Palliative care and Oncology

Question 1

Vincristine S/e

Answer 1

peripheral neuropathy

Question 2

cisplatin s/e

Answer 2

peripheral neuropathy
ototoxicity and nephrotoxicity
hypomagnesemia, hypokalaemia, hypocalcaemia

Question 3

bleomycin s/e

Answer 3

pulmonary fibrosis

Question 4

doxorubicin s/e

Answer 4

acute cardiotoxicity- myopericarditis
cardiomyopathy

Question 5

cyclophosphamide s/e

Answer 5

haemorrhage cystitis
(co-prescribe with mesna)

Question 6

dexamethasone s/e

Answer 6

water retention
hyperglycaemia

Question 7

Teratoma tumour markers

Answer 7

AFP and beta-hcg

Question 8

nausea and vomiting that is due to gastric dysmotility and stasis Tx

Answer 8

Metoclopramide

Question 9

bowel colic Tx

(colicky pain secondary to mechanical obstruction)

Answer 9

same as respiratory secretions:

hyoscine hydrobromide, hyoscine butylbromide, or glycopyrronium bromide.

Question 10

spinal cord compression above L1

Answer 10

upper motor neuron signs in the legs and a sensory level

Question 11

spinal cord compression below L1

Answer 11

lower motor neuron signs in the legs and perianal numbness.
Tendon reflexes tend to be increased below the level of the lesion and absent at the level of the lesion

Question 12

methotrexate s/e

Answer 12

Myelosuppression, mucositis, liver fibrosis, lung fibrosis

Question 13

Codeine to morphine

Answer 13

divide by 10

Question 14

nausea and vomiting associated with intracranial tumours

Answer 14

Dexamethasone

Question 15

pain relief in mild to moderate renal impairment (GFR 10-50mL/min/1.73²)

Answer 15

Oxycodone (oral and IV)

Question 16

pain relief in severe renal impairment (GFR <10mL/min/1.73²)

Answer 16

Buprenorphine or fentanyl

Question 17

oral to subcutaneous morphine

Answer 17

divide by 2

Question 18

first line anti-emetic for intracranial causes of nausea and vomiting

Answer 18

Cyclizine

Question 19

Metastatic bone pain may respond to

Answer 19

analgesia, bisphosphonates or radiotherapy

Question 20

oral morphine to diamorphine

Answer 20

divide by 3

Question 21

Hiccups in palliative care -

Answer 21

chlorpromazine or haloperidol

Question 22

Headache caused by raised intracranial pressure due to brain cancer (or metastases) can be palliated with

Answer 22

dexamethasone