Kamsi
Forum Guru
Topics: 103
Posts: 347
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37. A 72-year-old man is brought to the physicianby his daughter because of painless jaundice for 1 month. His wifedied 10 years ago, and his daughter is his only child. Before examiningthe patient, the daughter asks to speak privately with the physicianand asks that she be given the results of any tests. She specificallyrequests that he not be given any "bad news." The patient is alert. Hisvital signs are within normal limits. Examination shows scleralicterus and jaundice. There is mild abdominal tenderness on palpation. Heis oriented to person, place, and time. A CT scan of the abdomenshows a pancreatic mass with bile duct obstruction and probable metastaticlesions in the liver. Which of the following is the most appropriatenext step?A) Abide by the daughter's wishesB) Ask the patient if he wishes to discuss his testresults, preferably with his daughter presentC) Tell the daughter it is a legal requirement totell the patient any and all results of medical testingD) Consult with the hospital attorneyE) Ask another physician to take over the patient's care
34. A 54-year-old man with chronic obstructivepulmonary disease undergoes a total hip arthroplasty for avascularnecrosis of the femoral head. On the second postoperative day, he hasdiffuse, profound weakness and vomiting. His blood pressure is 85/50 mmHg, and pulse is 100/min. The operative site is clean and dry, withminimal output from the drains. Hemoglobin level is 13.8 g/dL, serum sodiumlevel is 132 mEq/L, and serum potassium level is 5.8 mEq/L. Which of thefollowing is most likely to confirm the diagnosis?A) Measurement of serum thyroid-stimulating hormonelevelB) Direct antiglobulin (Coombs') testC) ACTH stimulation testD) Ventilation-perfusion lung scansE) Echocardiography
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| donjuan
Forum Junior
Topics: 9
Posts: 68
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1.B
2.Acth stim test but not sure cant be pul embolism thats usually 5 days post op the pt is hyperkalemic and hyponatremic maybe to much iv fluid given???
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| dr confused
Forum Senior
Topics: 66
Posts: 107
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B
C
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| Ivonne
Forum Guru
Topics: 51
Posts: 1,392
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B
C
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| aaroho
Forum Junior
Topics: 8
Posts: 75
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1-C
2-C
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