A 75-Year-Old Man Recently Diagnosed with Advanced Colon Cancer Comes

question 83

Multiple Choice

A 75-year-old man recently diagnosed with advanced colon cancer comes to the physician with increasing abdominal pain.  He has known metastatic disease to the liver, lungs, brain, and peritoneum.  In addition to his pain, he complains of increasing fatigue and generalized weakness.  He now requires assistance from his family to perform activities of daily living and becomes dyspneic after walking from his bed to the bathroom.
His other medical problems include chronic obstructive pulmonary disease, hypertension, osteoarthritis, and coronary artery disease.  His medications include tiotropium, albuterol, lisinopril, aspirin, long-acting morphine, and oxycodone as needed for pain.
Which of the following risk factors is the most important predictor of this patient's prognosis?

• A)Advanced age
• B)Brain metastases
• C)Poor performance status
• D)Progressive pain syndrome
• E)Serum carcinoembryonic antigen levels

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Definitions:

Acetylcholinesterase

An enzyme that breaks down acetylcholine, a neurotransmitter, in the synaptic cleft, effectively terminating the signal between nerve cells.

Synaptic Vesicles

Membrane-bound sacs in the presynaptic terminal of a neuron that store neurotransmitters which are released into the synaptic cleft during neurotransmission.

Voltage-Gated Channels

Protein channels in cell membranes that open or close in response to changes in membrane voltage, crucial for nerve impulse transmission.

Exocytosis

The process by which cells transport molecules out of the cell by the fusion of vesicles with the plasma membrane.