Correct!
4. Thoracic CT scan

The portable AP of the chest shows a widened mediastinum (> 6 cm on upright chest x-ray). The next appropriate test would be a thoracic CT scan to evaluate the mediastinum (Figure 3).

Figure 3. Representative images from the contrast-enhanced thoracic CT scan in soft tissue windows.

Which of the following should be done next? (Click on the correct answer to proceed to the fourth of five panels)

  1. Begin tissue plasminogen activator
  2. Bronchoscopy with endobronchial ultrasound biopsy (EBUS)
  3. Mediastinoscopy
  4. Thoracentesis
  5. Video-assisted thorascopic biopsy

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