Flashcards in EXAM #3: ONCOLOGIC EMERGENCIES II Deck (22)
What is the definition of Malignant Spinal Cord Compression?
Compression of the spinal cord or cauda equina by an extra dural tumor
Outline the pathophysiology of MSCC?
Cord compression leads to interrupted blood flow and cord infarction
What is the most frequent site of MSCC?
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
What is the test of choice to diagnose MSCC if a patient CANNOT have a MRI?
How is MSCC treated?
3) Surgery/ decompression
****Surgery is the treatment of choice*****
What is Tumor Lysis Syndrome (TLS)?
Syndrome caused by rapid death of a rapidly proliferative volume of cells
What are the characteristics of TLS?
5) Metabolic acidosis
6) Acute kidney injury
What type of cancer is TLS common in?
What is the timeline for the diagnosis of TLS?
3 days prior to 7 days after chemotherapy
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
What induces acute kidney injury in TLS?
What patients are at high risk for TLS?
1) Pre-existing chronic renal insufficiency
3) Volume depletion
5) Acidic urine
How is TLS managed?
What is the mechanism of action of Allopurinol?
Blocks the conversion of xanthine and hypoxanthine to uric acid
What is the mechanism of action of Rasburicase?
This is urate oxidase--catalyzes the oxidation or uric acid to water soluble allantoin
Why does cancer predispose one to PE?
Hypercoaguability due to cancer
What is the gold standard for diagnosing PE?
CT pulmonary angiography (CTPA)
What is the treatment for a PE?
What are the most common symptoms of a PE?
Pleuritic chest pain
Calf or thigh pain
What are the most common signs of PE?