September/2006

ANSWER 8=B

DISCUSSION:

Using the prognostic index, you determine that the patient has a risk score of 11 points: she receives four points for age, one for diabetes, two for chronic lung disease, one for a low BMI, and three for functional limitations. Therefore, you predict that the patient has a four-year mortality risk of 42 percent. After you discuss the advantages and disadvantages of continued screening with her, she appropriately decides not to receive further mammograms. Instead, you and the patient discuss ways to optimize treatment for her chronic lung disease and how she can get help with home maintenance (e.g., cleaning, yard work) and with other activities of daily living.