Flashcards in Oncologic emergencies Deck (15):
What are five oncologic emergencies?
(1) Febrile neutropenia
(2) Spinal cord compression
(4) Superior vena cava syndrome
(5) Hyperviscosity syndrome
What is febrile neutropenia?
Fever occurring 10-14 days after chemotherapy due to low neutrophil count
How is febrile neutropenia managed?
(1) Always evaluate fever after chemotherapy
(2) Start patient on broad spectrum antibiotics
(3) Identify infection by blood culture, then treat specific organism
What is the mechanism spinal cord compression?
Spine metastases with expansion into the epidural space
What is the progression of symptoms in spinal cord compression?
(3) Sensory deficits
What cancers typically cause spinal cord compression?
Common cancers (nasopharyngeal, breast, lung, lymphoma, multiple myeloma)
Neuroblastoma, Ewing's sarcoma
What is the treatment for spinal cord compression?
(1) Steroids to decrease cord edema
(2) External beam irradiation
(3) Surgical decompression
What causes hypercalcemia?
(1) Paraneoplastic tumor produces factors that cause bone resorption or tubular calcium reabsorption
(2) Osteoclast-mediated upregulation of osteoclast-activating factors
How is hypercalcemia treated?
(1) Rapid rehydration to replace intravascular contraction and prevent renal calcium reabsorption
(2) Bisphosphonates - inhibit bone resorption
What causes superior vena cava syndrome?
Compression of SVC by malignancies in superior mediastinum
What are the symptoms of SVC syndrome?
(2) Facial swelling
(3) Distension of neck and chest wall
How is SVC syndrome treated?
(1) Radiation therapy
(2) Endovascular stenting
(4) Thrombolytic therapy
What are the causes of hyperviscosity syndrome?
(1) IgM in Waldenstrom's macroglobulinemia
(2) IgA or IgG in multiple myeloma
What are signs of hyperviscosity syndrome?
(1) Changing mental status
(2) Pulmonary distress
(3) Renal failure