Posts: 3,675,937
Threads: 734,344
Joined:
Sep 2021
Reputation:
5
39. A 57-year-old woman with breast cancer comes to the physician because of increasing neck pain over the past 3 days. She has fallen frequently because of muscle weakness. Vital signs are within normal limits. Examination shows hyperreflexia of all extremities. There is tenderness over the cervical spine. Serum calcium level is 11 mg/dL. X-ray films show metastases to the cervical spine. Which of the following is the most appropriate next step in management?
A
) Application of a soft cervical collar
B
) Physical therapy
C
) Mithramycin therapy
D
) Tamoxifen therapy
E
) Spinal cord decompression and cervical stabilization
Posts: 3,675,937
Threads: 734,344
Joined:
Sep 2021
Reputation:
5
E
) Spinal cord decompression and cervical stabilization
Posts: 3,675,937
Threads: 734,344
Joined:
Sep 2021
Reputation:
5
ok.. so we use tamoxifen for bone mets or not?
Posts: 3,675,937
Threads: 734,344
Joined:
Sep 2021
Reputation:
5
brother ur pt is fallling here & there, decompress her spinal mets, otherwise she will develop irreversible neuronal damage.
and who says u to treat mets with temoxifen.
Posts: 3,675,937
Threads: 734,344
Joined:
Sep 2021
Reputation:
5
i just wanted to know if there are no neural deficits then what do we use?? bisphosphonates?
Posts: 3,675,937
Threads: 734,344
Joined:
Sep 2021
Reputation:
5
yes bisphosphonates.
u are right. but remeber if pt's calcium is moderate, otherwise IV noraml saline would be next step for pt, if she is in crisis of calcuim. till level of 13 calcuim, u can use bispho, but after this give saline immediatly, pt can fly high, if we do late in crisis.
Posts: 3,675,937
Threads: 734,344
Joined:
Sep 2021
Reputation:
5
thanx man.. doing nbmes nnow.. exam in 4 days.. will keep popping up if i have any confusions
Posts: 3,675,937
Threads: 734,344
Joined:
Sep 2021
Reputation:
5
no pro. u are most welcome.
