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Palliative Care > Lesson 2 > Flashcards

Lesson 2 Flashcards

1
Q

antibiotic associated with serotonin syndrome

A

Linezolid

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2
Q

what percentage of deaths occur while enrolled in hospice?

A

50%

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3
Q

SSRI that can be stopped without taper

A

fluoxetine

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4
Q

side effect of meperidine

A

seizures
more common in patients with renal dysfunction

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5
Q

n/a

A

n/a

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6
Q

risk of elder abuse

A

caregiver assuming care at young age is risk factor

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7
Q

opioid induced respiratory depression

A

opioid agonism in ventral medullla

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8
Q

best predictor of patient survival

A

patient performance status

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9
Q

perineal pain management

A

impar ganglion block

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10
Q

superior hypogastric block

A

cervical
bladder
rectal

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11
Q

treatment of insomnia of bereaved

A

CBT-I

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12
Q

Prevalence of Alzheimer’s in US patients >85

A

30-50%

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13
Q

PCA in pediatrics

A

can be used for kids 6 and older

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14
Q

celiac plexus location

A

T12 and L1

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15
Q

stage IV SCLC prognosis

A

worst

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16
Q

stage IVV HCC

A

6 month prognosis

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17
Q

most potent opioid

A

sufentanil

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18
Q

opioid withdrawal sx

A

bowel hypermotility
temp instability
pain
sense of impending doom

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19
Q

Mucositis rx

A

lidocaine
diphenydramine

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20
Q

osteoblastic lesion radionucleotide treatment

A

samarium
strontium

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21
Q

higher Advance Directive completion in

A

higher education
higher SES
Caucasian
history of chronic disease

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22
Q

cough management

A

centrally acting opioids

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23
Q

medical examiners

A

must be MDs (not coroners)

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24
Q

continuous home hospice care

A

8 hours a day
>50% of that is nursing care

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25
Q

UGIB at end of life

A

specific sign

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26
Q

riluzole in ALS

A

most effective when sx have been present for less than five years

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27
Q

topical salicylates

A

avoid using heating pads in area

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28
Q

lowest rate of hospice use

A

Asians and Pacific Islanders

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29
Q

REMAP

A

reframe
expect emotion
map outpatient goals
align goals
propose plan

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30
Q

AKI in sepsis

A

mortality rate of 35%

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31
Q

ARDS mortality rate

A

40-50%

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32
Q

radiation-associated nausea rx

A

ondasetron

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33
Q

baclofen side effect

A

hypotension

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34
Q

myoclonus

A

use hydromorphone instead of morphine

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35
Q

bereavement risk factors

A

bipolar disorder
depression
PTSD
anxiety disorder
SUD

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36
Q

SSRI for anxiety

A

paroxetine

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37
Q

patient perception of good communication

A

as doctor more technically competent

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38
Q

HIV weight loss

A

refer to dietician

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39
Q

pain meds in pregnancy

A

safest in first trimester

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40
Q

opioid induced pruritus rx

A

diphenhydramine

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41
Q

cancer with neural findings

A

steroids and spine MRI

42
Q

complete SBO management

A

octreotide
haloperidol

43
Q

Morphine metabolites

A

heroin
morphine
codeine
poppy seed

44
Q

unique heroin metabolite

A

6-MAM

45
Q

majority of recovery period in CVA

A

3-6 months

46
Q

Federal patient self-determination act of 1990

A

hospitals, nursing homes, other facilities must provide information on advance directives

47
Q

Wong-Baker FACES Pain Rating Scale age

A

children 3-4 years old

48
Q

cancer related fatigue rx

A

glucocorticoids

49
Q

contraindication to stimulants

A

history of CAD

50
Q

colon cancer

A

left sided colon cancer associated with better prognosis than right side
signet cell bad prognosis
micro satellite instability good prognosis
KrAS gene bad prognosis

51
Q

ADA in pts w/ HIV/AIDS

A

HIV/AIDS patients protected by ADA

52
Q

breathing changes in dying

A

late stage

53
Q

lack of appetite in dying

A

early stage

54
Q

lamotrigine treatment, side effects

A

used for bipolar disorder, epilepsy, neuropathic pain
side effects: SJS-TEN, DRESS

55
Q

organ donation

A

only specially trained people can discuss w/ families

56
Q

opioid-induced hyperalgesia rx

A

NMDA antagonists can decrease

57
Q

most common mental health disorder in cancer patients

A

adjustment disorder

58
Q

glucocorticoid side effect

A

hiccups

59
Q

brain death criteria

A

normal BP
core temp >36F
absent brain reflexes

60
Q

periampullary adenoCa poor prognosis

A

poorly differentiated histology
elevated CEA, CA 19-9

61
Q

liver cancer marker poor prognosis

A

elevated AFP

62
Q

side effect of cyclophosphamide, rx

A

chemical cystitis
rx: hydration

63
Q

meperidine

A

associated with seizures
contraindicated in those w/ renal impairment

64
Q

delirium death pathway

A

followed by myoclonic jerks, seizures

65
Q

TCA with most favorable side effect profile

A

nortriptyline

66
Q

religious beliefs associated with what kind of care at EOL?

A

aggressive

67
Q

screening for opioid misuse among cancer patients

A

no tool exists

68
Q

opioid risk tool

A

5 yes/no questions

69
Q

screener and opioid assessment for pain patients

A

14 questions

70
Q

prognosis

A

patients who understand prognosis are more likely to decline LST at EOL

physicians tend to overestimate prognosis

71
Q

bad news delivery

A

even when following protocol, patients may still be dissatisfied with bad news delivery

72
Q

patients prefer to know (dx vs prognosis?)

A

more patients want to know diagnosis

73
Q

anticipatory grief

A

can contribute to suicidal thinking

refers to reaction to expected death and current losses

74
Q

HIV/AIDS wasting rx

A

ART
megestrol not as effective as ART

75
Q

transition to methadone from OME

A

<60 OME: opioid naive dosing
60-200 OME: 10:1 OME: metahdone
>200 OME: 20:1 OME:methadone

76
Q

most common lung cancer causes

A
  1. smoking
  2. radon exposure
77
Q

grief persistence

A

rate of mental illness, suicide, remains elevated for ten years

78
Q

grief differences by sex in loss of child

A

women more likely to develop serious psychiatric illness

79
Q

cancer-related pain analgesic ladder

A
  1. NSAID
  2. tramadol
  3. strong opioid
80
Q

cyclobenzaprine

A

has similar structure to TCA

81
Q

grief

A

can treat pre-emptively in caregivers

82
Q

conflict often due to

A

perception of family that there is poor communication

83
Q

MELD

A

developed as mortality prediction tool for three months s/p TIPS
INR
bilirubin
creatinine
etiology of cirrhosis
sodium

84
Q

Child Pugh

A

Risk for surgery in cirrhosis
albumin
INR
bilirubin
ascites
encephalopathy

85
Q

pediatric peri-op pain management

A

peripheral nerve catheters are as effective as continuous central blockade

86
Q

acute grief reaction

A

not a disorder
intense focus on thoughts and memories of loss

87
Q

alternative medicine

A

in place of (not concurrent with) conventional medicine

88
Q

homeopathy

A

uses substances that cause symptoms of disease in healthy people to cure symptoms in sick people

89
Q

TCA side effects

A

histamine blockade (sedation, weight gain, tachycardia, blurred vision)
anti-cholinergic sx

90
Q

duloxetine FDA approved for

A

diabetic neuropathy
fibromyalgia

91
Q

serotonin syndrome meds

A

meperedine
dextromethorphan
fentanyl
tramadol
cyclobenzaprine

92
Q

brain death mechanism

A

elevation in ICP leads to impairment in brain oxygenation and neuronal damage, followed by circulatory collapse

93
Q

poor prognosis in metastatic breast cancer

A

circulating tumor cells in peripheral blood
weight loss
short relapse-free interval
poor performance status
elevated serum LdH
HER2+
younger diagnosis (<35 years old)

94
Q

cancer meds high emetogenic potential

A

cisplatin
cyclophosphamide
decarbazine

95
Q

majority of heroin users start with

A

opioids obtained illegally from drug dealers

96
Q

percentage of cancer patients with opioid addiction

A

8%

97
Q

4 A’s of opioid therapy

A

analgesia
adverse effects
aberrant behaviors
activity

98
Q

susto

A

frightening event causes ones soul to leave one’s body

99
Q

Dhat syndrome

A

South Asian cultures
anxiety, depression, somatic sx attributed to semen loss

100
Q

coraje

A

illness is the result of long-term social struggle

Palliative Care (4 decks)

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