Question 2602 (highlight for discussion)
The question clearly depicts a patient with Horner syndrome, then asks what would be the next best step in management of the patient. Obviously (now, not at the time for me), out of the choices given, CXR would be the best option for the next step in management. However, I feel that in reality, chest CT would be the best choice, and I would likely select it if I were to encounter a choice between chest CT and CXR. My logic is as follows: If you do a CXR and find a lesion, the next step is chest CT to characterize/determine the staging of the lesion. If you do a CXR and don't find a lesion, the next step is CT because you're certain based on clinical findings that this patient has a lung cancer causing Horner syndrome. Does anyone agree? Why/why not?
The question clearly depicts a patient with Horner syndrome, then asks what would be the next best step in management of the patient. Obviously (now, not at the time for me), out of the choices given, CXR would be the best option for the next step in management. However, I feel that in reality, chest CT would be the best choice, and I would likely select it if I were to encounter a choice between chest CT and CXR. My logic is as follows: If you do a CXR and find a lesion, the next step is chest CT to characterize/determine the staging of the lesion. If you do a CXR and don't find a lesion, the next step is CT because you're certain based on clinical findings that this patient has a lung cancer causing Horner syndrome. Does anyone agree? Why/why not?
