GP Vivas · palliative-care
Palliative symptom control in the community — structured viva
Structured oral on palliative symptom control: opioid selection by renal function with equianalgesic conversions, breakthrough dosing, fan therapy evidence for breathlessness, receptor-based antiemetic selection, laxative co-prescribing, terminal agitation management, and syringe driver initiation.
On this page
Study tools
Target exams
RACGP CCEFRACGP oralsMRCGP SCA
Prompt
The examiner opens: 'Palliative care is just morphine and kind words — what do you actually prescribe?' The viva branches through pain ladder, renal-adjusted opioids, breakthrough dosing, breathlessness management, nausea matching, constipation prevention, terminal agitation and last-days care.
Stem
A GP registrar asks what makes palliative prescribing different from regular chronic disease prescribing. You are asked to demonstrate the key principles. [1]
References5ShowHide
- [1]King S, Forbes K, Hanks GW, Ferro CJ, Chambers EJ A systematic review of the use of opioid medication for those with moderate to severe cancer pain and renal impairment: a European Palliative Care Research Collaborative opioid guidelines project. Palliat Med, 2011.PMID 21708859
- [2]Chamberlain BH, Rhiner M, Slatkin NE, Stambler N, Israel RJ Methylnaltrexone Treatment for Opioid-Induced Constipation in Patients with and without Cancer: Effect of Initial Dose. J Pain Res, 2023.PMID 37533563
- [3]Jesuyajolu DA, Abubakar AK, Kowe T, Ogunlade S, Abioye AI, et al. The Management of Opioid-Induced Constipation in Cancer and Advanced Illness: A Meta-Analysis. J Pain Symptom Manage, 2024.PMID 38092261
- [4]Smallwood NE, Pascoe A, Wijsenbeek M, Russell AM, Holland AE, et al. Opioids for the palliation of symptoms in people with serious respiratory illness: a systematic review and meta-analysis. Eur Respir Rev, 2024.PMID 39384304
- [5]Pereira RA, Barcellos G, Lenz G, Christmann A, de Mello MAJ, et al. Fan Therapy for Dyspnea in Palliative and Supportive Care: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Respir Care, 2026.PMID 41761933