A 75-Year-Old Man Has a 3 Month History of Cough

question 604

Multiple Choice

A 75-year-old man has a 3 month history of cough and weight loss.  He also complains of back pain and difficulty breathing.  He was initially wheelchair bound, but now he is bedbound and unable to perform any of his activities of daily living.  He has a long history of cigarette smoking.
On examination, he is thin and appears tired.  Vital signs are within normal limits.  Breath sounds are decreased at the left lung base.  A stage 2 presacral pressure ulcer is present.
CT scan of the chest demonstrates a left perihilar mass, multiple enlarged mediastinal lymph nodes, and bone metastases.  A biopsy at bronchoscopy confirms a diagnosis of squamous cell cancer.
Which of the following is the best next step in the management of this patient?

• A)Carboplatin monotherapy
• B)Combination chemotherapy
• C)Hospice referral
• D)Risedronate
• E)Tissue analysis for EGFR receptor and ALK fusion oncogene

---

Definitions:

Team-oriented

A focus or preference for working collaboratively in groups or teams to achieve common goals.

Autonomous

Having the ability or power to make decisions independently, without external influence or control.

Humane Orientations

Leadership or organizational cultures that prioritize compassionate, ethical, and people-centric values and practices.

GLOBE Studies

Cross-cultural research studies focusing on understanding the impact of culture on leadership and organizational behavior.