Aashi
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a) panendoscopy to detect primary tumor and then biposy it
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| Justice
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b) cervical Ln biopsy promptly to further evaluate the mass
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| nadiabarati
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I also think it's a
coz there was a Q in UW that explained a hard large lymph node in an alcoholic person and next best step was, panendoscopy.
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| docnikki
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yes Nadia there was that quest but there was another quest for SCC in which they did biopsy of node and said in exaplaination that this is what should be done next. thats why I put it up in here..because 2 different concepts UW gave for the same scenario.
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| Justice
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I chose (B) because the logics of (A) is confusing: if you don't find the primary tumor is the pharynx, you then don't need to do the biopsy, which would be wrong. The biopsy should go first.
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| Aashi
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Justice plss open up surgery kaplan, under surgery vignette, this is unique case,were u dont follow the 'logic' business of excisinal bx of the L.N--->u may do a FNA, but NOT A BX--->coz the incision in this neck for a bx,will eventually mess up the appropraite surgical approach that this pt will ultimately require.
GL
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"Obstacles are those frightful things you see when you take your EYES off your goal."
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| docnikki
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thats pretty convincing.thanks ashi!
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