWER: African-american
- Which of the following symptoms can be seen in patients with prostate adenocarcinoma? ANSWER: lower back pain
- Which of the following symptoms can be seen in patients with prostate adenocarcinoma? ANSWER: terminal hematuria
- Which of the following is a key fact associated with prostate adenocarcinoma? ANSWER: most common cancer in men
8. PROSTATE CANCER ASSESSMENT
● PROSTATE CANCER is the most common cancer among men, and typically occurs in men over the age of 65. It can initially present with symptoms similar to those seen in BPH, like dysuria, dribbling, urgency, hesitancy, and hematuria. ● Prostate cancer can metastasize, and often does so to bone, and a common site is the lumbosacral vertebrae. ● Patients can display fatigue and lower back pain. ● There are diagnostic tests if there is a clinical suspicion of malignancy, such as PSA, PAP, and digital rectal exam. ● The only definitive diagnostic test is via ultrasound-guided needle biopsy. QUESTIONS:
- Which of the following is a diagnostic test for prostate cancer? ANSWER: Digital Rectal Examination (DRE)
- Which of the following is a procedure for prostate cancer? ANSWER: biopsy
- Which of the is most likely a sign or symptom of prostate cancer? ANSWER: mimics BPH
- Which of the following is most likely a sign or symptom of prostate cancer? ANSWER: fatigue
- Which of the following is most likely a sign or symptom of prostate cancer? ANSWER: Low back pain
- Which of the following is a key fact of prostate cancer? ANSWER: metastasis to back
- Which of the following is a diagnostic test for prostate cancer? ANSWER: Transrectal ultrasound (TRUS)
- Which of the following is a key fact associated with prostate cancer? ANSWER: most common cancer in men
- Which of the following is lab value, neurotransmitter or hormone identified with prostate cancer?
ANSWER: usually asyptomatic
ANSWER: Prostate specific antigen (PSA)
- Which of the following is the most likely associated with ABCDEs of the melanoma?
Ans. Diameter: Melanoma lesions are often greater than 6 millimeters in diameter, which is greater than size of a pencil
- Which of the following is the most likely associated with ABCDEs of the melanoma?
ANS. BORDER: The border of an early melanoma tends to be uneven or difficult to define. Edges may be scalloped or notched.
- Which of the following is the most likely associated with ABCDEs of the melanoma?
ANS. Evolving: Any changes in size, shape, color, or elevation is important in diagnosis. New symptoms such as bleeding, itching, or crusting should be brought to the attention of the healthcare provider.
- Which of the following is the most likely associated with ABCDEs of the melanoma?
Ans. COLOR : The presence of more than one color (black, brown, blue. red etc) or the uneven distribution of color can be a warning signs, Benign moles are typically one shape.
- Which of the following is the most likely associated with ABCDEs of the melanoma?
Ans Asymmetry: Melanoma lesions are typical irregular, or not symmetrical in shape. Benign lesions are usually symmetrical.
