Palliative

Question 1

Conversion of oral to subcut morphine?

Answer 1

divide oral dose by 2

Question 2

Breakthrough dosing of morphine?

Answer 2

divide 24 hour requirement by 6

Question 3

Increasing dose of morphine?

Answer 3

increase by 30 to 50% of the previous dose

Question 4

How to manage metastatic bone pain?

Answer 4

Metastatic bone pain may respond to analgesia, bisphosphonates or radiotherapy

Question 5

Conversion of codeine to morphine?

Answer 5

divide by 10

Question 6

Pain relief of choice in patients with CKD/severe renal impairment (GFR <10)?

Answer 6

Alfentanil, buprenorphine and fentanyl

Question 7

Pain relief of choice if mild to moderate renal impairment? (GFR 10-50)

Answer 7

Oxycodone

avoided in severe renal impairment

Question 8

How to manage a painful mouth that can occur at EoL?

Answer 8

Benzydamine hydrochloride mouthwash or spray may be useful in reducing the discomfort associated with a painful mouth

Question 9

First-line anti-emetic for intracranial cause of N+V?

Answer 9

Cyclizine

Question 10

Conversion of oral morphine to SC diamorphine?

Answer 10

Total daily morphine divided by 3

Question 11

Conversion of oral morphine to oral oxycodone?

Answer 11

divide by 2

Question 12

Conversion of oral morphine to SC oxycodone?

Answer 12

divide by 4

Question 13

Management of hiccups in palliative care?

Answer 13

Chlorpromazine or haloperidol

Question 14

How to manage headache caused by raised intracranial pressure due to brain cancer or mets?

Answer 14

Dexamethasone

Question 15

What antiemetic to give when gastric stasis is cause?

Answer 15

Metoclopramide, domperidone

Question 16

What antiemetic to give when bowel obstruction w/ colic is cause?

Answer 16

Hyoscine, cyclizine

Question 17

What antiemetic to give when chemical pathology (electrolytes) is cause?

Answer 17

Haloperidol

Question 18

What antiemetic to give when raised ICP is cause?

Answer 18

Dexamethasone, cyclizine

Question 19

What antiemetic to give when motion is cause?

Answer 19

Hyoscine, cyclizine

Question 20

What antiemetic to give when chemotherapy is cause?

Answer 20

Ondansetron

Question 21

Anticipatory medication prescribed for pain?

Answer 21

Opioids

Question 22

Anticipatory medication prescribed for respiratory secretion?

Answer 22

Hyoscine

Question 23

Anticipatory medication prescribed for breathlessness?

Answer 23

Opioids

Question 24

Anticipatory medication prescribed for agitation / anxiety?

Answer 24

Midazolam

Question 25

Anticipatory medication prescribed for nausea and vomiting?

Answer 25

Haloperidol/ levomepromazine

Question 26

Anticipatory medication prescribed for delirium?

Answer 26

Haloperidol/ levomepromazine