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* question for cardio96
 #843388  
  notablebiochemist - 08/11/17 04:33
 
  24-year-old woman is scheduled for delivery by Cesarean section after her unborn child is determined to be wedged in a breech position. Prior to the surgery, the woman asks the physician to pray with her, and to carry a “charm,” a dried animal tongue, with him as he performs the procedure. The physician is not religious and is taken aback by the request. He comes to you and asks your advice as to what he should do. Your best advice would be to tell him to
(A) advise the patient that her beliefs are not in keeping with modern medical practice
(B) go along with the patient’s request by praying with her and carrying the charm
(C) politely explain to the patient that he does not share her religious beliefs
(D) pray with her and tell her he will carry the charm, but leave it outside the operating theater for sanitary reasons
(E) schedule an appointment for the patient with the appropriate hospital chaplain
(F) stand in the room as she prays, but decline to carry the charm (G) suggest to the patient that she might be more comfortable with another physician performing the procedure
this is from kaplan behavioral science questions i thought it is D, but answer says B, isn't carrying dry animal tongue into OR against sanitary rules?
 
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* Re:question for cardio96
#3345548
  cardio69 - 08/11/17 12:48
 
  We always support pat religiosity.

The majority of caregivers including you (no matter what religion you got) faith/religious/spirituality it pretty important to your pat. As been proven meditation/prayer … help pat family as caregivers help them to reduce that depressive symptom or ease grief. Also on help partner with Alzheimer pat and psychological impact on the family having cancer pat and help area heightened anxiety & depressions.

Remember (don’t look at the ugly world we live in) regardless, the religious pat may want to receive religious support. In U.S at least and what u need to know for you prep, pat holding many forms of spiritual/religious beliefs times unfamiliar to Americans health care ( pat & providers) world. So, you will go along w pat request and pray with her.

I made up some Q long way back regard to it u can search the forum if you like.

~ “Jack” Kevorkian... “My religion centers in different areas than what's considered conventional religion.”

 
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* Re:question for cardio96
#3345590
  notablebiochemist - 08/12/17 03:59
 
  why it is not D? i mean you would pray with him, but wouldn't bring that animal thing into OR, isn't it dangerous(Sanitary)?  
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* Re:question for cardio96
#3345595
  notablebiochemist - 08/12/17 07:41
 
  another Q if you don't mind please, on NBME 13 block 4 q 32 they basically ask what is increased in multiple myeloma and you have Il1(OAF) and Monoclonal immunoglobulin as answer choices, i choose later one but on this forum, explanation says IL1, isn't M spike due to monoclonal gammopathy?  
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* Re:question for cardio96
#3345743
  cardio69 - 08/14/17 18:18
 
  D would be 100% wrong
PLEASE READ MY EXP with care:)) otherwise u not learn much:)
Your goal to make pat comfortable. Again you take D which wrong ans it means you not accepting pat spiritual/religious beliefs as you promise to participate in it. As a doctor (no matter what part of the world you coming from) promise keeping is very special importance for you as a physician. Dr-pat relationship is based on “trust”, D pat might feel betrayed as you break a promise and that spiritual that assoc not gone have a good outcome.

______________________________
I dont have form or Q at momement. But if I recall corrctly is Q with img.

That I think you referring to img if I recall correctly “compression fracture” you understand presence of an atraumatic/OR vertebral signifies -> osteoporosis

You recall cytokines like IL-6 (pat had long illness that make it worse), IL-1 & TNF especially postmenopausal (independently or downstream mediators of estrogen signaling). That been said, you understand key mediators of osteoclastic bone resorption as been follow on pat with MM malignancy of plasma cells ( as u know B lymphocyte lineage)

If I drill you, the tumor cells produce what that can tickle osteoclasts & enhance bone resorption? You gone tell me some osteoclast activating factors that you know activate those osteoclastic, so the only thing u may see on option if I recall IL-1. And that would be your correct ans.

In setting of MM you see a spike in gamma (M spike) due production of Ig (if you recall IgGk or IgA or pure chain myeloma)




 
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* Re:question for cardio96
#3345766
  notablebiochemist - 08/15/17 07:57
 
  ok thanks for help  
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* Re:question for cardio96
#3345879
  cardio69 - 08/16/17 16:45
 
  NP.  
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