Case 40 Part 1

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Activity: Check your evidence-based thinking. Click start to begin. The site will provide feedback at the end.
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Select the option only if this one video gives the evidence to prove it. Skip the option if there’s no evidence.

Tip: You’re not trying to guess a reasonable diagnosis or pick what could be true. You’re practicing evidence-based decision-making.

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Discussion Questions

   

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1. Summarize the history.
 
 
2. How many different cancers did the patient have? Where were they?
 
 
3. Why did the patient have so many cancers?
 
 
4. How many different procedures did the patient have? What were they? Which were diagnostic? Which were for cancer resection? Which were to restore body function? Which were for post-operative complications?
 
 
5. Do you think the initial lung cancer and the later lung mass are related? If so, how?
 
 
6. What is the likelihood of a new metastasis years after an initial lung cancer is resected? What is the likelihood of a second, new lung cancer after a first?
 
 
7. What are common ways patients with lung cancer die? Which are gradual? Which are catastrophic events? What is the anatomic basis of each?
 
 
8. How would you incorporate end-of-life discussions into your care of cancer patients? At what point in the care would you have this discussion?
 
 
9. What unique discussions might you have with a patient with a central vs. peripheral tumor?
 
 
10. What are the risks of tumor biopsy?
 
 
11. How does the risk of cancer change after cessation of smoking?
 
 
12. What are the risks of a tracheostomy procedure?
 
 
13. How is an intestinal autotransplant performed?
 
 
14. Inventory all the physical findings.
 
 
15. Correlate each finding with the history.
 
 
16. Are there any physical findings that aren’t explained in the history? How do you account for that?
 
 
17. Are there any parts of the history that don’t have a physical finding you might expect?





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