Challenging questions Flashcards
An educated 58-year-old woman asks, “I read in a scientific journal that hormonal replacement therapy causes breast cancer. What do you think of that, doctor?”
“Studies do in fact show a slight increase
in the risk of developing breast cancer
after more than four years of combination
estrogen and progesterone use for
hormonal replacement therapy. The
current recommendations are to use
hormonal replacement therapy solely
for the relief of hot flashes, and only for
a limited period of time.”
“Did I have a stroke?”
“We don’t know yet. Your symptoms
could be explained by a small stroke,
but we need to wait for the results of
your MRI.”
An African American man with sickle cell anemia presents with back and chest pain and says, “Please, doctor, I need some Demerol now or I will die from pain.”
“I know that you are in pain, but I need to ask you a few questions first to better understand your pain. Then we will get you some medications to help ease your discomfort.”
A patient with symptoms of a common
cold says, “I think I need antibiotics,
doctor.”
“It appears that you have a common cold, which is caused by a virus. Antibiotics do not treat viruses, and they have adverse effects that could make you feel worse. We should focus on treating your symptoms.”
“My mother had breast cancer. What
is the possibility that I will have breast
cancer too?”
“You are at increased risk, but it doesn’t
mean that you will get it. There are
other risk factors that need to be considered,
and regular screening tests will
be very important.”
“Can I get pregnant even though my
tubes are tied?”
“There is no single contraceptive
method that is 100% effective. The risk
of pregnancy after tubal ligation is less
than 1%, but on rare occasions it does
occur. There is a high probability that
if such a pregnancy occurs, it will be an
ectopic pregnancy.”
A woman who is in her first trimester
of pregnancy with vaginal bleeding
asks, “Do you think I am losing my
pregnancy?”
“Bleeding early in pregnancy increases your risk of losing the pregnancy, but at the same time, most women who have bleeding carry the pregnancy to term without any problems.”
“Obesity runs in my family. Do you
think that is why I am overweight?”
“Genes play an important role in obesity, but lifestyle, diet, and daily habits are also major factors influencing weight. These factors can be used in a way that can help you lose weight.”
A very thin patient with weight loss
asks, “Doctor, do you think I am too
fat?”
Even if the patient appears to be thin, do not state as much. Instead, respond by saying, “I cannot tell right now. First I need to determine your height and weight and calculate your body mass index, and then we can let the numbers tell us if you are at a healthy weight.”
