A 79-year-old male presents to your office for his annual flu shot. On physical exam you note several linear bruises on his back. Upon further questioning he denies abuse from his daughter and son-in-law, who live in the same house. The patient states he does not want this information shared with anyone. What is the most appropriate next step, paired with its justification?
ABreach patient confidentiality, as this patient's care should be discussed with the daughter as she is his primary caregiver
BSee the patient back in 2 weeks and assess whether the patient's condition has improved, as his condition is not severe
CDo not break patient confidentiality, as elder abuse reporting is not mandatory
DDo not break patient confidentiality, as this would potentially worsen the situation
EBreach patient confidentiality, as this patient is a potential victim of elder abuse and reporting is mandated in most states
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.
Which of the following study designs would be most appropriate to investigate the association between electronic cigarette use and the subsequent development of lung cancer?
ASubjects with lung cancer who smoke and subjects with lung cancer who did not smoke
BSubjects who smoke electronic cigarettes and subjects who smoke normal cigarettes
CSubjects with lung cancer who smoke and subjects without lung cancer who smoke
DSubjects with lung cancer and subjects without lung cancer
ESubjects who smoke electronic cigarettes and subjects who do not smoke
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