Robert W. Viggiano, MD
Department of Pulmonary Medicine
Mayo Clinic Arizona
Pulmonary Case of the Month CME Information
Members of the Arizona, New Mexico and Colorado Thoracic Societies and the Mayo Clinic are able to receive 0.25 AMA PRA Category 1 Credits™ for each case they complete. Completion of an evaluation form is required to receive credit and a link is provided on the last panel of the activity.
0.25 AMA PRA Category 1 Credit(s)™
Estimated time to complete this activity: 0.25 hours
Lead Author(s): Robert W. Viggiano, MD. The author(s)/contributor(s) state that they do not have any financial arrangements that could constitute a conflict of interest. Detailed Information
As a result of this activity I will be better able to:
- Correctly interpret and identify clinical practices supported by the highest quality available evidence.
- Will be better able to establsh the optimal evaluation leading to a correct diagnosis for patients with pulmonary, critical care and sleep disorders.
- Will improve the translation of the most current clinical information into the delivery of high quality care for patients.
- Will integrate new treatment options in discussing available treatment alternatives for patients with pulmonary, critical care and sleep related disorders.
Learning Format: Case-based, interactive online course, including mandatory assessment questions (number of questions varies by case). Please also read the Technical Requirements.
CME Sponsor: University of Arizona College of Medicine at the Arizona Health Sciences Center Credit Designation and Accreditation Statements.
Current Approval Period: January 7, 2013 - January 6, 2015
Original Release Date: December 1, 2013
Most Recent Review by Author: December 1, 2013
Most Recent Review by CME Sponsor: December 1, 2013
Financial Support Received: None
History of Present Illness
A 68 year old woman was seen for increased back pain in April 2012. In 2000 she had a right lower lobe lung resection for low grade adenocarcinoma, bronchoalveolar type, nonmucinous. Her mass was 2.6 cm in maximal dimension extending to but not invading the pleura. There were clear surgical margins but involvement of one bronchial node. Multiple mediastinal nodes were negative. She had back pain for many years and yearly CTs were negative for metastatic disease.
PMH, SH, FH
Other than the above there was no significant past medical history, social history or family history.
- Non-steroidal anti-inflammatory drugs for pain
- Nitrofurantoin for chronic urinary tract infections
There was tenderness to palpation over the mid-thoracic spine and evidence of a previous thoracotomy.
Her complete blood count (CBC), urinanalysis, liver function tests, and calcium were all within normal limits.
An x-ray of the chest is interpreted as unchanged from previous x-rays.
At this point which of the following radiologic testing is not indicated? (click on correct answer to move to next panel)