What is the opioid of choice for intrathecal infusion for pain relief at the end of life?

Q 37 What is the opioid of choice for intrathecal infusion for pain relief at the end of life?

a)Morphine

b)Fentanil

c)Oxycodone

d)Diamorphine

Q 38 Metastatic spinal cord compression can be the result of ?

a)vertebral collapse

b)hypercalcaemia of malignancy

c)chemotherapy treatment

d)muscular spasm

Q 39 Metastatic spinal cord compression occurs most frequently in ?

a)the cervical spine

b)the thoracic spine

c)the lumbar spine

d) the cauda equine

Q 40 Diagnosis of metastatic spinal cord compression is best made by ?

a)isotope bone scan

b)plain film X-ray

c)magnetic resonance imaging

d)computerised tomography

Q 41 Initial management of metastatic spinal cord compression includes ?
a) analgesia and prednisolone 40mg po od

b)intravenous bisphosphonate (e.g. pamidronate 90mg)

c)dexamethasone 16mg po od and proton pump inhibitor cover

d)analgesia and consultation with oncology / neurosurgery experts

Q 42 Rehabilitation following diagnosis of metastatic spinal cord compression should commence ?

a)once definitive treatment has been completed

b)three days after starting high dose steroid treatment

c)as soon as possible after diagnosis and progressed as appropriate

d)once the patient is more mobile following treatment