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Palliative Care > Lesson 3 > Flashcards

Lesson 3 Flashcards

1
Q

megestrol acetate side effects

A

adrenal insufficiency
VTE
andogren deficiency in males

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2
Q

SIDS

A

stillbirth significantly more common than SIDS
SIDS more common in boys than in girls

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3
Q

carisoprodol (soma)

A

has potentiating effects on opioids and alcohol

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4
Q

most common means of suicide in men >50 years old

A

firearms

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5
Q

neonate pharmacokinetics of morphine

A

half-life is prolonged
greater first-pass toxicity

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6
Q

opioid misuse: most patients who misuse prescriptions first started using opiods in their…

A

20s

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7
Q

duration of taking opiods that increases risk for SUD

A

90 days

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8
Q

opioid misuse screening tools

A

little evidence

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9
Q

complicated grief explained by

A

attachment relationship model

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10
Q

spinal cord compression management

A

corticosteroids
NSGY consult

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11
Q

most common psychiatric disorder in those with HIV, SUD

A

depression

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12
Q

advance directive consists of

A

durable power of attorney
living will

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13
Q

side effects of opioids without tolerance

A

constipation
mioisis

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14
Q

constipation work up

A

digital rectal exam

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15
Q

organ donation in HIV+ patients

A

only can be for other HIV+ patients

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16
Q

malignant bowel obstruction management

A

octreotide
haldol

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17
Q

complicated grief length before dx

A

loss of loved one had to occur >1 year ago

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18
Q

complicated grief sx

A

intense longing
preoccupation

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19
Q

meperidine side effect

A

tachycardia

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20
Q

preferential opioid in CKD

A

hydromorphone
avoid oxycodone if possible

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21
Q

black people with cancer

A

less likely than whites to get treatment for cancer

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22
Q

fluoxetine washout period

A

5 weeks

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23
Q

phenelzine risk for

A

serotonin syndrome

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24
Q

most common type of elder abuse

A

neglect/abandonment

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25
Q

mirtazapine sedating dose

A

7.5 mg or higher

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26
Q

naltrexone

A

treats opioid and EtOh dependence

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27
Q

morphine epidural

A

delayed respiratory depression

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28
Q

cancer patients age depression

A

younger rather than older at higher risk

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29
Q

cancers with highest risk of depression

A

head and neck
pancreatic

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30
Q

leading cause of death from blood transfusions

A

TRALI

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31
Q

bleeding at home management

A

crisis pack including dark towels
TXA: can be given GI or ENT bleed

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32
Q

methylnaltrexone

A

mu opioid receptor antagonist
reduces opioid-associated constipation and urinary retention
does not cross BBB

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33
Q

minimum age at which screening EKG should be obtained when started on TCA

A

40 years

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34
Q

3 day rule

A

patient need to be hospitalized for 3 days to qualify for SNF

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35
Q

totodal inpatient days (inpatient and GIP) cannot exceed

A

20% of total days

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36
Q

metabolite of carisoprodol (soma)

A

meprobamate

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37
Q

codeine metabolites

A

morphine
morphine-6-glucuronide

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38
Q

dyspnea without hypoxia rx

A

hand held fan
morphine

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39
Q

dry mouth (xerostomia) rx

A

ice chips
sugarless gum
pilocarpine

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40
Q

buprenorphine

A

25-50x more potent than morphine
can be given IM, SQ, SL, transdermal, neuraxially
partial mu agonist

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41
Q

Hindu female patients may prefer

A

female providers

42
Q

Extrapyramidal side effects

A

first-gen anti-psychotics
fluphenazine, haloperidol

43
Q

classic five stages of death

A

denial, anger, bargaining, depression, acceptance

44
Q

lymphedema contraindication to compression

A

severe neuropathic pain
DVT
thrombocytopenia
acute CHG

45
Q

IV: oral morphine ratio

A

3:1

46
Q

SBP dx

A

> 250 PMNs in ascitic fluid

47
Q

SBP treatment

A

CTX or cefotaxime (3rd gen cephalosporin)
albumin

48
Q

certification of terminal illness must be completed

A

within two calendar days after patient has started to receive hospice services

49
Q

percentage of patients with advanced cancer who meet dx criteria for psychiatric disorder

A

50%

50
Q

most common complementary meds for cancer patients in US

A

vitamins and minerals

51
Q

anorexia and cachexia in advanced cancer patients management

A

megestrol
glucocorticoids

52
Q

dronabinol FDA approved for

A

anorexia and weight loss in patients with HIV
treatment of refractory CINV

53
Q

screening tool to assess for elder mistreatment

A

elder abuse suspicion index

54
Q

morphine epidural injection

A

cannot be done outpatient, need to monitor for at least 24 hours

55
Q

morphine PO bio-availability

A

10-45%

56
Q

notification of death

A

should be notified within 2 minutes of starting conversation

57
Q

notification of death in person vs. phone

A

can do by phone if >1 hour away

58
Q

HIV neuorapthy

A

allodynia and hyperalgesia present

59
Q

adjustment disorder first-line rx

A

psychotherapy

60
Q

opioid med without active metabolites

A

methadone

61
Q

buprenorphineshould be used in caution in patients taking

A

class III anti-arrythmmics

62
Q

pulmonary rehab beneficial in

A

COPD

63
Q

gabapentinoids plusthiazolideinediones

A

increased risk of fluid retention

64
Q

wound management, topical Metronidazole

A

anti-inflammatory
anti-microbial

65
Q

wound management dressings

A

silver dressings

66
Q

Hindu dietary beliefs

A

can eat pork, but not other meat

67
Q

rx for opioid induced sedation

A

methylphenidate
dextroamphetamine
modafinil
not caffeine

68
Q

preferred opioid in CKD/ESRD

A

dilaudid or fentanyl

69
Q

delirium definition

A

inattention
acute onset
fluctuating sx

70
Q

buprenorphine patch duration

A

seven days

71
Q

buprenorphine patch how long should elapse before using same site?

A

21 days

72
Q

spinal cord compression management

A

IV loading dose of 10 mg dexamethasone

73
Q

malignant ascites

A

SAAG<1.1
paracentesis
does not respond well to diuresis

74
Q

best predictor for favorable prognosis in schizophrenia

A

medical compliance

75
Q

schizophrenia symptoms on meds

A

positive symptoms (psychosis) respond well to meds
negative symptoms do not respond as well

76
Q

better outcomes for those with schizophrenia on meds: females or males?

A

females

77
Q

cancer most associated with chronic cough

A

head and neck cancer

78
Q

morphine metabolite that causes seizures

A

morphine-3-glucuronide (M3G)

79
Q

stage 4 pressure injury treatment

A

debridement
dressings

80
Q

incidence of what anxiety disorder is increased in cancer patients?

A

agoraphobia

81
Q

incidence of anxiety disorders in cancer patients

A

10-20%

81
Q

screening tool for anxiety

A

General Anxiety Disorder Scale

81
Q

Insomnia treatment in cancer survivors

A

CBT

82
Q

fall prevention

A

exercise program

83
Q

treatment for pruritus

A

gabapentin
paroxetine
sertraline, mirtazapine

84
Q

most common opioid cause of prurirtus

A

morphine

85
Q

opioid-induced pruritus rx

A

low-dose naloxone continuous infusion

86
Q

depression meds for patients on tamoxifen

A

venlafaxine
desvenlafaxine

87
Q

most common side effects of celiac plexus block via trans-aortic approach

A

orthostatic hypotension
diarrhea

88
Q

Sikh beliefs surrounding death

A

if not present, family members will want to know about patient’s death as soon as possible

89
Q

Muslim beliefs about death

A

body needs to be cleaned before praying (5x day)
prefer quick burial
ill are exempt from fasting

90
Q

Lidocaine patch interacts with

A

oral anti-arrhythmic meds

91
Q

lidocaine patch dosing

A

no dose escalation necessary
no tolerance

92
Q

use lidocaine patch cautiously in patients with

A

hepatic disease

93
Q

serotonin syndrome

A

high fevers
muscle stiffness, pain

94
Q

Hospice nursing home medicare spending

A

higher medicare spending in nursing home for hospice beneficiaries

95
Q

most comprehensive pain scale

A

McGill Pain Questionnaire

96
Q

buprenorphine mechanism

A

mixed agonist-antagnosit

97
Q

first-line delirium rx

A

haloperidol

98
Q

Fatigue supplement

A

American ginseng

Palliative Care (4 decks)

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