Deck 20: Lung Cancer

Question 1

Which of the following is/are true regarding primary lung cancer?

A)Is also known as bronchogenic carcinoma
B)Is often metastasized from other sites
C)Lags behind breast cancer in women and prostate cancer in men as the most common fatal malignancy
D)All the above

Answer 1

A

Question 2

What is the major benefit of PET scanning in patients suspected of having lung cancer?

A)Lower cost
B)Decreases the frequency of futile surgery
C)Decreases the risk of missing multiple lesions
D)It is easier for the patient

Answer 2

B

Question 3

What are the two most common clinical manifestations associated with the presence of bronchogenic carcinoma?

A)Fever and hemoptysis
B)Cough and fever
C)Dyspnea and weight loss
D)Cough and weight loss

Answer 3

D

Question 4

Which of the following imaging studies is/are useful in diagnosing lung cancer?

A)MRI
B)Chest radiograph
C)Chest CT scanning
D)All the above

Question 5

Hoarseness in your lung cancer patient may lead you to suspect what?

A)Acute bronchitis
B)Subglottic edema
C)Vocal cord paralysis
D)Acid-reflux disease

Question 6

Bronchoscopes can be used with all of the following appliances to extend their usefulness except:

A)Brush
B)Forceps
C)Needle
D)Continuous suction

Question 7

Transbronchial needle aspiration to obtain tumor cells employs a needle passed through what type of artificial airway?

A)Tracheostomy
B)Bronchoscope
C)Oral endotracheal tube
D)Oropharyngeal airway

Question 8

What is the major imaging modality of choice for the evaluation of lung cancer?

A)Chest CT
B)Chest radiograph
C)PET scan
D) scan

Question 9

Which of the following is true regarding the etiology of lung cancer?

A)Lung cancer affects 40-50% of all smokers
B)10-20% of all lung cancer patients smoke,have smoked,or have had chronic exposure to smoke
C)After about 13 years of smoking cessation lung cancer risk returns to a non-smoker's level of risk
D)None of the above

Question 10

Your patient's sputum analysis reveals a considerable number of epithelial cells and malignant cells already degenerated.What should be done with the specimen?

A)It should be sent out of facility to a better qualified lab
B)The lab must stain and make fixed preparations of the sputum quickly before more degeneration occurs
C)The specimen should be discarded and another more viable one sent
D)Send the specimen to the lab as usual

Question 11

The fact that the overall survival rate for patients presenting with lung cancer is about 10% reflects what fact?

A)The disease is already advanced at time of diagnosis
B)The patients generally continue smoking
C)Infections are common
D)The patient is noncompliant with antineoplastic regimen

Question 12

Which of these are common sites for extrathoracic spread?

A)Brain and spinal cord
B)Bone marrow
C)Liver
D)All the above

Question 13

Your patient has a solitary pulmonary nodule ("coin lesion")as seen on the chest radiograph.What characteristic(s)is/are used to describe this lesion?

A)It is a focal lesion surrounded by aerated lung
B)It is described in terms of margination
C)It is described in terms of size and shape
D)All the above

Question 14

All of these are major histological types of bronchogenic carcinoma except:

A)Small-cell
B)Hamartoma
C)Large-cell
D)Squamous cell

Question 15

In the physical examination of the chest,percussion will typically reveal what over a large tumor,pleural effusion,or pneumonia?

A)Increased resonance
B)Crepitus
C)Decreased resonance
D)None of the above

Question 16

All of the following are risk factors for lung cancer except:

A)Exposure to side stream smoke
B)Asbestos exposure
C)Consumption of fatty foods
D)Positive family history

Question 17

Your patient has one eyelid drooping with a pinpoint pupil,with lack of sweating and arm weakness on that same side.What is the likely cause?

A)Horner's syndrome
B)Erb's paralysis
C)Bell's palsy
D)Eaten-Lambert syndrome

Question 18

Magnetic resonance imaging (MRI)has this advantage over CT for evaluating pulmonary nodules or mediastinal metastases

A)Better for seeing chest wall invasion
B)Uses less ionizing radiation
C)Is less expensive than CT
D)Is more available to the patient

Question 19

The clinical presentation of lung cancer depends on all of these except:

A)Cell type and growth rate
B)Location within lung
C)Immune status of patient
D)If the patient consumed filtered cigarettes

Question 20

Which of these are clues to metastatic disease?

A)Chest wall pain
B)Seizures and stroke
C)Weight loss
D)All the above

Question 21

Your patient has been determined to have this stage - TX,NO MO - in his lung cancer.What should be recommended?

A)Nothing.Cancer is totally metastasized
B)Imaging and bronchoscopy to ascertain site and nature of the tumor
C)Immediate surgery accompanied by chemotherapy and radiation therapy
D)None of the above

Question 22

What percent of lung cancer patients have a surgically resectable tumor at the time of diagnosis?

A)10%
B)20-30%
C)30-50%
D)50-60%

Question 23

What has long been the gold standard among staging tests of mediastinal lymph nodes and offers possibility of biopsy?

A)Flexible fiberoptic bronchoscopy
B)Direct laryngoscopy
C)Mediastinoscopy
D)Pleurocentesis

Question 24

What is the primary treatment for small-cell carcinoma?

A)Surgery
B)Radiation
C)Chemotherapy
D)No therapy

Question 25

What are the criteria for an exudative pleural effusion?

A)Elevated LDH
B)Elevated pleural protein level
C)Both A and B
D)Neither A nor B

Question 26

An FEV1 measurement below what value indicates a poor postoperative prognosis for the patient facing surgery to remove a bronchogenic carcinoma?

A)1.5 liters
B)1.0 liter
C)0.8 liter
D)None of the above