Devita, Hellman, and Rosenberg's Cancer

LWBK1006-45 LWW-Govindan-Review December 13, 2011 15:32

562 DeVita, Hellman, and Rosenberg’s CANCER: Principles and Practice of Oncology Review

Question 45.4. Christine completed whole brain radiation, which she tolerated poorly

with worsening fatigue. Unfortunately, 2 months later, she is more short

of breath. Her CT scan shows worsening pulmonary and liver metastases.

Her Eastern Cooperative Oncology Group (ECOG) performance status

(PS) is 3. You are convinced that there is no further standard therapy

that would be of benefit to her. She is not eligible for any clinical trials

available at your institution. After discussing her latest scan results, you

say:

A. I am sorry, but there is nothing more I can offer you.

B. There are no other treatments against the cancer, but I will continue

taking care of you and make sure your comfort remains a priority.

C. Unfortunately, you have only 2 months to live, but we will make sure

you have as much quality time as possible.

D. I can offer you other chemotherapy, but it is unlikely that it will

provide any benefit.

Question 45.5. Which of the following neuroablative procedures is useful for refractory

pain from tumor infiltration of cranial nerves?

A. Rhizotomy

B. Cordotomy

C. Thalamotomy

D. Mesencephalic tractomy

Question 45.6. Which of the following is TRUE about palliative care services?

A. Patients need to abandon other forms of therapy, such as chemother-

apy, to receive palliative care.

B. Palliative care has no role in management of patients with curable

cancers.

C. Total costs of care are higher for patients who died in the palliative

care unit, compared with those who died outside the unit.

D. Palliative care teams can assist oncology patients and their doctors

with symptom management, as well as other forms of pain, at any

point along the disease trajectory, beginning from diagnosis.

Question 45.7. The MOST common symptom experienced by patients in the last days

to week before death is:

A. Fatigue and/or pain

B. Restlessness/delirium

C. Dyspnea

D. Nausea and vomiting

Question 45.8. Which of the following provides oral equivalent doses to methadone

20 mg oral?

A. Hydromorphone 15 mg

B. Oxycodone 30 mg

C. Propoxyphene 200 mg

D. Codeine 300 mg