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Non-resolving pneumonia due to possible lung cancer — SCE Respiratory MCQ

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HardRespiratory InfectionsNon-resolving pneumonia due to possible lung cancerSCE Respiratory

A 70-year-old smoker is treated for right upper-lobe pneumonia. Symptoms improve but CXR at 6 weeks shows persistent focal consolidation and volume loss. He has lost 5 kg and has mild haemoptysis. What is the most appropriate investigation?

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Correct answer: B — CT chest with bronchoscopy if an obstructing lesion is suspected

Persistent focal consolidation, weight loss and haemoptysis in a smoker require evaluation for underlying lung cancer, starting with CT and often bronchoscopy. Repeated antibiotics alone risks delaying diagnosis. ACE and D-dimer do not address a possible obstructing endobronchial lesion.

Reference: BTS CAP Guideline; NICE NG12; NICE NG122