ling
Forum Senior
Topics: 23
Posts: 46
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A 47-year-old man comes to the physician because of a 3-week history of increasing facial swelling and a 1-week history of morning headaches and mild shortness of breath. He had previously felt well. He completed a course of chemotherapy 4 months ago for small cell carcinoma of the lung. His temperature is 37.2°C (98.9°F), blood pressure is 142/80 mm Hg with an 8-mm Hg paradoxical pulse, pulse is 84/min, and respirations are 18/min. Examination shows significant diffuse facial and periorbital edema. The optic discs are sharp, and ocular movements are intact. The lungs are hyperresonant bilaterally with a moderately prolonged expiratory phase. Mild rhonchi are heard on inspiration and expiration. An x-ray film of the chest shows a 10-cm mass in the right upper lobe and apex. Which of the following is the most likely explanation for these findings?
A ) Chemotherapy-induced bone marrow toxicity
B ) Chemotherapy-related cardiac toxicity
C ) Hypercoagulable state secondary to malignancy
D ) Interstitial metastatic pulmonary disease
E ) Intracranial metastases
F ) Lymphatic obstruction
G ) Malignant pericarditis
H ) Paraneoplastic syndrome
I ) Pleural metastases
J ) Soft tissue metastases
K ) Vascular obstruction
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| muna
Forum Senior
Topics: 17
Posts: 126
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K ?
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| neuroblastoma
Forum Guru
Topics: 110
Posts: 1,097
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H
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| robin082006
Forum Hero
Topics: 471
Posts: 5,123
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K ) Vascular obstruction
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The Key to Succeed is Patience.
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| Justice
PGY-I, now officially
Topics: 120
Posts: 2,439
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F
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The winner takes it all...
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| dr.shailu
Forum Senior
Topics: 26
Posts: 191
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K
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| yasmeen
Forum Guru
Topics: 72
Posts: 954
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K
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| dr_jojo
Forum Newbie
Topics: 3
Posts: 5
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SVC Syndrome ..........K
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| monterusca2004
Forum Junior
Topics: 7
Posts: 42
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I will go for vascular obstruction, but I think that more than edema it should suggest pletoric facies, with change in color of the skin or somthing.
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| maiya
Forum Newbie
Topics: 3
Posts: 35
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although i understand choice K, why not F - lymphatic obstruction?
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| r_albayunen
Forum Senior
Topics: 0
Posts: 218
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hmm where is the plethora?? JVDs? ill go for lymphatic obstruction F ..
paraneoplastic symdrome SIADH .. will cause hyponatremia symptoms
suggestions??
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| krsna
Forum Senior
Topics: 1
Posts: 211
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IS IT F OR IS K??WATS THE ANS?
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| Adam
Forum Senior
Topics: 6
Posts: 136
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SVC Syndrome ..........K
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