Quiz
ON10 Lung Cancer
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Questions in this quiz (14)
1Epidemiology -
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- Aincreasing
- Bcancer
- Cnever
- DMaori women
- EMaori men
2Which of these is NOT a risk factor for lung cancer?
- AAge
- BHistory or current use of tobacco cigarettes, pipes, cigars
- CExposure to secondhand smoke
- DOccupational exposures (asbestos, arsenic, chromium, etc.)
- EEnvironmental exposures eg polluted air
- FFamily history
- GHIV
- HBeta carotene supplements in heavy smokers
- IRadiation exposure
- JExposure to lung cancer patients
3Screening - 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]- ALow-dose helical CT
- Bno benefit
- Chigh
4Which of these is not a clinical presentation of lung cancer?
- AHoarseness
- BDyspnoea
- CWeight loss
- DMalaise
- EHemoptysis (blood mixed with sputum)
- FBlood in faeces
5CT scan, chest x-ray, and biopsy are all used for diagnosis of lung cancer.
- ATrue
- BFalse
6Types 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].- A80-85
- B5-20
- Cepithelial
- Dnerve producing
- ETNM
- Fsurvival
- Gnon-smokers
- Hspreading
- Iprognosis
7Which of these is NOT a feature of an adverse (poor) prognosis?
- APresence of pulmonary symptoms
- BLarge tumor size (>3cm)
- CSquamous histology
- DMetastases to multiple lymph nodes
- EVascular invasion
8Staging 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- Acarcinoma in situ
- B3
- Cno
- Dregional lymph
- Epresence
- F5
- Gextensive
9Match 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]- A2
- B1
- C3
- D4
10Match 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…- ASurgery
- BSurgery, Radiation
- CSurgery, Radiation, Adjuvant CT,
- D, Adjuvant CT, Neoadjuvant CT,
- ECombination
- Fantibodies
11Treatment – 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.- ACisplatin
- Bvinorelbine, etoposide, vinca alkaloid
- Cno
12Treatment – 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).- ACisplatin and vinorelbine
- BDurvalumab
- C16.8
13Cisplatin 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)- ANephrotoxicity
- Bototoxicity
- Cnausea and vomiting
- Dneuropathy
- EConstipation
- FVesicant
14SCLC 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.- ACisplatin / Etoposide
- BDoxorubicin / Vincristine
- C4-6
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- User has deleted their subject information Quiz on ON10 Lung Cancer, created by Deleted user on 09/10/2019.
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- Deleted user
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- Created on 9 Oct 2019 · updated on 9 Oct 2019
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