HPM Questions 2 Flashcards
What is the relationship between dyspnea and quality of life?
Strong and inversely proportional relationship
What is the treatment course to take for bronchospasm-related dyspnea?
Neublized albuterol and ipratropium
Inhaled beclomethasone
Systemic steroids (SVC syndrome)
What is the treatment course for dyspnea with rales?
Diuretics
Antibiotics
What is the treatment course for dyspnea with effusions?
Thoracentesis
What is the treatment course for dyspnea with airway obstruction?
Suctioning
Positioning
What is the treatment course for dyspnea with secretions?
Nebulized saline with guaifenesin
Thicken secretions
What benzodiazepine may be helpful as a second/third-line agent for chronic refractory dyspnea due to its long acting effects?
Clonazepam
What medication can help with radiation-induced dry mouth and should typically be started prior to radiation therapy?
Pilocarpine
What values are associated with GOLD 1 COPD?
FEV1 greater than 80%
What values are associated with GOLD 2 COPD?
FEV1 between 50% and 80%
What values are associated with GOLD3 COPD?
FEV1 between 30% and 50%
What values are associated with GOLD4 COPD?
FEV1 less than 30%
What factors portend a poor prognosis for individuals with end-stage renal disease?
Hypoalbuminemia, older age, poor functional status, BMI less than 18.5, peripheral vascular disease, end-stage heart failure, diabetes mellitus, active malignacy, and cerebrovascular disease
What are common symptoms related to spiritual suffering?
Joking, afterlife concerns, indescribable pain, and feelings of guild, anger, conflict, and punishment
What intervention may be helpful in patients with end-stage pulmonary disease who are refusing medication titrations?
High-flow oxygen therapy
What is the drug of choice to treat delirium in patients with Parkinson’s disease?
Quetiapine
What steroid regimen has been found to be as effective as very-high dose Dexamethasone for spinal compression?
Loading dose of 10mg followed by 16mg daily in divided doses
What is a closed family system?
A family that fears change, refuses to discuss feared topics, restricts contact with those outside of the family, and has privacy regarding family rules
What is an open family system?
One that views change as normal, inevitable, and desirable, and encourages supportive relationships with others
What is a disengaged family system?
One in which there is little mutual dependence or emotional support
What is the first line therapy to treat pruritis secondary to liver disease?
Cholestyramine
What is the standard of therapy for patients with COPD that is demonstrated to reduce mortality?
Oxygen
In what patients are ICDs not indicated?
Patients with NYHA class IV because their prognosis is less than 1 year
How often to stroke patients require long-term enteral feeding tubes?
Approximately 8% of the time, indicating that artificial nutrition may be effective acutely after a stroke
What are key features of breast cancer (i.e., adenocarcinoma) therapy in older patients?
Breast cancer in older women is generally hormone sensitive. This means that treatment may improve a patient’s prognosis and it is generally well-tolerated.
What are the key factors in determining prognosis in patients with advanced cancer?
Performance status
Tumor type
Extent of disease
What is the noted effect of a PEG tube in patients with ALS?
They typically stabilize body weight and BMI.
What is often seen in patients on checkpoint inhibitors in the early phase of treatment for metastatic malignant melanoma?
Transient worsening of disease before response is seen, also known as pseudoprogression
What is the mean life expectancy for patients with end-stage heart failure starting on inotrope infusions?
Approximately 9 months
What is the prognosis for survival to discharge for hospitalized patients who receive CPR?
25-29%
What is the time to death for patients with chronic kidney disease who discontinue dialysis?
8 to 12 days (median 10 days)