Palliative Care Flashcards
What anti-emetic should be used when the patient is hypercalcaemic?
Haloperidol
Which cytotoxic agent is most likely to have cardiomyopathy as a dose dependent side effect?
Doxorubicin
Intitial morphine prescription in palliative care
Slow release morphine 15mg BD
Plus top up morphine
What is the most aggressive primary tumour of the thyroid gland
Anaplastic carcinoma of the thyroid
Management in opiate induced constipation
Senna
Docusate
Lactulose
What can provide a survival benefit in MND
NIV
Riluzole
Where does a gliblastoma multiforme must commonly occur
Subcortical white matter of the cerebral hemispheres
Who does the gold standards framework identify
Patients with life limiting conditions
What is fentanyl a well known cause of
Itching
Sweating
Rash
if a fentany patch is 25ug/hr - how much morphine does this equate to in a day roughly
60-164mg
Is fentanyl safe in kidney impairment
yes
Does cyclizine lead to prolonged QTc?
No
Dose conversion from oral to s/c morphine
50%
Oral morphine to s/c diamorphine conversion
Divide by 3
What anti emetic acts via neurokinin 1 receptor
Aprepitant
Is fentanyl accumulated in the kidneys
No
Mechanism of action of lorazepam
GABA A modulation
What can belomycin (chemotherapy agent) commonly cause
Pulmonary toxicity
Poor prognosis factors for breast cancer
High grade tumour
Oestrogen receptor negative tumour
Progesterone receptor negative tumour
Young age < 40
Premenopausal at diagnosis
Increased tumour size
What can improve pain from a pancreatic cancer / chronic pancreatitis pain when not controlled with adequate oral analgesia
Coeliac plexus block
PS0
Fully active, able to carry on all predisease performance without restriction
PS1
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
PS2
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
PS3
Capable of limited self care
Confined to bed or chair > 50% waking hours
PS4
Comlpetely disabled, cannot perform any self care, totally confined to a bed or chair
Mechanism of action of baclofen
Gamma aminobutyric acid B receptor agonist
Treatment ladder for carcinoid syndrome symptoms
- Octreotide
- Telotristat
- interferon alpha
- radionucleotide therapy
Features of Li-Fraumeni syndrome
AD inheritance
Bone and soft tissue sarcomas
Breast ca
Genetics of Li-Fraumeni syndrome
TP53
Assosiations of BRAC2 mutation
Breast cancer
Ovarian
Pancreatic cancer
Prostate cancer
How to divide codeine to morphine dose
Divide by 10
Monitoring of testicular teratomas
AFP
WHat tymour marker is useful to monitor for metastatic disease secondary to breast cancer
CA 15-3
Treatment of oculogyric crisis secondary to metoclopramide
Benztropine
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
translocation of chromosomes in Burkitts lymphoma
t(8;14)(q24;q32)
Antibodies of lambert eaton myasthenic syndrome
Presynaptic voltage gated calcium channel antibodies
The risk of which cancer is reduced by taking the OCP
Colon cancer
Gene mutation of HNPCC
MLH1 gene
Another name for HNPCC
Lynch syndrome
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
Monitoring for papillary thyroid cancer recurrence
Thyroglobulin
