CRP:Albumin ratio was also highlighted as a key predictive factor.

Easy to get or include with monitoring labs for patients getting treatment. The only issue is on its own, seems to have fairly mild predictive effect (at least as estimated in the Cox proportional hazards method)

It's flu season, so that means it's also COPD exacerbation season in the hospital.

I always got a little confused as to what to do with all of their inhalers, but the gist is:

- Continue their long acting inhalers
- Duonebs will cover their rescue inhalers

The data is not great on prognosis (only case series b4 2000s), but roughly 2-7 months.

Even patients with resectable lung cancer (so not metastatic) had earlier mortality by about 2 years if they had positive post op cancer in lymphatics than those who did not

Diagnosis:

Usually t/ clinical presentation + imaging
- CT scan: interstitial thickening, nodular opacities, and Kerley B lines
- PET: high specificity (100%) and sensitivity (86%), but hard to get in inpatient

Transbronchial biopsy is technically gold standard, but more morbid

I took care of a patient with lung cancer who went to the ICU for respiratory failure of unclear etiology.

CT chest done that suggested “lymphangitic carcinomatosis”

Though he got better, that dx changed what happened next for him

A 🧵 on lymphangitic carcinomatosis

Ever wonder if a certain symptom your patient with cancer is endorsing is related to their chemotherapy?

The short answer is usually "maybe", but here's a helpful chart of common toxicities by chemotherapy classes.

From hemeoncnotes.com, the solid cancer intro lecture!

Step 4: Interpret your biopsy result

Biopsies are a combination of:
- Histology: Tissue type
- IHC: Markers that can help determine origin & subtype
- Molecular: Genetic testing (can take longer to come back)

Ex: "Adenocarcinoma of lung [histology], positive for TTF-1... [IHC]

Step 3: What to biopsy?

Unfortunately, your pt may have multiple potential biopsy sites. Which one to target?

In general, you want your target to be: :
- Metastatic site over primary site
- Safe & easily accessible
- Core biopsies better than FNA [more tissue = more studies]

Step 2: Do you need a biopsy?

Usually the answer is yes, but there are some exceptions.

- Notably HCC can be diagnosed primarily through imaging (triple phase CT or MRI)
- Some cancers (RCC, testicular, CNS) may require total excision as opposed to biopsy

Step 1: Where is the cancer?

Get a CT Chest/Abd/Pelvis with contrast. [Don't bother w/ inpatient PET]

This is fast and will tell if the cancer is localized or metastatic, which will help guide next steps

🧠 scans not part of initial staging unless syx