A 53-Year-Old Woman Comes to the Physician for Evaluation of a Pulmonary

question 641

Multiple Choice

A 53-year-old woman comes to the physician for evaluation of a pulmonary nodule detected on a chest x-ray performed for atypical central, burning chest pain.  Her pain resolved with omeprazole.  The patient has hypertension and chronic low back pain for which she takes hydrochlorothiazide and as-needed ibuprofen.  She has a 30-pack-year smoking history and quit 3 years ago.
Blood pressure is 142/88 mm Hg and pulse is 78/min.  The lungs are clear to auscultation, and the remainder of the examination shows no abnormalities.
CT scan of the chest reveals a 2.1-cm spiculated nodule with peripheral punctate calcifications in the periphery of the right upper lobe.  There is no mediastinal lymphadenopathy.  No previous radiographs are available for comparison.
Which of the following is the best next step in management of this patient's lung lesion?

• A)Bronchoscopy with transbronchial biopsy
• B)Induced sputum cytology
• C)Repeat CT scan in 3 months
• D)Surgical wedge resection
• E)Tuberculin skin testing

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Definitions:

Conversion Costs

Expenses related to converting raw materials into finished goods, including labor and overhead costs.

Opening Inventory

The value or quantity of goods on hand at the beginning of an accounting period.

FIFO Process Costing

A method of process costing that assumes the first items produced are the first sold or used, ideal for businesses where inventory shelf life is a concern.

Equivalent Unit

A concept in cost accounting used to measure the amount of work done on partial units of production, converting them into a number of fully completed units for costing purposes.