Question 1

A patient with a smoking history of 35 pack years reports having a chronic cough with recent symptoms of pink, frothy blood on a tissue. The chest radiograph shows a possible nodule in the right upper lobe. Which diagnostic test is indicated?

A) Coagulation studies
B) Computed tomography (CT)
C) Fiberoptic bronchoscopy
D) Needle biopsy

B

Accepted Answer

A CT is the most appropriate imaging test to further evaluate the possible nodule seen on the chest radiograph. Coagulation studies are not relevant to the patient's symptoms and findings. A fiberoptic bronchoscopy may be performed to evaluate the airways, but it may not necessarily provide information about the presence of a nodule. A needle biopsy may be considered if the CT scan shows a suspicious mass, but it is not the initial diagnostic test of choice.

Question 2

A patient with hemoptysis and no other symptoms has a normal chest radiograph (CXR), computed tomography (CT), and fiberoptic bronchoscopy studies. What is the next action in managing this patient?&#10;A) Observation&#10;B) Prophylactic antibiotics&#10;C) Specialist consultation&#10;D) Surgical intervention

Accepted Answer

Since the patient has no other symptoms and all investigations are normal, observation is the most appropriate management option. This means monitoring the patient closely for any changes in symptoms or additional findings on investigations. Prophylactic antibiotics or surgical intervention are not indicated in this scenario without further clinical indications. Specialist consultation may be warranted if the hemoptysis persists or worsens.

Question 3

A patient reports coughing up a small amount of blood after a week of cough and fever. The patient has been previously healthy and does not smoke or work around pollutants or irritants. What will the provider suspect as the most likely cause of this patient's symptoms?

A) Infection
B) Lung abscess
C) Malignancy
D) Thromboembolism

A

Accepted Answer

The patient's symptoms of cough and fever are typical of an infection, and coughing up a small amount of blood (hemoptysis) is a common symptom associated with respiratory infections such as bronchitis or pneumonia. In the absence of other risk factors or symptoms suggestive of more serious underlying conditions, infection is the most likely cause of this patient's hemoptysis.

Deck 90: Hemoptysis