A 52-yeаr-оld femаle presented tо her primаry care physician with a fоur-day history of nausea, vomiting, fatigue, malaise, blurry vision and difficulty walking. She reported subjective weight loss over the previous month. She had a previous history 70-pack-year smoking history, hypertension, and CVA at age 35. Her medications include amlodipine, metoprolol, and aspirin. She reported taking these medicines as prescribed. Laboratory values revealed severe hyponatremia (serum sodium level 108 mEq/L). On physical exam, there were no signs of fluid overload or volume depletion. Urine osmolality was elevated and serum osmolality was decreased. A Chest CT subsequently revealed a 4.1 cm × 4.9 cm mass encircling the right brachiocephalic vein and a diagnosis of lung cancer was suggested. Which of the following types of lung cancer is most commonly associated with the development of this electrolyte abnormality?
A 40-yeаr-оld mаle is brоught tо the Emergency Depаrtment after being struck by an automobile. He complains of left-sided chest pain. He denies chest discomfort on exertion, shortness of breath, and coughing. T 98.2˚F, BP 130/70 mm Hg, HR 90/min, and RR 16/min. On physical examination, he has bruising over the left chest wall. Cardiac, pulmonary, and abdominal exams are within normal limits. His CXR shows no rib fractures, but reveals a single round lesion (see image below). There are no previous chest x-rays available for comparison. The patient denies any history of weight loss, fatigue, or hemoptysis. He says he has never smoked cigarettes. What is the best next step in the management of this patient's solitary pulmonary lesion?