CFPC CAC Palliative Care case studies
CFPC CAC Palliative Care · Put your knowledge to work in context.
The Certificate of Added Competence (CAC) in Palliative Care is one of the Certificates of Added Competence in Family Medicine (CAC) offered through the CFPC's examinations and certification program, as listed on cfpc.ca alongside the Certification Examination in Family Medicine and the Examination of Added Competence in Emergency Medicine. It is intended for practising family physicians who have completed enhanced skills training or built substantial focused practice in palliative care and who want formal recognition of that added competence beyond the Certificate in Family Medicine. The CFPC CAC Palliative Care case studies are 5 cases and about 2,612 words.
1Opioid Rotation in Renal Failure with Myoclonus
L is 71 with metastatic pancreatic cancer and eGFR 22 mL/min/1.73m2. He has been on oral hydromorphone 4 mg every 4 hours plus 4 mg breakthrough doses (about 6 breakthrough doses daily) for 3 weeks.
515 words, about 3 min2Delirium versus 'Terminal Restlessness' in a Man Wanting to Go Home
K is 84 with advanced COPD (FEV1 0.6 L, on 2 L home oxygen) and a new diagnosis of likely lung cancer (no tissue diagnosis; she declined bronchoscopy). She is admitted with worsening breathlessness.
502 words, about 3 min3Advance Care Planning Conflict Between Daughter and Patient
T is 78 with advanced heart failure (NYHA III-IV, ejection fraction 25%) and stage 4 chronic kidney disease. He tells you he does not want CPR or intubation and wants to focus on comfort at home.
554 words, about 3 min4Withdrawing Non-Invasive Ventilation in ALS
R is 62 with bulbar-onset ALS, 18 months from diagnosis. He has a percutaneous endoscopic gastrostomy and uses non-invasive ventilation (NIV) at night and increasingly during the day.
526 words, about 3 min5Prognosis Conversation and Hydration at End of Life
S is 58 with metastatic ovarian cancer, now with bowel obstruction and ascites. She is cachectic, drowsy, and has not eaten for 4 days.
515 words, about 3 min