Devita, Hellman, and Rosenberg's Cancer

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

Chapter 45•Supportive Care and Quality of Life 563

Question 45.9. Which statement(s) is/are TRUE regarding nausea and vomiting that

occurs during treatment with opioid analgesics:

A. It is produced through chemoreceptor trigger zone.

B. Tolerance rarely develops to these side effects.

C. Switching to alternative opioid often results in improvement.

D. A and C.

Question 45.10. Which of the following can be a cause of depression in terminally ill

patients?

A. Hypercalcemia

B. Uncontrolled pain

C. Steroid treatment

D. All of the above

Question 45.11. Which of the following factors have been shown to be associated with

high rates of primary caregiver burnout?

A. Lower socioeconomic status

B. Race

C. Caring for a patient for more than 6 months

D. All of the above

Question 45.12. Professional barriers to cancer pain management include:

A. Inadequate knowledge of pain mechanisms

B. Fear of producing iatrogenic complications

C. Time and reimbursement pressures

D. All of the above

Question 45.13. Lisa, a 45-year-old woman with locally advanced right-sided breast can-

cer undergoes neoadjuvant chemotherapy, followed by modified radical

mastectomy and axillary dissection. She achieves partial response and

undergoes adjuvant irradiation to total dose of 55 GY. Five years later,

she has no evidence of disease recurrence. However, on routine visit, she

reports right shoulder ache, arm/hand numbness, and weakness. There is

mild arm edema. Her symptoms have been slowly progressive during the

last year. The best test to determine the cause of her symptoms is:

A. Brachial plexus magnetic resonance imaging (MRI)

B. Cervical spine MRI

C. Bone scan

D. EMG

Question 45.14. Lisa is very relieved that her symptoms are not related to progressive

disease. However, she is distressed by her pain and decreased ability to

function. On her recent office visit she is tearful. Treatment approaches

to this patient’s problem may include:

A. Physical therapy

B. Support group

C. Antidepressants and anticonvulsants

D. All of the above