4.5 of 4 Ratings
A 65-year-old male comes into your office for a check-up. He states that he has been feeling tired and short of breath but does not have any fevers or cough. He has a history of smoking 1 pack of cigarettes per day for the last 40 years. He states that, over the last few years, he has had difficulty walking even one block. He cannot climb a set of stairs and states that he has been hospitalized many times over the past year for pneumonia. He is prescribed inhaled corticosteroids along with ipratropium and albuterol. His chest radiograph is shown in Figure A. Which of the following is most likely to decrease this patient's risk of hospitalizations for disease exacerbation and development of lung cancer?
Home oxygen therapy
Long acting beta2-agonist
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A 58-year-old woman presents to her family physician for an annual checkup. During the visit, the patient asks her physician for help quitting smoking cigarettes. She has unsuccessfully tried quitting several times previously and has also failed prior attempts with meditation and exercise. The physician prescribes a partial agonist of the nicotinic receptor to aid the patient in cessation. Which of the following is a potential side effect of this medication?
Impaired kidney function
A 35-year-old man presents to his primary care physician for a routine visit. He is in good health but has a 15 pack-year smoking history. He has tried to quit multiple times and expresses frustration in his inability to do so. He states that he has a 6-year-old son that was recently diagnosed with asthma and that he is ready to quit smoking. What is the most effective method of smoking cessation?
Bupropion in conjunction with nicotine replacement therapy and cognitive behavioral therapy
Participating in a smoking-cessation support group
Nicotine replacement therapy alone
A 48-year-old woman presents to her primary care physician for a wellness visit. She states she is generally healthy and currently has no complaints. She drinks 1 alcoholic beverage daily and is currently sexually active. Her last menstrual period was 1 week ago and it is regular. She smokes 1 pack of cigarettes per day and would like to quit. She describes her mood as being a bit down in the winter months but otherwise feels well. Her family history is notable for diabetes in all of her uncles and colon cancer in her mother and father at age 72 and 81, respectively. She has been trying to lose weight and requests help with this as well. Her diet consists of mostly packaged foods. His temperature is 98.0°F (36.7°C), blood pressure is 122/82 mmHg, pulse is 80/min, respirations are 12/min, and oxygen saturation is 98% on room air. Her BMI is 23 kg/m^2. Physical exam reveals a healthy woman with no abnormal findings. Which of the following is the most appropriate initial intervention for this patient?
Varenicline and nicotine gum
Weight loss, exercise, and nutrition consultation