A 33-Year-Old Man Comes to the Office Due to 6

question 215

Multiple Choice

A 33-year-old man comes to the office due to 6 weeks of nonproductive cough and fatigue.  The patient has also had subjective fevers and a 2.26-kg (5-lb) unintended weight loss over the same period.  He has no prior medical conditions and takes no medications.  The patient drinks alcohol socially and has a 6-pack-year history of smoking but quit 2 years ago.  Vital signs are within normal limits.  Lungs are clear on auscultation, and heart sounds are normal.  Chest x-ray reveals clear lung fields but an enlarged mediastinum; subsequent CT scan of the chest shows hilar and mediastinal adenopathy.  A positron emission tomography scan using 18-fluorodeoxyglucose demonstrates avid tracer uptake in the brain, kidneys, urinary bladder, and supraclavicular and mediastinal lymph nodes.  Which of the following is the most likely diagnosis in this patient?

• A)Glioblastoma multiforme
• B)Hodgkin lymphoma
• C)Renal cell carcinoma
• D)Small cell lung cancer
• E)Transitional cell carcinoma

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Definitions:

Smoking

The act of inhaling and exhaling the smoke of tobacco or other substances, often associated with a range of health risks.

Binge Drinking

involves consuming large amounts of alcohol in a short period, typically leading to immediate and potentially long-term health risks.

Nongenetic Influence

External factors and environmental influences that affect an individual's development and traits, distinct from inherited genetic factors.

Prenatal Nutrition

Refers to the dietary and nutritional intake and guidelines provided to expectant mothers for optimal fetal development and maternal health.