1. Small cell lung cancer: 
- So often associated with smoking that if its diagnosed in a "never smoker", recheck the history or the pathology
- Staged as either "limited" (can all fit into one radiation port) or "extensive" (can't fit into one radiation port)
- Treated with chemo (platinum agent + etoposide or irinotecan). Add radiation if the disease is limited.
- Salvage chemo after the inevitable failure of first-line chemo
2. PSA + prostate cancer 
- If you're following PSA, any rise > 0.75/year or a rise to above 4 should be investigated with a biopsy. PSA > 4 is only 25% sensitive for detecting prostate cancer.
- However the biopsy false positive rate is >75%
- Only guys aged 50-70 should be screened (start at 45 for those with family hx of prostate cancer or who are black)
3. Metastatic prostate cancer: 
- If asymptomatic, first line treatment is leupron as most prostate cancer is hormone-sensitive.
- When first starting leupron, there may be a transient increase in FSH/LH and a concomitant worsening of prostate cancer symptoms; this can be managed with an anti-androgen (nilutamide, flutamide).
- If that fails, then try docetaxel
- Samarium 153 can be used to treat painful metastatic bone cancer that hasn't responded to other treatments; however this carries significant risks including marrow failure.
4. Pap smears
- ASCUS + positivity for high risk HPV strain (16,18) buys you a colpo
- 21-30: pap smear (no HPV test) every 3 years
- 30-65: pap smear q3 or pap+HPV q5
- No screening after hysterectomy with removal of cervix unless there was a personal history of advanced disease (CIN 2, 3 or cervical cancer)
5. Bowen's disease: 
- Aka squamous cell carcinoma in situ
- Slowly growing, non pruritic, scaly lesion, well defined, erythematous
6. Nodular skin cancers: 
- Nodular melanoma: single color nodule that grows on the skin; often blue or black, 'berry like', symmetric
- Keratoacanthoma: rapidly growing from solid nodule to crater-like with a central keratotic plug. Often involutes in a few months, rarely progresses to metastatic cancer. Treat with excision or injections of 5-FU or MTX or topical imiquimod or radiation.
- Seborrheic keratosis: stuck on tan or brown lesions, benign
- Spitz nevus: elevated mole, benign, often in kids, can be pink or red or pigmented.
- Basal cell: pink, pearly, often with specks of melanin, teleangiectasias.
7. Cancer pain management: 
- Start with short acting opiates, then titrate to pain relief, and then convert to long acting opiates (with 30-50% dose reduction) + short acting for breakthrough pain.
- Try to stay with the same medicine for both short and long acting
- Treat dyspnea with morphine in end-stage cancer patients
8. COPD
- No longer use response to inhaled bronchodilators to distinguish copd from asthma or to predict response to long term bronchodilator/steroid use. Any FEV1 <80% of predicted or FEV1/FVC < 0.7 demonstrates not fully reversible disease and excludes asthma
- Dyspnea 2/2 CHF should show no PFT abnormalities except maybe lower DLCO 2/2 pulmonary edema. Same with dyspnea 2/2 PE
9. Episodic cough/chest tightness lasting weeks triggered by URI with normal PFTs in between- think asthma (cough variant asthma) even in an older person.
- Diagnose with methacholine challenge- give increasing doses of methacholine until you see 20% reduction in FEV1 from baseline (provocative concentration 20- PC20). PC20 of 4 is asthma, 4-16 is hyperreactive, 16+ is normal
10. Hepatopulmonary syndrome: increased vasodilation of lung vessels, causing V/Q mismatch; NO concentration in exhaled air is greater in people with this disease than normal. Same with NO synthetase. Dyspnea will be improved with lying down and worse with sitting upright.