EXAM #3: ONCOLOGIC EMERGENCIES II Flashcards Preview

Hematology and Oncology > EXAM #3: ONCOLOGIC EMERGENCIES II > Flashcards

Flashcards in EXAM #3: ONCOLOGIC EMERGENCIES II Deck (22):
1

What is the definition of Malignant Spinal Cord Compression?

Compression of the spinal cord or cauda equina by an extra dural tumor

2

Outline the pathophysiology of MSCC?

Cord compression leads to interrupted blood flow and cord infarction

3

What is the most frequent site of MSCC?

T-spine

4

What are the signs and symptoms of MSCC?

1) Localized pain
2) Radicular pain
3) Lhermitte's Sign
4) Motor/Sensory signs
5) Bowel/bladder incontinence

5

What is the test of choice to diagnose MSCC if a patient CANNOT have a MRI?

CT myelogram

6

How is MSCC treated?

1) Glucocorticoids
2) Radiation
3) Surgery/ decompression

****Surgery is the treatment of choice*****

7

What is Tumor Lysis Syndrome (TLS)?

Syndrome caused by rapid death of a rapidly proliferative volume of cells

8

What are the characteristics of TLS?

1) Hyperkalemia
2) Hyperuricemia
3) Hyperphosphatemia
4) Hypocalcemia
5) Metabolic acidosis
6) Acute kidney injury

9

What type of cancer is TLS common in?

Hematologic malignancies

10

What is the timeline for the diagnosis of TLS?

3 days prior to 7 days after chemotherapy

11

Outline the pathophysiology of TLS.

- Lysed tumor cells release K+ and nucleic acid that are metabolized to uric acid
- Hyperphosphatemia leads to hypocalcemia
- Cytokines are released that cause systemic inflammatory response

12

What induces acute kidney injury in TLS?

Hyperuricemia

13

What patients are at high risk for TLS?

1) Pre-existing chronic renal insufficiency
2) Oliguria
3) Volume depletion
4) Hypotension
5) Acidic urine

14

How is TLS managed?

1) Hydration
2) Allopurinol
3) Rasburicase

15

What is the mechanism of action of Allopurinol?

Blocks the conversion of xanthine and hypoxanthine to uric acid

16

What is the mechanism of action of Rasburicase?

This is urate oxidase--catalyzes the oxidation or uric acid to water soluble allantoin

17

Why does cancer predispose one to PE?

Hypercoaguability due to cancer

18

What is the gold standard for diagnosing PE?

CT pulmonary angiography (CTPA)

19

What is the treatment for a PE?

Anticoagulation
1) Heparin
2) Coumadin

20

What are the most common symptoms of a PE?

Dyspnea
Pleuritic chest pain
Cough
Calf or thigh pain

21

What are the most common signs of PE?

Tachypnea
Tachycardia
Rales
JVD

22

What are the risk factors for a PE?

Malignancy
Immobility
Trauma- ortho
Surgery
Central catheter
Obesity