QuestionSBA
QuestionChoice
This is incorrect. This is a progressive fibrotic lung disease associated with shortness of breath. However, the symptoms of Cushing's syndrome in this case point more towards a paraneoplastic small cell lung carcinoma.
10027624
d
Interstitial Lung Disease
QuestionChoice
This is incorrect. The patient's shortness of breath and weight loss point towards lung cancer. However, adenocarcinoma is less likely to cause paraneoplastic syndromes such as Cushing's syndrome.
10027622
b
Adenocarcinoma
QuestionChoice
This is incorrect. Squamous cell carcinomas often cause hypercalcaemia and can be associated with hypertrophic pulmonary osteoarthropathy. The symptoms of Cushing's syndrome point more towards a paraneoplastic small cell lung carcinoma.
10027623
c
Squamous Cell Carcinoma
QuestionChoice
This is the most likely diagnosis. Small cell carcinomas arise from endocrine Kulchitsky cells in the lungs. These secrete polypeptides including adrenocorticotrophic hormone and can present as Cushing's syndrome: characterised by the patient's symptoms of fragile skin, low mood and a 'moon' shaped face.
10027621
a
Small cell lung carcinoma
QuestionChoice
This is incorrect. Although COPD can explain the shortness of breath, the symptoms of Cushing's syndrome point more towards a paraneoplastic small cell lung carcinoma.
10027625
e
Chronic Obstructive Pulmonary Disease (COPD)
Concept
Chapter
2693
5991
Lung Cancer
Topic
225
Oncology and Palliative Care
17922
A 72 year old man attends his GP surgery with shortness of breath that has been present for around 3 months. He has also noticed that his clothes have become very loose. The patient's primary concern is that his face has become noticeably rounder and 'puffy', his skin has become more fragile and he is feeling low in mood.


His observations are all within normal limits. Blood tests reveal a potassium of 2.9mmol/L (normal range 3.5-5.3 mmol/L).


Which of the following is the most likely diagnosis?
a