MND Death Trajectory Explanation — SCE Palliative Medicine MCQ

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

EasyNon-Malignant Palliative CareMND Death Trajectory ExplanationSCE Palliative Medicine

A 58-year-old woman with advanced MND has progressive bulbar and limb involvement. She is now wheelchair-dependent and using augmentative communication. She asks how death typically occurs in MND. What should she be told?

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

Reveal the answer and explanation

Correct answer: E — Death in MND is usually from respiratory failure – it commonly occurs during sleep, is generally peaceful when well managed, and anticipatory prescribing can prevent breathlessness and distress

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

Option A is correct. National UK guidance (NICE NG42) emphasises that respiratory failure is the common terminal event in MND, and that clinicians should explain this to patients and provide anticipatory prescriptions (opioids, benzodiazepines) to mitigate breathlessness and distress at end of life. Proper palliative management often makes the dying process peaceful, often occurring during sleep. Options B and D overemphasise dysphagia or aspiration as causes of death, which are not the primary terminal event. Option C is incorrect as emergencies can be avoided with planning and monitoring. Option E is inaccurate because distress and pain are not inevitable when skilled palliative care and anticipatory prescribing are in place.

Reference: NICE guideline NG42: Motor neurone disease: assessment and management, Recommendations section 1.7.3–1.7.7 (end‑of‑life care planning, anticipatory medicines), 2016 (updated 2019). https://www.nice.org.uk/guidance/NG42/chapter/Recommendations