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  #1  
Old 03-29-2012
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Medicolegal and Ethics Practicing Catholic is pregnant!

A 22-year-old, married woman presents with pain in her lower right abdomen. Her abdomen is tender to palpation and there is rebound tenderness. The patient reports nausea, and has a temperature of 38.3 C (101 F). A diagnosis of acute appendicitis is made, and the patient consents to, and is scheduled for immediate surgery. Prior to the surgery, the woman tells the surgeon that she is a practicing Catholic, and says that she will pray for the successful completion of the surgery. Surgical examination of the appendix reveals that it is normal and without inflammation. Examination of the abdominal cavity reveals that the true underlying cause of the patientís pain is an ectopic pregnancy on the right side. At this point, what action should the surgeon take next?

A. Close the incision, wait until the patient recovers from anesthesia, and seek full informed consent before proceeding
B. Consult the chief of surgery
C. Consult with the local Catholic chaplain about how to proceed based on the womanís expressed religious beliefs.
D. Seek permission to operate on the ectopic pregnancy from the womanís spouse
E. Surgical intervention to deal with the cause of the pain
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  #2  
Old 03-29-2012
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A) close the incision...
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Old 03-29-2012
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Ectopic pregnency has to be terminated
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  #4  
Old 03-29-2012
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A.....these ethics questions are tough to handle......
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Matched!!!
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Old 03-29-2012
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E .. its a medical emergency
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Old 03-29-2012
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I'd go with D
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Old 03-29-2012
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Confusing question huh ...

Ok so the answer is E)Surgical intervention to deal with the cause of the pain


here's the explanation:

unless the patient gives explicit permission, treatment of any kind is not permitted EXCEPT,

1. emergency
2. waiver by patient
3. patient is incompetent
4. therapeutic privilege

this is a LIFE THREATENING emergency, so the answer is
E. surgical intervention to deal with the cause of pain.



I got this from a different website called prep4usmle ... i thought this question was interesting and clearly everyone had answers all of the place! But good question in my opinion.
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Old 03-29-2012
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It's life threatening condition. so go with option" E".
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Old 03-29-2012
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Thanks for posting the questions bro...
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  #10  
Old 03-29-2012
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Quote:
Originally Posted by Hope2Pass View Post
unless the patient gives explicit permission, treatment of any kind is not permitted EXCEPT,

1. emergency
2. waiver by patient
3. patient is incompetent
4. therapeutic privilege

this is a LIFE THREATENING emergency, so the answer is
E. surgical intervention to deal with the cause of pain.
I remember that in Kaplan video "BS", a case like this was mentioned and the answer was A) "Close the incision, wait until the patient recovers from anesthesia, and seek full informed consent before proceeding"

The patient is not bleeding, not in shock and this was a scheduled procedure.

If I'm wrong... sorry... This is just what I remember right now.

Does anybody also remembers that part in Kaplan videos???
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Old 03-29-2012
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Quote:
Originally Posted by Hope2Pass View Post
Confusing question huh ...

Ok so the answer is E)Surgical intervention to deal with the cause of the pain


here's the explanation:

unless the patient gives explicit permission, treatment of any kind is not permitted EXCEPT,

1. emergency
2. waiver by patient
3. patient is incompetent
4. therapeutic privilege

this is a LIFE THREATENING emergency, so the answer is
E. surgical intervention to deal with the cause of pain.



I got this from a different website called prep4usmle ... i thought this question was interesting and clearly everyone had answers all of the place! But good question in my opinion.
Nice one!
I was going for A first..
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  #12  
Old 03-30-2012
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Quote:
Originally Posted by Dr. Mexito View Post
I remember that in Kaplan video "BS", a case like this was mentioned and the answer was A) "Close the incision, wait until the patient recovers from anesthesia, and seek full informed consent before proceeding"

The patient is not bleeding, not in shock and this was a scheduled procedure.

If I'm wrong... sorry... This is just what I remember right now.

Does anybody also remembers that part in Kaplan videos???

Yep! You are correct. Daugherty did say what you wrote above. However, in a life-threatening situation, we do not need the patient's consent. The patient may not be bleeding or in shock -- yet. But ectopic pregnancy is classified under medical emergencies/life-threatening situation even without shock bec. of the danger of rupture anytime. It inevitably leads to rupture and when it does, the patient may die in a few minutes.

In fact, significant pain (i.e. when the patient goes to the ER bec of it) in an ectopic pregnancy signifies intraperitoneal bleeding or impending rupture already. It's not like appendicitis that we can wait for a few hours before rushing the px to surgery. Once ectopic preg is diagnosed, we need to operate on it as soon as possible. The danger of shock and cardiovascular collapse is imminent.
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  #13  
Old 03-30-2012
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A...wake the patient up or at least wait for patient to wake up..as said by 100 cases of fischer
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  #14  
Old 03-30-2012
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Quote:
Originally Posted by d_wiqed View Post
But ectopic pregnancy is classified under medical emergencies/life-threatening situation even without shock bec. of the danger of rupture anytime.

In fact, significant pain (i.e. when the patient goes to the ER bec of it) in an ectopic pregnancy signifies intraperitoneal bleeding or impending rupture already.
Thank you!!! I was looking for this... I've been thinking about the Q for a long time. I owe you one...

Quote:
Originally Posted by Hope2Pass
Confusing question huh ...
Yeah... You got me there. Thank you for sharing this Q... you've got me thinking about this Q since the morning




P.S.
@d_wiqed: multiple quoting is really easy... You can write it yourself. "QUOTE=XX name, (then you quote the whatever you want to quote, and then "[/QUOTE]" (First quote is between "[ ]" also)... try it and let me know.
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  #15  
Old 03-30-2012
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Guys it wouldnt be A. The patient is under anesthesia which is why it' not painful while doing the surgery. But if the patient wasn't under anesthesia, the pain is an emergency situation!!
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  #16  
Old 03-30-2012
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Default e

the qs s frm kap qbank i suppose

the ans s E
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