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Old 08-16-2012
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Lungs case of lung cancer

A 62-yr old chronic smoker has an episode of hemoptysis.Other than a barrel chest suggestive of COPD,his P/E is unremarkable.A CXR shows a central hilar mass.Bronchoscopy and biopsy establish the diagnosis of squamous cell carcinoma of the lung.Pulm.function studies show that he has FEV1 of 2200 ml,and ventilation perfusion scan shows that 30% of his pulm function comes from affected lung.Which of the following is the most appropriate next step in management ?

A.CT scan of chest and upper abdomen
B.Radiation and chemotherapy
C.Random sampling of supraclavicular nodes
D.Lobectomy
E.Pneumonectomy

Do explain also..
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Old 08-16-2012
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A)
He is a surgical Candidate; 2,200 - 660 = 1540

Before operating must know extent of disease

He will be put under Pneumectomy
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Old 08-16-2012
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Originally Posted by K06100 View Post
A 62-yr old chronic smoker has an episode of hemoptysis.Other than a barrel chest suggestive of COPD,his P/E is unremarkable.A CXR shows a central hilar mass.Bronchoscopy and biopsy establish the diagnosis of squamous cell carcinoma of the lung.Pulm.function studies show that he has FEV1 of 2200 ml,and ventilation perfusion scan shows that 30% of his pulm function comes from affected lung.Which of the following is the most appropriate next step in management ?

A.CT scan of chest and upper abdomen
B.Radiation and chemotherapy
C.Random sampling of supraclavicular nodes
D.Lobectomy
E.Pneumonectomy

Do explain also..
I would assume that if Sx is the case, CT scan is the next step to analyze the extent and look for other abnormalities.
Please give us the answer. I hate when questions are posted and no answer was given.
I would answer A. and also agree with Dr. Paez, but i would think CT is first, that is just my opinion.
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Old 08-16-2012
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Originally Posted by XpaezX View Post
A)
He is a surgical Candidate; 2,200 - 660 = 1540

Before operating must know extent of disease

He will be put under Pneumectomy
So to be surgical candidate they need to still have 800ml to survive post surgery, so you took the 2200 and substracted the 30% of it. Got it!..
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Old 08-16-2012
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So to be surgical candidate they need to still have 800ml to survive post surgery, so you took the 2200 and substracted the 30% of it. Got it!..
Yeah, i got 2 questions wrong relating this same subject because I forgot to substract the % of the affected lung

As a rule of thumb

If they mention that more than 50% comes from the affected lung, assume they are not surgical candidates unless they are kind enough to give you a shitload of mls's (which I doubt lung cancer patients will have, unless they ran marathons at the Olympics)

Less than that then read carefully and do the simple calculation ...=)
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Answer is A......U both r right guys.....
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Hmmm I didn't even think about the calculation, but based on approaching Ca from other systems too, CT would be good to know the extent of mets.
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Oncology-, Pulmonology-, Step-2-Questions, Surgery-

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