Palliative care

Question 1

The drug of choice in mild cancer related pain is

a) Paracetamol/aspirin
b) Opioids oral
c) Morphine infusion
d) Paracetamol/codeine combination
e) Gabapentin

Answer 1

a) Paracetamol/aspirin

Question 2

Theme: Types of pain and first line treatment

1) Nociceptive pain
2) Neuropathic pain
3) Superficial burning pain
4) Tumour associated oedema
5) Bony metastases and other tissue destruction
6) Muscle spasm pain
7) Viscous(hollow organ obstruction) such as colic/tenesmus
8) Hypercalcaemia
9) Skin infiltration/ulceration

Answer 2

1) Aspirin
2) Amitriptyline first line/antiepileptics/antidepressants used
3) Antidepressants
4) Corticosteroids
5) NSAIDs/aspirin; radiotherapy most effective
6) Diazepam/baclofen
7) Antispasmodics
8) Bisphosphonates
9) Aspirin/opioids

Opioids second line for most of the conditions

Question 3

Which one of the following is true in pain management for palliation

a) Morphine is a last resort
b) Patient will become addicted

C) Patient will need ever increasing amounts

d) Morphine will cause respiratory depression
e) Morphine will not shorten life

Answer 3

e) Morphine will not shorten life

Question 4

All of the following are features of hypercalcaemia except

a) Drowsiness
b) Confusion
c) Twitching
d) Abdominal pain
e) Anorexia

Answer 4

e) Anorexia

Question 5

All of the following are true about hypercalcaemia except

a) Monitor calcium >3mmol/l
b) When present as part of a neoplastic syndrome, it has a poor prognosis
c) Manage with rehyrdration, reduction of tissue mass and bisphosphonated
d) Drowsiness, twitching and abdominal pain are typical features
e) Myeloma, lung and breast cancers are not common cause of hypercalcaemia

Answer 5

e) Myeloma, lung and breast cancers are not common cause of hypercalcaemia