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ACS in Palliative Heart Failure — SCE Palliative Medicine MCQ

Instant feedback + full explanation. One question, done properly.

HardNon-Malignant Palliative CareACS in Palliative Heart FailureSCE Palliative Medicine

A patient with complete malignant bowel obstruction has persistent high-volume vomiting despite hyoscine butylbromide, with no surgical or stent option. Which second-line antisecretory CSCI range is recommended?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Octreotide 250–500 micrograms/24 hours

Explanation lettering: C = shown as B · E = shown as C · B = shown as D · D = shown as E

D is correct. In mechanical obstruction, octreotide 250–500 micrograms over 24 hours is the second-line antisecretory option and is more effective than hyoscine when secretion-driven vomiting persists. It is not a prokinetic and does not reverse the obstruction.

Reference: Scottish Palliative Care Guidelines: bowel obstruction: https://www.rightdecisions.scot.nhs.uk/scottish-palliative-care-guidelines/symptom-control/bowel-obstruction/