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why not systemic scleroderma since i did this question wrong and i chose systemic sclerosis scleroderma , can someone explain that ?
My best guess answer to that @luke.10 is that:
a) there's no mention of any skin involvement (which there would be in order to be scleroderma)
b) Scleroderma shows pitting in the nails, not clubbing
c) There would be collagen deposition with fibrosis, not hypertrophy of the bone at joints
Saying that, I also got this wrong! (but put RA...) so I'm not claiming to "get this" Hope my thought process helps, though!
This is in FA 2019 page 229
I agree with @kernicterusthefrog on this one, Bronchogenic carcinoma = lung cancer. Squamous cell carcinoma gives you hypercalcemia (new bone formation; maybe?), commonly found in SMOKERS ...
the clubbing is the symptom that takes out alot of the answer choices. It's super tricky.
Plus the patient has an 84 pack-year smoking history, super high risk for lung cancer
FA 2019 pg 229 is all paraneoplastic syndromes. There is no mention of bronchogenic carcinoma in any of them. There is adenocarcinoma, but that is most likely in non smokers, not in someone with 84 pack year of smoking history. Why does he have 5 upvotes for referencing first aid here, what am I missing?
@veryhungrycaterpillar sounds like bronchogenic carcinoma is a general term for lung cancer. You are right that if a non-smoker gets lung cancer it is most likely adenocarcinoma as non-smokers rarely get small cell. However, smokers can get adenocarcinomas as well. The oncologist that I shadow sees this frequently. Adenocarcinoma of the lung causes hypertrophic osteoarthropathy per 229 in FA2019
@verhungrycaterpillar @jakeisawake Adenocarcinoma is the most common tumor in nonsmokers and in female smokers (like this patient), so adenocarcinoma would still be the most likely cancer for this pt over the others. Pathoma Pg. 96.
bronchogenic is another term for adenocarcinoma in situ according to pathoma
With the exception of mesothelioma- 95% are bronchogenic
can it be a facial nerve??? with lateral head trauma (injury during passage through middle ear, or external auditory canal??) doubt!!!
Olfaction is actually more important that tongue sensation in terms of food taste (think of how food tastes bland when you have a cold)
If taste is completely lost then it's an olfactory issue. If its lost only on a part of the tongue then the nerve that provides taste to that area is suspected.
UWorld QID 12227
The sense of taste isn't lost due to CSF in the nose, but due to avulsion of olfactory rootlets.
yeah i wanted something to do with chorda tympani but i guess its something to remember