do u know?

[AbuJadenDO]

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so i'm getting conflicting info from my review sources and was hopin' one of you brainiacs could give me the TRUTH.

so some sources say the hypercalcemia in Lung cancer is due to PTH secretion from Small cell CA and others say Squamous cell and the sources flip flop on which lung CA causes the hypercalcemia via increased bone destruction.

also...2 pages of step up to step II contradict each other when working out Angina vs GERD vs Esophageal spasm
page 1st page says Nitro will alleviate angina, GERD and esophageal spasms
then few pages later it says Nitro will relieve pain from diffuse esophageal spasm but WORSEN symptoms of GERD.


what the heck is goin on here!?

i wouldn't make a big fuss but since these points keep poppin' up on my World questions..i figured they were important.

thanks peoples

 

[QuinnB]

so i'm getting conflicting info from my review sources and was hopin' one of you brainiacs could give me the TRUTH.

so some sources say the hypercalcemia in Lung cancer is due to PTH secretion from Small cell CA and others say Squamous cell and the sources flip flop on which lung CA causes the hypercalcemia via increased bone destruction.

also...2 pages of step up to step II contradict each other when working out Angina vs GERD vs Esophageal spasm
page 1st page says Nitro will alleviate angina, GERD and esophageal spasms
then few pages later it says Nitro will relieve pain from diffuse esophageal spasm but WORSEN symptoms of GERD.


what the heck is goin on here!?

i wouldn't make a big fuss but since these points keep poppin' up on my World questions..i figured they were important.

thanks peoples

Re: the hypercalcemia in lung CA, PTHrP is most commonly associated with squamous cell CA of the lung (NOT small cell CA). Release of PTH alone has been noted rarely in some case reports (ovarian CA, etc...) but this is totally useless for the board exam. For all of the other pulmonary lesion paraneoplastic syndromes, you should pick small cell CA as the first (ACTH, Lambert-Eaton, SIADH, etc...). Remember that carcinoid syndrome from a pulm lesion is likely a met to the lung (but most commonly, carcinoid is a met in the liver from the small bowel).

For the Nitro, it does work in esophageal spasm and angina, but I am unaware of any positive effect on GERD.

 

[JayZee]

Sca++mous Cell 🙂 per FA

 

[AbuJadenDO]

thanks guys!
beware some review books say Chest pain 2' to Pericarditis is relieved when patient sits up but I know for a fact its relieved when they lean forward.
Boards & Wards is coo coo

 

[werd]

the confusion probably comes from the fact that small cell CAN cause hypercalcemia thru PTHrp (or bone mets), but squamous cell is the classic association. it's probably pretty safe that PTH/lung cancer combo's on a usmle would predict SCC...

 

[reza423]

as for your second question that is easy

nitrates relieve chest pain in angina and diffuse esophageal spasm but worsen the pain of GERD cuz they relax the lower esophageal sphincter

 

[RockfordWF]

the confusion probably comes from the fact that small cell CAN cause hypercalcemia thru PTHrp (or bone mets), but squamous cell is the classic association. it's probably pretty safe that PTH/lung cancer combo's on a usmle would predict SCC...

This was actually a question on my USMLE yesterday. I actually had about 10 questions on calcium disorders. The answer was squamous cell, by the way.

Squamous = PTH like peptide

Small Cell = ADH/ACTH

 

[AbuJadenDO]

just to be clear when you guys are referring to SCC you are referring to squamous cell because SCC can be used for both small cell and squamous cell...😉