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Year 4 Oncology > Complications of cancer > Flashcards

Complications of cancer Flashcards

1
Q

Complications of lung cancer

A 
SIADH - from small cell lung cancer 
Hypercalcaemia- bone mets or PTHrP 
SVCO 
Metastasise 
VTE 
Pleural effusion 
Pneumonitis 
Pneumothorax 
Cushing’s syndrome 
Lambert Eaton myasthenic syndrome 
Spinal cord compression
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2
Q

Presentation of SIADH

A

Confusion
Headache
Seizures
Lethargy

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3
Q

Investigations for SIADH

A

Bloods - low Na+

Urine and serum osmolality - urine osmolality > 100 mOsmol/kg (dilute)

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4
Q

Treatment for SIADH

A

Fluid restriction

Demeclocycline - may cause diabetes insipidus

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5
Q

Which lung cancer commonly causes SIADH

A

Small cell lung cancer

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6
Q

Causes of hypercalcaemia in cancer

A

Bone metastasise

PTHrP released by squamous cell carcinoma

Myeloma - increase in osteoclast activity

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7
Q

Presentation of hypercalcaemia

A 
Constipation 
Reduced fluid intake 
Confusion 
Nausea 
Lethargy 
Weakness
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8
Q

Calcium level classed as hypercalcaemia

A

> 3mmol/l

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9
Q

Management of hypercalcaemia

A

IV fluids

Bisphosphonates - IV pamidronate

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10
Q

How do bisphosphonates work

A

Inhibit osteoclast activity therefore less bone resorption, decreasing calcium levels

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11
Q

How to take bisphosphonates

A

First thing in the morning
Sitting up
Take 30 mins before breakfast
Drink plenty of water

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12
Q

Side effects of bisphosphonates

A

Oesophagitis

Gastritis

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13
Q

Presentation of SVCO

A

Swelling in face, arms and neck

Venous engorgement on chest

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14
Q

Investigations for SVCO

A

Urgent CT

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15
Q

Management of SVCO

A

Sit up right
Oxygen
Analgesia

Steroids - if histology confirmed
Urgent chemotherapy or radiotherapy or intraluminal stent

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16
Q

What causes pneumonitis

A

Reaction to radiotherapy or targeted immunotherapy

17
Q

Causes of pneumothorax in lung cancer

A

Lung biopsy

18
Q

Treatment of pleural effusion

A

Chest drain - either pleurodesis or IPC

19
Q

Types of chest drain

A

Pleurodesis

IPC - intrapleural catheter

20
Q

Pleurodesis

A

Requires a 4 - 5 day inpatient stay
Drain fluid
Then introduce doxycycline, talc or bleomycin as an irritant to induce inflammation so the pleura stick together to prevent further effusion
Recheck after 4 weeks to see if successful

21
Q

Intrapleural catheter procedure

A

Day case
Drain fluid
Insert tube
Drained 2 - 3 times per week at home via district nurses
Can learn to drain yourself
Semi permanent - if no more effusion occurs, can take out

22
Q

Presentation of spinal cord compression

A 
Back pain 
Paraesthesia 
Lack of power and movement in legs 
Faecal/urinary incontinence
Saddle area paraesthesia
23
Q

Investigations for spinal cord compression

A

Urgent MRI of whole spine

24
Q

Management of spinal cord compression

A

High dose steroids IV or oral dexamethasone

Radiotherapy +/- surgical decompression

Urinary catheterisation

25
Q

Complications of spinal cord compression

A

Paraplegia

Loss of bowel and urinary function

26
Q

Investigations for hypercalcaemia

A

Bloods - FBC, bone profile - Ca2+, phosphate, ALP

27
Q

Presentation of brain mets

A

Headache

Confusion

28
Q

Management of brain mets

A

Dexamethasone IV morning or early afternoon

Urgent radiotherapy

29
Q

Side effects of dexamethasone

A

Insomnia

Agitation

30
Q

Tumour lysis syndrome

A

Occurs when cancer cells lyse quickly, releasing the cellular components

31
Q

Tumour lysis syndrome cellular components

A

High K+ - hyperkalaemia
High phosphate
High urate - gout

Low Ca2+ - hypocalcaemia

32
Q

Complications of tumour lysis syndrome

A

Arrhythmia
Gout
Impaired kidney function

33
Q

Prophylactic treatment of tumour lysis syndrome

A

Give allopurinol and IV fluids when giving chemotherapy

34
Q

Treatment of VTE

A

LMWH injections for 3 - 6 months

or DOACs

35
Q

Risk factors for VTE in cancer

A

Cancer - hypercoagulable

Haemostasis - less mobile

Trauma - form procedures such as surgery

36
Q

Presentation of DVT

A

Leg swelling
Pain
Tenderness
Skin changes

37
Q

Presentation of PE

A

Acute breathlessness

Pleuritic chest pain

Year 4 Oncology (21 decks)

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