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AHIMA RHIA Exam - Topic 4 Question 78 Discussion

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
B) small cell lung carcinoma.
A) metastatic brain carcinoma.
C) hemoptysis.
D) pneumonia.

AHIMA RHIA Exam - Topic 4 Question 78 Discussion

Actual exam question for AHIMA's RHIA exam
Question #: 78
Topic #: 4
[All RHIA Questions]

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

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Suggested Answer: B

by Pamela at Mar 02, 2026, 04:22 PM

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Emilio
Agreed! The lung cancer is the main issue here. Metastasis is secondary.
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Mariko
5 days ago
I think the principal diagnosis is B) small cell lung carcinoma. It's the primary cancer.
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Shawnda
10 days ago
Pneumonia is secondary here, focus on the carcinoma!
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Twana
15 days ago
Hemoptysis is just a symptom, not the main issue.
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Nickolas
2 months ago
Wait, how did it spread to the brain so fast?
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Iluminada
2 months ago
I agree, the biopsy confirms it.
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Chauncey
2 months ago
Definitely small cell lung carcinoma.
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Florinda
3 months ago
I thought pneumonia was the main concern here!
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Vernice
3 months ago
Hemoptysis is just a symptom, not the main issue.
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Antonio
3 months ago
Wait, how did it spread to the brain so fast?
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Reed
3 months ago
I agree, B is the right choice!
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German
3 months ago
Definitely small cell lung carcinoma.
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Margurite
3 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.
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Carli
4 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.
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Roselle
4 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?
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Karina
4 months ago
I remember discussing how small cell lung carcinoma is often associated with metastasis, so I think B might be the right answer.
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