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Phys Clinical Casesoncological

Phys Clinical Cases · oncological

Pain Management IN Cancer AND Chronic Disease — DCE Clinical Case

DCE long-case and short-case station for Pain Management IN Cancer AND Chronic Disease.

1 min readVerification in progress

Target exams

FRACP DCEMRCP PACES
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Target exams

FRACP DCEMRCP PACES
Prompt
DCE long-case and short-case station for Pain Management IN Cancer AND Chronic Disease.

Pain Management IN Cancer AND Chronic Disease — Clinical Case

DCE Long Case

Patient brief

Patient: A middle-aged or older adult with multimorbidity and a presentation centred on Pain Management IN Cancer AND Chronic Disease. [1]

Presenting complaint: Subacute or acute symptoms referable to Pain Management IN Cancer AND Chronic Disease, with enough detail to force prioritisation. [1] [2]

Past history: Common cardiometabolic and organ comorbidities that interact with the plan. [2]

Medications: A polypharmacy list that includes at least one interaction or dosing issue. [2]

Examination: Key positives and critical negatives for dangerous differentials. [1]

Investigations: A small set of results that change management. [1] [2]

Tasks

  1. Present a prioritised problem list. [1]
  2. Defend investigations and immediate therapy. [1] [2]
  3. Provide safety-net and follow-up advice. [2]

Model discussion points

  • Working diagnosis and acuity. [1]
  • Differentials and discriminators. [2]
  • Treatment sequence and monitoring. [1] [2] [3]
  • Multimorbidity and communication. [2]
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References3ShowHide
  1. [1]Wiffen PJ, McQuay HJ Oral morphine for cancer pain Cochrane Database Syst Rev, 2007.PMID 17943804
  2. [2]Wiffen PJ, Wee B, Derry S, et al. Opioids for cancer pain - an overview of Cochrane reviews Cochrane Database Syst Rev, 2017.PMID 28683172
  3. [3]Coluzzi PH, Schwartzberg L, Conroy JD, et al. Breakthrough cancer pain: a randomized trial comparing oral transmucosal fentanyl citrate (OTFC) and morphine sulfate immediate release (MSIR) Pain, 2001.PMID 11240084
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