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Old 03-18-2013
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Question Contraindication for lung transplantation

A 51-year-old man is admitted to the hospital for treatment of advanced pulmonary fibrosis. His IQ is 78, and he has a history of major depressive disorder. When questioned, he says that he no longer smokes, but his wife immediately yells at him and says that he continues to smoke despite her best efforts to tell him daily not to do so. Throughout the interview, the patient continually opens his wallet and counts his credit cards to check that they are all there. Physical examination shows no other abnormalities. Which of the following psychosocial factors is the strongest contraindication to lung transplantation for this patient?

A ) Continued cigarette smoking
B ) Current marital discord
C ) History of major depressive disorder
D ) Mild mental retardation
E ) Obsessive-compulsive disorder
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Old 03-18-2013
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Quote:
Originally Posted by Evergreen View Post
A 51-year-old man is admitted to the hospital for treatment of advanced pulmonary fibrosis. His IQ is 78, and he has a history of major depressive disorder. When questioned, he says that he no longer smokes, but his wife immediately yells at him and says that he continues to smoke despite her best efforts to tell him daily not to do so. Throughout the interview, the patient continually opens his wallet and counts his credit cards to check that they are all there. Physical examination shows no other abnormalities. Which of the following psychosocial factors is the strongest contraindication to lung transplantation for this patient?

A ) Continued cigarette smoking
B ) Current marital discord
C ) History of major depressive disorder
D ) Mild mental retardation
E ) Obsessive-compulsive disorder
a. continued smoking
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Old 03-18-2013
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I'm going to say C. I remember Kaplan behavioral was talking about that most people that smoke usually have an underlying reason, and it's usually due to being depressed. Treating the depression with buproprion will help with the patient to stop smoking cigarettes.
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Old 03-19-2013
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this is nbme 6. q... i picked c and i got it wrong.

The answer is actually A.

i encountered the same question in some Qbank but they were talking about an alcoholic wanting a liver transplant and the contraindication was continued drinking.

same concept.

i guess the rationale is why give a smoker a new lung if he's going to mess it up anyways. same with a new liver..
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