Q:

A 68 year old diabetic, and hypertensive with a 45pack/year smoking history, has left sided chest pain increased with breathing. Exam: myosis on left side and wasting of small muscles of left hand. What is the single most appropriate diagnosis?

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A 68 year old diabetic, and hypertensive with a 45pack/year smoking history, has left sided chest pain increased with breathing. Exam: myosis on left side and wasting of small muscles of left hand. What is the single most appropriate diagnosis?


  1. Costochondritis
  2. Lung cancer
  3. Good pasture’s syndrome
  4. MND
  5. Progressive massive fibrosis

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The key is B. Lung cancer. [Smoking history, chest sign and Horner’s syndrome points towards lung cancer (probable pancoast tumour)].

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