Week 5 Flashcards
what are signs/symptoms of acute leukemia?
bleeding, bruising, fever, fatigue, weakness, and frequent infections
acute lymphoblastic leukemia derives from malignancy of B or T lymphoblasts?
B
acute lymphoblastic leukemia is a cancer of the ___________ and _______
bone marrow, blood
Neutropenia is defined as an ANC _______
<500
profound neutropenia is defined as an ANC _________
<100
define prolonged neutropenia
low number of neutrophils for longer than 7 days
how do we calculate ANC?
WBC * total neutrophils (segmented neutrophils% + segmented bands%) * 10=ANC
how do we classify febrile neutropenia?
fever over 100 F (38C) with sickness symptoms
what is the first step to treating febrile neutropenia?
blood/urine cultures and start empiric antibiotics
what is appropriate empiric tx for febrile neutropenia?
zosyn
what are signs/symptoms of tumor lysis syndrome?
blood in urine, seizures, muscle cramps, AKI, heart failure, renal failure
what are lab values indicating tumor lysis syndrome?
(calcium, uric acid, phosphate, potassium, SCr)
calcium less than 7
uric acid over 8
phosphate over 4
potassium over 6
Scr elevated
what are risk factors for tumor lysis syndrome?
leukemia, high-grade lymphomas, hepatoblastoma, and neuroblastoma
what does elevated lactate dehydrogenase indicate?
cells breaking down
what is tumor lysis syndrome?
when tumor cells release their contents into the bloodstream
what are the treatment measures to prevent TLS?
excessive hydration, allopurinol, rasburicase, and close monitoring of electrolytes
allopurinol given to patients with the HLA-B*5801 allele significantly increases the risk of?
allopurinol-induced severe cutaneous adverse reactions (SCAR)
how do we treat patients with G6PD deficiency in regards to rasburicase?
monitor closely, still give rasburicase
what medications are in the Hyper-CVAD regimen used to treat B-ALL?
cyclophosphamide, vincristine, mesna, doxorubicin, and dexamethasone
which chemo drug has a lifetime maximum cumulative dose?
doxorubicin
what is the maximum lifetime dose of doxorubicin?
450-550
why does doxorubicin have a maximum lifetime dose?
high risk of cardiotoxicity
which organisms are we concerned about with febrile neutropenia?
e. coli, klebsiella, and pseudomonas
which antibiotic do we use for antimicrobial prophylaxis for febrile neutropenia?
fluoroquinolone
