Clinical Manifestations of Cancer

Question 1

Cancer anorexia-cachexia syndrome defined as…

Answer 1

Involuntary loss of 5% of body weight
Shorter median survival
Do not respond as well to chemotherapy
Have more problems with toxicity

Question 2

Fatigue can be categorized into central or peripheral

Answer 2

Peripheral fatigue occurs in the neuromuscular junctions and muscles:
Lack of ATP and build up of lactic acid

Central fatigue arises in the CNS:
Difficulty in initiating or maintaining voluntary activities
May be secondary to dysregulation of serotonin and proinflammatory cytokines

Question 3

Paraneoplastic Syndromes

Answer 3

Collections of symptoms that result from substances produced by the tumor and occur remotely from the tumor itself
Most commonly associated with lung, breast and hematologic malignancies
SIADH
Hypercalcemia
Cushing syndrome
Hypoglycemia

Question 4

Cushing syndrome

Answer 4

Only 5-10% of all cases of Cushing syndrome are paraneoplastic
Associated cancers: 50-60% from Small cell lung cancer

Question 5

Cushing syndrome Lab Findings

Answer 5

Hypokalemia
Elevated baseline serum cortisol
Normal to elevated midnight serum ACTH
Not suppressed with dexamethasone

Question 6

Pure red cell aplasia

Answer 6

Most commonly associated with thymoma

May be caused by leukemia, lymphoma, myelodysplastic syndrome

Question 7

3 most common paraneoplastic syndromes

Answer 7

SIADH: Increased ADH production
Cushing syndrome: Increased ACTH production
Hypercalcemia: PTH related protein, Multiple myeloma or bony metastases