Oncology Flashcards Preview

Cancer, Skin & Infection > Oncology > Flashcards

Flashcards in Oncology Deck (16):
1

What is the management in suspected spinal cord compression?

Urgent MRI

Dex 8mg BD + PPI
Flat bed rest
AHP referral for assessment
Discuss with oncology team and spinal cord compression coordinator

2

What is the difference between curative, adjuvant, radio-sensitive and palliative chemotherapy?

Curative - cure chemo-sensitive tumors

Adjuvant - reduce risk of relapse

Radiosensitive - increase efficacy of radical radiotherapy

Palliative - relieve symptoms from wide-spread incurable tumor

3

How is chemotherapy administered and over how many cycles, over how long?

Once every 2-4 weeks

Allows for blood count to recover

No more than 6 cycles / 5 months of treatment

4

What is the triad of neutropenic sepsis?

Neutropaenia
Anaemia
Thrombocytopaenia

Any Pt with on CHEMOTHERAPY with PYREXIA needs URGENT FBC + ABX / RESUS

If PYREXIC + Neutrophil count < 1.0 = NEUTROPENIC SEPSIS

5

Management of neutropenic sepsis?

Treat as sepsis 6 (3 in 3 out)

3 in
- IV fluids
- IV Abx broad spec
- Oxygen

3 out
- Blood culture
- Urine output
- Lactate (ABGs)

6

What are the signs and symptoms of hypersensitivity reaction due to chemotherapy?

Think: Anaphylaxis

Fever
Hypotension
Tachycardic
Low SaO2
Wheeze
Oropharyngeal oedema

7

What is the immediate management of a chemotherapy hypersensitivity reaction?

- STOP infusion!

OIAIA

- O2
- IV Fluids stat (0.5-1l)
- Antihistamine chlorampheniramine stat
- IV steroids (hydrocortisone)
- Adrenaline IM

consier Salbutamol / Adrenaline nebulisers

8

What are the diagnostic features of tumor lysis syndrome?

Hyperuricaemia
Hyperkalaemia (cardiac arrythmias / VT)
Hyperphosphataemia / Hypocalcaemia

Renal failure (as a result of hyperuricaemia and hypocalcamia build up of crystals in kidneys)

9

Management of tumor lysis syndrome?

Prevention is better than cure!

IV Fluids (lots!)
Prophylactic allopurinol or rasburicase

Twice daily biochemistry with physician review of minor changes

Correct abnormalities, lots of IVF

Discuss with renal team / critical care if tumor lysis syndrome established

10

What are the red flag symptoms of lung cancer?

Cough
Haemoptysis
Dypnoea
Hoarse voice
Chest pain
Fatigue
Appetite loss
Weight loss

11

What scale is used to determine performance status?

ECOG scale (Eastern Cooperative Oncology Group)

0 Fully active, able to carry out all pre-disease performance without restriction
1 Restricted in physically strenuous activity but ambulatory and able to carry out light work
2 Ambulatory and capable of all selfcare but unable to carry out any work activities. Up and about >50% waking hours
3 Capable of only limited selfcare. Confined to bed/chair > 50% waking hours
4 Completely disabled and confined to bed/chair. No self care
5 Deceased

12

What are the symptoms suggestive of metastatic spinal cord compression?

According to NICE

Progressive pain in spine
Unremitting severity
Band-like
Straining aggravates
Tenderness localised
Nocturnal
Neurological symptoms

13

An MRI scan shows infiltration of the spinal cord with metastesis. What treatment should you consider at this point?

Steroids - Oral dex

Analgesia - Morphine

Neurosurgical consult

Radiotherapy

14

Blood test of a patient with metastatic cord compression reveals hypercalcaemia, hyperuricaemia and raised alk phos.

What treatment would you administer?

1. Saline infusion - dehydration from hypercalcaemia results in hyperuricaemia

2. Dex - for cord compression

3. Zoledronic acid - to correct calcium if still high after infusion of saline

15

What questions would you ask if you suspect brain mets in a patients history?

- Seizures, including focal fits or absences
- Weakness, poor coordination
- Visual symptoms such as double vision

16

What medication would you give to relieve a headache caused by brain mets?

Headache caused by raised ICP, therefore give high dose steroids with PPI cover to reduce peri-lesional oedema