Pulmonary Neoplasms

A 68-year-old woman presents to the emergency department after coughing up a cupful of red blood. For the previous 3-4 months, she has had a chronic non-productive cough without fever. More recently, she has noticed some blood-streaked sputum. On review of systems, she reports increased fatigue, decreased appetite, and a 25-lb weight loss in the past 3 months. She denies chest pain, fever, chills, or night sweats. The patient has smoked one pack of cigarettes per day for the past 35 years. Physical exam reveals fingernail clubbing. Which of the following is the most likely diagnosis?

A 61-year-old woman presents to the emergency room with headache, dyspnea on exertion, and facial swelling for nearly 2 weeks. She has smoked 3 packs of cigarettes per day for nearly 40 years. Her blood pressure is 120/88, pulse is 90/min, respirations are 16/minute, and she is afebrile. A heart and lung examination are normal. She has dilated veins in the neck and upper chest area. Which of the following is the most likely diagnosis?

A 64-year-old woman sees you in your office complaining of a hoarse voice for 4 months. She denies fever, sore throat, or cough. On examination, she has expiratory wheezes in her left mid-lung fields. Which of the following is the best next step?

A 33-year-old woman who is a nonsmoker has lost 30 lb and has a persistent cough. She is noted to have a lung mass on CXR. Which of the following lung cancers is the most likely cell type?

A 56-year-old man presents with dyspnea, and a CXR shows a hilar mass with ipsilateral pleural effusion. Which of the following is the best next step?

A 45-year-old non-smoker is noted to have a 2-cm soft tissue mass in the left lung field on routine chest imaging. Which of the following is the most appropriate next step?

A 45-year-old man with a persistent cough is noted to have a suspicious lesion on CXR. The physician orders a CT scan of the chest. Which of the following describes the main purpose of CT imaging for a patient with a suspicious lung mass?

A 53-year-old man with a 20 pack-year smoking history presents with a 2-week history of a productive cough. A CXR reveals a right middle lobe infiltrate. Which of the following is the most appropriate management of this patient?

Which of the following is essential in diagnosing bronchogenic carcinoma?

In terms of preventing bronchogenic carcinoma, what is the single most important factor?

What percentage of lung cancer patients are symptomatic at the time of diagnosis?

What is the purpose of physiologic staging?

Which of the following is NOT typically part of the general staging procedures for lung cancer?

For non-small cell tumors (NSCLC), staging is determined by:

Which of the following is a major contraindication for curative surgery in lung cancer?

According to the US Preventive Services Task Force (USPSTF), which of the following individuals should be screened annually for lung cancer via CT?

Which of the following is the most common type of lung cancer?

Which of the following risk factors is MOST associated with the development of squamous cell carcinoma of the lung?

A patient presents with new-onset shoulder pain, ptosis, miosis, and anhidrosis on the right side. What condition is most likely?

While reviewing a chest X-ray, you note a small peripheral mass. Which type of lung cancer is most likely to present this way?

A patient presents with a constellation of symptoms including facial flushing, diarrhea, and bronchospasm. Which of the following conditions is most associated with these symptoms?

For which disease is surgical resection the recommended treatment?

A construction worker who was exposed to asbestos for several years presents with shortness of breath and chest pain. Imaging reveals diffuse pleural thickening. Which of the following is the most likely diagnosis?

What finding on a solitary pulmonary nodule is most suggestive of malignancy?

A 55-year-old patient has a solitary pulmonary nodule measuring 9 mm in diameter, found incidentally on a CT scan. The patient has no prior history of malignancy and is a former smoker, having quit 5 years ago. According to Fleischner Society guidelines, what is the appropriate follow-up?

A 70-year-old male patient with a history of heavy smoking is diagnosed with small cell lung cancer (SCLC). After initial staging, the cancer is confined to one hemithorax and regional lymph nodes. According to the staging for SCLC, which stage is this?

A patient with small cell lung cancer develops syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following is the most appropriate initial management?

A patient is diagnosed with limited-stage small cell lung cancer (SCLC). What treatment approach is most appropriate?

A patient with a history of lung cancer presents with new onset back pain, lower extremity weakness, and urinary retention. What is your top differential?

A patient with a known history of lung cancer develops Horner's syndrome. Which of the following is the most likely location of the tumor?

A 60-year-old male presents with dyspnea, facial swelling, and prominent neck veins. Imaging reveals a mass in the mediastinum. What is the first step in the management of this patient?

Which of the following paraneoplastic syndromes is associated with small cell lung cancer?

What is the most common cause of lung cancer worldwide?

A 75-year-old male patient with a history of smoking presents with a solitary pulmonary nodule. Which factor would be MOST indicative of the need for resection of the nodule?

The majority of solitary lung nodules are:

A patient presents with cough, weight loss, and elevated serum calcium levels. Which type of lung cancer is MOST likely?

Which of the following is the MOST accurate diagnostic procedure for mediastinal lymph node staging in non-small cell lung cancer (NSCLC)?

For a lung lesion with radiographic stability for two or more years, what is the most appropriate next step?

A 55 year old patient gets the flu. She also has a history of lung cancer. Her labs show elevated serum calcium and a normal level of parathyroid hormone. Which paraneoplastic syndrome is most likely?

What is the most common site of metastasis for lung cancer?

Lung cancer is the third most common cancer in the United States. Behind which two cancers is the next most prevalent?

Which of the following best describes a solitary pulmonary nodule (SPN)?

Which factor is MOST predictive of malignancy in a solitary pulmonary nodule (SPN)?

A 72-year-old male former smoker new diagnosis of lung cancer has extensive involvement of the liver and bone. Systemic chemotherapy is initiated with improvement, but within several months, he returns, and labs show worsening thrombocytopenia. In addition to the typical culprits causing thrombocytopenia, which of the following should be considered?

Which of the following statements is MOST accurate regarding the overall survival rate in lung cancer?

A patient with suspected carcinoid syndrome is experiencing severe diarrhea and malabsorption. Which of the following laboratory findings would MOST strongly support the diagnosis?

What is the approximate percentage of patients diagnosed with lung cancer in the USA who succumb to the disease within 5 years?

Which of the following is identified as the primary etiological factor for lung cancer in the United States?

Non-small cell lung cancer (NSCLC) comprises what percentage of all primary lung cancer diagnoses?

Which subtype of non-small cell lung cancer is most frequently diagnosed?

Which of the following clinical manifestations is more typical of a centrally located endobronchial lung tumor compared to a peripheral lesion?

Superior vena cava syndrome, a complication of lung cancer, is primarily caused by:

Pancoast syndrome is characterized by Horner's syndrome and:

Which of the following is a common site for distant metastasis in lung cancer?

Paraneoplastic syndromes are systemic manifestations of cancer that are NOT due to direct physical effects of the tumor or metastases. Approximately what percentage of lung cancer patients experience systemic symptoms related to paraneoplastic syndromes?

Hypercalcemia is a paraneoplastic syndrome most commonly associated with which type of lung cancer?

Syndrome of Inappropriate Antidiuretic Hormone secretion (SIADH) is a paraneoplastic syndrome most commonly associated with which type of lung cancer?

Clubbing of the fingers is a skeletal connective tissue paraneoplastic syndrome seen in what percentage of non-small cell lung cancer patients?

Which type of lung cancer is most likely to present with a hilar mass, mediastinal widening, and cavitation on a chest X-ray?

Pleural thickening on a chest X-ray is most suggestive of which type of lung neoplasm?

In the context of lung cancer staging, what does 'physiologic staging' primarily assess?

The TMN staging system is used for which type of lung cancer?

In small cell lung cancer (SCLC) staging, 'limited stage disease' is defined as cancer confined to:

Which imaging modality is particularly useful in staging non-small cell lung cancer (NSCLC) to assess for mediastinal lymph node involvement and distant metastases?

Which procedure is considered essential for obtaining a definitive diagnosis of bronchogenic carcinoma?

For localized non-small cell lung cancer (NSCLC), what is generally considered the primary treatment modality?

In limited stage small cell lung cancer (SCLC), the addition of radiation therapy to chemotherapy can increase the 5-year survival rate from approximately:

Prophylactic cranial irradiation (PCI) is sometimes used in limited stage small cell lung cancer (SCLC) to improve survival. By approximately what percentage does PCI improve survival in these patients?

According to the US Preventive Services Task Force (USPSTF) guidelines, annual lung cancer screening with low-dose CT is recommended for adults aged 50 to 80 with:

Solitary pulmonary nodules are defined as being no larger than what maximal diameter?

Which factor is MOST predictive of malignancy in a solitary pulmonary nodule?

Radiographic stability of a pulmonary nodule for how long is considered strong evidence of a benign etiology?

For a solitary pulmonary nodule that is 8 mm or less in size, what is generally the recommended initial management strategy?

Carcinoid tumors of the lung represent approximately what percentage of all lung tumors?

Carcinoid syndrome is caused by the secretion of biogenic amines, especially:

Which of the following is a typical symptom of carcinoid syndrome?

What is the primary treatment for localized carcinoid tumors of the lung?

Lung is the second most common site for metastases. Which organ is the most common site of metastasis?

Which of the following primary cancers MOST commonly metastasize to the lung?

Malignant mesothelioma is strongly associated with occupational exposure to:

Which diagnostic procedure is typically required for the diagnosis of malignant mesothelioma?

In the context of solitary pulmonary nodules, 'popcorn' and 'bull's eye' calcifications are suggestive of:

A 60-year-old patient with a 40-pack-year smoking history presents with a new 3 cm solitary pulmonary nodule detected on CXR. A prior CXR from 3 years ago shows no nodule. According to Fleischner Society guidelines, what is the most appropriate next step?

Which of the following statements regarding lung cancer epidemiology is MOST accurate?

A patient with known small cell lung cancer presents with new onset facial edema, distended neck veins, and shortness of breath. What is the MOST likely underlying mechanism for these findings?

A patient with adenocarcinoma of the lung develops thrombophlebitis. This paraneoplastic syndrome is primarily classified under which category?

A researcher is studying the genetic lesions in lung cancer cells. Based on current understanding, what is the MINIMUM number of acquired genetic lesions typically found in lung cancer cells?

A 33-year-old non-smoking patient presents with a persistent cough, 30lb weight loss, and a lung mass found on CXR. Which of the following lung cancer types is MOST likely?

A 56-year-old male presents with dyspnea. A chest X-ray reveals a hilar mass and ipsilateral pleural effusion. What is the MOST appropriate next step in management?

Which of the following is considered a major contraindication to curative surgery for non-small cell lung cancer (NSCLC)?

What is the BEST initial step in evaluating a 3 cm solitary pulmonary nodule discovered on a chest X-ray in a 60-year-old patient with a 40-pack-year smoking history, with no prior films available for comparison?

Which of the following features MOST strongly suggests that a solitary pulmonary nodule seen on chest radiography is malignant rather than benign?

A 65-year-old male with a 40-pack-year smoking history presents with a chronic cough, hemoptysis, and recent unintentional weight loss. Imaging reveals a centrally located lung mass. A biopsy confirms squamous cell carcinoma. Which of the following findings is most characteristic of this type of lung cancer?

A 58-year-old male with a long history of smoking presents with confusion, nausea, and recent weight gain despite no changes in diet. Laboratory tests reveal hyponatremia (Na+ 121 mmol/L) with low serum osmolality. Which lung cancer is most commonly associated with this condition?

A 60-year-old woman presents with a 3-month history of progressive hoarseness. She denies fever, cough, or recent illness. A CT scan reveals a left-sided hilar mass. What is the most likely mechanism causing her hoarseness?

A 52-year-old non-smoker presents with chronic cough and unintentional weight loss. A CT scan reveals a peripheral lung nodule. Which of the following is the most likely diagnosis?

A 55-year-old male with a 30-pack-year smoking history presents with progressive facial swelling and distended neck veins. He reports shortness of breath and headaches that worsen when lying down. What is the most likely underlying cause?

A 64-year-old woman presents with shoulder pain, ptosis, miosis, and anhidrosis. Imaging reveals a lung mass in the superior sulcus. What is the most likely diagnosis?

A 70-year-old man with a history of asbestos exposure presents with progressive dyspnea and pleuritic chest pain. A CT scan shows extensive pleural thickening and a large pleural effusion. What is the most likely diagnosis?

A 45-year-old man presents with a 2 cm solitary pulmonary nodule found incidentally on imaging. He has no history of smoking. Which of the following factors would be most concerning for malignancy?

A 55-year-old male with metastatic non-small cell lung cancer is found to have multiple brain metastases. What is the most appropriate treatment strategy?

A 63-year-old man with a history of heavy smoking presents with a 3 cm hilar mass on imaging. Biopsy confirms small cell lung cancer. What is the most appropriate initial treatment?

A 70-year-old man presents with new-onset headache, confusion, and difficulty walking. He has a history of squamous cell lung carcinoma. MRI of the brain shows multiple ring-enhancing lesions. What is the most likely cause of his symptoms?

A 60-year-old male with chronic smoking history presents with progressive fatigue, polyuria, and muscle weakness. His calcium level is 13.5 mg/dL. Which lung cancer is most likely responsible for this paraneoplastic syndrome?

A 55-year-old female presents with weight loss, chronic cough, and digital clubbing. Chest X-ray shows a well-defined peripheral lung mass. Which of the following is the most likely diagnosis?

A 59-year-old male presents with dyspnea and facial edema. His wife reports he wakes up with a swollen face that improves throughout the day. Physical exam reveals prominent jugular veins and upper extremity swelling. What is the underlying cause?

A 67-year-old man presents with chronic cough and hemoptysis. A biopsy of a lung mass reveals undifferentiated large cells. Which of the following best describes the characteristics of this cancer type?

A 45-year-old male non-smoker presents with a persistent cough. Imaging reveals a centrally located, well-circumscribed lung mass. His 24-hour urine 5-HIAA levels are elevated. What is the most likely diagnosis?

A 72-year-old man with a history of asbestos exposure presents with progressive dyspnea. Imaging reveals pleural thickening with encasement of the lung. What is the most definitive diagnostic step?

A 64-year-old male smoker presents with chronic cough and a centrally located lung mass. Biopsy shows small, poorly differentiated cells with extensive necrosis. Which of the following is the best initial treatment?

A 58-year-old male presents with a new-onset seizure. CT scan shows a large solitary pulmonary nodule and multiple brain lesions. Which of the following lung cancers is most likely responsible?

A 60-year-old man with a 30-pack-year smoking history presents for an annual check-up. Based on USPSTF guidelines, which of the following patients qualifies for lung cancer screening?

A 63-year-old male with a 40-pack-year smoking history presents with worsening dyspnea and weight loss. Imaging shows a cavitary central lung lesion. Which of the following lung cancers is most associated with cavitation?

A 55-year-old male presents with chronic cough and a lung nodule found on CXR. The lesion measures 1 cm and has "popcorn" calcifications. What is the most likely diagnosis?

A 70-year-old male presents with hemoptysis, weight loss, and digital clubbing. A biopsy of a lung mass reveals mucin-producing glandular cells. What is the most likely diagnosis?

A 65-year-old man with extensive smoking history presents with worsening weakness in his lower extremities. He has diminished deep tendon reflexes and autonomic dysfunction. What is the most likely paraneoplastic syndrome?

A 68-year-old man with a history of mesothelioma presents with progressive dyspnea. A chest X-ray shows pleural thickening with an effusion. Which of the following is the strongest risk factor for this condition?

A 55-year-old man with chronic smoking history presents with a persistent cough. A chest CT shows a large central lung mass compressing the superior vena cava. What is the most likely diagnosis?

A 50-year-old man presents with a 2.5 cm lung nodule discovered incidentally on imaging. What is the next best step?

A 72-year-old man presents with chronic cough, hemoptysis, and hoarseness. His CXR shows a hilar mass. What is the best next step?

A 65-year-old male smoker presents with a 3 cm pulmonary nodule with irregular borders and no calcification. What is the next best step in management?

A 60-year-old male presents with a history of recurrent pneumonia in the same lung lobe. CXR reveals a hilar mass. What is the most likely underlying cause?

A 70-year-old patient with advanced non-small cell lung cancer presents with worsening dyspnea. Imaging reveals a large pleural effusion. What is the next best step?

A 66-year-old man with advanced lung cancer presents with a painful, swollen lower leg. Duplex ultrasound confirms a deep vein thrombosis (DVT). What is the most likely underlying cause?

A 68-year-old man presents with chronic cough, clubbing, and periostitis of the long bones. Imaging reveals a peripheral lung mass. Which lung cancer is most commonly associated with hypertrophic pulmonary osteoarthropathy?