A 65 year old man with known metastatic (to brain and bones) non-small cell lung cancer is brought in by his daughter-in-law for intractable
back pain. His last round of chemotherapy was carboplatin/taxol approximately 10 days ago. Vital signs in the ED: 38.9, 137/85, 85, 14,
SpO2 98% RA

1) If you only have time to ask this patient ONE question, what would it be? Why?

2) If you can only order ONE

diagnostic/imaging test for this patient, what would it be? Why?

While you are working-up the patient’s back pain, the daughter-in-law

gives you his medication list:

Atenolol 5omg QD (h/o HTN), MS Contin 3omg q12 hrs (been on this for past 3 months for known left hip bone

mets), MSIR 15mg q4 hrs prn pain (using 4-5 times per day, recently using more due to back pain), Senna and Colace BID, decadron 4mg TID
(for cerebral edema r/t brain mets).

3) Which medication in this list most catches your attention? Why?

Pertinent labs drawn in the ED

include:

WBC: 1.8

-segs: 21%
-bands: 7%

Hemoglobin: 8.5

Hematocrit: 28%

Platlets: 65,000

Glucose: 174

4) Based on

this new information, what are your next immediate steps? Why?
Provide an initial response to ONE question listed above (4-5 students can work together as a group on this initial

posting)

Provide ONE lNDl/IDUAL critique (this means provide feedback regarding the appropriateness and accuracy ofthe response, adding to,

or correcting, any information you feel necessary) to ONE group response (not the group you are in) As always, backing up your statements
with references is helpful and strengthens your argument. Please remember to add something meaningful to the discussion, not simply a repeat
of what another student has written.

Please write no more than one page on the assignment. I will have you write a one page critique of

another students post.