Correct!
2. Chest x-ray

None of the answers are totally inappropriate. Establishing a tissue diagnosis will help guide therapy. Whole-brain radiation would be appropriate if the patient was having uncontrolled seizures or other neurologic complications from the metastases. Of the possibilities for a primary source of her cancer, lung cancer seems likely based on her pulmonary symptoms. A chest x-ray was performed (Figure 2).

Figure 2. Chest radiograph.

Which of the following should be done next? (Click on the correct answer to proceed to the fourth of six panels)

  1. Abdominal CT scan and mammogram
  2. Chest CT scan
  3. Colonoscopy for possible adenocarcinoma of the bowel
  4. 1 and 3
  5. All of the above

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