Hoarseness of Voice (1434/1700)

A 22yo man reports a 2d hx of hoarseness of voice. He denies any weight loss but he has been smoking for 4yrs. What is the single most appropriate inv?
a. None
b. Laryngoscopy
c. Bronchoscopy
d. BAL
e. CXR
































answer: A

We only worry about persistent hoarseness, more than at least 3 weeks. This man has no red flags for further investigation. Two days doesn't warrant any investigation. 

N.b
NICE guidance advises an urgent chest X-ray for hoarseness that persists for more than three weeks. If the X-ray is positive, urgent referral for suspected lung cancer should be made. In the absence of findings on the X-ray, a referral for suspected head and neck cancer should be made. Referral may be indicated if there are red flag symptoms or signs.