ABFM Palliative Care study guide
ABFM Palliative Care · Work through your exam, one topic at a time.
The Certificate of Added Qualification (CAQ) in Hospice and Palliative Medicine is a subspecialty credential for family physicians who want formal recognition of their training and knowledge in caring for patients with serious, life-limiting illness and their families. ABFM offers the CAQ in conjunction with the American Board of Internal Medicine and eight other ABMS member boards. The ABFM Palliative Care study guide has 10 sections and about 3,162 words.
01The Palliative Care Approach and Prognostication
Palliative care is specialized medical care focused on relieving symptoms and improving quality of life for people with serious illness, whatever the diagnosis or stage. It is appropriate at diagnosis and can be delivered alongside disease-directed treatment.
343 words, about 2 min02Pain Assessment and Management
Patient self-report is the gold standard. Ask about location, quality, timing, radiation, aggravating and relieving factors, incident pain, and functional impact.
336 words, about 2 min03Non-Pain Symptom Assessment and Management
Dyspnea is subjective. Opioids are first-line for refractory dyspnea in palliative care, titrated similarly to pain.
305 words, about 2 min04Communication and Shared Decision Making
Use structured tools such as SPIKES for breaking bad news, NURSE for responding to emotion, and Ask-Tell-Ask to check understanding before and after information. Shared decision making requires eliciting the patient's goals and values, explaining options and tradeoffs, and confirming a plan.
344 words, about 2 min05Psychosocial, Spiritual, and Cultural Aspects of Care
Suffering includes physical, psychological, social, spiritual, and cultural dimensions. Screen for depression, anxiety, demoralization, and meaning-related distress.
299 words, about 1 min06Ethical and Legal Aspects of Palliative Care
Autonomy, beneficence, nonmaleficence, and justice guide decisions. Informed consent requires capacity, disclosure, understanding, voluntariness, and authorization.
322 words, about 2 min07Care of the Imminently Dying Patient and Hospice Care
Signs of the last days include declining performance status, decreased oral intake, dysphagia, oliguria, cool or mottled extremities, Cheyne-Stokes breathing, terminal secretions, and agitated delirium. These are expected and not automatically treated as emergencies.
302 words, about 2 min08Interdisciplinary Team and Systems-Based Practice
The palliative care team typically includes physicians, advanced practice providers, nurses, social workers, chaplains, pharmacists, aides, and volunteers. Each discipline has distinct expertise: social workers address benefits, housing, and family dynamics; chaplains address spiritual distress; pharmacists optimize medications and deprescribing.
304 words, about 2 min09Pediatric and Perinatal Palliative Care
Pediatric palliative care begins at diagnosis and can continue alongside curative treatment. Care is family-centered, developmentally appropriate, and focused on the child's quality of life.
305 words, about 2 min10Grief, Bereavement, and Caregiver Support
Grief is individualized and not a linear sequence of stages. Yearning, sadness, waves of emotion, and temporary disbelief are normal.
302 words, about 2 min