A 75-year-old woman with metastatic colon cancer comes to the physician requesting assistance in ending her life. She states: “I just can't take it anymore; the pain is unbearable. Please help me die.” Current medications include 10 mg oral hydrocodone every 12 hours. Her cancer has progressed despite chemotherapy and she is very frail. She lives alone and has no close family. Which of the following is the most appropriate initial action by the physician?
AConsult with the local ethics committee
BSubmit a referral to psychiatry
CSubmit a referral to hospice care
DIncrease her pain medication dose
EInitiate authorization of physician-assisted suicide
A 52-year-old man with stage IV melanoma comes to the physician with his wife for a routine follow-up examination. He was recently diagnosed with new bone and brain metastases despite receiving aggressive chemotherapy but has not disclosed this to his wife. He has given verbal consent to discuss his prognosis with his wife and asks the doctor to inform her of his condition because he does not wish to do so himself. She is tearful and has many questions about his condition. Which of the following would be the most appropriate statement by the physician to begin the interview with the patient's wife?
AHave you discussed a living will or goals of care together?
BWe should talk about how we can manage his symptoms with additional chemotherapy.
CWhy do you think your husband has not discussed his medical condition with you?
DWhat is your understanding of your husband's current condition?
EYour husband has end-stage cancer, and his prognosis is poor.
You conduct a medical research study to determine the screening efficacy of a novel serum marker for colon cancer. The study is divided into 2 subsets. In the first, there are 500 patients with colon cancer, of which 450 are found positive for the novel serum marker. In the second arm, there are 500 patients who do not have colon cancer, and only 10 are found positive for the novel serum marker. What is the overall sensitivity of this novel test?
A450 / (450 + 10)
B490 / (10 + 490)
C490 / (50 + 490)
D450 / (450 + 50)
E490 / (450 + 490)
+ 2 more in the PDF
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