ON10 Lung Cancer

Description

PHCY320 (Oncology) Quiz on ON10 Lung Cancer, created by Mer Scott on 07/10/2019.
Mer Scott
Quiz by Mer Scott, updated more than 1 year ago
Mer Scott
Created by Mer Scott about 5 years ago
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Resource summary

Question 1

Question
Epidemiology​ - Lung cancer rates [blank_start]increasing[blank_end] worldwide​ Rates in males higher in developed vs. developing countries but decreasing due to tobacco control initiatives ​ Leading cause of [blank_start]cancer[blank_end]-related deaths in NZ (1600 per year)​ 1 in 5 people diagnosed have [blank_start]never[blank_end] smoked​ Lung cancer incidence and mortality 4x higher in [blank_start]Maori women[blank_end] and 3x higher in [blank_start]Maori men[blank_end] vs. non-Maori populations​
Answer
  • increasing
  • cancer
  • never
  • Maori women
  • Maori men

Question 2

Question
Which of these is NOT a risk factor for lung cancer?
Answer
  • Age
  • History or current use of tobacco cigarettes, pipes, cigars
  • Exposure to secondhand smoke​
  • Occupational exposures (asbestos, arsenic, chromium, etc.)​
  • Environmental exposures eg polluted air
  • Family history​
  • HIV
  • Beta carotene supplements in heavy smokers
  • Radiation exposure
  • Exposure to lung cancer patients

Question 3

Question
Screening​ - For [blank_start]high[blank_end] risk patients. - [blank_start]Low-dose helical CT[blank_end] scanning - only intervention to influence mortality​ - X-ray and/or sputum cytology has shown [blank_start]no benefit ​[blank_end]
Answer
  • Low-dose helical CT
  • no benefit ​
  • high

Question 4

Question
Which of these is not a clinical presentation of lung cancer? ​
Answer
  • Hoarseness​
  • Dyspnoea​
  • Weight loss​
  • Malaise​
  • Hemoptysis (blood mixed with sputum)
  • Blood in faeces

Question 5

Question
CT scan, chest x-ray, and biopsy are all used for diagnosis of lung cancer.
Answer
  • True
  • False

Question 6

Question
Types of Lung Cancer​ 1. Non-Small Cell Lung Cancer ​ [blank_start]80-85[blank_end]% of lung cancers​. Origin from [blank_start]epithelial[blank_end] cells​. Includes adenocarcinomas, squamous cell carcinomas, large cell carcinomas​. Staged using [blank_start]TNM[blank_end]​. Better [blank_start]survival[blank_end] outcomes​. 2. Small Cell Lung Cancer ​ [blank_start]5-20[blank_end]% of lung cancers . Origin from [blank_start]nerve producing[blank_end] cells in bronchi. Rarely occurs in [blank_start]non-smokers[blank_end]​. Limited vs. Extensive staging​. Rapidly [blank_start]spreading[blank_end] (metastases)​; poor [blank_start]prognosis[blank_end].
Answer
  • 80-85
  • 5-20
  • epithelial
  • nerve producing
  • TNM
  • survival
  • non-smokers
  • spreading
  • prognosis

Question 7

Question
Which of these is NOT a feature of an adverse (poor) prognosis?
Answer
  • Presence of pulmonary symptoms​
  • Large tumor size (>3cm)​
  • Squamous histology​
  • Metastases to multiple lymph nodes ​
  • Vascular invasion​

Question 8

Question
Staging NSCLC​ Stage 0 – [blank_start]carcinoma in situ​[blank_end] Stage 1 – small tumor (<[blank_start]3[blank_end]cm), [blank_start]no[blank_end] lymph node involvement or mets​ Stage 2 – small to medium tumor (<3cm or 3-[blank_start]5[blank_end]cm), [blank_start]regional lymph[blank_end] node involvement, no metastases​ Stage 3 – medium to large tumor, more [blank_start]extensive[blank_end] lymph node involvement, no metastases Stage 4 – any size / lymph node involvement, [blank_start]presence[blank_end] of metastases
Answer
  • carcinoma in situ​
  • 3
  • no
  • regional lymph
  • presence
  • 5
  • extensive

Question 9

Question
Match the stage to the estimated 5 year survival rate. (Randomised order.) 53-60%​ - Stage [blank_start]2[blank_end] 77-92%​ - Stage [blank_start]1[blank_end] 13-36%​ - Stage [blank_start]3[blank_end] 0-10%​ - Stage [blank_start]4[blank_end]
Answer
  • 2
  • 1
  • 3
  • 4

Question 10

Question
Match the Tx to the staging. Stage 0​ - [blank_start]Surgery[blank_end]​ Stage I​ - [blank_start]Surgery, Radiation​[blank_end] Stage II​ = [blank_start]Surgery, Radiation, Adjuvant CT,​[blank_end] ?Neoadjuvant CT Stage III​ - Surgery, Radiation​[blank_start], Adjuvant CT, Neoadjuvant CT,[blank_end] Stage IV​ - [blank_start]Combination[blank_end] CT, monoclonal [blank_start]antibodies[blank_end], maintenance therapy, EGFR tyrosine kinase inhibitor (EGFR mutations), ALK inhibitors (ALK translocations), ROS1 inhibitors (ROS1 rearrangements), BRAFV600E and MEK inhibitors (BRAFV600E mutations), immune checkpoint inhibitor, local therapies…
Answer
  • Surgery
  • Surgery, Radiation​
  • Surgery, Radiation, Adjuvant CT,​
  • , Adjuvant CT, Neoadjuvant CT,
  • Combination
  • antibodies

Question 11

Question
Treatment – Stage II​ Adjuvant​ (post-primary tx): - [blank_start]Cisplatin[blank_end] based therapy (5 year survival absolute benefit of 5.4%)​ - Combination drugs include [blank_start]vinorelbine, etoposide, vinca alkaloid ​[blank_end] Neoadjuvant​ (pre primary Tx) Absolute benefit of 5 year survival of 6% across all stages. ​Largest study (most patient Stage I) showed [blank_start]no[blank_end] survival benefit. Controversial.
Answer
  • Cisplatin
  • vinorelbine, etoposide, vinca alkaloid ​
  • no

Question 12

Question
Treatment – Stage III​ Adjuvant​ - Modest survival benefits shown in FRE-IALT and ANITA trials​. [blank_start]Cisplatin and vinorelbine[blank_end] typically regimen of choice . [blank_start]Durvalumab[blank_end] immunotherapy for patients with no progression after 2 or more cycles of chemoradiation therapy) - interim analysis showed progression-free survival [blank_start]16.8[blank_end] months (durvalumab) vs. 5.6 months placebo (HR 0.52)​.
Answer
  • Cisplatin and vinorelbine
  • Durvalumab
  • 16.8

Question 13

Question
Cisplatin toxicity - [blank_start]Nephrotoxicity[blank_end] (stay hydrated) - Dose dependent [blank_start]ototoxicity[blank_end] - Severe [blank_start]nausea and vomiting[blank_end], loss of appetite and taste - Myelosuppression Vinorelbine toxicity - Peripheral [blank_start]neuropathy[blank_end] - [blank_start]Constipation[blank_end] - Neutropenia - [blank_start]Vesicant[blank_end] (as are all vinca alkaloids)
Answer
  • Nephrotoxicity
  • ototoxicity
  • nausea and vomiting
  • neuropathy
  • Constipation
  • Vesicant

Question 14

Question
SCLC Tx Limited disease​ standard Tx = [blank_start]Cisplatin / Etoposide[blank_end] (21 day cycle x 4 cycles)​\ Extensive disease​ standard Tx = [blank_start]Doxorubicin / Vincristine[blank_end] / Cyclophosphamide (21 day cycle x [blank_start]4-6[blank_end] cycles)​. Can also use cisplatin / etoposide as above​.
Answer
  • Cisplatin / Etoposide
  • Doxorubicin / Vincristine
  • 4-6
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