Oncological emergencies Flashcards
(26 cards)
what is spinal cord compression?
an oncological emergency
what are the symptoms of spinal cord compression?
back pain bilateral leg weakness difficulty walking sensory loss bowel/bladder dysfunction
what is the investigation for spinal cord compression?
an urgent MRI spine
management of spinal cord compression in a cancer patient?
urgent dexamethasone
then consider radiotherapy or de-compressive surgery
a patient undergoing chemotherapy presents with a temperature >38 and neutrophil count <0.5x10^9, what are you suspecting?
neutropenic sepsis
when may neutropenic sepsis occur?
within 6 weeks of starting chemotherapy
treatment of neutropenic sepsis?
urgent blood cultures and antibiotics (piperacillin / tazobactam)
what are the symptoms of superior vena cava syndrome?
SOB orthopnoea stridor cyanosis oedema of face and arm cough headache enlarged neck veins
which cancer is a common cause of superior vena cava syndrome?
lung cancer (75%)
management of superior vena cava syndrome?
prop up and give oxygen if needed
dexamethasone
then consider radiotherapy or chemotherapy
what is the most common metabolic abnormality in cancer patients?
malignancy associated hypercalcaemia
which cancers release may PTH?
lung, oesophagus, skin, cervix, breast, kidney
management of malignancy associated hypercalcaemia
IV saline (rehydrate) and bisphosphonates
management of hypercalcaemia not related to malignancy?
IV saline
what might lethargy, consitpation, anorexia, confusion, weakness, polyuria suggest?
hypercalcaemia
how common are brain metastases in cancer patients?
about 40% of cancer patients get them
which cancers are most commonly associated with brain metastases?
lung, breast, colorectal, melanoma
what are some symptoms of brain metastases?
headache focal neurological signs ataxia fits nausea, vomiting papilloedema
imaging for suspected brain metastases?
urgent CT/MRI
immediate management for brain metastases?
dexamethasone
what causes tumour lysis syndrome?
rapid death of neoplastic cells e.g. during chemotherapy of leukaemia, lymphoma or myeloma
signs of tumour lysis syndrome?
increased serum urate, potassium and phospate
decreased serum calcium
risks associated with tumour lysis syndrome?
arrhythmias and renal failure
what should be given to prevent tumour lysis syndrome?
hydration and uricolytics e.g. allopurinol
