A 50-year-old man with no significant past medical history presents for a follow-up. He notes that he has developed increased non-productive cough and shortness of breath over the past week. He has had a chronically progressive cough and shortness of breath upon exertion over the past year. His occupational history reveals coal mining for 25 years. He denies any smoking, alcohol consumption, travel history, or sick contacts. He also denies fever, chills, sore throat, otalgia, chest or abdominal pain, peripheral edema, rashes, or pruritus. A chest radiograph was performed. What treatment would be most beneficial?
1 Trexall
2 Oseltamivir
3 Amoxicillin-clavulanate
4 Prednisone
5. Acyclovir

Mr. j, age 42, is a construction worker in las vegas. he recently noticed that a mole on his face seemed to be getting larger and darker. at first he did not worry because he was in the sun a lot and assumed the change may have been caused by sunburn. after a month, not only was the mole larger and darker, but it appeared to be “bumpy.” his doctor diagnosed a malignant melanoma skin cancer following biopsy of the nevus. mr. j reports pain in his right shin that does not go away when he puts his feet up or sleeps. discussion questions 1. relate mr. j’s skin changes to the warning signs for malignant melanoma. (see malignant melanoma.) 2. discuss the normal progression of this malignancy. what is the significance of the bone pain that mr. j is experiencing? (see malignant melanoma.) 3. discuss the treatment available for this patient and the prognosis for recovery. (see malignant melanoma.)