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A patient is admitted with shortness of breath and hemoptysis. A chest x-ray revealed patchy infiltrates in the left lung and possible pneumonia. On the third day of hospitalization a bronchoscopy with biopsy was done which revealed a small cell carcinoma of the left upper lobe of the lung. A metastatic lesion in the brain was detected. The principal diagnosis is the
Suggested Answer: B
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26 comments · newest first
ED
Edison
1 month ago
True, but the lung cancer is the main issue. B is the best choice.
HE
Helga
1 month ago
But what about A) metastatic brain carcinoma? It’s also important.
AI
Aide
2 months ago
I agree, B) small cell lung carcinoma makes sense. It started in the lung.
DO
Domonique
2 months ago
I think the answer is B) small cell lung carcinoma. It’s the primary cancer here.
MA
Macy
2 months ago
True, but the question asks for the principal diagnosis. B is still the best choice.
ER
Erick
2 months ago
But what about the brain lesion? Isn't that significant?
LA
Lacey
2 months ago
Agreed! The primary issue is the lung cancer, not the pneumonia.
JE
Jerrod
2 months ago
I think the answer is B) small cell lung carcinoma. It fits the findings.
AL
Alverta
3 months ago
No, hemoptysis is a symptom, not the diagnosis. B is definitely correct.
VA
Valentin
3 months ago
But hemoptysis is a serious symptom. Shouldn't we consider C)?
EM
Emilio
3 months ago
Agreed! The lung cancer is the main issue here. Metastasis is secondary.
MA
Mariko
3 months ago
I think the principal diagnosis is B) small cell lung carcinoma. It's the primary cancer.
SH
Shawnda
3 months ago
Pneumonia is secondary here, focus on the carcinoma!
TW
Twana
4 months ago
Hemoptysis is just a symptom, not the main issue.
NI
Nickolas
5 months ago
Wait, how did it spread to the brain so fast?
IL
Iluminada
5 months ago
I agree, the biopsy confirms it.
CH
Chauncey
5 months ago
Definitely small cell lung carcinoma.
FL
Florinda
6 months ago
I thought pneumonia was the main concern here!
VE
Vernice
6 months ago
Hemoptysis is just a symptom, not the main issue.
AN
Antonio
6 months ago
Wait, how did it spread to the brain so fast?
RE
Reed
6 months ago
I agree, B is the right choice!
GE
German
6 months ago
Definitely small cell lung carcinoma.
MA
Margurite
6 months ago
I keep second-guessing myself, but I think pneumonia is just a complication in this case, so I’m leaning towards B as well.
CA
Carli
7 months ago
This question reminds me of a practice case we did where we had to identify the primary cancer. I think B is definitely the principal diagnosis here.
RO
Roselle
7 months ago
I’m not entirely sure, but I feel like hemoptysis is just a symptom, not the main diagnosis. So maybe it’s not C?
KA
Karina
7 months ago
I remember discussing how small cell lung carcinoma is often associated with metastasis, so I think B might be the right answer.