06-22-2014, 05:34 PM
44.
A 72-year-old woman comes to the physician because of an increase in abdominal girth over the past 2 months. She has had a 3.6-kg (8-lb) weight gain during this period despite being unable to finish any meal. She has one martini daily after her 3-mile walk. She underwent lumpectomy and radiation therapy for stage I breast cancer 4 years ago and has been treated with tamoxifen since then. Abdominal examination shows a fluid wave. Pelvic examination shows an 8-cm, fixed, nontender mass in the cul-de-sac. Laboratory studies show normal findings. Which of the following is the most appropriate next step in management?
A
)
Intravenous albumin therapy
B
)
Intravenous antibiotic therapy
C
)
Intravenous cisplatin and paclitaxel therapy
D
)
Oral angiotensin-converting enzyme (ACE) inhibitor therapy
E
)
Oral spironolactone therapy
F
)
Therapeutic paracentesis
G
)
Exploratory laparotomy
A 72-year-old woman comes to the physician because of an increase in abdominal girth over the past 2 months. She has had a 3.6-kg (8-lb) weight gain during this period despite being unable to finish any meal. She has one martini daily after her 3-mile walk. She underwent lumpectomy and radiation therapy for stage I breast cancer 4 years ago and has been treated with tamoxifen since then. Abdominal examination shows a fluid wave. Pelvic examination shows an 8-cm, fixed, nontender mass in the cul-de-sac. Laboratory studies show normal findings. Which of the following is the most appropriate next step in management?
A
)
Intravenous albumin therapy
B
)
Intravenous antibiotic therapy
C
)
Intravenous cisplatin and paclitaxel therapy
D
)
Oral angiotensin-converting enzyme (ACE) inhibitor therapy
E
)
Oral spironolactone therapy
F
)
Therapeutic paracentesis
G
)
Exploratory laparotomy