Palliative Care Flashcards

1
Q

What anti-emetic should be used when the patient is hypercalcaemic?

A

Haloperidol

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2
Q

Which cytotoxic agent is most likely to have cardiomyopathy as a dose dependent side effect?

A

Doxorubicin

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3
Q

Intitial morphine prescription in palliative care

A

Slow release morphine 15mg BD
Plus top up morphine

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4
Q

What is the most aggressive primary tumour of the thyroid gland

A

Anaplastic carcinoma of the thyroid

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5
Q

Management in opiate induced constipation

A

Senna
Docusate
Lactulose

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6
Q

What can provide a survival benefit in MND

A

NIV
Riluzole

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7
Q

Where does a gliblastoma multiforme must commonly occur

A

Subcortical white matter of the cerebral hemispheres

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8
Q

Who does the gold standards framework identify

A

Patients with life limiting conditions

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9
Q

What is fentanyl a well known cause of

A

Itching
Sweating
Rash

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10
Q

if a fentany patch is 25ug/hr - how much morphine does this equate to in a day roughly

A

60-164mg

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11
Q

Is fentanyl safe in kidney impairment

A

yes

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12
Q

Does cyclizine lead to prolonged QTc?

A

No

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13
Q

Dose conversion from oral to s/c morphine

A

50%

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14
Q

Oral morphine to s/c diamorphine conversion

A

Divide by 3

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15
Q

What anti emetic acts via neurokinin 1 receptor

A

Aprepitant

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16
Q

Is fentanyl accumulated in the kidneys

A

No

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17
Q

Mechanism of action of lorazepam

A

GABA A modulation

18
Q

What can belomycin (chemotherapy agent) commonly cause

A

Pulmonary toxicity

19
Q

Poor prognosis factors for breast cancer

A

High grade tumour
Oestrogen receptor negative tumour
Progesterone receptor negative tumour
Young age < 40
Premenopausal at diagnosis
Increased tumour size

20
Q

What can improve pain from a pancreatic cancer / chronic pancreatitis pain when not controlled with adequate oral analgesia

A

Coeliac plexus block

21
Q

PS0

A

Fully active, able to carry on all predisease performance without restriction

22
Q

PS1

A

Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, e.g. light housework, office work

23
Q

PS2

A

Ambulatory and capable of all self care but unable to carry out any work activities
Up and about more than 50% of the waking hours

24
Q

PS3

A

Capable of limited self care
Confined to bed or chair > 50% waking hours

25
PS4
Comlpetely disabled, cannot perform any self care, totally confined to a bed or chair
26
Mechanism of action of baclofen
Gamma aminobutyric acid B receptor agonist
27
Treatment ladder for carcinoid syndrome symptoms
1. Octreotide 2. Telotristat 3. interferon alpha 4. radionucleotide therapy
28
Features of Li-Fraumeni syndrome
AD inheritance Bone and soft tissue sarcomas Breast ca
29
Genetics of Li-Fraumeni syndrome
TP53
30
Assosiations of BRAC2 mutation
Breast cancer Ovarian Pancreatic cancer Prostate cancer
31
How to divide codeine to morphine dose
Divide by 10
32
Monitoring of testicular teratomas
AFP
33
WHat tymour marker is useful to monitor for metastatic disease secondary to breast cancer
CA 15-3
34
Treatment of oculogyric crisis secondary to metoclopramide
Benztropine
35
Risk factors for bladder cancer
Smoking Exposure to coal, tar and asphalt Working in the chemical or plastics industries Exposure to drugs such as cyclophosphamide
36
translocation of chromosomes in Burkitts lymphoma
t(8;14)(q24;q32)
37
Antibodies of lambert eaton myasthenic syndrome
Presynaptic voltage gated calcium channel antibodies
38
The risk of which cancer is reduced by taking the OCP
Colon cancer
39
Gene mutation of HNPCC
MLH1 gene
40
Another name for HNPCC
Lynch syndrome
41
Features of HNPCC
Colon cancers seen as early as 5th dease Uterine cancers around 60 y/o Screening upper and lower GI endoscopies recommended from 20 y/o
42
Monitoring for papillary thyroid cancer recurrence
Thyroglobulin