complications of haemato-oncology Flashcards
what are the specific complications associated with chemotherapy and radiotherapy of haematological malignancies ?
leukopenia and neutropenia
tumor lysis syndrome
graft vs host disease ( graft rejection )
what are the precautions that should be available in isolation rooms for Hematopoietic stem cell transplant recipients ?
1- central of point use HEPA filters
2- well sealed rooms
3- positive room air pressure
4- self closing doors ( no handles )
whatt is the ANC below which prophylacticc antibiotics should be used ?
less than 0.5x109
what is the benefit of using prednisolone in Hematopoietic stem cell transplant recipients ?
to guard against developing GVHD
what is the management for MRSA positive cultures ?
carbapanem
cephalosporins
vancomyciin ccan also be used
what is used in cases of vancomycin resistance ?
linezolid
what is thee management for canddidisasis inffeection ?
if previously exposed to azoles :
liposomal amphotericin B or capsofungin
what can be taken in cases of low risk of infection by invasive aspergillosis ?
fluconazole
what is the presentation of GVHD ?
maculopapular rash , classically involving the soles and the palms
persistent nausea and vomiting
increased bilirubin levels
what are the risk factors associated with GVHD ?
1- immunologically competent donor graft
2- histo-incompatibility between the donor and the host
3- allogenic transplant from an unrelated donor
4- immunologically incompetent host
what is the general approach for the treatment options for GVHD ?
1- increase immunosuppression in the form of corticosteroids
what is the treatment for mild skin-only acute GVHD ?
continue with their general medications such as cyclosporine
in addition to topical steroid cream
what is the treatment for patients with GVHD that show systemic manifestations ?
continue immunosuppressive
add methylpreddnisolone or prednisolonee
what is the treatment for steroid-refractory GVHD in adults ?
Ruxolitinib (Jakafi)
what ar the most serious complications of tumor lysis syndrome ?
advancedd renal failuree
cardiac arrythmmia
what are the lab findings in TLS ?
hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia.
what are the ECG findings in hyperkalemia ?
peaked T waves
medication used for TLS?
allopurinol - rasburicase
what is the prophylaxis for TLS ?
IV fluids - hydration
allopurinol or rasburicase can be prescribed
what is the type of anemia associated with CLL ?
autoimmune hemolytic anemia
what type of test is used to confirm thee autoimmune hemolytic anemia ?
positive coombs test
what is the treatment for AIHA in CLL ?
corticosteroids is the first line treatment
second line is rituximab
presentation of multiple myeloma
bone disease
hyperviscosity
anemia
hypercalcaemia
renal impairment
high ESR
monoclonal band
Bence jones in urine
what investigations are used to confirm a diagnosis of multiple myeloma ?
serum and urine electrophoresis
immunofixation
how does renal impairment happen in multiple myeloma ?
renal impairment in MM is IgA mediated
monoclonal immunoglobulin deposition disease
light chain amyloidosis
prognosis of renal disease in multiple myeloma ?
poor prognosis in patients who require dialysis
