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  #1  
Old 09-29-2011
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Lungs Smoker, Hemoptysis, Lung Mass, likely diagnosis?

A 70 year old man comes to the emergency because of cough and sputum production. He has smoked 1 pack of cigarette daily for 35 years and still actively smokes. In last 2 weeks he has noticed flecks of blood in sputum. Chest X ray shows a 4 cm mass in the left lung. Based on his history which is the most likely diagnosis

A. Bronchoalveolar cancer
B. Bronchogenic cancer
C. Large cell neuroendocrine cancer
D. Small cell neuroendocrine cancer
E. Squamous cell cancer
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Old 09-29-2011
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E. Squamous cell cancer
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E. Squamous cell cancer
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B. bronchogenic carcinoma

MCC is Bronchogenic adenocarcinoma which may be associated with smoking
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I inmediatly thought squamous because it's the second most related to smoking (behind small cell, but I doubt a small cell would reach the size of 4 cm before giving worse symptoms than coughing and hemoptysis)

The adeno rarely causes hemoptysis because it tends to locate peripherically in the lung. And it's not very heavily linked to smoking, I think.
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  #6  
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Guys this is from Kaplan qbank
and the correct answer is bronchogenic cancer.

But my feels is it should be Squamous cell cancer as it is the most common cancer associated with smoking (Goljan).

Also BRONCHOGENIC ADENOCARCINOMA is one of the most common lung cancer in non smokers.(FA)

The explanation given by kaplan is Although Adenocarcinoma is the most common type in non smokers , in general in 90% of Non Small Cell Carcinoma( Including Adenocarcinoma) is associated with smoking.
Please Guys whats ur feedback on this .
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Old 10-01-2011
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strange really
i know smoker will have SCC we memorize this in step 2( 2 s

and non smoker(religion ) lady had bronchogenic lung ca

iam confuse too
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Most common is bronchogenic adenocarcinoma(40%). .. ..if only history is given weather smoker or nonsmoker choose adenocarcinoma. . . . It can be associated with filtered cigarett smoking.

one such doubtful question was also in kaplan qbank. . . .saying which is most common cause of nephrotic syndrome in adult?
Ans : focal segmental gomerulonephritis. . .. . and not the membranous glomerulopathies!!!!!?
any feedback?
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Old 10-01-2011
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Quote:
Originally Posted by dinosaur108 View Post
Most common is bronchogenic adenocarcinoma(40%). .. ..if only history is given weather smoker or nonsmoker choose adenocarcinoma. . . . It can be associated with filtered cigarett smoking.

one such doubtful question was also in kaplan qbank. . . .saying which is most common cause of nephrotic syndrome in adult?
Ans : focal segmental gomerulonephritis. . .. . and not the membranous glomerulopathies!!!!!?
any feedback?
no way there must be hx of HIV or IV drug abuse so that the answer FSGN because membranous is most common cause in adult iam sure 100 %from that
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Quote:
Originally Posted by dinosaur108 View Post
Most common is bronchogenic adenocarcinoma(40%). .. ..if only history is given weather smoker or nonsmoker choose adenocarcinoma. . . . It can be associated with filtered cigarett smoking.

one such doubtful question was also in kaplan qbank. . . .saying which is most common cause of nephrotic syndrome in adult?
Ans : focal segmental gomerulonephritis. . .. . and not the membranous glomerulopathies!!!!!?
any feedback?
Yes Dude its FSGS Harrison has it updated.
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  #11  
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But dont you think if one sees this question for the first time it directly leads to SCC The linesHe has smoked 1 pack of cigarette daily for 35 years and still actively smokes. are more than indicative of SCC.

Also Goljan states that Adenocarcinoma has no relationn with smoking

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Quote:
Originally Posted by usmle2011 View Post
But dont you think if one sees this question for the first time it directly leads to SCC The linesHe has smoked 1 pack of cigarette daily for 35 years and still actively smokes. are more than indicative of SCC.

Also Goljan states that Adenocarcinoma has no relationn with smoking


Well,my uncle recently presented with the exact same presentation and just got his biopsy report today stating he has adenocarcinoma.that's where it clicked me that the answer to this question would be 'bronchogenic'.you are right it says that this kind is NOT linked to smoking,however,just this morning i googled my uncle's report and found out that adenocarcinoma..ooo yes is linked to smoking!

experiences help at times!
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one such doubtful question was also in kaplan qbank. . . .saying which is most common cause of nephrotic syndrome in adult?
Ans : focal segmental gomerulonephritis. . .. . and not the membranous glomerulopathies!!!!!?
any feedback?[/QUOTE]


By Uworld also,most common cause of nephrotic syndrome in adults is FSGS and membranous GN is second most common cause.
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Quote:
Originally Posted by aknz View Post
one such doubtful question was also in kaplan qbank. . . .saying which is most common cause of nephrotic syndrome in adult?
Ans : focal segmental gomerulonephritis. . .. . and not the membranous glomerulopathies!!!!!?
any feedback?

By Uworld also,most common cause of nephrotic syndrome in adults is FSGS and membranous GN is second most common cause.[/QUOTE]

still not started uworld. . .but Will keep it in mind
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  #15  
Old 10-02-2011
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Quote:
Originally Posted by doc Mm View Post
Well,my uncle recently presented with the exact same presentation and just got his biopsy report today stating he has adenocarcinoma.that's where it clicked me that the answer to this question would be 'bronchogenic'.you are right it says that this kind is NOT linked to smoking,however,just this morning i googled my uncle's report and found out that adenocarcinoma..ooo yes is linked to smoking!

experiences help at times!
Yes but in exams we still follow book stats.

Anyways I have asked for a feedback from Kaplan student support service
lets see if they respond.
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Old 10-03-2011
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so this is what i got from Kaplan feedback

Adenocarcinoma accounts for 35-40% of all non-small cell lung cancers (NSCLC), while squamous carcinoma accounts for 25-30%. Although adenocarcinoma is the most common type in never-smokers, in general, about 90% of NSCLC in men (including adenocarcinomas) ARE associated with smoking. Don't let the fact that adencarcinoma is the most common type of lung cancer in nonsmokers fool you into thinking that adenocarcinoma isn't usually associated with smoking - it is. The increased incidence of adenocarcinomas has even been suggested to be associated with smoking low-tar cigarettes, but the association with smoking is still strong.


So guess Adenocarcinoma is right answer.

I actually love kaplan for their prompt replies
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Old 11-17-2011
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Quote:
Originally Posted by usmle2011 View Post
so this is what i got from Kaplan feedback

Adenocarcinoma accounts for 35-40% of all non-small cell lung cancers (NSCLC), while squamous carcinoma accounts for 25-30%. Although adenocarcinoma is the most common type in never-smokers, in general, about 90% of NSCLC in men (including adenocarcinomas) ARE associated with smoking. Don't let the fact that adencarcinoma is the most common type of lung cancer in nonsmokers fool you into thinking that adenocarcinoma isn't usually associated with smoking - it is. The increased incidence of adenocarcinomas has even been suggested to be associated with smoking low-tar cigarettes, but the association with smoking is still strong.


So guess Adenocarcinoma is right answer.

I actually love kaplan for their prompt replies
Actually, the Kaplan folks are wrong; and they frequently make mistakes. I have corrected over 20 errors in their questions and answers.

Look at the answer options again. The answer options do not list Bronchogenic Adenocarcinoma as an option, only Bronchogenic Carcinoma. Since Bronchogenic Carcinoma is defined as any primary lung tumor, it has to be the answer as it emcompasses all other options such as Squamous Cell Carcinoma and Bronchogenic Adenocarcinoma (which, incidentally or purposefully, is not a listed choice).
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Old 11-17-2011
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Quote:
Originally Posted by feller View Post
Actually, the Kaplan folks are wrong; and they frequently make mistakes. I have corrected over 20 errors in their questions and answers.

Look at the answer options again. The answer options do not list Bronchogenic Adenocarcinoma as an option, only Bronchogenic Carcinoma. Since Bronchogenic Carcinoma is defined as any primary lung tumor, it has to be the answer as it emcompasses all other options such as Squamous Cell Carcinoma and Bronchogenic Adenocarcinoma (which, incidentally or purposefully, is not a listed choice).
Bronchogenic Cancer is NOT the same as Bronchogenic ADENOcarcinoma. The latter is a subset of the former.
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Old 11-17-2011
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Quote:
Originally Posted by aknz View Post
one such doubtful question was also in kaplan qbank. . . .saying which is most common cause of nephrotic syndrome in adult?
Ans : focal segmental gomerulonephritis. . .. . and not the membranous glomerulopathies!!!!!?
any feedback?

By Uworld also,most common cause of nephrotic syndrome in adults is FSGS and membranous GN is second most common cause.[/QUOTE]

Hey! Also FA updated this in their errata:Note that focal segmental glomerulosclerosis, not membranous
glomerulonephritis, is the most common cause of adult nephrotic
syndrome. So I guess the kaplan answer is right..
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Old 11-17-2011
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Bronchogenic Cancer is NOT the same as Bronchogenic ADENOcarcinoma. The latter is a subset of the former.
Please what is the histological difference between bronchogenic adenocarcinoma and carcinoma
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Please what is the histological difference between bronchogenic adenocarcinoma and carcinoma
Hey rapiddo, Bronchogenic carcinoma is like the term for all lung cancer coming from the lung. And then you have different histological subtypes. Like a adenocarcinoma which consists of glands and mucin production and a desmoplastic stroma. They usually grow in the periphery and not central next to the bronchus. Then there is the SCC which has typically intercellular bridges and keratin pearls and grows centrally. and then many others Hope it helps and answers your question!
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Thanks a lot.
Quote:
Originally Posted by Glomerulus View Post
Hey rapiddo, Bronchogenic carcinoma is like the term for all lung cancer coming from the lung. And then you have different histological subtypes. Like a adenocarcinoma which consists of glands and mucin production and a desmoplastic stroma. They usually grow in the periphery and not central next to the bronchus. Then there is the SCC which has typically intercellular bridges and keratin pearls and grows centrally. and then many others Hope it helps and answers your question!
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