What will you answer to this patient?

[IMG SURVIVOR]

You are in a party and your one of the guess comes to you and say Hey Doc I have a question, during the past year I have been suffering from peptic ulcer, but when I go to the Doc, he treats me and I get better then I get them back again, I’m frustrated with this, I started to smoke again because the past year they gave me that big promo, but it has a lot of responsibilities that I was not aware of.

What will you answer to this patient?
1-Stop Smoking
2-Give 3 therapy
3-Tell him to go back to his Doc
4-Tell him that he has esophagus cancer

[rose.82]

Hi,

I think the answer is 1-Stop Smoking.

[Dr. X]

i would probably say "im a doctor, im not your doctor".. lol.. sorry.. saw it on a tshirt and had to share. what is give 3 therapy? even though you cant be just prescribing like that.

stress plays a bigger role in relapse of peptic ulcer than smoking. Also, while the heavy smokers relapse sooner, non-smokers may relapse later. The reason im saying this is because stopping smoking (a risk factor) does not necessarily mean that his peptic ulcer will not relapse. I would advice him on any details he wishes to know (even about H.pylori and Nsaids) yet ultimately suggest that he pays a visit to his physician for a thorough examination and start therapy accordingly.

ya whenever we see the answer choice "send him to another doctor", the reflex kicks in reminding us that we MUST not refer to another doctor without a real need. I have also read in UW explanation, if you ever see "send him to another doctor", chances are very high that wont be the answer. In this case however, this is not your patient and is only a guest.

[Ella]

I agree ... normally never refer a patient to another doc...but in this case i think the answer is 3 - Tell him to go back to his Doc.

[nafees ahmad]

in medical ethics tell him to go to his doc

[shisha]

whats the correct one img survivor

[MDXRS22]

Go to your Doc and stay there for a while. THis is the right and best answer.

[student-2]

USMLE is big on advising against smoking. I don't think you can ever go wrong with that

[nicolasita]

Hi,
I think that after all those arguments the best choice is "go and see your doc".

[rose.82]

Hi ,
The answer is 1-stop smoking.

[crackmle]

IMG SURVIVOUR,can you please post the answer:confused:
Thanks

[Jakeislove]

why wouldn't it be go back to your doctor? Smoking cessation is a safe answer but does every question someone asks immediately begin a doctor patient relationship?

[pac2md]

this brief question sounds as if he has an H. pylori infection...his GP has been treating with, first, antacids then PPI's feels better for a short period but then resumes symptoms...should ask patient to see his physician and ask for further lab work up...you might even write some tests on your napkin (CBC, CMP, H.pylori IgG/IgM, amylase, Lipase)and give it to this person, then you could ask what he does and start asking him questions regarding his work. Tricky question as you know the therapy but what are they (USMLE) looking for. ethics, therapy, or long term health....Hmmmmmm