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MEDICAL SCHOOL
"LUNG CANCER"
(Training manuals)
Moscow
2004
a) Two
b) Tree
a) Two
b) Three
3. How many segments are there in the upper lobe of right lung?
a) Tree
b) Four
c) Five
4. How many segments are there in the middle lobe of right lung?
a) Two
b) Three
c) Four
5. How many segments are there in the lower lobe of right lung?
a) Three
b) Four
c) Five
6. How many segments are there in the upper lobe of the left lung?
a) Three
b) Four
c) Five
7. How many segments are there in the lower lobe of the left lung?
a) Three
b) Four
c) Five #
a) Flat
b) ciliate
c) Cubic
a) Mucous secreting
b) Hormone producing
10. What are the 4 major risk factor for lung cancer?
a) Tobacco
b) Professional Hazard
a) Errors in feeding
d) Features of the anatomical structure of the lungs
e) The impact of hazardous chemicals
g) Chronic respiratory diseases (tuberculosis, bronchitis, fungal lung)
d) ionizing radiation
a) The tumor has the form of spherical formations located in the pulmonary parenchyma
a) globular cancer
b)Pancoast tumour
c) Pneumonic type cancer
d) mediastinal cancer
e) Primary carcinomatosis
20. What are the main histological forms of lung cancer produce?
a) Squamous
b) small-cell
a) Sarcoma
d) Adenocarcinoma
a) Glandular peripheral lung cancer growing in the form of multiple nodes in the lung
parenchyma
b) A form of small cell lung cancer
23. What is meant by the symbol T1 in the classification of peripheral lung cancer in the TNM?
a) The tumor is not more than 3 cm in its greatest dimension, surrounded by lung tissue or visceral
pleura.
b) The tumor more than 3 cm in greatest dimension, surrounded by lung tissue or visceral pleura
c) The tumor of any size, germinating the chest wall, mediastinal pleura or pericardium, without lesion
of the heart, great vessels, esophagus
24. What is meant by the symbol T2 in the classification of peripheral lung cancer in the TNM?
a) The tumor is not more than 3 cm in greatest dimension, surrounded by lung tissue or visceral pleura
b) The tumor more than 3 cm in greatest dimension, surrounded by lung tissue or visceral pleura.
c) The tumor of any size, germinating the chest wall, mediastinal pleura or pericardium, without lesion
of the heart, great vessels, esophagus
25. What is meant by the symbol of T3 in the classification of peripheral lung cancer in the TNM?
a) The tumor is not more than 3 cm in greatest dimension, surrounded by lung tissue or visceral pleura
b) The tumor more than 3 cm in greatest dimension, surrounded by lung tissue or visceral pleura
c) The tumor of any size, germinating the chest wall, mediastinal pleura or pericardium, without lesion
of the heart, great vessels, esophagus
26. What is meant by the symbol of T4 in the classification of peripheral lung cancer in the TNM?
a) The tumor of any size, germinating the chest wall, mediastinal pleura or pericardium, without damage
of the heart, great vessels, esophagus
b) The tumor of any size with a lesion of the mediastinum, heart, great vessels, esophagus
29. What is meant by the symbol T1 in the classification of central lung cancer in the TNM?
a) The tumor, located in the bronchial wall and affects the segmental or lobar bronchus, but not
affecting the mouth lobe bronchus, atelectasis radiologically can be segment #
b) The tumor bronchial wall of any size, passing the mouth of the equity or the main bronchus, but not
reaching 2 cm to the carina, X-ray may be atelectasis share.
c) The tumor that affects the wall of the main bronchus is closer than 2 cm from carina, rentgenolgicheski may occur
atelectasis
30. What is meant by the symbol T2 in the classification of central lung cancer in the TNM?
a) The tumor, located in the bronchial wall and affects the segmental or lobar bronchus, but not
affecting the mouth lobe bronchus, radiologically atelectasis of segments can be seen.
b) The tumor is on the bronchial wall of any size, passing the mouth of the main bronchus, but not
reaching by 2 cm to the bifurcation of trachea, X-ray may show atelectasis of the lobe.
c) The tumor that affects the wall of the main bronchus is closer than 2 cm from carina, radiologically
atelectasis maybe seen.
31. What is meant by the symbol of T3 in the classification of central lung cancer in the TNM?
a) The tumor, located in the bronchial wall and affects the segmental or lobar bronchus, but not
affecting the mouth lobe bronchus, radiologically atelectasis of segment can be seen.
b) The tumor in the bronchial wall of any size, passing the mouth of the equity or the main bronchus,
but not reaching by 2 cm to the bifurcation of the trachea, X-ray may show atelectasis.
c) The tumor that affects the wall of the main bronchus and is closer than 2 cm from the bifurcation of
trachea, radiologically atelectasis maybe seen.
33. What are the regional lymph nodes that constitute the group of N1 in lung cancer?
a) The peribronchial lymph nodes, lung lymph nodes of the base of lungs
b) bifurcation, mediastinal lymph nodes
c) mediastinal or base of the lung with opposite sides
34. What are the regional lymph nodes that constitute the group of N2 lung cancer?
a) The peribronchial lymph nodes, lymph nodes of the base of lung
b) bifurcation, mediastinal lymph node
c) mediastinal or base of the lung with opposite sides
35. What are the regional lymph nodes that constitute the group of N3 for lung cancer?
36. What remote lymphogenous metastasis of lung cancer occur most frequently?
a) liver metastases
b) Metastases in bones of the skeleton
c) Metastases in the adrenal glands and kidneys
d) brain metastases
g) Metastases to the skin
g) Metastases to the spleen
a) T1N0M0, T2N0M0
b) T1N1M0, T2N1M0
a) T3N0M0, T3N1M0, T1-3N2M0, N1-4N3M0, T4N0M0
d) T1-4N0-3M1
a) T1N0M0, T2N0M0
b) T1N1M0, T2N1M0
a) T3N0M0, T3N1M0, T1-3N2M0, N1-4N3M0, T4N0M0
d) T1-4N0-3M1
40. Which combinations of symbols mean TNM stage III lung cancer?
a) T1N0M0, T2N0M0
b) T1N1M0, T2N1M0
a) T3N0M0, T3N1M0, T1-3N2M0, N1-4N3M0, T4N0M0
d) T1-4N0-3M1
a) T1N0M0, T2N0M0
b) T1N1M0, T2N1M0
a) T3N0M0, T3N1M0, T1-3N2M0, N1-4N3M0, T4N0M0
d) T1-4N0-3M1
a) Cough
b) Hemoptysis
c) chest pain
d) Shortness of breath
e) Trouble in swallowing
a) Hemoptysis
b) Obturation of the lumen of the bronchus by the tumor
c) Swelling of the bronchial mucosa due to inflammation
a) Chronic
b) Residual
46. Which syndrome often occurs in metastatic lesions of paratracheal lymph node on the right?
47. What's syndrome often occurs in lesions of the left paratracheal lymph nodes in lung cancer?
49. What syndrome occurs in metastatic lesions of the pleura in lung cancer?
a) metastatic pleurisy
b) pain syndrome
c) Hemoptysis
52. What are the main clinical manifestations of peripheral lung cancer?
a) Ultrasonic
b) Endoscopic
c) X-ray
d) Radioisotope
56. What are the radiological diagnostic methods used for lung cancer?
a) Computed tomography
b) Survey radiography of the lungs
c) Flurography
g) X-ray tomography
e) Pneumoscintigraphy
57. What are the main radiological signs of central lung cancer?
58. What are the main radiological signs of peripheral lung cancer?
59. What are the main radiological signs of broncho-alveolar lung cancer?
60. With which diseases, radiological differential diagnosis of peripheral lung cancer carried out?
a) Hamartoma
b) Tuberculoma
c) Metastasis of cancer of other sites
d) neurenomas
e) Cyst of lung
e) carcinoid tumor
g) Parasitic cyst
62. What are the main differences between X-ray-parameter of peripheral lung cancer and benign
nodules?
63. What are the main objectives of bronchoscopy for central lung cancer?
a) Identification of direct signs of tumors - imaging of tumor lesions in the bronchial mucosa
b) Identification of indirect signs of tumor - strain with the narrowing of the bronchi, the rigidity of
the walls, restricting the mobility of the respiratory bronchial walls
a) Restoring patency of the affected bronchus
d) Morphological confirmation of the diagnosis
64. What are the main objectives of bronchoscopy in peripheral lung cancer?
65. What are the main methods of morphological verification of peripheral lung cancer?
66. What are the main methods of morphological verification of central lung cancer?
67. What are the main methods of diagnosis of metastatic regional lymph nodes for lung cancer?
a) radiography
b) Tomography
c) X-ray computed tomography
d) Magnetic Resonance Imaging
e) Thoracoscopy
g) Scintigraphy with gallium
68. What methodology is used to assess the status of functional lung tissue in lung cancer?
a) Radiography
b) Tomography
c) X-ray computed tomography
d) Magnetic resonance imaging
e) Thoracoscopy
e) Perfusion pneumoscintigraphy
69. What is the most informative method to detect early distant hematogenous metastasis in the
bones of the skeleton in lung cancer?
a) Computed tomography
b) Bone scan
c) X-ray examination of bones of the skeleton
d) Study of tumor markers
70. Which radioisotope technique allows visualizing tumor metastasis in lung cancer?
a) Perfusion pneumoscintigraphy
b) Ventilation pneumoscintigraphy
c) Positive pneumoscintigraphy
71. What methodologies are used to assess the prevalence of the tumor process in lung cancer in the
large vessels of the mediastinum?
a) Pneumoscintigraphy
b) Angiography
c) CT
d) Magnetic resonance imaging
e) Ultrasound imaging
72. What methods are used to detect distant haematogenic metastases for lung cancer in the adrenal
glands and kidneys?
a) Pneumoscintigraphy
b) Angiography
c) CT
d) Magnetic Resonance Imaging
e) Ultrasonic tomography
73. . What methods are used to detect distant haematogenic metastases for lung cancer in the brain?
a) Pneumoscintigraphy
b) Angiography
c) CT
d) Magnetic Resonance Imaging
e) Ultrasound imaging
74. What are the 2 most commonly used method of treatment of lung cancer?
a) Surgical
b) Drug
c) Radiotherapy
g) Radio immune
75. What are the standard surgical procedures performed for lung cancer?
a) segmentectomy
b) Pneumonectomy
c) Lobectomy
d) wedge resection
e) Boundary resection
76. Which organ preserving surgical intervention is used for lung cancer?
a) segmentectomy
b) Pneumonectomy
c) Lobectomy
d) wedge resection
e) Boundary resection
80. What radical treatment is most often used in stage I lung cancer?
a) Combined
b) Radiation
a) Surgical
d) Complex
81. What radical treatment is most often used in II-III stages of lung cancer?
a) Combined
b) Radiation
c) Surgical
d) Complex
82. What dose of radiation therapy is used in radical radiotherapy treatment of lung cancer?
a) 36-40 Gy.
b) 56-66 Gy.
83. What dose of radiation therapy is used in the palliative treatment of lung cancer?
a) 30-36 Gy.
b) 36-40 Gy.
b) 56-66 Gy.
84. What type of radiation therapy is most often used in the combined treatment of lung cancer
a) Preoperative radiotherapy
b) Intraoperative radiotherapy
c) Postoperative radiotherapy
85. What dose of postoperative radiation therapy is used in the combined treatment of lung cancer?
a) 30-36 Gy.
b) 46-50 Gy.
b) 56-66 Gy.
86. For the treatment of which type of lung cancer is systemic chemotherapy most often used?
a) Squamous
b) small-cell
c) glandular
a) Surgical
b) Combined
c) Complex treatment
88. What drugs are used in systemic chemotherapy for lung cancer?
a) Lomustin
b) Platinum compound
c) Adriomysin, bleomycin
d) Etoposide
d) 5-Fluorouracil
90. What method is most frequently used to detect X-ray-negative lung cancer?
a) Computed tomography
b) Magnetic resonance imaging
a) Radioisotope studies
d) Endoscopic methods
Central cancer - arises from the large bronchi (the main, lobar,
segmental) There are three forms of central lung cancer:
a) polypous cancer - a cancer growing in the bronchi as a
polyp on a stalk
b) endobronchial - a cancer growing in the bronchus as a
node of irregular shape
c) peribronchial - a cancer growing along the bronchial wall
and outward
Classification TNM:
Peripheral lung cancer
TOMOGRAPHY
COMPUTER TOMOGRAPHY
Angiography
Bronchoscopy
Tomography:
Computed Tomography:
Bronchoscopy:
Angiography:
Five main groups of angiographic signs of
1) Surgical treatment
2) Radiotherapy
3) Polychemotherapy
a) Lomustin
b) Platinum compound
c) Adriomysin, bleomycin
d) Etoposide
e) nitrosourea.