A 70-year-old male with a 40 pack-year history of smoking and ...

[skymedlock]

A 70-year-old male with a 40 pack-year history of smoking and long-standing non-insulin-dependent diabetes has been diagnosed with pancreatic cancer.
 
  Which of the following teaching points should the physician provide?
  A)
  While this is indeed serious, you should know that you have a good chance of beating this disease with appropriate treatment.
  B)
  Most likely your pattern of high alcohol intake over the years contributed to your cancer.
  C)
  You will likely be facing surgery in the near future, but know that this is very unlikely to eliminate your cancer.
  D)
  I know it may seem trivial at this point, but the levels of pain that accompany cancer of the pancreas are normally quite low.

Question 2

The nurse knows that a diabetic patient admitted for a lower limb infection likely is experiencing which of the following pathophysiologic principles listed below? Select all that apply.
 
  A)
  Many diabetic patients have sensory deficits and ignore minor trauma just because they can't feel it in their feet.
  B)
  Patients with chronic diabetes may have vascular problems that impair circulation, and therefore cells needed for adequate inflammatory response cannot reach the site.
  C)
  Hyperglycemia may provide an environment that enhances the growth of microorganisms.
  D)
  Infections happen to all age groups and people, and the diabetic patient has the same risk for developing an infection as other patients without diabetes.
  E)
  Any exercise that creates diaphoresis in the feet can cause a fungal infection in diabetic patients.

[recede]

Answer to Question 1

Ans:
C

Feedback:

Surgery is the most common treatment modality for pancreatic cancer, but it does not commonly result in the resolution of the disease. Pancreatic cancer has a very poor prognosis, and alcohol is not a common contributor. Pancreatic cancer is noted to be exceptionally painful.

Answer to Question 2

Ans:
A, B, C

Feedback:

Suboptimal response to infection in a person with diabetes is caused by the presence of chronic complications, such as vascular disease and neuropathies, and by the presence of hyperglycemia and altered neutrophil function. Certain types of infections occur with increased frequency in people with diabetes: soft tissue infections of the extremities, osteomyelitis, UTIs and pyelonephritis, candidal infections of the skin and mucous surfaces, dental caries, and periodontal disease.

[skymedlock]

Excellent

[Jossy]

TYSM