Asthma USMLE Step 1 Practice Question
A 66-year-old man presenting with cough and dyspnea has vital signs: BP 138/88, HR 92, RR 18, SpO2 92% on room air. CT chest reveals a 3.4 cm spiculated right upper lobe nodule with irregular margins that enlarged from 2.8 cm over 6 months, associated with asymmetric hilar adenopathy. Laboratory studies show normal ACE level. He denies constitutional symptoms and takes only albuterol as needed. Which feature most strongly suggests malignancy rather than benign granuloma?
Answer choices
- ADiameter less than 4 mm
- BSpiculated border with interval growthCorrect answer
- CStable size over 2 years
- DSmooth sharply circumscribed border
- ECentral laminated calcification
- FNormal serum ACE level with hilar adenopathy
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