257b paraneoplastic Flashcards
Paraneoplastic syndrome -1,25 OH D3 (calcitriol)
effect? neoplasm?
hypercalcemia
hodgkin lymphoma, non-hodgkin lymphoma
Paraneoplastic syndrome -ACTH
effect? neoplasm?
Cushing’s syndrome
small cell lung carcinoma
Paraneoplastic syndrome -ADH
effect? neoplasm?
SIADH
small cell lung carcinoma
intracranial neoplasm
Paraneoplastic syndrome -Abs –> Ca channels at NMJ -
effect? neoplasm?
LEMS (muscle weakness)
small cell lung carcinoma
Paraneoplastic syndrome -EPO
effect? neoplasm?
polycythemia
RCC thymoma hemangioblastoma HCC leiomyoma pheochromocytoma
Paraneoplastic syndrome -PTHrP
effect? neoplasm?
hypercalcemia
squamous cell lung carcinoma
RCC
Breast cancer
what cancer is associated with myasthenia gravis?
thymoma
paraneoplastic cerebellar degeneration - symptoms? what is targeted in brain?
dysarthria
truncal, limb, gait ataxia
vertigo
diplopia
Anti-purkinje cell abs
paraneoplastic - limbic encephalitis
symptoms?
psychiatric
MS changes/memory loss
seizures
various abs against GABA receptor, NMDA, etc.
LEMS - symptoms? cause?
muscle weakness below the neck that improves with exercise
dry mouth
Ab –> reduced Ca channels on presynaptic terminal
sensory neuronopathy - symptoms? pathophysiology?
painful paresthesias and sensory loss
anti-hu (small cell lung cancer)
acanthosis nigricans - appearance? cancers that can cause it?
brown velvety hyperpigmented skin at armpits, groin, navel, neck
GI malignancies OR hyperinsulonmeia (DM, obesity, cushings)
dermatomyositis - what does it effect? labs? cancer causes? abs?
inflammation of muscles and skin
increased CPK, ESR
adenocarcinoma of breast, lung, ovarian
Anti-Jo-1, anti-SRP, anti-Mi-2
Cushing Syndrome - symptoms? lab? cancer cause?
muscle weakness, edema, HTN, fat face, back hump
hypokalemia (increased insulin drives K into cells)
ectopic ACTH (SCLC, neuro-endocrine)
SIADH - symptoms, lab, tumors?
unsteady gait, HA, nausea, confusion, seizures
low Na, increased urine concentration –> increased volume decreases aldosterone –> low Na –> cerebral swelling (correct slowly to prevent central pontine myelinolysis)
tumors: SCLC –> ADH + ANP
head trauma
pulmonary diseases
drugs (cyclophosphamide
Rx - restrict fluids, IV saline, conivaptan, tolvaptan, demeclocycline
