Emergencies Flashcards
How would you manage malignant hypercalcaemia?
3L before meds as they will have low sodium
bisphosphonates
loop diuretics (e.g. furosemide)
What tests would you do in superior vena cava obstruction?
CXR, ABG, bloods, CT, pemberton’s test
How would you manage superior vena cava obstruction?
15-20mg dexamethsone
stent, radio, chemo
What are the 3 elements of tumour lysis syndrome?
lab findings + symptoms + AKI
What electrolyte changes are there in tumour lysis syndrome?
increased potassium, phosphorous and uric acid
hypocalcaemia
How would you prevent tumour lysis syndrome?
allopurinol if low risk (prevents uric acid production)
rasburicase if high risk (breaks down uric acid)
How do you treat tumour lysis syndrome?
correct electrolytes
fluid
rasburicase
What are the elements to diagnose neutropenic sepsis?
signs of sepsis, temp > 38, neutrophil < 0..5 x 10^9
How would you manage neutropenic sepsis?
Tazocin +/- gentamicin Culture, CXR, procalcitonin GCSF injections (increase neutrophils) Septic 6 (inc antibiotics) Septic screen
How would you manage cord compression?
MRI of whole spine
catheter
15-20mg dexamethasone
What are the 5 major oncological emergencies?
cord compression, malignant hypercalcaemia, neutropenic sepsis, superior vena cava obstruction, tumour lysis syndrome
What level is hypercalcaemia?
> 2.6 mmol/L
life threatening is >/= 3.5
What are the symptoms of malignant hypercalcaemia?
bones, stones, moans and groans
drowsiness, seizure, coma, death
What tests would you do in management of malignant hypercalcaemia?
corrected calcium level,
XR and bone scans
Renal function, U&E, plasma PTH
ECG - increased PR, decreased QT, wide QRS
What are the signs and symptoms of superior vena cava obstruction?
severe respiratory distress, oedema of upper torso, cyanosis, convulsions and coma, dilated veins in upper torso and head and neck
