All Sample Questions

Paraneoplastic Syndrome 2

Paraneoplastic syndrome
pathology

Question

Vignette:

A 55-year-old woman presents to her primary care physician with a complaint of chronic fatigue, weakness, and unintentional weight loss over the past 6 months. She has a 30-pack year history of smoking and drinks alcohol occasionally. Physical examination reveals pallor, and her body mass index is 18kg/m2. Lab tests reveal microcytic, hypochromic anemia. Chest radiograph shows a mass in the right lung. A biopsy of the lung mass reveals squamous cell carcinoma. Which of the following paraneoplastic syndromes is most likely to be associated with this patient's malignancy?

Choices

A. Syndrome of inappropriate antidiuretic hormone secretion

B. Cushing Syndrome

C. Lambert-Eaton Syndrome

D. Hypercalcemia of malignancy

E. Carcinoid syndrome

Answer

D. Hypercalcemia of malignancy

Explanation

The correct answer is hypercalcemia of malignancy, which is a common paraneoplastic syndrome associated with squamous cell carcinoma of the lung. This occurs due to production of parathyroid hormone-related protein (PTHrP) by the tumor cells, which leads to increased bone resorption and renal tubular reabsorption of calcium, resulting in hypercalcemia. Symptoms of hypercalcemia include fatigue, weakness, and weight loss, as seen in this patient. Other common symptoms include constipation, polyuria, polydipsia, and confusion. Hypercalcemia can also cause anemia, which could explain the patient's microcytic, hypochromic anemia in the absence of other causes such as iron deficiency.

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