Deck 31: Lung Cancer

Question 1

Which of the following is not associated with the clinical features of lung cancer?

A) Local growth of tumor
B) Metastasis extrathoracic or intrathoracic
C) Associated pain or discomfort
D) Paraneoplastic syndrome

Answer 1

C
Explanation: The clinical features of lung cancer result from the effects of local growth of the tumor, regional growth or spread through the lymphatic system, hematogenous (blood-borne) distant metastatic spread, and remote paraneoplastic effects from tumor products or immune cross-reaction with tumor antigens.

Question 2

Which of the following comments regarding lung cancer is true?

A) The incidence has risen over the past few decades.
B) It is the third leading cause of cancer deaths in the United States.
C) The peak incidence occurred in the mid-1970s.
D) Incidence has increased in women 40 to 58 years of age.

Answer 2

A
Explanation: The frequency of lung cancer deaths peaked in 1984 and declined until the end of the 1990s and has leveled off since. In 2010, there were 187,000 cancer deaths.

Question 3

Approximately what percentage of all lung cancer is linked to smoking?

A) 50% to 55%
B) 70% to 75%
C) 85% to 90%
D) 100%

Answer 3

C
Explanation: Direct exposure to tobacco has occurred in 85% to 90% of individuals with lung cancer.

Question 4

Squamous cell carcinoma is composed of which of the following?

A) Glandular structures from lung scars
B) Common pulmonary stem cells
C) Flattened stratified epithelial cells
D) Multicentric stratified cells

Question 5

On a chest radiograph, large-cell carcinoma is commonly seen as what type of lesion?

A) Central lesion
B) Well-defined mass
C) Bilateral nodules
D) Unilateral nodules

Question 6

What is the most effective way to prevent lung cancer?

A) Vitamin E
B) Beta-carotene
C) Smoking prevention
D) Avoidance of atmospheric pollution

Question 7

What is the number one cause of cancer-related death in the United States?

A) Leukemia
B) Lung cancer
C) Breast cancer
D) Brain cancer

Question 8

What minimum size does a lesion in the lung need to be in order to be called a nodule?

A) 1 cm
B) 2 cm
C) 3 cm
D) 4 cm

Question 9

Which of the following are being targeted as a primary source of new customers by tobacco companies?

A) Young people and developing countries
B) Women aged 21 to 35 years
C) Men aged 21 to 35 years
D) Men and women over 50 years of age

Question 10

Which of the following organs is not commonly compromised in metastatic lung cancer?

A) Brain
B) Liver
C) Bone
D) Stomach

Question 11

Which of the following is the most common type of lung cancer?

A) Large cell
B) Adenocarcinoma
C) Squamous cell
D) Small cell

Question 12

What composition of adenocarcinoma best describes its histopathology?

A) Stratified epithelial cells
B) Pleomorphic cells
C) Polygonal cells
D) Glandular structures

Question 13

Which of the following is typically not associated with local tumor growth in the central airways?

A) Large airway obstruction
B) Cough
C) Hemoptysis
D) Fine crackles

Question 14

What type of lung cancer usually is seen as a central lesion that may obstruct airways and lead to atelectasis?

A) Adenocarcinoma
B) Squamous cell
C) Large cell
D) Bronchogenic carcinoma

Question 15

Which of the following best describes the cell characteristics in small-cell carcinoma?

A) Larger than lymphocyte nucleus
B) Enlarged nuclei-differentiated cells
C) Keratin structures throughout lung tissue
D) Develops from a common pulmonary stem cell

Question 16

In what age group has smoking increased recently?

A) 18 to 24 years
B) 25 to 40 years
C) 45 to 60 years
D) Older than 70 years

Question 17

Which of the following are major histopathologic types of lung cancer?
1) Adenocarcinoma
2) Squamous cell carcinoma
3) Small-cell carcinoma
4) Ciliated cell carcinoma

A)2, 3, and 4 only
B)1, 2, and 3 only
C)3 and 4 only
D)1 and 2 only

Question 18

What type of histopathologic cells is associated with large-cell carcinoma?

A) Pleomorphic cells
B) Glandular structures
C) Stratified epithelial cells
D) Pulmonary stem cells

Question 19

Other causes of lung cancer include:
1) asbestos.
2) arsenic.
3) chromium.
4) microwave radiation.

A)2, 3, and 4 only
B)2 and 3 only
C)1 and 4 only
D)1, 2, and 3 only

Question 20

Apical growth may be associated with which of the following syndromes?

A) Good pasture
B) Pancoast
C) Miller
D) Granulomatosis

Question 21

Which of the following pulmonary function tests are frequently used to determine tolerance to resectional surgery?
1) FEV₁
2) FEF_{25% to 75%}
3) FVC
4) DLCO

A)1 only
B)1 and 4 only
C)2 and 4 only
D)2, 3, and 4 only

Question 22

Which of the following are common purposes for staging a case of lung cancer?
1) Selection of therapy
2) Assessment of extent of the disease
3) Prognosis
4) Etiology

A)2, 3, and 4 only
B)1, 2, and 4 only
C)3 and 4 only
D)1 and 2 only

Question 23

Which of the following PFT values are indications a patient can safely undergo surgical resection for lung cancer?

A) An FEV₁ greater than 80% predicted value or 2 L
B) An FEV₁ between 30% and 60% predicted value or 1.75 L
C) An FEV₁ greater than 70% predicted value or 1.75 L
D) An FEV₁ between 30% and 60% predicted value or 2 L

Question 24

What does the acronym TNM mean?

A) Tumor, number, mass
B) Tumor, non-small, metastases
C) Tracheal, number, metastases
D) Tumor, lymph node, metastases

Question 25

What treatment is the best initial modality for patients with non-small-cell lung cancer because it offers the best prospect of long-term survival?

A) Chemotherapy
B) Surgical resection
C) Radiation therapy
D) Endobronchial laser therapy

Question 26

What is the most commonly used additional imaging technique to confirm lung cancer?

A) Gammagraphy
B) Videoscintigraphy
C) Positron emission tomography
D) Enhanced computed tomography

Question 27

What is the treatment of choice for limited-stage small-cell lung cancer?

A) Surgical resection
B) Chemoradiotherapy
C) Radiation therapy only
D) Chemotherapy only

Question 28

Which of the following is not a therapeutic option for patients with lung cancer?

A) Surgical resection
B) Radiotherapy
C) Laser
D) Chemotherapy