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  #1  
Old 10-22-2011
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Lungs COPD Smoker with Hyponatremia!

A 52 years old male patient admitted at Hospital with marked breathlessness, fever and purulent expectoration for 10 days. He was a known case of COPD and was on oral bronchodialator. There was no history of hemoptysis or chest pain. He was a heavy smoker (two packs/day for > 20 years). On examination the following points were noted: mild, Respiratory Rate (28/min) with increased AP diameter of thorax. Bilateral hyper-resonant note on percussion. Breath sound - Vescicular with prolonged expiration. Bilateral rhonchi present, crepitation present. Following treatment with bronchodialator, oxygen and antibiotics, the fever subsided, cough and respiratory distress diminished. But on 3 weeks later, the patient developed new symptoms of drowsiness, tremor, disorientation, irrelevant talks, without any evidence of breathlessness. CT scan of brain was normal. Plasma sodium level was 120 mEq/L. Potassium was 3.7 mEq/L. Despite administration of several bottles of sodium chloride, Sodium level remained low. Urinary hyper-osmolarity and serum hypo-osmolarity were detected. Ultrasonography of abdomen showed evidence of liver metastasis. Which of the following statements regarding the patient disease is correct?

A) The condition is amenable to surgical cure.
B) This condition is more common in women and a lesser clear relation to smoking.
C) The histopathology from liver biopsy possibly shows small round blue cells in metastatic parts.
D) The original pathology is usually in the peripheral rather than in a central location of lung.
E) Hyponatremia is mostly due to the metastasis to adrenal gland.
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Old 10-22-2011
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just guess d)
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Old 10-23-2011
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I am with D tooo
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Old 10-23-2011
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Friends!
Your answer is wrong! There are some clues in the question...
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Old 10-23-2011
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omg... just read FA again.. o goddd .. know the answer now.. but I won't spoil it for the rest of the crowd.
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Old 10-23-2011
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than Ccccc)
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Old 10-23-2011
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This is small cell carcinoma with ectopic ADH and the answer is C.
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Old 10-24-2011
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C) The histopathology from liver biopsy possibly shows small round blue cells in metastatic parts

cause ectopic ADH release that cause hyponatremia
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