Flashcards in Oncology Deck (16):
What are the features on metastatic spinal cord compression?
Back pain - may be worse lying down and coughing
lower limb weakness
Neurological signs - these depend on the level of the lesion of the compression
How is metastatic spinal cord compression managed?
Urgent MRI whole spine
High dose oral dexamethasone
Urgen oncological assessment for radiotherapy or surgery
When is surgery indicated in MSCC?
Patients who have residual sensory or motor function and a good prognosis
What is SVC obstruction?
An oncological emergency caused by compression of the SVC.
What are the features of SVC obstruction?
Hx of lung cancer
Swelling of the face, neck, arms and possibly conjunctiva and orbit
Pulseless jugular venous distension
What malignancies commonly cause SVC obstruction?
How is SVC obstruction managed?
SCLC = chemo and radiotherapy
NSCLC = radiotherapy
What is tumour lysis syndrome?
A condition caused by the breakdown of tumour cells and the subsequent release of the chemicals in the cell. This leads to a
HGH URIC ACID
(in the presence of a low calcium)
How does tumour lysis syndrome present?
How is tumour lysis syndrome diagnosed in the lab?
uric acid >475umol/L or 25% increase
K+ >6mmol/l or 25% increase
phosphare >1.125mmol/l or 25% increase
calcium <1.75mmol/l or 25% decrease
How is tumour lysis syndrome managed?
prevention - give allopurinol or rasburicase and fluids
What is the definition of neutropenic sepsis?
WCC <0.5 and temp >38 (or other signs consistent with sepsis)
How is neutropenic sepsis treated?
Do NOT delay antibiotics
- Start Pip/Taz
If still febrile after 48 hours give meropenem +/- vancomycin
How is hypercalcaemia treated?
What cancers commonly cause hypercalcaemia
Squamous cell carcinoma of the lung