Cancer care Flashcards
What cancers are associated with tumour lysis syndrome
Lymphoma
Leukaemia
What is given to reduce the risk of tumour lysis syndrome
Allopurinol
Rasburicase
Electrolyte abnormalities in tumour lysis syndrome
High K+
High phosphate
Low Ca
High urate
Symptoms of tumour lysis syndrome
Nausea
Vomiting
Muscle pain
Dysuria
Oligouria
Weakness
Criteria for neutropenic sepsis
T >38.5 or 2 readings >38
Neutrophils <0.5
Risk factors for neutropenic sepsis
Sustained neutropenia >7days
Clinically unstable
High intensity chemotherapy
Significant co-morbidities
Management of neutropenic sepsis
IV piperacillin + tazocin
Fluoroquinolone prophylaxis
Cancers typically associated with SVCO
Non-small cell lung cancer
Small cell lung cancer
Lymphoma
Features of SVCO
Dyspnoea
Orthopnoea
Facial plethora
Dilated/engorged chest veins
+ve Pemberton’s test
Management of SVCO
PO dexamethasone
IVC stenting once stabilised
Cause of hypercalcaemia in malignancy
Tumour secretion of PTHrP
Increased osteoclast activity
Lymphoma cell production of calcitriol
Tumour production of PTH
Risk factors for hypercalcaemia of malignancy
Non-metastatic malignancy
Metastatic skeletal involvement
Lymphoma
Features of hypercalcaemia
Dry mucous membranes
Confusion
Fatigue
Constipation
Nausea
Loss of appetite
Polyuria
Bone pain
Management of hypercalaemia
Treat underlying malignancy
IV normal saline
IV bisphosphonate
Haloperidol
Antiemetic(s) of choice for chemical causes of nausea
Haloperidol (D2)
Metoclopramide (D2, 5HT3)
Antiemetic(s) of choice in gastric stasis
Metoclopramide (D2, 5HT3)
Domperidone (D2)
Antiemetic(s) of choice in bowel obstruction
Cyclizine (H1, ACh)
Dexamethasone
Antiemetic(s) of choice in raised ICP
Cyclizine (H1, ACh)
Dexamethasone
Antiemetic of choice for psychological causes of nausea
Benzodiazepines
Antiemetic of choice for post-op nausea
Ondansetron (5HT3)
Stimulant laxatives
Senna
Bisacodyl
Stool softener
Docusate
Osmotic lxatives
Lactulose
Movicol
Laxido
When to use Tamoxifen for breast cancer
Oestrogen receptor +ve tumours
Premenopausal women
When to use Letrozole/Anastrozole for breast cancer
Oestrogen receptor +ve tumours
Postmenopausal women
When to use Herceptin for breast cancer
HER2 receptor +ve tumours