Acute illness

Question 1

What general pathologies should always be considered for oncologic patients presenting to the hospital with generalized weakness?

Answer 1

• CNS metastases
• Treatment effect
• Metabolic/electrolyte disorder

Question 2

True/False.

The threshold to image a patient with active oncologic disease who presents to the hospital with non-specific symptoms is very low.

Answer 2

True.

Even the patient’s normal headaches would warrant head imaging.
Low threshold for spine MRIs, brain MRI, etc.

Question 3

If new signs of sepsis after a patient begins CAR-T cell therapy, suspect ____________.

Answer 3

Cytokine release syndrome

Begin steroids.

Question 4

What are the typical causes of secondary HLH?

Answer 4

• Rheumatologic disease
• Malignancy
• Infections

HLH can also occur as a congenital/familial due to T-cell mutation and present as a pediatric disease.

Question 5

What is the basic cause of HLH?

Answer 5

T-cell mutations lead to uncontrolled inflammatory response and cytokine activation

Often occurs in susceptible individuals due to underlying rheumatologic, malignant, or infectious disease.

Question 6

For oncologic patients on DOACs being admitted to the hospital, what should be done for anticoagulation and/or VTE prophylaxis?

Answer 6

Hold the DOAC and start a heparin product

In case proceduralization is needed.