Welcome to your Review Board III
1.
AM IS 84 YO M WITH MULTIPLE MYELOMA AND IS ADMITTED TO THE HOSPITAL W/CORD COMPRESSION AND IS MADE NPO AWAITING CORPECTOMY BY NEUROSURG,PAIN PREVIOUSLY WELL CONTROLLED ON Long Acting MORPHINE 30MG PO Q8H,WHAT IS THE EQUIVALENT IV DOSE?
3.
59 year old M with initial presentation of follicular lymphoma s/p treatment with relapse and now diffuse large B cell lymphoma. Patient with prior deep vein thrombosis. Patient with large 10 cm right flank mass currently receiving local radiation therapy only and no chemotherapy treatment,continues to receive weekly port flushes. Patient on pregabalin 25 mg po qHS for bilateral lower extremity neuropathic pain with acute on chronic thrombocytopenia. Which is next step?
5.
Despite appropriate treatment in question #4, patient remains thrombocytopenic,CT Angiogram of the chest does not show PE. Which is the most likely case
6.
58 year old with metastatic Renal Cell Carcinoma diagnosed 5 years ago presents with progressive weakness in his bilateral lower extremities. He is very fatigued and his legs hurt at the end of the day. He denies bowel/bladder incontinence. Anal sphincter tone is adequate on exam. Recently his methadone was increased to 40 mg PO TID. He is also on atorvastatin, Lisinopril, HCTZ and oxycodone 15-20 mg every 4 hours as needed. What is the next best step in management?
7.
Appropriate step chosen for patient in question #6. Which is next best step in treatment?
12.
After choosing appropriate step in question #11, patient more comfortable. On POD#3, no longer using breakthrough. Primary team would like to prepare pt for discharge within the next 48 hours,acute on chronic renal failure is improving but not resolved. Which is most appropriate?
14.
Patient with delirium for 12 hours with history of prostate cancer, CHF, COPD with acute onset severe agitation and fever for the last 48 hours. Which is most likely cause?
16.
A 74 yo M with NYHA Class 3 CHF is referred for Hospice Care, the patient is ambulatory 75% of waking hours, eating 75% of meals and able to complete ADLS independently. Patient with hypertension and LVH, also has been diagnosed with dementia(FAST 6E) 2 years ago,the patient has had one brief hospitalization in the last six months. The most appropriate action at this time
21.
AM IS 84 YO M WITH MULTIPLE MYELOMA AND IS ADMITTED TO THE HOSPITAL W/CORD COMPRESSION AND IS MADE NPO AWAITING CORPECTOMY BY NEUROSURG,PAIN PREVIOUSLY WELL CONTROLLED ON Long Acting MORPHINE 30MG PO Q8H,WHAT IS THE EQUIVALENT IV DOSE?