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1 of 25 Questions

You have a patient with uncontrolled diabetes and co-morbidities. The patient's condition is deteriorating. The treatment presently available in the country is not working and you want to try a newer insulin delivery system that is not yet approved by Indian FDA. You want to be doubly sure that you are on the right side of the law. How will you proceed further in this case?

You will search the internet and if the available information points out that this newer delivery system is safe and acceptable you will go ahead.

As the information available on the internet is not reliable, you will not browse the internet for any information but only refer to authoritative medical literature to confirm its acceptability to medical science.

You will search the websites of prestigious institutions / associations / journals as well as standard medical literature but exercise exceptional caution in taking a decision based solely on the strength of information / literature available on the internet.

2 of 25 Questions

A patient of chronic cough consults you. You advise an x-ray and the x-ray reports "Miliary tuberculosis? Clinical co-relation required." But you are of the opinion that it is sarcoidosis. Out of abundant precaution, you refer the patient to a senior chest consultant who opines in favour of miliary tuberculosis. But you still are of the opinion that the patient suffers from sarcoidosis. The dilemma is that steroids are fatal for miliary tuberculosis but happen to be standard treatment for sarcoidosis. Which one of the following is the best alternative that should be followed?

You should go ahead with your diagnosis of sarcoidosis and manage the patient accordingly if you are confident. The patient is under your care and you are qualified and competent.

You should accept the diagnosis of the senior chest consultant. If any legal issues arise, you have x-ray report and the chest consultants opinion for your defense.

You should take opinion of another doctor, if possible, and advise other investigations. Even if these do not help you in any way, you can still remain firm on your opinion, but for reasons that are acceptable to medical science and in the bonafide interest of the patient.