Palliative care jeopardy i fall 2011

Palliative Care Jeopardy!
A Highly Interactive Game

Mary Lynn McPherson, Pharm.D., BCPS
Professor
University of Maryland School of Pharmacy

Palliative Care Jeopardy – The Rules

Game board contain 25 squares with 5 categories
and 5 “answers” of increasing difficulty and point
values
In sequential order, teams get to select the square
at the beginning of each round
If the designated team member is able to answer
the question, the team earns full point value. If
more than one team member works together to
supply the correct answer, half the points are
awarded to the team.

Palliative Care Jeopardy – The Rules

The correctness of your team’s “answer” will
be determined by me.
The correct “answers” and my decisions are
final. They, admittedly, may be arbitrary.
The team with the most points at the end of
50 rounds plus Final Jeopardy WINS!!

The
The
categories
categories
are …
are …

Nausea, Vomiting
and Constipation:
Oh My!

NVC PQRST Pain Opioid Neuro-
Patho Facts Psych Sx

100 100 100 100 100

200 200 200 200 200

300 300 300 300 300

400 400 400 400 400

500 500 500 500 500

NVC for 100
The answer is …
Defined as forceful contracture of the abdominal
muscles.

The question is …
What is retching?

Return to Game Board

NVC for 200
The answer is …
An antipsychotic agent also used to treat chemical-
induced nausea.

The question is …
What is haloperidol (Haldol)?


NVC for 300
The answer is …
The area of the brain that detects toxins and lacks a
blood brain barrier.

The question is …
What is the chemoreceptor trigger zone?


NVC for 400
The answer is …
Epigastric pain, early satiety, and regurgitation are
symptoms of this cause of nausea.

The question is …
What is gastric stasis?


NVC for 500
The answer is …
A sugar-coated treatment option for the
management of high bowel impaction.

The question is …
What are frozen vaseline balls?


PQRST for 100
The answer is …
“It’s a lot worse when I roll over, but if I lie perfectly
still, it’s not too bad.”

The question is …
What is “what precipitates or worsens your pain?”


PQRST for 200
The answer is …
“It feels like a lightning bolt at first, but ends up
numb and tingling.”

The question is …
What is “describe the quality of your pain?”


PQRST for 300
The answer is …
“I can’t eat, I can’t sleep, I can’t get out of bed, and I
cry all of the time.”

The question is …
What is “what symptoms accompany your pain?”


PQRST for 400
The answer is …
“Right here in the center of my left rib cage, and it
moves around to my back.”

The question is …
What is “where is your pain located?”


PQRST for 500
The answer is …
“That long acting morphine generally controls it, but
I have to take the short acting when the pain is 5 or
higher, and the heating pad didn’t help at all.”

The question is …
What is “what have you tried to relieve the pain and
how well did it work?”


Pain Pathogenesis for 100
The answer is …
A myelinated, large diameter fiber that transmits
sharp, well localized pain.

The question is …
What is an A-delta fiber?


The answer is …
The step during which a noxious stimulus is
changed by the body into an action potential.

The question is …
What is transduction?


The answer is …
Enkephalins, dynorphins and beta endorphins.

The question is …
What are endogenous opioids?


The answer is …
Free nerve endings that are activated by noxious
stimuli.

The question is …
What are nociceptors?


The answer is …
A relay station for reception and processing of
nociceptive information.

The question is …
What is the thalmus?


Opioid Facts for 100
The answer is …
This opioid is used as a cough suppressant and has
the highest incidence of nausea and constipation.

The question is …
What is codeine?


The answer is …
This long-acting opioid is dosed every 12 hours, has
minimal active metabolites, and is available as 10, 15,
20, 30, 40, 60 and 80 mg.

The question is …
What is oxycodone (OxyContin)?


The answer is …
This short-acting opioid has poor oral bioavailability
and is available parenterally, transdermally, and as
an oral transmucosal lozenge, an effervescent
tablet, a transmucosal film, a sublingual tablet and
intranasal spray.

The question is …
What is fentanyl?


The answer is …
This opioid used to be commonly used for acute
pain, and has an active metabolite that can
accumulate and cause CNS excitation including
seizures.

The question is …
What is meperidine?


The answer is …
This combination analgesic is no more effective than
plain acetaminophen and its active metabolite
causes sedation and confusion, particularly in the
elderly, and most importantly IS OFF THE MARKET!

The question is …
What is Darvocet N-100?


Neuropsychiatric Symptoms for 100

The answer is …
A patient with opioid-induced daytime sedation is
best treated with this agent, which may also be used
to treat depression.

The question is …
What is methylphenidate?



The answer is …
A patient with acute agitated, confused behavior and
a history of Parkinson’s disease is best treated with
this behavior.

The question is …
What is quetiapine (or another atypical antipsychotic
agent)



The answer is …
Neuropathic pain AND depression are best treated
with this type of antidepressant.

The question is …
What is a TCA (e.g., nortriptyline or desipramine) or
SNRI (e.g., duloxetine or venlafaxine)?



The answer is …
This medication, used adjunctively to treat
metastases to the brain, to reduce intracerebral
edema, and to treat metastatic bone pain may
cause anxiety or delirium.

The question is …
What is dexamethasone (or other CCS)?



The answer is …
The number of anxiety-induced dyspnea attacks
may be reduced by this agent.

The question is …
What is lorazepam (or other BZD)?


Palliative care jeopardy i fall 2011

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