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* nbme q2
 #139228  
  santabanta - 11/17/06 00:34
 
  WHILE MAKING ROUNDS IN A REHAB FACILITY, YOU SEE A 76 YR OLD WHITE WOMAN WHO HAS BEEN YOUR PATIENT FOR 25 YRS. ONE MONTH AGO SHE WAS DIAGNOSED WITH METASTATIC NON SMALL CELL CARCINOMA OF THE LUNG WITH METASTATES TO THE OTHER LUNG,LIVER AND BRAIN. SHE NOW HAS MODERATE LEFT HEMIPARESIS THAT LIMITS WALKING. SHE ALSO HAS MULTIPLE,ASYMPTOMATIC, DEEP VENOUS THROMBI OF BOTH LEGS THAT ARE BEING TREATED WITH A VENA CAVAL FILTER. DESPITE DISCUSSION WITH THE PATIENT AND HER FAMILY ABOUT HER ILLNESS, HER SON TELLS YOU THAT SHE IS APPARENTLY UNAWARE THAT HER CONDITION IS TERMINAL.

WHICH OF THE FOLL IS THE MOST APPRORIATE NEXT STEP?

A. ARRANGING TRANSFER TO THE INPATIENT PSYCHIATRIC WARD

B. BEGINNING ANXIOLYTIC THERAPY

C. DISCUSSING THE PROGNOSIS AGAIN WITH THE PATIENT

D. ENCOURAGING THE FAMIY TO DISCUSS THE PATIENTS PROGNOSIS WITH HER

E. EXPLAINING TO THE SON THAT IT IS INAPPROPRIATE FOR YOU TO SPEAK ABOUT HIS MOTHERS ILLNESS.
 
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* Re:nbme q2
#561802
  joscohmd - 11/17/06 00:41
 
  C-is the answer  
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* Re:nbme q2
#561813
  humerus - 11/17/06 00:57
 
  agree  
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* Re:nbme q2
#561945
  chinni - 11/17/06 07:26
 
  c  
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* Re:nbme q2
#562038
  dr_nuri - 11/17/06 09:09
 
  yes c..  
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* Re:nbme q2
#562100
  soujany - 11/17/06 09:59
 
  yes agree C
 
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* Re:nbme q2
#562949
  tea - 11/17/06 17:32
 
  c
 
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