LWBK1006-45 LWW-Govindan-Review December 13, 2011 15:32
CHAPTER 45 SUPPORTIVE CARE
AND QUALITY OF LIFE
ANNA ROSHAL
DIRECTIONS Each of the numbered items below is followed by lettered answers. Select the
ONE lettered answer that is BEST in each case unless instructed otherwise.
QUESTIONS
Question 45.1. Christine is a 45-year-old woman with newly diagnosed triple negative
metastatic breast cancer. She and her husband have two school-aged chil-
dren. She is beginning chemotherapy and asks you, “How much should
we share with the kids?” Your advice is:
A. I am sorry, this is out of my area of expertise, but I will be glad to
refer you to a social worker.
B. Talk as little as possible about the cancer to preserve the sense of
normalcy in the children’s lives.
C. Sit the children down and explain her disease process, including even-
tual death from cancer.
D. Try to let the children initiate the discussion, and then answer all
of their questions in an age-appropriate manner, including fears and
concerns about their mother dying.
Question 45.2. Christine is treated with Abraxane and bevacizumab and achieves a very
good partial response. However, she has numbness, tingling, and aching in
her hands. You diagnose her as having treatment-related grade 2 periph-
eral neuropathy. In addition to giving her a chemotherapy holiday, you
will also recommend:
A. Oxycodone 5 mg every 6 hours as needed
B. Gabapentin 300 mg three times per day
C. Dexamethasone 4 mg every 6 hours
D. Refer her to neurologist for electromyography (EMG)
Question 45.3. What are the two most common causes in insomnia in dying patients?
A. Pain and depression
B. Pain and dyspnea
C. Anxiety and nausea
D. Anxiety and depression
Corresponding Chapters inCancer: Principles & Practice of Oncology,Ninth Edition: 170 (Management of Cancer
Pain), 171 (Nutritional Support), 172 (Sexual Problems), 173 (Psychological Issues in Cancer), 174 (Communicating
News to the Cancer Patient), 175 (Specialized Care of the Terminally Ill), and 176 (Community Resources).
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