Palliative care Flashcards

1
Q

6 categories of palliative care patients

A
  1. Incurable cancer
  2. Progressive organ failure
  3. Progressive neurological disorders
  4. Dementia
  5. Frailty
  6. Multimorbidity
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2
Q

what is step 1 of pain management?

A

Paracetamol and/or NSAID

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3
Q

What is step 2 of pain management?

A

Codeine or co-codomol

and/or adjuvant

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4
Q

What is step 3 of pain management?

A

STOP codeine
Switch to strong opiod
with paracetamol/NSAID/Adjuvant

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5
Q

If there is renal failure you avoid opioids as they can accumulate. What do you use instead?

A

Fentanyl

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6
Q

TRUE/FASLE

The highest dose of codeine=lowest dose of morphine

A

TRUE

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7
Q

The pathway for morphine for pain relief and reward are the same TRUE/FALSE

A

FASLE

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8
Q

TRUE/FASLE

Morphine is always addictive

A

FALSE

Not addictive is used judiciously

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9
Q

3 SE of morphine

A

Constipation
N&V
Respiratory depression

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10
Q

What drug reverses the effect of morphine?

A

Naloxone

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11
Q

What are the symptoms of opiod toxicity?

A

Hallucinations
Air plucking
Myoclonus
Drowsiness

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12
Q

How do you convert from the dose of morphine to codeine?

A

Morphine= Codine/10

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13
Q

TRUE/FALSE

The dose for breakthrough pain of morphine is often 5X the background dose

A

FALSE

1/6th of the background dose

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14
Q

What are treatable conditions that may mimic the dying process?

A
Sepsis
Delirium
Hypoglycaemia
AKI
Opiod/drug toxicity
Hypercalcaemia
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15
Q

Anticipatory medication for PAIN/SOB

A

Morphine

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16
Q

Anticipatory medication for Distress?

A

Midazolam

17
Q

Anticipatory medication for nausea?

A

Levomepromazine

18
Q

Anticipatory medication for secretions?

A

Buscopan

19
Q

What is a common cause of agitation?

A

Urinary retention

20
Q

TRUE/FALSE

Morphine is 2x as potent when given submit therefore to convert to shrine driver /2

A

TRUE

21
Q

What does the doctor have to check before they can verify death?

A
Spontaneous movement
Reaction to voice/pain
Pulse
Eyes
Heart/Lungs
22
Q

TRUE/FALSE

You cannot be used for anatomical dissection if you have had a post-mortem

A

TRUE

23
Q

When should a report be made to the Procurator Fiscal?

A
Sudden
Unexplained
Suspicious
Suicide/neglect
Drug related
<18 and in care
infectious disease that's a public health risk
Under MHA at time of death
24
Q

Registration of death is required by law within how many days of the death?

A

8 days

25
Q

When is advanced registration allowed?

A

Religious/Cultural reasons
Practical- buried abroad
Compassionate- death <16

26
Q

Who issues the “medical certificate of cause of death”

A

Registered medical professional

27
Q

Who issues the “registration of death”

A

Registrar

28
Q

What percentage of deaths have a level 1 review?

A

10% of deaths

29
Q

How quickly are level 2 reviews completed?

A

3 working days

30
Q

What is in part a of the mccd?

A

details of deceased

31
Q

What is in part b of MCCD?

A

Details of certifying doctor

32
Q

WHAT is in part c of MCCD?

A

Cause of death

33
Q

What are the subparts of part c of the MCCD?

A

1a- Condition leading directly to cause of death
1b,c,d- Antecedent causes

II- Other significant conditions contributing to death but NOT to the disease causing it

34
Q

What Is in part d of the MCCD?

A

Hazards inc pacemakers

35
Q

What is in part e of the MCCD?

A

Additional information

36
Q

What are MCCDs used for?

A

Designing public health services and prioritising areas for medical research and healthcare

37
Q

TRUE/FALSE

Grief is solely to do with death

A

FALSE
It is an intense sorrow
Can be to do with a change in job, relationship, income etc

38
Q

What are the 5 stages of grief?

A
Denial
Anger
Bargaining
Depression
Acceptance