Question 1
What is the most common cause of superior vena cava obstruction syndrome?
(A) Small cell lung cancer
(B) lymphoma
(C) Non-small cell lung cancer
(D) Metastatic deposits
(E) Thyroid cancer
C: According to N Engl J Med 2007; 356:1862-1869
Question 2
A 64 year old male has been recently diagnosed with non small cell lung cancer, stage 3B. He has an ECOG performance status of 0. He presents acutely to the emergency department with upper limb swelling, conjunctival suffusion, stridor and significant dyspnoea. What is the most appropriate diagnosis matched with treatment strategy?
(A) superior vena cava syndrome, surgical stent insertion
(B) superior vena cava syndrome, chemotherapy
(C) superior vena cava syndrome, chemotherapy and radiotherapy
(D) Pulmonary embolism, therapeutic UFH
(E) Pulmonary embolism, surgical endarterectomy
A: Given the acuity of presentation, surgical stent insertion would be the best option. However, if the patient had a subacute presentation then C would be more appropriate as it is treating the course. If the patient had stage 4 disease, then chemotherapy alone would be a viable option. N Engl J Med 2007; 356:1862-1869
What is the most common cause of superior vena cava obstruction syndrome?
(A) Small cell lung cancer
(B) lymphoma
(C) Non-small cell lung cancer
(D) Metastatic deposits
(E) Thyroid cancer
C: According to N Engl J Med 2007; 356:1862-1869
Question 2
A 64 year old male has been recently diagnosed with non small cell lung cancer, stage 3B. He has an ECOG performance status of 0. He presents acutely to the emergency department with upper limb swelling, conjunctival suffusion, stridor and significant dyspnoea. What is the most appropriate diagnosis matched with treatment strategy?
(A) superior vena cava syndrome, surgical stent insertion
(B) superior vena cava syndrome, chemotherapy
(C) superior vena cava syndrome, chemotherapy and radiotherapy
(D) Pulmonary embolism, therapeutic UFH
(E) Pulmonary embolism, surgical endarterectomy
A: Given the acuity of presentation, surgical stent insertion would be the best option. However, if the patient had a subacute presentation then C would be more appropriate as it is treating the course. If the patient had stage 4 disease, then chemotherapy alone would be a viable option. N Engl J Med 2007; 356:1862-1869
