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pindi/stephan/guest... a question - rocky.ky

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pindi/stephan/guest... a question - rocky.ky
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#1
12-14-2008, 06:01 PM

I always get confuse when to order bronchoscopy and when CT chest in the diagnosis of Lung cancer. which one is next, which one is best and next best? If some can simplify it, I will be grateful. Thanks
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#2
12-14-2008, 06:13 PM
my understanding is...
non-inasive test first..so u start with...

sputum cytology
cxr
CT chest
Bronchoscopy
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#3
12-14-2008, 06:50 PM
thanks

If pt has recurrent pneumonia and CXR shows suspicion of bronch obstruction

1. bronch or CT chest

If pt has recurrent pneumonia with h/o smoking and no option of cytology or CXR

1. bronch or CT chest

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#4
12-14-2008, 07:02 PM
i already showed you the sequence /order of carrying out the tests, in my initial post.....


A...CT
B...CT
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#5
12-14-2008, 07:11 PM
agree,i think CT shud be done first to detect the area of suspicion,then bronchoscopy. for the 2 scenario in ur 2nd post.
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#6
12-14-2008, 07:14 PM
If pt has recurrent pneumonia and CXR shows suspicion of bronch obstruction
here answer is bronchoscopy as you have to see what kind of mass and possible biopsy

pls correct me if I am wrong (this is as per UW mcq)
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#7
12-14-2008, 07:17 PM
recurrent pneumonia = a malignancy...in most likely!
so you want to see where the obs is before...you broch and biopsy it to see what it is...
i agree this a very confusing issue...
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#8
12-14-2008, 07:19 PM
thanks
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#9
12-15-2008, 06:19 AM
If pt has recurrent pneumonia and CXR shows suspicion of bronch obstruction

1. bronch or CT chest

If bronchial obstruction u have to remove the obstruction and see wats there causing it therefore u will go for Broncho. CT cant remove the obstruction and cant do the biopsy too.

In the scanario given by u in case B, the ans would be CT.
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#10
12-15-2008, 06:27 AM
so meduploader..

coz it is recurrect pneumonia..you do broch first???
to see what is causing the obstruction???
how can you remove obs by bronch..i f it is Cancer???
and why would you think that a mucus plug could be a cause of recurrent pneumonia...

you maybe right...but plz teach me the concept..behind bronching a recuurent pneumonia pt first!

UW says the same..per rocky!
i guess i am confused!
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