Correct!
5. 1 and 3

The chest CT scan shows a number of small lung nodules predominately in the lower lobes (Figure 2).

Figure 2. Thoracic CT scan lung windows from figure 1 showing multiple lung nodules (arrows). The mediastinal windows do not show any mediastinal lymphadenopathy.

What is the best choice as the next diagnostic step?

1. Bronchoscopy with bronchoalveolar lavage
2. Bronchoscopy with transbronchial biopsy
3. Needle biopsy of the nodules
4. Serial thoracic CT scans with biopsy of any enlarging nodules
5. Video-assisted thorascopic biopsy

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