mfe and palliative

Question 1

whats oculogyric crisis

Answer 1

dystonic reaction to certain drugs or medical conditions
- restlessness
- involuntary upward deviation of the eyes

Question 2

causes of oculogyric crisis

Answer 2

antipsychotics
meotclopramide
postencephalic parkinsons’ disease

Question 3

Mx oculogyric crisis

Answer 3

stop meds
-IV benztropine or procyclidine

Question 4

if pharmacological therapy required for delirium

Answer 4

haloperidol - make sure no parkinson’s
parkison’s - lorazepam

Question 5

what medications cause postural hypotension

Answer 5

• nitrates
• diuretics
• anticholinergics (oxybutynin, antihistamines and tricyclic antidepressants)
  -beta blockers
• L-dopa
• ACEi

Question 6

medications that cause falls for other reasons

not postural hypotension

Answer 6

• benzodiazepines
• antipsychotics
• opiates
• anticonvulsants
• codeine
• digoxin
• other sedating drugs

Question 7

Mx vomiting due to raised ICP or vesitbular causes

Answer 7

cyclizine
- 2nd line dexamethasone

Question 8

Mx vomiting due to reduced gastric motility

Answer 8

pro kinetics: metoclopramide
and domperidone

Question 9

STOPP screening

Answer 9

identifies medications that the risk outweighs the benefit

Question 10

START screening

Answer 10

medications that provide additional benefits

Question 11

PRISMA-7 questionnaire

Answer 11

frailty

Question 12

from oral morphine to subcut morphine, dosage?

Answer 12

divide by 2

Question 13

what is the breakthrough dose of morphine

Answer 13

1/6 of the daily dose

Question 14

opioids in CKD?

Answer 14

oxycodone preferred
- if renal impairment is severe then buprenorphine and fentanyl

Question 15

Mx acute confusional state

Answer 15

• treat underlying cause
• modify environment
• HALOPERIDOL (CI: parkinson’s)

Question 16

syring driver medications

Answer 16

nausea and vomiting: cyclizine, levomepromazine, haloperidol, metoclopramide

respiratory secretions/bowel colic: hyoscine hydrobromide, hyoscine butylbromide, or glycopyrronium bromide.

agitation/restlessness: midazolam, haloperidol, levomepromazine

pain: diamorphine is the preferred opioid

Question 17

management of alzheimers

Answer 17

DONEPEZIL
- acetylcholinesterase inhibitors
- memantine second line

Question 18

how do you differentiate DLB from parkisons dementia

Answer 18

in parkinsons: motor symptoms precede dementia
in DLB: dementia then parkinsonism motor symptoms

Question 19

widespread cerebral atrophy mainly involving the cortex and hippocampus

Answer 19

Alzheimer’s