Complications of Brain Tumor Flashcards
Which cancers are most common for metastases to the brain
Breast and Lung
What is the only way to know someone hasa brain tumor
Biopsy
What are the most common brain tumors
Meniginoma, Pituitary tumor, gioblastomas
What are clinical symptoms of Brain Tumor
Worst headache, N/V, seizure, personality changes, sppech impairment, loss of balance, numbness
What contrast is used for MRI, what is the caution of use
Galatium, can’t use in patient with bad kidney function
What are the goals of treatment
Control signs and symptoms, preserve normal brain function, control tumor growth and its surrounding effects
What are treatment options for brain tumors
Surgery, radiation, chemotherapy, rehabilitation
What are medical complications of brain tumors
Intracranial hypertension ( cerebral edema, hydrocephalus, herniation), Intracranial hemorrhage, seizure, VTE
How is the intractanial hypertension managed, what medications are used at what doses
Osmotic gradient moves water into the intravascular space/ Mannitol 20%: 1 gram/kg IVPB PRN, Hypertonic 23.4? saline: 30-60 ml IVPB PRN
What should be monitored while giving mannitol, hypertonic saline
serum Na, osmolality, osmolar gap, urine output/ serum sodium
How is cerebral edema managed, what medication is used and at what dose
Decrease mass effect, pressure, and vascular permeability, Dexemethasone 10 mg IV, then 4-6 mg by mouth every 6 hours
What are the adverse effects of dexamthasone
Myopathy, hyperglycemia, psychosis, edema, weight gain
How is hydrocephalus treated in brain tumors
External ventricular drain
What are the three most common herniations associated with Brain tumors/ most dangerous
Subfaicine herniation, Transfentorial (uncal), Tonsillar (cerebellar) herniation/ Cerebellar
What drugs are used for seizure due to brain tumor
Valproic acid, phenytoin, phenobarbital
What drugs are used to treat VTE and at what doses, monitor
Heparin 5000 units sc every 8 to 12 hours, enoxaparin 30 mg sc every 12 hours OR daleparin 5000 units sc every 24 hours, signs and symptoms of bleeding, PTT, INR, platelet
What is the most common type of pituitary adenoma
Prolactinoma
For a patient with prolactinma what are the treatment options, what type of surgeries
Dopamine receptor 2 agonist (bromocriptine, peroglide, cabergoline)/ trans-sphenoidal adenomectomy
What happens after surgery of the pituitary
Reduction of certain hormones
What should be given for ADH deficiency
Desmopressin: 100 mcg tablet OR 10 mcg spray ONCE IN A NOSTRIL OR 1 mg sc/iv
What should be given for ACTH deficiency, TSH deficiency, Hypogonadism, GH
hydrocortisone or cortisone acetate, L-thyroxine, estrogen/progestrin for women, testosterone for men, GH 3-4 mcg/kg/day in adults (6-26 mcg/kg/day in kids)
What is a good way to tell if a patient has little activity at the adrenal glands
They are hypotensive
