A 65yo known case of liver ca and metastasis presents with gastric reflux and bloatedness. On
bone exam there is osteoporosis. He also has basal consolidation in the left lung. What is the
next appropriate step?
a. PPI IV
b. Alendronate
c. IV antibiotics
d. Analgesic
e. PPI PO
answer: C
Here we have 3 things that need treating , osteoporosis (alendronate), refulx(PPI), pneumonia(antibiotics) .... it asks for the next step.....the most urgent matter is the lung infection as it can be rapidly fatal in a compromised individual, the other issues should be addressed after that.
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