𝐍𝐚𝐢𝐥 𝐩𝐢𝐭𝐭𝐢𝐧𝐠 𝐨𝐜𝐜𝐮𝐫𝐬 𝐝𝐮𝐞 𝐭𝐨

[Medicoman]

𝐍𝐚𝐢𝐥 𝐩𝐢𝐭𝐭𝐢𝐧𝐠 𝐨𝐜𝐜𝐮𝐫𝐬 𝐝𝐮𝐞 𝐭𝐨

• 𝐀. 𝐅𝐨𝐜𝐚𝐥 𝐩𝐚𝐫𝐚𝐤𝐞𝐫𝐚𝐭𝐨𝐬𝐢𝐬 𝐨𝐟 𝐏𝐫𝐨𝐱𝐢𝐦𝐚𝐥 𝐧𝐚𝐢𝐥 𝐟𝐨𝐥𝐝
• 𝐁. 𝐅𝐨𝐜𝐚𝐥 𝐝𝐲𝐬𝐤𝐞𝐫𝐚𝐭𝐨𝐬𝐢𝐬 𝐨𝐟 𝐏𝐫𝐨𝐱𝐢𝐦𝐚𝐥 𝐧𝐚𝐢𝐥 𝐟𝐨𝐥𝐝
• 𝐂. 𝐅𝐨𝐜𝐚𝐥 𝐩𝐚𝐫𝐚𝐤𝐞𝐫𝐚𝐭𝐨𝐬𝐢𝐬 𝐨𝐟 𝐃𝐢𝐬𝐭𝐚𝐥 𝐧𝐚𝐢𝐥 𝐟𝐨𝐥𝐝
• 𝐃. 𝐅𝐨𝐜𝐚𝐥 𝐝𝐲𝐬𝐤𝐞𝐫𝐚𝐭𝐨𝐬𝐢𝐬 𝐨𝐟 𝐃𝐢𝐬𝐭𝐚𝐥 𝐧𝐚𝐢𝐥 𝐟𝐨𝐥𝐝

A 70 year old patient comes with swelling in the parotid region for the last 10 years. Exam: gland is soft and cystic. Choose the most probable diagnosis?

• a. Pleomorphic adenoma
• b. Carcinoma of the salivary glands
• c. Mikulicz’s disease
• d. Adenoid cystic carcinoma
• e. Parotid duct stones

A 22-year-old, married woman presents with pain in her lower right abdomen. Her abdomen is tender to palpation and there is rebound tenderness. The patient reports nausea, and has a temperature of 38.3 C (101 F). A diagnosis of acute appendicitis is made, and the patient consents to, and is scheduled for immediate surgery. Prior to the surgery, the woman tells the surgeon that she is a practicing Catholic, and says that she will pray for the successful completion of the surgery. Surgical examination of the appendix reveals that it is normal and without inflammation. Examination of the abdominal cavity reveals that the true underlying cause of the patient’s pain is an ectopic pregnancy on the right side. At this point, what action should the surgeon take next?

• A. Close the incision, wait until the patient recovers from anesthesia, and seek full informed consent before proceeding
• B. Consult the chief of surgery, the director, and ethics committee so they can discuss what to do next
• C. Consult with the pope about how to proceed based on the woman’s expressed religious beliefs.
• D. Seek permission to operate on the ectopic pregnancy from the woman’s spouse, then have a heated argument for 1/2 hour.
• E. Take the fetus out, tell no soul
• F. Surgical intervention to deal with the cause of the pain, inform the patient afterwards