Phys Written Answers · oncological
Breakthrough Cancer Pain AND Opioid Titration — Written Clinical Reasoning
DCE-style written reasoning for Breakthrough Cancer Pain AND Opioid Titration.
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Target exams
SAQ 1 — Integrated plan (12 marks)
Prompt: Provide a prioritised problem list and management sequence for this presentation. [1] [2]
Model Answer
1. Frame and red flags (3 marks) [1]
State the working diagnosis/syndrome, acuity, and what would force emergency treatment now. [1] [2]
2. Discriminating assessment (3 marks) [2]
List the key history, examination and investigations that separate dangerous differentials from benign mimics. [1] [2]
3. Treatment sequence (4 marks) [1] [3]
Immediate stabilisation, disease-specific therapy, monitoring, and complications prevention. [1] [2] [3]
4. Follow-up and communication (2 marks) [2]
Disposition, safety-net advice, and who owns follow-up. [1] [2]
References5ShowHide
- [1]Mercadante S, Candido K, Staats P, Davis M Spinal analgesia in cancer pain management-MASCC general practice recommendations Support Care Cancer, 2025.PMID 40634640
- [2]Mercadante S Once again... breakthrough cancer pain: an updated overview J Anesth Analg Crit Care, 2023.PMID 37480136
- [3]Mercadante S An overview of the current drug treatment strategies for moderate to severe, chronic malignant tumor-related pain Expert Opin Pharmacother, 2024.PMID 37016731
- [4]Kiani CS, Hunt RW Lidocaine Continuous Subcutaneous Infusion for Neuropathic Pain in Hospice Patients: Safety and Efficacy J Pain Palliat Care Pharmacother, 2021.PMID 33793373
- [5]Michenot N, Rostaing S, Baron L, Faure S, et al. [Opioid switch and change of route of administration in cancer patients treated by morphine] Bull Cancer, 2018.PMID 30274680