Changes

questionnumber="6"

questionnumber="6"

question="What would you choose to do next?"

question="What would you choose to do next?"

choice1="Abdominal ultrasound for staging purposes "

choice1="a) Abdominal ultrasound for staging purposes "

choice2="Thoracic radiographs for staging purposes "

choice2="b) Thoracic radiographs for staging purposes "

choice3="Thoracic computed tomography (CT) for staging purposes "

choice3="c) Bone marrow biopsy for staging purposes"

choice4="Bone marrow biopsy for staging purposes "

choice4="d) Palpation of regional lymph node and FNA of this lymph node if enlarged."

choice5="Palpation of regional lymph node and FNA of this lymph node if enlarged."

choice5="e) Options b) and d)"

correctchoice="2"

correctchoice="5"

feedback1="'''Incorrect'''. Although this is reasonable to check for intercurrent disease, it is unlikely that a grade 2 STS would metastasize to intra-abdominal organs so not your next choice. This option is more appropriate for high-grade or anaplastic STS."

feedback1="'''Incorrect'''. Although this is reasonable to check for intercurrent disease, it is unlikely that a grade 2 STS would metastasize to intra-abdominal organs so not your next choice. This option is more appropriate for high-grade or anaplastic STS."

feedback2="'''Correct'''. This is the commonest site for metastatic disease for STS. However, you should also assess your regional lymph nodes, as in option e."

feedback2="This is correct but there is a better option. This is the commonest site for metastatic disease for STS. However, you should also assess your regional lymph nodes, as in option e."

feedback3="Although correct, it is probably not money well spent, given that the metastatic rate for grade 2 STS is only up to 20% and this is expected to occur late in the course of disease. Thoracic radiographs are adequate for staging purposes in this case."

feedback3="This is of little or no value in this case."

feedback4="This is of little or no value in this case."

feedback4="This is also correct as STS can metastasize to regional lymph nodes. You should try and demonstrate evidence of metastasis with FNA before surgery, as this may change the prognosis and thus the client’s willingness to treat. However, cytology of regional lymph nodes may not be adequate for staging and histopathology is better to prove lymph node metastasis. It is important to remove enlarged regional lymph nodes at the time of surgery and send for histopathology just to be sure. You should also take thoracic radiographs for staging purposes, as lung is the most common site for metastasis of STS. Choose again."

feedback5="This is also correct as STS can metastasize to regional lymph nodes. You should try and demonstrate evidence of metastasis with FNA before surgery, as this may change the prognosis and thus the client’s willingness to treat. However, cytology of regional lymph nodes may not be adequate for staging and histopathology is better to prove lymph node metastasis. It is important to remove enlarged regional lymph nodes at the time of surgery and send for histopathology just to be sure. You should also take thoracic radiographs for staging purposes, as lung is the most common site for metastasis of STS. Choose again."

feedback5="'''Correct'''. This is the best answer.]]>"

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