Examkin

Soru

Zorluk: KolayEnd-of-Life and Palliative Care

Match the following end-of-life clinical scenarios or symptoms with their most appropriate first-line pharmacological intervention.

  • Refractory dyspnea at rest in a terminally ill patientLow-dose systemic morphine
  • Loud, gurgling respirations ('death rattle') in an actively dying patientGlycopyrrolate or scopolamine
  • Severe, distressing hyperactive delirium near the end of lifeHaloperidol
  • Nausea and early satiety due to gastroparesis in advanced cancerMetoclopramide

Cevap

Refractory dyspnea matches with Low-dose systemic morphine; Loud, gurgling respirations match with Glycopyrrolate or scopolamine; Severe, distressing hyperactive delirium matches with Haloperidol; Nausea and early satiety due to gastroparesis match with Metoclopramide.
Each symptom is paired with its standard evidence-based pharmacological intervention in palliative care: opioids for dyspnea, anticholinergics for terminal secretions, typical antipsychotics for hyperactive delirium, and prokinetics for gastroparesis.

Adım Adım Çözüm

1
Identify the primary distressing symptom in each clinical scenario.
The scenarios represent dyspnea, pooled oropharyngeal secretions, hyperactive delirium, and nausea from gastroparesis.
Accurate symptom identification dictates the correct pharmacological choice in palliative care.
2
Match the symptom of refractory dyspnea to its gold-standard treatment.
Matched to low-dose systemic morphine.
Opioids reduce respiratory drive and the central sensation of breathlessness without significantly compromising oxygenation at low doses.
3
Match the 'death rattle' (pooled secretions) to its treatment.
Matched to glycopyrrolate or scopolamine.
Anticholinergics decrease secretory production, whereas suctioning may cause unnecessary distress in an actively dying patient.
4
Match terminal hyperactive delirium to its treatment.
Matched to haloperidol.
Antipsychotics are first-line for refractory agitation in terminal delirium, whereas benzodiazepines may paradoxically worsen delirium.
5
Match nausea from gastroparesis to its treatment.
Matched to metoclopramide.
Prokinetics improve gastric emptying, directly addressing the underlying mechanism of early satiety and nausea in this context.

Anahtar Kavram

First-line pharmacological management of common distressing symptoms (dyspnea, secretions, delirium, nausea) at the end of life.
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Konular

End-of-Life and Palliative Care

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