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Medicine

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Respiratory

Question
15 out of 27
 

A 60 year old man presents with non-productive cough and hemoptysis for 4 weeks; He has grade III clubbing, and a lesion in the apical lobe on x ray. Most likely diagnosis here is: (AIPG 2010)



A Small cell ca

B Non-small cell ca

C Fungal infection

D Tuberculosis

Ans. B

Non-small cell ca

Non metastatic neurological: confusion; fits; cerebellar syndrome Q; proximal myopathy; Q neuropathy; polymyositis; Eaton-Lambert syndrome.Q

Other: clubbingQ, HPOA Q, dermatomyositis Q; acanthosis nigricans Q, thrombophlebitis migrans Q.

Note

1). Skeletal connective tissue syndromes including clubbing is usually seen in non-small cell carcinomas

2). Clubbing is least common with small cell carcinoma of lung.

Most common histological variant associated with clubbing: non-small cell carcinoma

Most common histological variant presenting at peripheral location: non-small cell carcinoma.

Extra Edge: - Chest signs: May be normal, or: consolidation; collapse, pleural effusion.

Metastases: bone tenderness; hepatomegaly; confusion; fits; focal CNS signs; cerebellar syndrome; proximal myopathy Q; peripheral neuropathyQ.

Complications:

Local:

1). Recurrentlaryngeal nerve palsy

2). Phrenic nerve palsy

3). SVC obstruction (non-pulsatile raised JVP) Q & prominent upper lobe veins..

4). Horner's syndrome (Pancoast's tumour) Q

5). Rib erosion

6). Pericarditis

7). Atrial fibrillation

Respiratory Flashcard List

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