Mind map

Quit Smoking

Menna Emam English

Map content

Quit Smoking

Ali was later found out to have
- Bronchogenic Carcinoma ( lung cancer)
  - classified into
    - Neuroendocrine cells
      - Small Cell Lung Cancer (SCLC)
    - Epithelial cells
      - Non-small Cell Lung Cancer (NSCLC)
        includes
        Squamous cell carcinoma
        Large cell carcinoma
        Adenocarcinoma
        Histology
        Gland-forming adenocarcinoma, which on IHC will show TTF-1 positivity which is se- en in majority of pulmonary adenocarcinomas
        Histology
        Composed of solid groups of large anaplastic malignant cells. Cells typically have large nu- clei, prominent nucleoli, and a moderate amo- unt of cytoplasm.
        Histology
        Well differentiated squamous cell carcinoma showing nests of squ- amous cells with central areas of keratinization
        Desmosomes
        Desmosomes
        squamous cell nests (pearls) with central keratinization
        X-ray
        left lung opacity (central lung mass)
        Gross
  - Treatment
    - The commonest used chemotherapy combination for small cell is:
      - Cisplatin and etoposide
      - CAV (cyclophosphamide, doxorubicin, vincristine)
      - GemCarbo (gemcitabine and carboplatin)
      - For relapsed disease:
        ACE (doxorubicin, cyclop- hosphamide and etoposide)
      - Topotecan:
        for people whose SCLC has relapsed after treatment, but only if they are not able to have doxorubicin
    - Chemotherapy for non-small cell lung cancer (NSCLC)
      - NSCLC is not as sensitive to chemotherapy as SCLC.
        Surgery or radiotherapy are the main treatments.
        Chemotherapy may be given before or after surgery or radiotherapy
        Chemotherapy with either:
        Gemcitabine, paclitaxel, docetaxel or vinorelbine
        Together with a platinum drug (carboplatin or cisplatin) should be the first choice for people with advanced NSCLC stage 3 and 4
  - Multistep carcinogenesis
    - Smoking
    - Environmental exposure
    - Genetics
  - Local Effects
    - Cough (75%)
      - Weight loss (40%)
        Chest pain (40%)
        Dyspnea (20%)
        Others : Hemoptysis, Loss of appetite, Obstructive symptoms
  - Systemic effects
    - Paraneoplastic Syndromes:
      - Cushing's syndrome (ACTH)
        Inappropriate ADH secretion
        Hypercalcemia (PTH)
        Acromegaly (GH)
        Lambert-Eaton mysthenic syndrome
        Peripheral neuropathy (sensory)
        Hematologic abnormalities (leukemoid reaction, DIC, migratory thrombophlebitis)
        Hypertrophic pulmonary osteoarthropathy (clubbing of the fingers)
  - Etiology
  - Diagnosis
    - Medical History
      - Physical Examination
        Chest x-ray
        CT scan
        Low dose spiral CT
        PET scan
        Sputum cytology
        Guided needle biopsy
        Thoracoscopy
        Bronchoscopy
        Bronchoscopy is a test to view the airways and diagnose lung disease. It may also be used during the treatment of some lung conditions.
Ali's Chief complain was
- Hemoptysis
  - definition
    - The expectoration of blood or bloodstained sputum. With massive hemoptysis the main priorities are to secure the airway and initiate emergency resuscit- ative measures before establishing a diagnosis.
- Percussion showed
  - Pleural effusion
    - Abnormal values
    - Normal contents of pleural fluid