Patient Care & Treatment Decision Making Flashcards
7 cards from real ABPS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Patient Care & Treatment Decision Making flashcards as text
A 68-year-old patient with stage IV COPD refuses intubation during an acute exacerbation. What is the most appropriate next step?
Answer: Respect the patient's refusal and pursue non-invasive ventilation and comfort measures
A competent adult's refusal of treatment must be respected; non-invasive ventilation and comfort-focused care align with the patient's wishes.
Which principle of bioethics is best exemplified when a physician discloses all risks of a surgical procedure before obtaining the patient's signature?
Answer: Autonomy
Informed consent respects autonomy by ensuring the patient can make a voluntary, informed decision about their own care.
A 45-year-old diabetic patient presents with a new HbA1c of 9.8%. Current regimen is metformin 1000 mg BID. What is the most guideline-concordant next step?
Answer: Add a second oral agent or GLP-1 agonist per ADA guidelines
ADA guidelines recommend combination therapy when HbA1c remains above goal on metformin monotherapy.
During a care conference, the team disagrees on whether to pursue aggressive treatment for a terminally ill patient. What resource is most appropriate to resolve this conflict?
Answer: Hospital ethics committee
Ethics committees are specifically designed to mediate complex clinical-ethical disputes among patients, families, and care teams.
A patient's surrogate decision-maker demands aggressive life-sustaining treatment the care team believes is medically futile. What is the best approach?
Answer: Explain the concept of medical futility and facilitate an ethics consultation
Open communication about futility combined with ethics consultation helps align surrogate expectations with medical reality.
A 55-year-old man with chronic low back pain asks to continue opioid therapy indefinitely. What is the most appropriate response according to current pain management guidelines?
Answer: Reassess functional status, risks, and benefits; taper if risks outweigh benefits
CDC guidelines recommend periodic reassessment of opioid therapy with tapering when harms outweigh functional benefits.
A 30-year-old pregnant patient in her third trimester is diagnosed with acute appendicitis. What is the correct treatment approach?
Answer: Perform appendectomy promptly regardless of gestational age
Acute appendicitis in pregnancy requires prompt surgical intervention regardless of trimester, as delay increases perforation risk and fetal mortality.