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The C Word, Pleural fluid protein/serum protein greater than 0.5, Pleural…

- - - - Experimental study
        
        e.g. Randomised controlled trial
    - - Observational study
        
        comparison group?
        
        yes
        
        Analytical study
        
        Direction?
        
        exposure ← outcome
        
        1 more item...
        
        exposure & outcome at the same time
        
        1 more item...
        
        exposure → outcome
        
        1 more item...
        
        no
        
        Descriptive
        study
        
        Case Series
        
        report on the characteristics of a group of subjects have the same disease
        
        Case report
        
        a detailed description of disease occurrence in a single person
- - - - Lie beneath the Visceral pleura & surface of the lung
    - - Vessels follow branches of pulmonary artery & vein
  - - - Anterior
      - Middle
      - Posterior
        
        The Left Posterior side contains the thoracic duct
      - Superior
  - - - Costal, mediastinal & diaphragmatic
    - - Anterior,inferior & posterior
- - - - thoracentesis
      - fine needle aspiration
- - - - if you lack both
        
        surrogate
- - - - HR= possibility of lung cancer in exposed group / possibility of lung cancer in unexposed group
- - - - Squamous cell cancer
        
        Location
        
        Central
        
        Histopathology
        
        keratin pearls & intracellular bridge
        
        Associations
        
        smoking & paraneoplastic syndrome
      - Large cell cancer
        
        Location
        
        peripheral
        
        Histopathology
        
        anaplastic undifferentiated large polymorphic cells
        
        Associations
        
        poor prognosis
        
        less response to chemotherapy
        
        gynecomastia
      - Adenocarcinoma
        
        Histopathology
        
        Mucin
        
        Associations
        
        non-smokers, women
        
        EGFR, ALK, KRAS gene mutations
        
        Hypertrophic osteoarthropathy
        
        Location
        
        peripheral
    - - Location
        
        Central
      - Histopathology
        
        small, oval, or round malignant cells ( previously called oat cell cancer)
      - Associations
        
        smoking & paraneoplastic syndromes
  - - - 2nd most common cancer worldwide
        
        in both genders
      - More than 2.2 million new cases of lung cancer in 2020
    - - in 2019, the incidence was 106 cases
        
        19% Qataris
        
        81% non-qataries
      - 4th most common cause of death
  - - - such as:
        
        weight loss
        
        anorexia
- - - - Alkylating Agents
        
        Cisplatin & Carboplatin
        
        MOA
        
        alkylate DNA, inhibiting function and replication
      - Antimetabolites
        
        Pemetrexed & Pralatrexate
        
        MOA
        
        Inhibit DHFR & thymidylate synthase (folate antagonists)
        
        Gemcitabine
        
        MOA
        
        pyramiding analog
      - Topoisomerase Inhibitors
        
        Irinotecan, Topotecan & Etoposide
        
        MOA
        
        Inhibit Topoisomerase
      - Microtubule inhibitors
        
        Paclitaxel & the more potent Docetaxel
        
        MOA
        
        Stabilize microtubules
  - - - VEGF inhibitors
        
        Bevacizumab
      - EGFR inhibitors
        
        Erlotinib & Gefitinib
      - Immunomodulatory monoclonal antibodies
        
        Nivolumab & Pembrolizumab
        
        MOA
        
        Blocks PD-1 on cancer cells, restoring T cell activity
      - Anaplastic Lymphoma Kinase inhibitors
        
        Crizotinib, Alectinib, and Ceritinib