title: Is a "palliative" patient always a palliative patient? Two case studies.
abstract: Review of the literature suggests that misdiagnosis of terminal illness is infrequent. In the first 6 months of the recently established Edmonton Regional Palliative Care Program, two of 330 referrals proved to be in the category of erroneous diagnosis of terminal disease. These two cases are reported, along with discussion of aspects of the time-honored usefulness of careful history and physical examination. This experience highlights the importance of assessment, investigation, and aggressive therapy, even in "terminal" patients, including those in the geriatric population.
authors.affiliation: Regional Palliative Care Program, University of Alberta, Edmonton, Canada.
authors.forename: A W
authors.initials: AW
authors.lastname: Taube
authors.forename: C
authors.initials: C
authors.lastname: Jenkins
authors.forename: E
authors.initials: E
authors.lastname: Bruera
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced; D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D002637:Chest Pain / Q000188:drug therapy / Q000209:etiology; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D003863:Depression / Q000150:complications / Q000188:drug therapy; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004077:Digoxin / Q000009:adverse effects; D005260:Female; D005853:Geriatrics; D006117:Grief; D006801:Humans; D009020:Morphine / Q000008:administration & dosage; D009369:Neoplasms / Q000175:diagnosis; D009661:Nortriptyline / Q000627:therapeutic use; D010166:Palliative Care; D013276:Stomach Ulcer / Q000139:chemically induced; D019452:Terminally Ill / Q000523:psychology*; D015431:Weight Loss
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000929:Antidepressive Agents, Tricyclic; D004077:Digoxin; D009020:Morphine; D009661:Nortriptyline