A 21-Year-Old Man Comes to the Emergency Department Due to a 6-Week

question 168

Multiple Choice

A 21-year-old man comes to the emergency department due to a 6-week history of progressive shortness of breath and cough.  The patient wheezes at night and has to sit up to relieve the chest discomfort.  He has no other medical conditions.  He takes no medications.  The patient denies the use of tobacco, alcohol, and illicit drugs.  Temperature is 36.1 C (97 F) , blood pressure is 120/70 mm Hg, pulse is 70/min, and respirations are 14/min.  Pulse oximetry is 98% on room air.  The patient is awake, alert, and in no distress.  No masses are palpable in the neck.  Heart and lungs sounds are normal.  CT scan of the chest reveals a large, anterior mediastinal mass causing tracheal compression.  Serum levels of alpha fetoprotein and β-hCG are elevated.  Which of the following is the most likely diagnosis?

• A)High-grade lymphoma
• B)Mixed germ cell tumor
• C)Seminoma
• D)Small cell neuroendocrine tumor
• E)Thymoma

---

Definitions:

Company Ethical Code

A set of principles and standards that guide behavior and decisions within a business organization.

Unethical Act

Behaviors or actions that violate moral or professional principles, often leading to negative consequences.

Illegal

Actions or activities that are forbidden by law, which can lead to penalties or punishment if one is caught and convicted.

Legal But Unethical

Actions or practices that may not violate laws but are considered wrong or inappropriate according to ethical standards.