A 72-year-old woman presents with advanced oesophageal cancer.
She has an inoperable tumour and is being managed palliatively. From the description of her symptoms you diagnose oesophageal spasm.
Which of the following would be most helpful in managing her symptoms?
A 59-year-old man calls for advice regarding persistent hiccups. His medical history shows that he was diagnosed with pancreatic cancer two months ago. He has tried simple remedies like drinking cold water, holding his breath, and the Valsalva manoeuvre, but they have not worked. He is asking if you could prescribe something to help. What is the most suitable initial treatment to suggest?
You are assessing a patient at home with metastatic colon cancer. She is receiving symptom relief through a syringe driver and is being given diamorphine and cyclizine continuously via the device. In the past 24 hours, she has become increasingly restless and agitated. Her family is present and asks if there is a medication that can alleviate her symptoms without causing excessive sedation.
What medication would you recommend to be administered via the syringe driver?
You are called to see a palliative care patient who is homebound and receiving care from the district nurses and community palliative care nurses. The primary diagnosis is lung cancer and symptom control is currently being achieved with the use of a syringe driver. The reason for the call today is that the patient’s 85-year-old mother has had three seizures in the last 24 hours. The patient is for palliative treatment only and neither she nor her family want her to be admitted to the hospital. You review the current medications being administered via the syringe driver and see that she is being given diamorphine, cyclizine, and hyoscine hydrobromide.
Which of the following treatment plans is most appropriate?
A 68-year-old retired teacher has been diagnosed with a renal cell carcinoma.
He has been steadily increasing his analgesia in recent weeks and is currently taking the maximum dose of co-codamol 30/500. You are considering switching to morphine.
What is the equivalent 24-hour oral morphine dose to maintain the same level of analgesia as his current co-codamol regimen?
At what stage are GPs typically involved in myeloma?
What is the correct order of relative potency, from least to most potent, for these opioid analgesics, considering that diamorphine is typically administered parenterally while the others are usually given orally?
You are discussing a case with the pediatric palliative care nurse. You have a young patient who has been on long term oral prednisolone that the palliative care team want to switch to oral dexamethasone. This prompts discussion about the relative potencies of steroid preparations.
Place the following corticosteroid medications in order of their anti-inflammatory (glucocorticoid) potency from strongest to weakest:
A Deflazacort
B Dexamethasone
C Hydrocortisone
D Methylprednisolone
E Prednisolone
A 35-year-old lady comes to the clinic seeking guidance regarding her potential risk of developing cancer. She has received proper treatment for CIN II, is a former smoker, and currently takes the combined oral contraceptive pill. Her two paternal aunts passed away from ovarian carcinoma at ages 40 and 48. What is the primary predisposing factor for ovarian cancer in this patient?
What is the correct definition of advanced decisions according to the Mental Capacity Act (2005)?