Lung Cancer Quiz
Created by Chris Galbraith and Connor Bohlken
Edited by Dr. Paris Ingledew
You are a four year medical student on an elective family medicine rotation. You have just finished lunch and are about to see your next patient, Mr. Carcin O. Gyn. He is a 55 year old male in for a prescription refill of his COPD medications. At this moment he does not feel ready to quit smoking. History and physical examination are otherwise unremarkable. You report back to your attending, who congratulates you on an excellent job. Your attending wonders if there are any lung cancer screening recommendations for patients with a 30 pack year history, and between 55-74 years old. You answer:
Flexible Bronchoscopy q5 Years
Sputum Cytology q2 Years
Endoscopic Ultrasound q2 Years
Annual Low Dose CT
Chest XRay q6 Months
You are a third year medical student midway through your thoracics rotation. Today you are with the highly esteemed surgeon: Dr. Laura Craft. You are super excited, as the first surgery slated is a lobectomy. As you are scrubbing in, Dr. Craft asks you what type of lung cancer accounts for the majority of lung cancers. You answer:
Non-Small Cell Lung Cancer
Small Cell Lung Cancer
Oat Cell Carcinoma
Primary Lung Sarcoma
Which of the following risk factors is associated with the vast majority of cases of lung cancer?
Personal or Family History of Lung Cancer
Exposure to Radiation
Occupational Asbestos Exposure
Second Hand Tobacco Smoke
Arsenic in Drinking Water
Pollutants from Cooking and Heating with Coal or Wood
You are a 3rd year medical student in their second week of their rural family medicine clerkship rotation. Your preceptor, Dr. Reducetherisk, has asked you to see Mr. Lotsapackyr a 65 year old male. The note on your electronic medical record indicated the reason for the visit is: “Smoking cessation”. Dr. Reducetherisk is a strong advocate for smoking cessation and asks you the following question. Which of the following is true?
The duration of smoking influences ones risk for lung cancer
The number of cigarettes smoked / day influences ones risk for lung cancer
The age of onset influences ones risk for lung cancer
Smoking cessation should always be pursued as it always reduces ones risk of lung cancer.
All of the above.
You’re a R4 resident in Radiation Oncology. You are working with a 3rd year medical student, James Keen. You want to test his knowledge. You ask him, which of the following is the most common symptom of lung cancer in a known smoker? You’re delighted when he states:
New onset of worsening cough
Dyspnea and auscultation of wheeze
New onset of hoarseness of voice
Unilateral miosis, ptosis, and anhidrosis
You’re on call and it is 0200AM. Due to IT problems, lab results for Sidney Hara a 78 year old female just got reported, the nurse calls you immediately. She is a 78 year female with diabetes, hypertension, and a 50 plus pack year history of smoking. She was brought in by her son for failure to thrive over the past couple months. You recall on your exam that she looked quite cachexic, but her fluid status appeared euvolemic. She is currently on 3L O2 nasal prong, and has an IV of NS going at 75ml /hr. The nurse is concerned about a sodium level of 128. What could be causing this?
Forgot to take her Ramipril
You are seeing Mr. Lesion, a 67 year old male with 30 year pack history. Mr. Lesion was found to have a solitary pulmonary lesion detected on Chest Xray done in the emergency room after he sustained a traumatic injury to his chest wall while precariously driving a Golf Cart. His family Dr is now following up on this lesion on the recommendation of the Emergency Physician. Which of the following results would be most suspicious for a potential metastatic lung cancer?
Hemoglobin 99 g/L, MCV 64
A Chest CT that demonstrates a 6.8 cm Lung tumor without local invasion or distant metastasis or any detectable nodes.
Elevated Calcium, ALP, and Phosphate.
A normal Endoscopic Ultrasound
A normal appearing bronchoscopy and subsequent negative cytology brushings.
You are a third year medical student who has just started their third year clinical rotation in Oncology. Today you will be working with Dr. Terry Nuvielle-Man, who primarily treats Lung Cancers. You begin the day with a quick review of TNM Staging. To gauge your knowledge he asks the following: If you have a patient with a known NSCLC that has the following characteristics: 3.5 centimeters, involvement of ipsilateral mediastinal nodes, and one distant metastasis to the liver, what TNM stage would it be?
T2a, N0, M0
T3a, N2, M1
T2a, N2, M1
T1c, N1, M1
T4, N1, M1
Nick Tino is an 68 year old chain smoking Italian man with stage II Non-Small Cell Lung Cancer. His past medical history is significant for an NSTEMI 2 years ago, and ESRD for which he has recently started on hemodialysis. He would like to pursue treatment for his lung cancer so is presenting to your office today to discuss possible options. Which of the following would you recommend?
Targeted Therapy with EGFR inhibitors
You are a medical student on a rural family medicine rotation. You are just about to see Mrs. Potshore, a 72 year female with recently diagnosed lung cancer. She has already had a meeting with a surgeon, and radiation oncologist, but she seems to value the opinion of young medical students. She asks you what the net five year survival for lung cancer in Canada is. You are a little hesitant to answer, but she insists. You answer:
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