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Kaplan Qbank USMLE



Author10 Posts
  #1

Patient with obvious paraneoplastic manifestations of Small Cell CA (SIADH/Cushing syndrome) + mets to supraclavicular LN.
CXR shows peripheral lung node 2 cm in size.
What would CONFIRM diagnosis?

A) Serum osmolarity
B) CT scan
C) Bronchoscopy
D) Sputum cytology
E) LN biopsy

?

  #2

OOPS!!!I got it wrong.....Small cell CA with peripheral lesion--->Management cannot be bronchoscopy or sputum cytology...Betwen CT and LN biopsy I think I will go for the latter.....

Edited by sprint123 on 05/01/07 - 04:29 PM

  #3

But look at CXR! Peripheral lesion!

  #4

I'd pick LN, since CT will give just confirmation of expansive/infiltrative lesion. If it were MRI, I'd think twice. However, biopsy would still be more sensitive.
Any other opinion?

  #5

E) LN biopsy
And this is most likely is not SCLC, which is a central form of the lung cancer, not periferal... The Q is not correct by itself

___________________
Don't live in a town where there are no doctors

  #6

Based on paraneoplastic manifestations, which one would you pick? SCLC is usually central, but in the light of symptoms...

  #7

My choice is LN biopsy... CT guided tumor biopsy is not an option on the list

I am always worried when Qs composed inappropriately ...disapproval

___________________
Don't live in a town where there are no doctors

  #8

No, no, no, I asked you which CA would you pick? I'd say LN biopsy as well (from offered answeres), but in real life it'd be CT guided biopsy of the Tm.

  #9

As a rule Any Cancer needs tissue diagnosis for confirmation . So one an either biopsy the primary( the lung nodule) using a CT guided biopsy /FNA, or biopsy the supraclavicular node ( the question already suggests a metastssis to the supraclavicular node).

  #10

YEAH BIOPSY ALWAYS...bcz u cant stain the CT u cant culture an MRIi u cant get sensitivity testing on scans...







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