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Pulmonary nodule — RCPSC IM MCQ

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HardRespirologyPulmonary noduleRCPSC IM

A 66-year-old smoker has an incidentally detected 11-mm spiculated upper-lobe solid pulmonary nodule and no prior imaging. Estimated malignancy probability is intermediate. What is the best next step?

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Correct answer: E — Refer through a pulmonary-nodule pathway for PET-CT and tissue or surveillance planning

The best answer is “Refer through a pulmonary-nodule pathway for PET-CT and tissue or surveillance planning”. An intermediate-risk solid nodule of this size warrants structured specialist evaluation, often PET-CT followed by biopsy, resection or CT surveillance according to refined risk. No follow-up, plain radiographs and unplanned major surgery are inappropriate.

Reference: Canadian Thoracic Society, 2023 COPD pharmacotherapy guideline: https://cts-sct.ca/guideline-library/