NBME Form 4 ?

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NBME Form 4 ?

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14 Posts

pearljam59
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03/30/06 - 10:59 AM

A 78-year-old man comes to the physician because of progressive swelling of the right side of his face and neck and his right upper extremity. His right jugular vein is engorged. Which of the following diagnoses is most likely to be confirmed on an x-ray of the chest?

A) Aortic arch aneurysm
B) Mass in the upper lobe of the right lung
C) Right cervical rib
D) Right pneumothorax
E) Thoracic duct blockage in the posterior mediastinum

shocked

vanshita
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03/30/06 - 11:03 AM

sosikan
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03/30/06 - 12:06 PM

ı think the right answer is C

yasmeen
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03/30/06 - 12:34 PM

its B .PANCOAST TUMOUR COMPRESSING SUPERIOR VENA CAVA

yasmeen
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03/30/06 - 12:54 PM

BUT SYMPTOMS R POINTING TO RIGHT LYMPHATIC DUCT OBSTRUCTION AS THEY R NOT BILATERAL shocked

huzefa
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03/30/06 - 01:50 PM

Answer is B (Pancoast Tumor). The question states the Right Jugular vein is engorged; this would be highly unlikely with a Thoracic duct blockage; moreover the Thoracic duct only drains the Right lower body and Left side of the body; it does not drain the right side of the head or right arm.

vanshita
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04/02/06 - 09:52 PM

you r right huzefa nice explation

r_albayunen
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04/05/06 - 12:16 AM

Pancoast tumor .. I agree with Huzefa explanation.

sosikan
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04/15/06 - 06:31 AM

now ı see its pancoast

studydork
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06/12/06 - 10:49 AM

#10

answer B, due to lung cancer, but it's not pancoast tumor, it's superior vena cava syndrome...they are not the same thing

docsrinu
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08/31/06 - 06:43 PM

#11

small cell ca of lung causes svc sydrome.

klimt
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10/01/06 - 10:47 AM

#12

I go with B too

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drfax
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10/01/06 - 02:02 PM

#13

B

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MD_toronto
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10/01/06 - 04:57 PM

#14

B.
Brochogenic Ca centrally located causing SVC syndrome (compression SVC)
Pancost tumor will have presentation w/ Horner syndrome(ptosis,miosis).
Thoracic duct as someone explain drains left side of body.

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