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9 Posts

99doc
Forum Elite

Topics: 52
Posts: 370

04/30/05 - 10:42 PM

a middle aged female comes to your clinic with cough,
she is an active smoker.you advice her smoking cessation.
but she says that she will stop later as presently she is too tensed in her life.what do youdo next.
a)give her benzodiazepines to reduce anxiety
b)give her nicotone gum
c)refer her to a smoking cessation program
any other possibility is welcome.

mjl1717
Forum Hero
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Topics: 956
Posts: 5,452

05/01/05 - 04:15 AM

1)"I recommend that you stop smoking." Explain the objective reasons why she shouldnt smoke.

2)"I cant force you to stop smoking" Here is a nicotine patch and here is the phone # for a smoking cessation program.

[What gets me is: Why is it inappropiate? showing gross photos of squamous or small cell CA of the lung. Literally attempting to scare the patient into NOT smoking???]

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99doc
Forum Elite

Topics: 52
Posts: 370

05/01/05 - 07:49 AM

thanks for the reply but in usmle exam we have to pick one choice only.
and according to you ,you are selecting 2.
are there any set criteria to refer a patient to smoking cessation program.
i mean smoking can be treated by a general physcian or not.

what i feel is that showing patient photos of CA is unethical.one does not want to scare ones patient into following our advice.

att
Forum Senior

Topics: 4
Posts: 135

05/05/05 - 12:15 PM

give her nicotine gum

ATX
Forum Newbie

Topics: 0
Posts: 14

05/11/05 - 10:18 AM

C- refer her to a prgram> maybe if she sees other people trying to quit it will give her strength to continue she can buy the gum herself

anjushree
Forum Guru

Topics: 64
Posts: 386

05/13/05 - 07:03 PM

wrote:
a middle aged female comes to your clinic with cough,
she is an active smoker.you advice her smoking cessation.
but she says that she will stop later as presently she is too tensed in her life.what do youdo next.
a)give her benzodiazepines to reduce anxiety
b)give her nicotone gum
c)refer her to a smoking cessation program
any other possibility is welcome.

anjushree
Forum Guru

Topics: 64
Posts: 386

05/13/05 - 07:11 PM

My answer is Try to know what is causing tension in her life & give support for that .Then offer advice on cessation of smoking as she is telling that tension in life is preventing her in leaving smoking

anjushree wrote:

docofthebigapple
Forum Senior
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Topics: 23
Posts: 182

05/22/05 - 12:02 PM

I think we should ask the patient what he/she wants to do about it (smoking) and offer different possibilities/programs to quit. i would first prescribe nicotine gum if patient agrees and if not then offer the phone number of a smoking cessation group. showing pictures of carcinoma lung would be gross and scaring for the patient. the patient might avoid coming to me again and continue with smoking. Untimately its the patient's choice about what he/she wants to do about quitting.

I would not want to explore patient's private life about tentions. Maybe i would inadvertently embarras the patient. Not good.

My answer would be b.

KEROCHI
Forum Guru

Topics: 60
Posts: 971

06/18/05 - 12:19 AM

60% of me agrees w/ anjushree

40% says discuss smoking w/ pt offerring her the options given by docofhtebigapple

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