QuestionSBA
QuestionChoice
This is a good differential when considering the cause of haemoptysis, frail appearance (which could be due to weight loss) and shortness of breath. However, TB would not explain this patient's confusion and ECG results.
10001289
d
Tuberculosis
QuestionChoice
This would present with systemic subacute symptoms. You would also expect a fever alongside her chest pain, shortness of breath and clubbing.
10001288
c
Lung abscess
QuestionChoice
This patient has symptoms suggesting lung cancer and hypercalcemia. Hypercalcemia is associated with squamous cell lung cancers due to the release of parathyroid hormone-related protein (PTHrp).

A helpful way to remember the signs of hypercalcaemia is by learning 'bones (bone pain), stones (renal stones), abdominal groans (abdominal pain and GI upset) and psychiatric moans (confusion)'. This woman has psychiatric moans by way of her confusion and disorientation. In addition, hypercalcemia is associated with shortened QT intervals on ECG.
10001286
a
Squamous cell lung cancer
QuestionChoice
Although it is likely that this patient has lung cancer due to her haemoptysis and clubbing, small-cell lung cancers are not associated with hypercalcemia. In fact, small-cell lung cancers are associated with Cushing's syndrome due to the ectopic release of ACTH.
10001287
b
Small cell lung cancer
QuestionChoice
Asthma would not present with clubbing or haemoptysis and would be associated with shortness of breath on exertion and a diurnal variation in symptoms.
10001290
e
Asthma
Concept
Chapter
2693
3702
Lung Cancer
Topic
132
Respiratory
12804
A 70-year-old female presents to the clinic with a 3-month history of shortness of breath and chest pain. She mentions that she has noticed blood in his sputum.

On examination, she has finger clubbing and appears frail, confused and disorientated.

An ECG is carried out which shows a shortened QT interval.

What is the most likely diagnosis?
a