Welcome. This is episode 526 of the Devand Intervention Podcasts.

And today's podcast, we're going to be continuing the conversation on the USMLE, Step 2, CK, 312.

This is going to be part 8. If you've missed the first seven parts in the series, you should listen to it, a lot of learning to be had.

I've pretty much done the first 60 questions.

For the last few podcasts, I've been trying to knock out 10 questions per podcast, but

61 to 70 have pretty extensive discussions that I want to give. So I'm going to kind of split it up.

So I'm going to do 61 to 65 in this one. So let's get right into it. So question 61 says a 67 year

old man is evaluated in the intensive care unit.

He has end-stitched pancreatic cancer and was hospitalized three days ago for treatment of pneumonia.

Respiration 06 per minute, pulse oxymetry and 100% oxygen by face mask, shows an auto-saturation of 878%.

Examination shows feeble respiratory efforts.

He's using accessory muscles of respiration.

On mental status examination, the patient is oriented to person, but not to place or time.

If the patient is not endotrically intubated and mechanically ventilated, he will die within hours.

His wife says the parent recently told her,

the patient recently told her that he would never want mechanical ventilation. But in ever

completed paperwork regarding his wishes, his daughter insists that he be mechanically ventilated.

Which of the following is the most appropriate action for the physician to take?

A says, perform endotricial intubation and begin mechanical ventilation.

B says, perform endotricial intubation and then consult the hospital ethics committee regarding mechanical ventilation.

Option C says, perform indotricial intubation only. Option D says,

provide palliative therapy only. Option E says, seek a court order to assign a legal guardian.

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