Practice questions › Davidson's Principles of Medicine › Davidson's Medicine - Part 1: Fundamentals of Medicine
08 Pain and palliative care MCQs
Davidson's Medicine - Part 1: Fundamentals of Medicine · Davidson's Principles of Medicine · 11 practice questions
- Capacity
- Opioid prescribing
- Palliative care principles
- Pain neurobiology
- Death and dying
- Chronic pain
- Palliative care symptoms
- Nausea and vomiting
1. A patient with malignant bowel obstruction not for surgery has colic and large-volume vomiting; another has constant nausea with hypercalcaemia. Which management fits?
- AOctreotide and hyoscine butylbromide for the first, treating the reversible cause for the second
- BMetoclopramide for the first, steroids for the second
- CCyclizine alone for both
- DNasogastric tube alone for both
Show answer
A. Octreotide and hyoscine butylbromide for the first, treating the reversible cause for the second Octreotide reduces secretions and hyoscine treats colic; hypercalcaemia and constipation are reversible causes; metoclopramide is generally avoided with colic.
2. A patient with cancer cachexia has lost 10 kg with anorexia and muscle wasting. Which measures are recommended?
- ABed rest
- BLong-term steroids
- CFish oil as proven treatment
- DExercise to maintain muscle, adequate calories and supplements, with short-term steroids only for appetite
Show answer
D. Exercise to maintain muscle, adequate calories and supplements, with short-term steroids only for appetite Steroids boost appetite temporarily but cause fluid retention, so generally short-term only; exercise maintains muscle mass.
3. A patient on an SSRI for chronic pain wants an herbal remedy and another drinks grapefruit juice. Which interactions are described?
- AGinkgo increases serotonin
- BGrapefruit lowers levels of all drugs
- CHerbal remedies never interact
- DSt John's wort increases serotonergic effects with antidepressants and grapefruit may too
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D. St John's wort increases serotonergic effects with antidepressants and grapefruit may too St John's wort and grapefruit may increase serotonergic effects with some antidepressants; ginkgo may increase bleeding time with paracetamol.
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