🏥 USMLE Exam Prep

A 72-year-old patient with advanced pancreatic cancer is receiving palliative care. She experiences persistent, severe nausea and vomiting despite receiving standard antiemetics (ondansetron, prochlorperazine). Her pain is well-controlled with opioids. What is the most appropriate next step in managing her nausea and vomiting?

A Increase the dose of her current antiemetics
B Consider a trial of dexamethasone
C Initiate a promotility agent such as metoclopramide
D Evaluate for opioid-induced gastroparesis or bowel obstruction

✓ Correct Answer: Option D

In patients with advanced cancer and refractory nausea on opioids, it's crucial to evaluate for underlying treatable causes like opioid-induced gastroparesis or bowel obstruction. Managing these specific issues is often more effective than adding more symptomatic antiemetics.

Related USMLE Exam Prep Questions