Urgent question
October 25, 2012 | 25,00 EUR | answered by Dr. med. Kathrin Hamann
Editor's note:
Dear questioner, after Dr. Berg supported Dr. Hamann's assessment of a vague question, the editorial team has deactivated your rating. We believe that Dr. Hamann's efforts to answer the question based on unclear inquiries do not warrant a one-star rating for "recommendable."
Good day,
I am currently undergoing training to become a geriatric nurse. I have been given a task and am seeking assistance with it.
The issue at hand is as follows: The patient has been experiencing pain and severe cramps in the abdominal area for weeks and has been receiving subcutaneous Buscopan for weeks with no improvement. A doctor ordered an ultrasound of the abdomen, which revealed a non-malignant tumor near the intestines (not in the intestines!) measuring approximately 7*3cm. The patient is being prescribed medication to reduce the size of the tumor and eventually make it disappear.
Now, my questions are:
1. What diagnosis could fit this case (what type of tumor)?
2. What medication is he receiving to reduce the tumor?
3. How can the diagnosis of "benign" be confirmed without surgical intervention?
I kindly ask that you only accept the task if you are able to answer all 3 questions.
Thank you in advance.
Best regards!
Good day,
this question is very vague.
With this mass (tumor) it could be various things. But the following restrictions should help you, as a geriatric nurse, to make the diagnosis:
-Size 7x3cm
-it is not in the intestine
-is it related to medication?
-it is not malignant
Let's approach this systematically.
Which organs are possible (excluding the intestine, located in the abdomen)?
-Liver
-Gallbladder
-Pancreas
-Kidneys
-Stomach (lower part)
-Lymph nodes
-Vessels
A benign diagnosis ONLY by ultrasound must be really clear. The following are possible:
-Cyst (hollow chamber filled with fluid)
-Stone (acoustic shadow)
Therefore, only a few organs remain possible:
-Kidney
-Pancreas
-Gallbladder
Cysts and many gallstones cannot be eliminated with medication.
Therefore, a special form of gallstones remains.
These can be dissolved with Ursodeoxycholic acid (UDCA) and Chenodeoxycholic acid. This will make the swelling smaller and it will disappear completely.
This is the only diagnosis that comes to mind for me in response to this question, after careful consideration.
As mentioned above, I find the question very ambiguous and not suitable for the geriatric nursing exam.
As I teach at a nursing school myself, I strongly advise the examiner to remove this question from their question bank.
Do you have any questions about this? I am happy to help.
Best regards,
Dr. K. Hamann
