ABA Palliative Care case studies
ABA Palliative Care · Put your knowledge to work in context.
The Hospice and Palliative Medicine Exam is one of the subspecialty exams listed by the American Board of Anesthesiology (ABA), appearing in the ABA's Subspecialty Exams menu alongside Adult Cardiac Anesthesiology, Critical Care Medicine, Neurocritical Care, Pain Medicine, Pediatric Anesthesiology, Sleep Medicine, and Health Care Administration, Leadership and Management. Per the ABA, subspecialty exams are aimed at diplomates who are already certified and want to go further: "Once certified, diplomates can go further with subspeciality certification programs in multidisciplinary fields." So this credential sits on top of primary certification rather than replacing it, and it is designed for physicians who want formal recognition in a field that crosses specialty lines. The ABA Palliative Care case studies are 5 cases and about 2,523 words.
1Opioid Rotation in Renal Failure with Refractory Dyspnea
A 71-year-old woman with stage 5 chronic kidney disease (eGFR 9 mL/min/1.73 m², not on dialysis by patient choice) and metastatic lung cancer is admitted with refractory dyspnea. She has been on oral morphine 15 mg every 4 hours for 3 weeks; total daily dose 90 mg.
497 words, about 2 min2Withdrawing Non-Beneficial Dialysis in a Patient Without Decision-Making Capacity
An 84-year-old man with end-stage kidney disease on hemodialysis three times weekly, heart failure (EF 25%), and a recent hip fracture has been hospitalized for 3 weeks. He now has delirium, is unable to participate in decisions, and has been declining functionally; he can no longer transfer and has pressure injuries.
500 words, about 3 min3Prognosis Communication and Hope When the Family Requests 'Full Disclosure Only'
A 58-year-old man with newly diagnosed metastatic pancreatic cancer (liver metastases, ECOG 1) is seen in clinic. His wife pulls you aside before the visit and says, 'Please don't tell him the numbers.
469 words, about 2 min4Refractory Terminal Delirium and the Role of Palliative Sedation
A 66-year-old woman with widely metastatic breast cancer and brain metastases is in her final days. She has agitated delirium with hallucinations, is pulling at lines, and has not slept in 3 days.
518 words, about 3 min5Goals-of-Care Conflict at ICU Discharge and the Hospice Eligibility Question
A 79-year-old woman with advanced COPD (FEV1 28%, on 2 L home oxygen, 3 hospitalizations in 6 months) and mild cognitive impairment is in the ICU with a COPD exacerbation and possible aspiration pneumonia. She was intubated 4 days ago.
539 words, about 3 min