Lesson 2 Flashcards
(100 cards)
1
Q
antibiotic associated with serotonin syndrome
A
Linezolid
2
Q
what percentage of deaths occur while enrolled in hospice?
A
50%
3
Q
SSRI that can be stopped without taper
A
fluoxetine
4
Q
side effect of meperidine
A
seizures
more common in patients with renal dysfunction
5
Q
n/a
A
n/a
6
Q
risk of elder abuse
A
caregiver assuming care at young age is risk factor
7
Q
opioid induced respiratory depression
A
opioid agonism in ventral medullla
8
Q
best predictor of patient survival
A
patient performance status
9
Q
perineal pain management
A
impar ganglion block
10
Q
superior hypogastric block
A
cervical
bladder
rectal
11
Q
treatment of insomnia of bereaved
A
CBT-I
12
Q
Prevalence of Alzheimer’s in US patients >85
A
30-50%
13
Q
PCA in pediatrics
A
can be used for kids 6 and older
14
Q
celiac plexus location
A
T12 and L1
15
Q
stage IV SCLC prognosis
A
worst
16
Q
stage IVV HCC
A
6 month prognosis
17
Q
most potent opioid
A
sufentanil
18
Q
opioid withdrawal sx
A
bowel hypermotility
temp instability
pain
sense of impending doom
19
Q
Mucositis rx
A
lidocaine
diphenydramine
20
Q
osteoblastic lesion radionucleotide treatment
A
samarium
strontium
21
Q
higher Advance Directive completion in
A
higher education
higher SES
Caucasian
history of chronic disease
22
Q
cough management
A
centrally acting opioids
23
Q
medical examiners
A
must be MDs (not coroners)
24
Q
continuous home hospice care
A
8 hours a day
>50% of that is nursing care
25
UGIB at end of life
specific sign
26
riluzole in ALS
most effective when sx have been present for less than five years
27
topical salicylates
avoid using heating pads in area
28
lowest rate of hospice use
Asians and Pacific Islanders
29
REMAP
reframe
expect emotion
map outpatient goals
align goals
propose plan
30
AKI in sepsis
mortality rate of 35%
31
ARDS mortality rate
40-50%
32
radiation-associated nausea rx
ondasetron
33
baclofen side effect
hypotension
34
myoclonus
use hydromorphone instead of morphine
35
bereavement risk factors
bipolar disorder
depression
PTSD
anxiety disorder
SUD
36
SSRI for anxiety
paroxetine
37
patient perception of good communication
as doctor more technically competent
38
HIV weight loss
refer to dietician
39
pain meds in pregnancy
safest in first trimester
40
opioid induced pruritus rx
diphenhydramine
41
cancer with neural findings
steroids and spine MRI
42
complete SBO management
octreotide
haloperidol
43
Morphine metabolites
heroin
morphine
codeine
poppy seed
44
unique heroin metabolite
6-MAM
45
majority of recovery period in CVA
3-6 months
46
Federal patient self-determination act of 1990
hospitals, nursing homes, other facilities must provide information on advance directives
47
Wong-Baker FACES Pain Rating Scale age
children 3-4 years old
48
cancer related fatigue rx
glucocorticoids
49
contraindication to stimulants
history of CAD
50
colon cancer
left sided colon cancer associated with better prognosis than right side
signet cell bad prognosis
micro satellite instability good prognosis
KrAS gene bad prognosis
51
ADA in pts w/ HIV/AIDS
HIV/AIDS patients protected by ADA
52
breathing changes in dying
late stage
53
lack of appetite in dying
early stage
54
lamotrigine treatment, side effects
used for bipolar disorder, epilepsy, neuropathic pain
side effects: SJS-TEN, DRESS
55
organ donation
only specially trained people can discuss w/ families
56
opioid-induced hyperalgesia rx
NMDA antagonists can decrease
57
most common mental health disorder in cancer patients
adjustment disorder
58
glucocorticoid side effect
hiccups
59
brain death criteria
normal BP
core temp >36F
absent brain reflexes
60
periampullary adenoCa poor prognosis
poorly differentiated histology
elevated CEA, CA 19-9
61
liver cancer marker poor prognosis
elevated AFP
62
side effect of cyclophosphamide, rx
chemical cystitis
rx: hydration
63
meperidine
associated with seizures
contraindicated in those w/ renal impairment
64
delirium death pathway
followed by myoclonic jerks, seizures
65
TCA with most favorable side effect profile
nortriptyline
66
religious beliefs associated with what kind of care at EOL?
aggressive
67
screening for opioid misuse among cancer patients
no tool exists
68
opioid risk tool
5 yes/no questions
69
screener and opioid assessment for pain patients
14 questions
70
prognosis
patients who understand prognosis are more likely to decline LST at EOL
physicians tend to overestimate prognosis
71
bad news delivery
even when following protocol, patients may still be dissatisfied with bad news delivery
72
patients prefer to know (dx vs prognosis?)
more patients want to know diagnosis
73
anticipatory grief
can contribute to suicidal thinking
refers to reaction to expected death and current losses
74
HIV/AIDS wasting rx
ART
megestrol not as effective as ART
75
transition to methadone from OME
<60 OME: opioid naive dosing
60-200 OME: 10:1 OME: metahdone
>200 OME: 20:1 OME:methadone
76
most common lung cancer causes
1. smoking
2. radon exposure
77
grief persistence
rate of mental illness, suicide, remains elevated for ten years
78
grief differences by sex in loss of child
women more likely to develop serious psychiatric illness
79
cancer-related pain analgesic ladder
1. NSAID
2. tramadol
3. strong opioid
80
cyclobenzaprine
has similar structure to TCA
81
grief
can treat pre-emptively in caregivers
82
conflict often due to
perception of family that there is poor communication
83
MELD
developed as mortality prediction tool for three months s/p TIPS
INR
bilirubin
creatinine
etiology of cirrhosis
sodium
84
Child Pugh
Risk for surgery in cirrhosis
albumin
INR
bilirubin
ascites
encephalopathy
85
pediatric peri-op pain management
peripheral nerve catheters are as effective as continuous central blockade
86
acute grief reaction
not a disorder
intense focus on thoughts and memories of loss
87
alternative medicine
in place of (not concurrent with) conventional medicine
88
homeopathy
uses substances that cause symptoms of disease in healthy people to cure symptoms in sick people
89
TCA side effects
histamine blockade (sedation, weight gain, tachycardia, blurred vision)
anti-cholinergic sx
90
duloxetine FDA approved for
diabetic neuropathy
fibromyalgia
91
serotonin syndrome meds
meperedine
dextromethorphan
fentanyl
tramadol
cyclobenzaprine
92
brain death mechanism
elevation in ICP leads to impairment in brain oxygenation and neuronal damage, followed by circulatory collapse
93
poor prognosis in metastatic breast cancer
circulating tumor cells in peripheral blood
weight loss
short relapse-free interval
poor performance status
elevated serum LdH
HER2+
younger diagnosis (<35 years old)
94
cancer meds high emetogenic potential
cisplatin
cyclophosphamide
decarbazine
95
majority of heroin users start with
opioids obtained illegally from drug dealers
96
percentage of cancer patients with opioid addiction
8%
97
4 A's of opioid therapy
analgesia
adverse effects
aberrant behaviors
activity
98
susto
frightening event causes ones soul to leave one's body
99
Dhat syndrome
South Asian cultures
anxiety, depression, somatic sx attributed to semen loss
100
coraje
illness is the result of long-term social struggle
